@Article{info:doi/10.2196/65986,
author="Murray, M. Regan
and Chiang, C. Shawn
and Klassen, C. Ann
and Manganello, A. Jennifer
and Leader, E. Amy
and Lo, Wen-Juo
and Massey, M. Philip",
title="Developing an Online Community Advisory Board (CAB) of Parents From Social Media to Co-Design an Human Papillomavirus Vaccine Intervention: Participatory Research Study",
journal="JMIR Form Res",
year="2025",
month="Apr",
day="16",
volume="9",
pages="e65986",
keywords="online community advisory boards",
keywords="community engagement",
keywords="social media",
keywords="digital health",
keywords="digital health intervention",
keywords="HPV vaccine",
keywords="human papillomavirus",
keywords="HPV",
keywords="parent health",
keywords="child health",
abstract="Background: Social media health interventions have grown significantly in recent years. However, researchers are still developing innovative methods to meaningfully engage online communities to inform research activities. Little has been documented describing this approach of using online community advisory boards (CABs) to co-create health communication interventions on social media. Objective: This study describes the formation, engagement, and maintenance of an online CAB focused on co-creating a health education intervention for parents regarding the human papillomavirus (HPV) vaccine. The study provides guiding principles for public health researchers implementing such CABs in future digital health interventions. Methods: In May 2020, Twitter was used to recruit parents of children aged 9?14 years, who were active users of the platform and were interested in serving on a CAB focused on child health and online programs. The recruitment campaign included Twitter (rebranded as X in 2023) advertising tools (eg, ``interests'' and ``audience look-a-likes''). A total of 17 parents completed a screening survey and 6 completed a follow-up phone interview. Following phone interviews, 6 parents were invited to join the CAB, where they committed to a 1-year involvement. The CAB participated in eleven 1-hour online meetings in the first year, contributing to monthly feedback through participatory workbooks. Long-term engagement was sustained through icebreakers and casual online interactions, as well as providing real-time updates to demonstrate CAB feedback integration. An anonymous midterm evaluation was conducted at the end of the project's first year to assess processes and identify future growth opportunities. Results: A total of 6 parents (5 females and 1 male) with children aged 9-14 years from diverse racial and ethnic backgrounds (African American, South Asian American, and White) across 6 states in the United States, representing urban, suburban, and rural areas, agreed to serve as CAB members. All 6 CAB members committed to 1 year of service beginning in July 2020 with 4 extending their participation into a second year (August 2021-August 2022). The CAB provided expert insights and feedback to co-develop the intervention, including character development, narrative content creation, study recruitment, survey development, and intervention delivery. The midterm evaluation showed 100\% (6/6) satisfaction among CAB members, who valued the connections with other parents and their contribution to research. While all members felt confident discussing HPV, 83\% (5/6) suggested diversifying the group and increasing informal bonding to enhance engagement and inclusivity, especially for differing vaccination views. Conclusions: This study demonstrates that online CABs are a highly effective model for co-creating and informing online health communication interventions. The engagement of parents from diverse backgrounds and the structured use of online tools (eg, interactive workbooks) creates a constructive and thoughtful environment for incorporating parent contributions to research. This study highlights guiding principles to forming, engaging, and maintaining an online CAB to enhance health research and practice. ",
doi="10.2196/65986",
url="https://formative.jmir.org/2025/1/e65986"
}


@Article{info:doi/10.2196/68093,
author="Harry, Christiana
and Goodday, Sarah
and Chapman, Carol
and Karlin, Emma
and Damian, Joy April
and Brooks, Alexa
and Boch, Adrien
and Lugo, Nelly
and McMillan, Rebecca
and Tempero, Jonell
and Swanson, Ella
and Peabody, Shannon
and McKenzie, Diane
and Friend, Stephen",
title="Using Social Media to Engage and Enroll Underrepresented Populations: Longitudinal Digital Health Research",
journal="JMIR Form Res",
year="2025",
month="Apr",
day="15",
volume="9",
pages="e68093",
keywords="digital health research",
keywords="digital health technology",
keywords="recruitment",
keywords="research subject",
keywords="participant",
keywords="pregnancy",
keywords="maternal health",
keywords="underrepresented populations",
keywords="health equity",
keywords="diversity",
keywords="marginalized",
keywords="advertisement",
keywords="social media",
keywords="retention",
keywords="attrition",
keywords="dropout",
abstract="Background: Emerging digital health research poses roadblocks to the inclusion of historically marginalized populations in research. Exclusion of underresourced communities in digital health research is a result of multiple factors (eg, limited technology access, decreased digital literacy, language barriers, and historical mistrust of research and research institutions). Alternative methods of access and engagement may aid in achieving long-term sustainability of diversified participation in digital health research, ensuring that developed technologies and research outcomes are effective and equitable. Objective: This study aims to (1) characterize socioeconomic and demographic differences in individuals who enrolled and engaged with different remote, digital, and traditional recruitment methods in a digital health pregnancy study and (2) determine whether social media outreach is an efficient way of recruiting and retaining specific underrepresented populations (URPs) in digital health research. Methods: The Better Understanding the Metamorphosis of Pregnancy (BUMP) study was used as a case example. This is a prospective, observational, cohort study using digital health technology to increase understanding of pregnancy among 524 women, aged 18-40 years, in the United States. The study used different recruitment strategies: patient portal for genetic testing results, paid/unpaid social media ads, and a community health organization providing care to pregnant women (Moses/Weitzman Health System). Results: Social media as a recruitment tool to engage URPs in a digital health study was overall effective, with a 23.6\% (140/594) enrollment rate of those completing study interest forms across 25 weeks. Community-based partnerships were less successful, however, resulting in 53.3\% (57/107) engagement with recruitment material and only 8.8\% (5/57) ultimately enrolling in the study. Paid social media ads provided access to and enrollment of a diverse potential participant pool of race- or ethnicity-based URPs in comparison to other digital recruitment channels. Of those that engaged with study materials, paid recruitment had the highest percentage of non-White (non-Hispanic) respondents (85/321, 26.5\%), in comparison to unpaid ads (Facebook and Reddit; 37/167, 22.2\%). Of the enrolled participants, paid ads also had the highest percentage of non-White (non-Hispanic) participants (14/70, 20\%), compared to unpaid ads (8/52, 15.4\%) and genetic testing service subscribers (72/384, 18.8\%). Recruitment completed via paid ads (Instagram) had the highest study retention rate (52/70, 74.3\%) across outreach methods, whereas recruitment via community-based partnerships had the lowest (2/5, 40\%). Retention of non-White (non-Hispanic) participants was low across recruitment methods: paid (8/52, 15.4\%), unpaid (3/35, 14.3\%), and genetic testing service subscribers (50/281, 17.8\%). Conclusions: Social media recruitment (paid/unpaid) provides access to URPs and facilitates sustained retention similar to other methods, but with varying strengths and weaknesses. URPs showed lower retention rates than their White counterparts across outreach methods. Community-based recruitment showed lower engagement, enrollment, and retention. These findings highlight social media's potential for URP engagement and enrollment, illuminate potential roadblocks of traditional methods, and underscore the need for tailored research to improve URP enrollment and retention. ",
doi="10.2196/68093",
url="https://formative.jmir.org/2025/1/e68093"
}


@Article{info:doi/10.2196/59002,
author="Phiri, Doreen
and Makowa, Frank
and Amelia, Leona Vivi
and Phiri, Abero Yohane Vincent
and Dlamini, Portia Lindelwa
and Chung, Min-Huey",
title="Text-Based Depression Prediction on Social Media Using Machine Learning: Systematic Review and Meta-Analysis",
journal="J Med Internet Res",
year="2025",
month="Apr",
day="11",
volume="27",
pages="e59002",
keywords="depression",
keywords="social media",
keywords="machine learning",
keywords="meta-analysis",
keywords="text-based",
keywords="depression prediction",
abstract="Background: Depression affects more than 350 million people globally. Traditional diagnostic methods have limitations. Analyzing textual data from social media provides new insights into predicting depression using machine learning. However, there is a lack of comprehensive reviews in this area, which necessitates further research. Objective: This review aims to assess the effectiveness of user-generated social media texts in predicting depression and evaluate the influence of demographic, language, social media activity, and temporal features on predicting depression on social media texts through machine learning. Methods: We searched studies from 11 databases (CINHAL [through EBSCOhost], PubMed, Scopus, Ovid MEDLINE, Embase, PubPsych, Cochrane Library, Web of Science, ProQuest, IEEE Explore, and ACM digital library) from January 2008 to August 2023. We included studies that used social media texts, machine learning, and reported area under the curve, Pearson r, and specificity and sensitivity (or data used for their calculation) to predict depression. Protocol papers and studies not written in English were excluded. We extracted study characteristics, population characteristics, outcome measures, and prediction factors from each study. A random effects?model was used to extract the effect sizes with 95\% CIs. Study heterogeneity was evaluated using forest plots and P values in the Cochran Q test. Moderator analysis was performed to identify the sources of heterogeneity. Results: A total of 36 studies were included. We observed a significant overall correlation between social media texts and depression, with a large effect size (r=0.630, 95\% CI 0.565-0.686). We noted the same correlation and large effect size for demographic (largest effect size; r=0.642, 95\% CI 0.489-0.757), social media activity (r=0.552, 95\% CI 0.418-0.663), language (r=0.545, 95\% CI 0.441-0.649), and temporal features (r=0.531, 95\% CI 0.320-0.693). The social media platform type (public or private; P<.001), machine learning approach (shallow or deep; P=.048), and use of outcome measures (yes or no; P<.001) were significant moderators. Sensitivity analysis revealed no change in the results, indicating result stability. The Begg-Mazumdar rank correlation (Kendall $\tau$b=0.22063; P=.058) and the Egger test (2-tailed t34=1.28696; P=.207) confirmed the absence of publication bias. Conclusions: Social media textual content can be a useful tool for predicting depression. Demographics, language, social media activity, and temporal features should be considered to maximize the accuracy of depression prediction models. Additionally, the effects of social media platform type, machine learning approach, and use of outcome measures in depression prediction models need attention. Analyzing social media texts for depression prediction is challenging, and findings may not apply to a broader population. Nevertheless, our findings offer valuable insights for future research. Trial Registration: PROSPERO CRD42023427707; https://www.crd.york.ac.uk/PROSPERO/view/CRD42023427707 ",
doi="10.2196/59002",
url="https://www.jmir.org/2025/1/e59002"
}


@Article{info:doi/10.2196/68724,
author="Shereefdeen, Hisba
and Grant, Elizabeth Lauren
and Patel, Vayshali
and MacKay, Melissa
and Papadopoulos, Andrew
and Cheng, Leslie
and Phypers, Melissa
and McWhirter, Elizabeth Jennifer",
title="Assessing the Dissemination of Federal Risk Communication by News Media Outlets During Enteric Illness Outbreaks: Canadian Content Analysis",
journal="JMIR Public Health Surveill",
year="2025",
month="Apr",
day="10",
volume="11",
pages="e68724",
keywords="risk communication",
keywords="health communication",
keywords="enteric illness",
keywords="foodborne illness",
keywords="zoonotic disease",
keywords="media",
keywords="content analysis",
keywords="health belief model",
keywords="public health",
keywords="Canada",
abstract="Background: Effective dissemination of federal risk communication by news media during multijurisdictional enteric illness outbreaks can increase message reach to rapidly contain outbreaks, limit adverse outcomes, and promote informed decision-making by the public. However, dissemination of risk communication from the federal government by mass media has not been evaluated. Objective: This study aimed to describe and assess the dissemination of federal risk communication by news media outlets during multijurisdictional enteric illness outbreaks in Canada. Methods: A comprehensive systematic search of 2 databases, Canadian Newsstream and Canadian Business \& Current Affairs, was run using search terms related to the source of enteric illnesses, general outbreak characteristics, and relevant enteric pathogen names to retrieve news media articles issued between 2014 and 2023, corresponding to 46 public health notices (PHNs) communicating information about multijurisdictional enteric illness outbreaks during the same period. A codebook comprised of 3 sections---general characteristics of the article, consistency and accuracy of information presented between PHNs and news media articles, and presence of health belief model constructs---was developed and applied to the dataset. Data were tabulated and visualized using RStudio (Posit). Results: News media communicated about almost all PHNs (44/46, 96\%). News media commonly developed their own articles (320/528, 60.6\%) to notify the public about an outbreak and its associated product recall (121/320, 37.8\%), but rarely communicated about the conclusion of an outbreak (12/320, 3.8\%). News media communicated most outbreak characteristics, such as the number of cases (237/319, 74.3\%), but the number of deaths was communicated less than half the time (114/260, 43.8\%). Benefit and barrier constructs of the health belief model were infrequently present (50/243, 20.6\% and 15/243, 6.2\%, respectively). Conclusions: Canadian news media disseminated information about most multijurisdictional enteric illness outbreaks. However, differences in coverage of multijurisdictional enteric illness outbreaks by news media were evident. Federal organizations can improve future risk communication of multijurisdictional enteric illness outbreaks by news media by maintaining and strengthening interorganizational connections and ensuring the information quality of PHNs as a key information source for news media. ",
doi="10.2196/68724",
url="https://publichealth.jmir.org/2025/1/e68724"
}


@Article{info:doi/10.2196/55065,
author="Zhu, Zhiyu
and Ye, Zhiyun
and Wang, Qian
and Li, Ruomei
and Li, Hairui
and Guo, Weiming
and Li, Zhenxia
and Xia, Lunguo
and Fang, Bing",
title="Evolutionary Trend of Dental Health Care Information on Chinese Social Media Platforms During 2018-2022: Retrospective Observational Study",
journal="JMIR Infodemiology",
year="2025",
month="Apr",
day="10",
volume="5",
pages="e55065",
keywords="social media",
keywords="dental health education",
keywords="natural language processing",
keywords="information quality assessment",
keywords="dental care",
keywords="dental hygiene",
keywords="dentistry",
keywords="orthodontic",
keywords="health care information",
keywords="retrospective study",
keywords="observational study",
keywords="user engagement",
keywords="Chinese",
keywords="dental practitioner",
keywords="WeChat",
keywords="health information",
keywords="preventive care",
abstract="Background: Social media holds an increasingly significant position in contemporary society, wherein evolving public perspectives are mirrored by changing information. However, there remains a lack of comprehensive analysis regarding the nature and evolution of dental health care information on Chinese social media platforms (SMPs) despite extensive user engagement and voluminous content. Objective: This study aimed to probe into the nature and evolution of dental health care information on Chinese SMPs from 2018 to 2022, providing valuable insights into the evolving digital public perception of dental health for dental practitioners, investigators, and educators. Methods: This study was conducted on 3 major Chinese SMPs: Weibo, WeChat, and Zhihu. Data from March 1 to 31 in 2018, 2020, and 2022 were sampled to construct a social media original database (ODB), from which the most popular long-text posts (N=180) were selected to create an analysis database (ADB). Natural language processing (NLP) tools were used to assist tracking topic trends, and word frequencies were analyzed. The DISCERN health information quality assessment questionnaire was used for information quality evaluation. Results: The number of Weibo posts in the ODB increased approximately fourfold during the observation period, with discussion of orthodontic topics showing the fastest growth, surpassing that of general dentistry after 2020. In the ADB, the engagement of content on Weibo and Zhihu also displayed an upward trend. The overall information quality of long-text posts on the 3 platforms was moderate or low. Of the long-text posts, 143 (79.4\%) were written by nonprofessionals, and 105 (58.3\%) shared personal medical experiences. On Weibo and WeChat, long-text posts authored by health care professionals had higher DISCERN scores (Weibo P=.04; WeChat P=.02), but there was a negative correlation between engagement and DISCERN scores (Weibo tau-b [$\tau$b]=--0.45, P=.01; WeChat $\tau$b=--0.30, P=.02). Conclusions: There was a significant increase in the dissemination and evolution of public interest in dental health care information on Chinese social media during 2018-2022. However, the quality of the most popular long-text posts was rated as moderate or low, which may mislead patients and the public. ",
doi="10.2196/55065",
url="https://infodemiology.jmir.org/2025/1/e55065"
}


@Article{info:doi/10.2196/69013,
author="Laestadius, Linnea
and Hamad, Fridarose
and Le, Leena
and Buchtel, Rosemary
and Campos-Castillo, Celeste",
title="Amplifying the Voices of Youth for Equity in Wellness and Technology Research: Reflections on the Midwest Youth Wellness Initiative on Technology (MYWIT) Youth Advisory Board",
journal="JMIR Public Health Surveill",
year="2025",
month="Apr",
day="10",
volume="11",
pages="e69013",
keywords="advisory boards",
keywords="adolescents",
keywords="social media",
keywords="qualitative research",
keywords="community engagement",
doi="10.2196/69013",
url="https://publichealth.jmir.org/2025/1/e69013"
}


@Article{info:doi/10.2196/59767,
author="Yeung, Kan Andy Wai
and Hammerle, Peter Fabian
and Behrens, Sybille
and Matin, Maima
and Mickael, Michel-Edwar
and Litvinova, Olena
and Parvanov, D. Emil
and Kletecka-Pulker, Maria
and Atanasov, G. Atanas",
title="Online Information About Side Effects and Safety Concerns of Semaglutide: Mixed Methods Study of YouTube Videos",
journal="JMIR Infodemiology",
year="2025",
month="Apr",
day="8",
volume="5",
pages="e59767",
keywords="YouTube",
keywords="semaglutide",
keywords="social media",
keywords="Ozempic",
keywords="Wegovy",
keywords="Rybelsus",
keywords="safety",
keywords="knowledge exchange",
keywords="side effects",
keywords="online information",
keywords="online",
keywords="videos",
keywords="health issues",
keywords="drugs",
keywords="weight loss",
keywords="assessment",
keywords="long-term data",
keywords="consultation",
abstract="Background: Social media has been extensively used by the public to seek information and share views on health issues. Recently, the proper and off-label use of semaglutide drugs for weight loss has attracted huge media attention and led to temporary supply shortages. Objective: The aim of this study was to perform a content analysis on English YouTube (Google) videos related to semaglutide. Methods: YouTube was searched with the words semaglutide, Ozempic, Wegovy, and Rybelsus. The first 30 full-length videos (videos without a time limit) and 30 shorts (videos that are no longer than 1 minute) resulting from each search word were recorded. After discounting duplicates resulting from multiple searches, a total of 96 full-length videos and 93 shorts were analyzed. Video content was evaluated by 3 tools, that is, a custom checklist, a Global Quality Score (GQS), and Modified DISCERN. Readability and sentiment of the transcripts were also assessed. Results: There was no significant difference in the mean number of views between full-length videos and shorts (mean 288,563.1, SD 513,598.3 vs mean 188,465.2, SD 780,376.2, P=.30). The former had better content quality in terms of GQS, Modified DISCERN, and the number of mentioned points from the custom checklist (all P<.001). The transcript readability of both types of videos was at a fairly easy level and mainly had a neutral tone. Full-length videos from health sources had a higher content quality in terms of GQS and Modified DISCERN (both P<.001) than their counterparts. Conclusions: The analyzed videos lacked coverage of several important aspects, including the lack of long-term data, the persistence of side effects due to the long half-life of semaglutide, and the risk of counterfeit drugs. It is crucial for the public to be aware that videos cannot replace consultations with physicians. ",
doi="10.2196/59767",
url="https://infodemiology.jmir.org/2025/1/e59767"
}


@Article{info:doi/10.2196/56092,
author="Karschuck, Philipp
and Groeben, Christer
and Koch, Rainer
and Krones, Tanja
and Neisius, Andreas
and von Ahn, Sven
and Klopf, Peter Christian
and Weikert, Steffen
and Siebels, Michael
and Haseke, Nicolas
and Weissflog, Christian
and Baunacke, Martin
and Thomas, Christian
and Liske, Peter
and Tosev, Georgi
and Benusch, Thomas
and Schostak, Martin
and Stein, Joachim
and Spiegelhalder, Philipp
and Ihrig, Andreas
and Huber, Johannes",
title="Urologists' Estimation of Online Support Group Utilization Behavior of Their Patients With Newly Diagnosed Nonmetastatic Prostate Cancer in Germany: Predefined Secondary Analysis of a Randomized Controlled Trial",
journal="J Med Internet Res",
year="2025",
month="Apr",
day="7",
volume="27",
pages="e56092",
keywords="peer support",
keywords="prostate cancer",
keywords="online support",
keywords="health services research",
keywords="randomized controlled trial",
keywords="decision aid",
abstract="Background: Due to its high incidence, prostate cancer (PC) imposes a burden on Western societies. Individualized treatment decision for nonmetastatic PC (eg, surgery, radiation, focal therapy, active surveillance, watchful waiting) is challenging. The range of options might make affected persons seek peer-to-peer counseling. Besides traditional face-to-face support groups (F2FGs), online support groups (OSGs) became important, especially during COVID-19. Objective: This study aims to investigate utilization behavior and physician advice concerning F2FGs and OSGs for patients with newly diagnosed PC. We hypothesized greater importance of OSGs to support treatment decisions. We assumed that this form of peer-to-peer support is underestimated by the treating physicians. We also considered the effects of the COVID-19 pandemic. Methods: This was a secondary analysis of data from a randomized controlled trial comparing an online decision aid versus a printed brochure for patients with nonmetastatic PC. We investigated 687 patients from 116 urological practices throughout Germany before primary treatment. Of these, 308 were included before and 379 during the COVID-19 pandemic. At the 1-year follow-up visit, patients filled an online questionnaire about their use of traditional or online self-help, including consultation behaviors or attitudes concerning initial treatment decisions. We measured secondary outcomes with validated questionnaires such as Distress Thermometer and the Patient Health Questionnaire-4 items to assess distress, anxiety, and depression. Physicians were asked in a paper-based questionnaire whether patients had accessed peer-to-peer support. Group comparisons were made using chi-square or McNemar tests for nominal variables and 2-sided t tests for ordinally scaled data. Results: Before COVID-19, 2.3\% (7/308) of the patients attended an F2FG versus none thereafter. The frequency of OSG use did not change significantly: OSGs were used by 24.7\% (76/308) and 23.5\% (89/308) of the patients before and during COVID-19, respectively. OSG users had higher levels of anxiety and depression; 38\% (46/121) reported OSG as helpful for decision-making. Although 4\% (19/477) of OSG nonusers regretted treatment decisions, only 0.7\% (1/153) of OSG users did (P=.03). More users than nonusers reported that OSGs were mentioned by physicians (P<.001). Patients and physicians agreed that F2FGs and OSGs were not mentioned in conversations or visited by patients. For 86\% (6/7) of the patients, the physician was not aware of F2FG attendance. Physicians underestimated OSG usage by 2.6\% (18/687) versus 24\% (165/687) of actual use (P<.001). Conclusions: Physicians are more aware of F2FGs than OSGs. Before COVID-19, F2FGs played a minor role. One out of 4 patients used OSGs. One-third considered them helpful for treatment decision-making. OSG use rarely affects the final treatment decision. Urologists significantly underestimate OSG use by their patients. Peer-to-peer support is more likely to be received by patients with anxiety and depression. Comparative interventional trials are needed to recommend peer-to-peer interventions for suitable patients. Trial Registration: German Clinical Trials Register DRKS-ID DRKS00014627; https://drks.de/search/en/trial/DRKS00014627 ",
doi="10.2196/56092",
url="https://www.jmir.org/2025/1/e56092"
}


@Article{info:doi/10.2196/54650,
author="Al-Mansoori, Alghalia
and Al Hayk, Ola
and Qassmi, Sharifa
and Aziz, M. Sarah
and Haouari, Fatima
and Chivese, Tawanda
and Tamimi, Faleh
and Daud, Alaa",
title="Infoveillance of COVID-19 Infections in Dentistry Using Platform X: Descriptive Study",
journal="J Med Internet Res",
year="2025",
month="Apr",
day="3",
volume="27",
pages="e54650",
keywords="COVID-19",
keywords="dentistry",
keywords="infection",
keywords="patient",
keywords="infoveillance",
keywords="platform X",
keywords="Twitter",
abstract="Background: The effect of the COVID-19 pandemic on the well-being of dental professionals and patients has been difficult to track and quantify. X (formerly known as Twitter) proved to be a useful infoveillance tool for tracing the impact of the COVID-19 pandemic worldwide. Objective: This study aims to investigate the use of X to track COVID-19 infections and deaths associated with dental practices. Methods: English Tweets reporting infections or deaths associated with the dental practice were collected from January 1, 2020, to March 31, 2021. Tweets were searched manually using the X Pro search engine (previously known as TweetDeck [X Corp], Twitter Inc, and TweetDeck Ltd) and automatically using a tweet crawler on the X Academic Research application programming interface. Queries included keywords on infection or death of dental staff and patients caused by COVID-19. Tweets registering events on infection or death of dentists, dental staff, and patients as part of their conversation were included. Results: A total of 5641 eligible tweets were retrieved. Of which 1583 (28.1\%) were deemed relevant after applying the inclusion and exclusion criteria. Of the relevant tweets, 311 (19.6\%) described infections at dental practices, where 1168 (86.9\%) infection cases were reported among dentists, 134 (9.9\%) dental staff, and 41 (3.1\%) patients. The majority of reported infections occurred in the United States, India, and Canada, affecting individuals aged 20-51 years. Among the 600 documented deaths, 253 (42.2\%) were dentists, 22 (3.7\%) were dental staff, and 7 (1.2\%) were patients. The countries with the highest number of deaths were the United States, Pakistan, and India, with an affected age range of 23-83 years. Conclusions: The data suggest that analyses of X information in populations of affected areas may provide useful information regarding the impact of a pandemic on the dental profession and demonstrate a correlation with suspected and confirmed infection or death cases. Platform X shows potential as an early predictor for disease spread. However, further research is required to confirm its validity. ",
doi="10.2196/54650",
url="https://www.jmir.org/2025/1/e54650"
}


@Article{info:doi/10.2196/68483,
author="Wight, Lisa
and Tenove, Chris
and Hirani, Saima
and Tworek, Heidi",
title="Mental Health and Coping Strategies of Health Communicators Who Faced Online Abuse During the COVID-19 Pandemic: Mixed Methods Study",
journal="JMIR Infodemiology",
year="2025",
month="Apr",
day="2",
volume="5",
pages="e68483",
keywords="mental health",
keywords="online harassment",
keywords="online abuse",
keywords="coping strategies",
keywords="resilience",
keywords="social media",
keywords="online advocacy",
keywords="public health communication",
keywords="health communication",
abstract="Background: During the COVID-19 pandemic, health experts used social media platforms to share information and advocate for policies. Many of them faced online abuse, which some reported took a toll on their mental health and well-being. Variation in the impacts of online abuse on mental health, well-being, and professional efficacy suggest that health communicators may differ in their coping strategies and ultimately their resilience to such abuse. Objective: We aimed to explore the impacts of online abuse on health communicators' mental health and well-being as well as their emotion- and problem-focused coping strategies. Methods: We recruited health communicators (public health officials, medical practitioners, and university-based researchers) in Canada who engaged in professional online communication during the COVID-19 pandemic. In phase 1, semistructured interviews were conducted with 35 health communicators. In phase 2, online questionnaires were completed by 34 individuals before participating in workshops. Purposive recruitment resulted in significant inclusion of those who self-identified as racialized or women. Interview and workshop data were subjected to inductive and deductive coding techniques to generate themes. Descriptive statistics were calculated for selected questionnaire questions. Results: In total, 94\% (33/35) of interviewees and 82\% (28/34) of questionnaire respondents reported experiencing online abuse during the study period (2020-2022). Most health communicators mentioned facing an emotional and psychological toll, including symptoms of depression and anxiety. Racialized and women health communicators faced abuse that emphasized their ethnicity, gender identity, and physical appearance. Health communicators' most common emotion-focused coping strategies were withdrawing from social media platforms, avoiding social media platforms altogether, and accepting online abuse as unavoidable. Common problem-focused coping strategies included blocking or unfriending hostile accounts, changing online behavior, formal help-seeking, and seeking peer support. Due to the impacts of online abuse on participants' mental health and well-being, 41\% (14/34) of the questionnaire respondents seriously contemplated quitting health communication, while 53\% (18/34) reduced or suspended their online presence. Our findings suggest that health communicators who used problem-focused coping strategies were more likely to remain active online, demonstrating significant professional resilience. Conclusions: Although health communicators in our study implemented various emotion- and problem-focused coping strategies, they still faced challenges in dealing with the impacts of online abuse. Our findings reveal the limitations of individual coping strategies, suggesting the need for effective formal organizational policies to support those who receive online abuse and to sanction those who perpetrate it. Organizational policies could improve long-term outcomes for health communicators' mental health and well-being by mitigating online abuse and supporting its targets. Such policies would bolster professional resilience, ensuring that important health information can still reach the public and is not silenced by online abuse. More research is needed to determine whether gender, race, or other factors shape coping strategies and their effectiveness. ",
doi="10.2196/68483",
url="https://infodemiology.jmir.org/2025/1/e68483"
}


@Article{info:doi/10.2196/72002,
author="Evans, Douglas William
and Ichimiya, Megumi
and Bingenheimer, B. Jeffrey
and Cantrell, Jennifer
and D'Esterre, P. Alexander
and Pincus, Olivia
and Yu, Q. Linda
and Hair, C. Elizabeth",
title="Design and Baseline Evaluation of Social Media Vaping Prevention Trial: Randomized Controlled Trial Study",
journal="J Med Internet Res",
year="2025",
month="Mar",
day="31",
volume="27",
pages="e72002",
keywords="social media",
keywords="e-cigarettes",
keywords="randomized controlled trial",
keywords="nicotine",
keywords="oral nicotine products",
keywords="nicotine poly-use",
abstract="Background: Electronic cigarette (e-cigarette) use is a major public health problem and young adults aged 18-24 years are at high risk. Furthermore, oral nicotine products (ONPs) are growing in popularity in this population. Poly-use is widespread. New methodologies for rigorous online studies using social media have been conducted and shown to reduce nicotine use. Objective: We report on the design and baseline evaluation of a large-scale social media--based randomized controlled trial to evaluate the effects of antivaping social media on young adult vaping and determinants of use. Methods: Using the Virtual Lab social media platform, participants were recruited using an artificial intelligence chatbot and social media advertising, completed a baseline survey, and were randomized to 1 of 4 study arms. The design was to achieve specific numbers of impressions per arm over 3 survey time points. We recruited 8437 participants, stratified by vaper (n=5026) and nonvaper (n=3321) status. Questionnaire data were collected using the Qualtrics survey platform. Future analyses will examine the effects of social media content on vaping at the endline. Our data analysis describes the 2 cohort samples, examines balance across the 4 study arms on baseline variables in each of the cohorts, and evaluates the internal consistency of several multi-indicator measures of psychosocial constructs. Results: Among vapers, almost three-fourths were current vapers, >40\% were current smokers (using in the past 30 days), and >48\% were current poly-users (using e-cigarettes and ?1 other tobacco products). Substantial numbers of current vapers also currently use some other product, including cigars (n=1520, 30.2\%), hookah (n=794, 15.8\%), smokeless devices (n=462, 9.2\%), and ONPs (n=578, 11.5\%). The average age of participants was 21.2 (SD 2) years. Just less than 45\% of participants were non-Hispanic White (n=3728, 44.7\%), just less than 47\% (n=3913, 46.9\%) of the sample was male, more than 44\% (n=3704, 44.4\%) reported completing high school, and 79.3\% reported meeting basic needs or better. There were no significant differences between arms and strata by any of these demographics. We calculated scale scores for depression and covariates related to nicotine use and found high alphas. Finally, participants who reported having seen antitobacco brand advertising were more likely to have higher levels of these variables and scales than participants who reported not having seen the advertisements. These results will be examined in future studies. Conclusions: Social media can be used as a platform at scale for longitudinal randomized controlled trials over extended periods, which extends previous research on short-term trials. Interventions delivered by social media can be used with large samples to evaluate social media health behavior change interventions. Future studies based on this research will evaluate the intervention and dose-response effects of social media exposure on vaping behavior and determinants. Trial Registration: ClinicalTrials.gov NCT04867668; https://clinicaltrials.gov/study/NCT04867668 ",
doi="10.2196/72002",
url="https://www.jmir.org/2025/1/e72002"
}


@Article{info:doi/10.2196/57987,
author="Bologna, Federica
and Thalken, Rosamond
and Pepin, Kristen
and Wilkens, Matthew",
title="Endometriosis Communities on Reddit: Quantitative Analysis",
journal="J Med Internet Res",
year="2025",
month="Mar",
day="31",
volume="27",
pages="e57987",
keywords="online health communities",
keywords="patient-centered care",
keywords="chronic disease",
keywords="internet",
keywords="consumer health information",
keywords="self-help groups",
keywords="community networks",
keywords="information science",
keywords="social support",
abstract="Background: Endometriosis is a chronic condition that affects 10\% of the people with a uterus. Due to the complex social and psychological impacts caused by this condition, people with endometriosis often turn to online health communities (OHCs) for support. Objective: Prior work identifies a lack of large-scale analyses of the experiences of patients with endometriosis and of OHCs. This study aims to fill this gap by investigating aspects of the condition and aggregate user needs that emerge from 2 endometriosis OHCs, r/Endo and r/endometriosis. Methods: We used latent Dirichlet allocation topic modeling, an unsupervised machine learning method, to extract the subject matter (``topic'') of >30,000 posts and >300,000 comments. In addition to latent Dirichlet allocation, we leveraged supervised classification. Specifically, we fine-tuned a series of the DistilBERT models to identify the people and relationships (personas) a post mentions as well as the type of support that the post seeks (intent). Combining the results of these 2 methods, we identified associations between a post's topic, the personas mentioned, and the post's intent. Results: The most discussed topics in posts were medical stories, medical appointments, sharing symptoms, menstruation, and empathy. Through the combination of the results from topic modeling and supervised classification, we found that when discussing medical appointments, users were more likely to mention the endometriosis OHCs than medical professionals. Medical professional was the least likely of any persona to be associated with empathy. Posts that mentioned partner or family were likely to discuss topics from the life issues category, particularly fertility. Users sought experiential knowledge regarding treatments and health care processes, and they also wished to vent and establish emotional connections about the life-altering aspects of the condition. Conclusions: We conclude that members of the OHCs need greater empathy within clinical settings, easier access to appointments, more information on care pathways, and more support for their loved ones. Endometriosis OHCs currently fulfill some of these needs as they provide members with a space where they can receive validation, discuss care pathways, and learn to manage symptoms. This study demonstrates the value of quantitative analyses of OHCs. Computational analyses can support and extend findings from small-scale studies about patient experiences and provide insights into hard-to-reach groups. Finally, we provide recommendations for clinical practice and medical training programs. ",
doi="10.2196/57987",
url="https://www.jmir.org/2025/1/e57987"
}


@Article{info:doi/10.2196/70067,
author="Nguyen, Derek
and Javaheri, Jennifer
and Sanchez, Ruth
and Han, Vy",
title="Popular Treatments of Psoriasis on Social Media: Google Trends Analysis",
journal="JMIR Dermatol",
year="2025",
month="Mar",
day="28",
volume="8",
pages="e70067",
keywords="psoriasis",
keywords="biologics",
keywords="Google Trends",
keywords="Reddit",
keywords="Facebook",
keywords="treatment",
doi="10.2196/70067",
url="https://derma.jmir.org/2025/1/e70067"
}


@Article{info:doi/10.2196/56147,
author="Wang, Xiao
and Xiao, Yuxue
and Nam, Sujin
and Zhong, Ting
and Tang, Dongyan
and Li, Cheung William Ho
and Song, Peige
and Xia, Wei",
title="Use of Mukbang in Health Promotion: Scoping Review",
journal="J Med Internet Res",
year="2025",
month="Mar",
day="27",
volume="27",
pages="e56147",
keywords="mukbang",
keywords="health promotion",
keywords="eating behaviors",
keywords="appetite",
keywords="scoping review",
abstract="Background: Mukbang is a recent internet phenomenon in which anchors publicly record and show their eating through short video platforms. Researchers reported a tangible impact of mukbang on the psychological and physical health, appetite, and eating behavior of the public, it is critical to obtain clear and comprehensive insights concerning the use of mukbang to promote the viewers' appetite, eating behaviors, and health to identify directions for future work. Objective: This scoping review aims to comprehensively outline the current evidence regarding the impact of mukbang consumption on dietary behaviors, appetite regulation, flavor perception, and physical and psychological well-being. Specifically, we conducted an analysis of public perceptions and attitudes toward mukbang while summarizing the reciprocal influence it has on health promotion. Methods: This study was conducted as a scoping review following the Joanna Briggs Institute guideline and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist. We comprehensively searched 8 electronic databases in Chinese, English, and Korean languages. We also searched gray literature sources like Google Scholar and ProQuest. We used a data extraction chart to extract information relevant to the impact of mukbang on health. The extracted data were qualitatively analyzed to form different themes related to health, categorizing and integrating the results based on the type of study (qualitative, observational, and experimental). Results: This scoping review finally included 53 studies; the annual distribution exhibited a consistent upward trend across all categories since their initial publication in 2017. Based on the results of the analysis, we have summarized 4 themes, which showed that mukbang may have positive effects on viewers' appetite, food choices, and weight control; it can also meet the psychological needs of viewers and provide digital companionship and happiness. However, excessive viewing may also be harmful to viewer's health, which has also caused health concerns for some viewers. Conclusions: This study conducted a comprehensive search, screening, and synthesis of existing studies focusing on mukbang and health across various languages and varying levels of quality, which has presented the analytical evidence of the relationship between mukbang and dietary behaviors, appetite, flavor perception, and health. According to the results, future research could consider analyzing the beneficial and harmful factors of mukbang, thereby further optimizing the existing mukbang videos accordingly to explore the potential of using mukbang for health intervention or promotion, so as to improve or customize the content of mukbang based on this scoping review, maximize the appetite and health promotion effects of mukbang videos. Trial Registration: INPLASY INPLASY2022120109; https://inplasy.com/inplasy-2022-12-0109/ ",
doi="10.2196/56147",
url="https://www.jmir.org/2025/1/e56147"
}


@Article{info:doi/10.2196/50536,
author="Kautsar, Prawira Angga
and Sinuraya, Kurnia Rano
and van der Schans, Jurjen
and Postma, Jacobus Maarten
and Suwantika, A. Auliya",
title="Exploring Public Sentiment on the Repurposing of Ivermectin for COVID-19 Treatment: Cross-Sectional Study Using Twitter Data",
journal="JMIR Form Res",
year="2025",
month="Mar",
day="27",
volume="9",
pages="e50536",
keywords="COVID-19",
keywords="ivermectin",
keywords="sentiment analysis",
keywords="Twitter",
keywords="social media",
keywords="public health",
keywords="misinformation",
keywords="geolocation analysis",
doi="10.2196/50536",
url="https://formative.jmir.org/2025/1/e50536"
}


@Article{info:doi/10.2196/63822,
author="Cardwell, T. Ethan
and Ludwick, Teralynn
and Chang, Shanton
and Walsh, Olivia
and Lim, Megan
and Podbury, Rachel
and Evans, David
and Fairley, K. Christopher
and Kong, S. Fabian Y.
and Hocking, S. Jane",
title="Engaging End Users to Inform the Design and Social Marketing Strategy for a Web-Based Sexually Transmitted Infection/Blood-Borne Virus (STI/BBV) Testing Service for Young People in Victoria, Australia: Qualitative Study",
journal="J Med Internet Res",
year="2025",
month="Mar",
day="27",
volume="27",
pages="e63822",
keywords="web-based STI/HIV testing",
keywords="social marketing",
keywords="sexual health",
keywords="participatory design",
keywords="codesign",
keywords="sexually transmitted infections",
keywords="STI",
keywords="HIV",
keywords="Australia",
keywords="social media",
keywords="survey",
keywords="blood-borne viruses",
abstract="Background: The rates of sexually transmitted infections (STIs) continue to rise across Australia among 16- to 29-year-olds. Timely testing is needed to reduce transmission, but sexual health clinics are at capacity. This demand, coupled with barriers to getting tested faced by young people, has led to web-based services as a pragmatic solution. However, for young people to use these services, they must be acceptable, attractive, and usable. Social marketing principles combined with end user engagement can be used to guide the development of a web-based service and create a marketing strategy to attract them to the service. Objective: Working closely with end users and guided by social marketing, this project explored messaging, design elements (imagery), and promotional strategies that will support high usage of a web-based STI/blood-borne virus (BBV) testing service for young people in Victoria, Australia. Methods: Young people were recruited to participate in half-day workshops via youth organizations and targeted Meta (Facebook/Instagram) advertisements. An initial web-based survey was deployed to inform workshop content. Workshops were held in metropolitan, outer metropolitan, and regional Victoria. Young people were presented with a range of ``image territories'' developed by a social marketing firm and social marketing messages that were informed by the literature on communicating health messages. Participants discussed the feelings and reactions evoked by the content. Data collected through mixed methods (transcribed notes, audio recording, and physical outputs) were thematically analyzed to understand features of messaging and imagery that would attract young people to use the service. Results: A total of 45 people completed the initial survey with 17 participating in focus group workshops (metropolitan: n=8, outer metropolitan: n=6, and regional: n=3). Young people preferred messages that highlight the functional benefits (confidential, affordable, and accessible) of a web-based service and include professional imagery and logos that elicit trust. Young people indicated that the service should be promoted through digital communications (eg, dating apps and social media), with endorsement from government or other recognized institutions, and via word-of-mouth communications. Conclusions: This study has highlighted the value of applying social marketing theory with end user engagement in developing a web-based STI/BBV testing service. Through the voices of young people, we have established the foundations to inform the design and marketing for Victoria's first publicly funded web-based STI/BBV testing clinic. Future research will measure the reach and efficacy of social marketing, and how this service complements existing services in increasing STI/BBV testing uptake among young Victorians. ",
doi="10.2196/63822",
url="https://www.jmir.org/2025/1/e63822"
}


@Article{info:doi/10.2196/66058,
author="Zhang, Chenglin
and Mohamad, Emma
and Azlan, Anis Arina
and Wu, Anqi
and Ma, Yilian
and Qi, Yihan",
title="Social Media and eHealth Literacy Among Older Adults: Systematic Literature Review",
journal="J Med Internet Res",
year="2025",
month="Mar",
day="26",
volume="27",
pages="e66058",
keywords="eHealth literacy",
keywords="digital health literacy",
keywords="older adults",
keywords="social media",
keywords="health information",
keywords="systematic review",
abstract="Background: The advent of social media has significantly transformed health communication and the health-related actions of older adults, offering both obstacles and prospects for this generation to embrace eHealth developments. Objective: We aimed to investigate the correlation between social media and eHealth literacy in older individuals and answer four research questions: (1) What are the specific social media behaviors (including general use behaviors and health behaviors) of older adults on social media? (2) How do these behaviors impact their eHealth literacy? (3) How does eHealth literacy influence older adults' social media behaviors? and (4) What factors influence older adults' use of social media for health-related purposes? Methods: Using predetermined keywords and inclusion criteria, we searched Scopus, Web of Science, and PubMed databases for English-language journal articles published from 2000 to 2024, following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) principles. The initial search identified 1591 publications, and after removing duplicates, 48.21\% (767/1591) of publications remained. Ultimately, 1\% (16/1591) of studies met the inclusion criteria. A research question--driven manual qualitative thematic analysis was conducted, guided by the categorization of social media use behaviors, the definition of eHealth literacy, and the social-ecological model to provide direction for coding and thematic analysis. In addition, attention was given to identifying unanticipated behaviors or phenomena during the coding process, and these were subsequently incorporated into the analytical framework. Results: The results indicated that older adults' general social media use behaviors are primarily characterized by social media preferences, with 2 subthemes identified. Their social media health behaviors revealed 5 main themes and 14 subthemes. Among the primary themes, health information behavior appeared most frequently (12/16, 75\%), followed by self-management (8/16, 50\%). Other themes included health decision-making (4/16, 25\%), telemedicine (3/16, 19\%), and health interventions (2/16, 13\%). Cross-thematic analysis confirmed that older adults' social media use behaviors and their eHealth literacy had a reciprocal relationship. Finally, the study revealed that the use of social media to improve eHealth literacy among older adults was influenced by individual, interpersonal, institutional or organizational, and social factors. Conclusions: The reciprocal relationship between older adults' social media use and eHealth literacy highlights the importance of establishing a long-term positive mechanism that mutually reinforces social media health practices and eHealth literacy. Based on the findings, this review proposes key directions for efforts to achieve this goal: (1) leveraging postpandemic momentum to enhance eHealth literacy among older adults through social media, (2) reconsidering the dimensions of eHealth literacy among older adults in the context of Web 2.0, (3) actively developing age-friendly integrated social media health service platforms, (4) optimizing social media for engaging and reliable health information for older adults, and (5) integrating social support systems to foster lifelong eHealth learning for older adults. ",
doi="10.2196/66058",
url="https://www.jmir.org/2025/1/e66058"
}


@Article{info:doi/10.2196/57468,
author="Chen, T. Annie
and Wang, C. Lexie
and Johnny, Shana
and Wong, H. Sharon
and Chaliparambil, K. Rahul
and Conway, Mike
and Glass, E. Joseph",
title="Stigma and Behavior Change Techniques in Substance Use Recovery: Qualitative Study of Social Media Narratives",
journal="JMIR Form Res",
year="2025",
month="Mar",
day="26",
volume="9",
pages="e57468",
keywords="stigma",
keywords="substance use",
keywords="transtheoretical model",
keywords="behavior change techniques",
keywords="social media",
abstract="Background: Existing literature shows that persons with substance use disorder (SUD) experience different stages of readiness to reduce or abstain from substance use, and tailoring intervention change strategies to these stages may facilitate recovery. Moreover, stigma may serve as a barrier to recovery by preventing persons with SUDs from seeking treatment. In recent years, the behavior change technique (BCT) taxonomy has increasingly become useful for identifying potential efficacious intervention components; however, prior literature has not addressed the extent to which these techniques may naturally be used to recover from substance use, and knowledge of this may be useful in the design of future interventions. Objective: We take a three-step approach to identifying strategies to facilitate substance use recovery: (1) characterizing the extent to which stages of change are expressed in social media data, (2) identifying BCTs used by persons at different stages of change, and (3) exploring the role that stigma plays in recovery journeys. Methods: We collected discussion posts from Reddit, a popular social networking site, and identified subreddits or discussion forums about 3 substances (alcohol, cannabis, and opioids). We then performed qualitative data analysis using a hybrid inductive-deductive method to identify the stages of change in social media authors' recovery journeys, the techniques that social media content authors used as they sought to quit substance use, and the role that stigma played in social media authors' recovery journeys. Results: We examined 748 posts pertaining to 3 substances: alcohol (n=316, 42.2\%), cannabis (n=335, 44.8\%), and opioids (n=135, 18\%). Social media content representing the different stages of change was observed, with the majority (472/748, 63.1\%) of narratives representing the action stage. In total, 11 categories of BCTs were identified. There were similarities in BCT use across precontemplation, contemplation, and preparation stages, with social support seeking and awareness of natural consequences being the most common. As people sought to quit or reduce their use of substances (action stage), we observed a variety of BCTs, such as the repetition and substitution of healthful behaviors and monitoring and receiving feedback on their own behavior. In the maintenance stage, reports of diverse BCTs continue to be frequent, but offers of social support also become more common than in previous stages. Stigma was present throughout all stages. We present 5 major themes pertaining to the manifestation of stigma. Conclusions: Patterns of BCT use and stigmatizing experiences are frequently discussed in social media, which can be leveraged to better understand the natural course of recovery from SUD and how interventions might facilitate recovery from substance use. It may be important to incorporate stigma reduction across all stages of the recovery journey. ",
doi="10.2196/57468",
url="https://formative.jmir.org/2025/1/e57468"
}


@Article{info:doi/10.2196/67361,
author="Amoozegar, B. Jacqueline
and Williams, Peyton
and Giombi, C. Kristen
and Richardson, Courtney
and Shenkar, Ella
and Watkins, L. Rebecca
and O'Donoghue, C. Amie
and Sullivan, W. Helen",
title="Consumer Engagement With Risk Information on Prescription Drug Social Media Pages: Findings From In-Depth Interviews",
journal="J Med Internet Res",
year="2025",
month="Mar",
day="25",
volume="27",
pages="e67361",
keywords="social media",
keywords="prescription drugs",
keywords="risk information",
keywords="safety information",
keywords="Facebook",
keywords="Instagram",
keywords="prescription",
keywords="risk",
keywords="information",
keywords="safety",
keywords="interview",
keywords="consumer engagement",
keywords="digital",
keywords="drug promotion",
keywords="user experience",
keywords="promotion",
abstract="Background: The volume of digital drug promotion has grown over time, and social media has become a source of information about prescription drugs for many consumers. Pharmaceutical companies currently present risk information about prescription drugs they promote in a variety of ways within and across social media platforms. There is scarce research on consumers' interactions with prescription drug promotion on social media, particularly on which features may facilitate or inhibit consumers' ability to find, review, and comprehend drug information. This is concerning because it is critical for consumers to know and weigh drug benefits and risks to be able to make informed decisions regarding medical treatment. Objective: We aimed to develop an understanding of the user interface (UI) and user experience (UX) of social media pages and posts created by pharmaceutical companies to promote drugs and how UI or UX design features impact consumers' interactions with drug information. Methods: We conducted in-person interviews with 54 consumers segmented into groups by device type (laptop or mobile phone), social media platform (Facebook or Instagram), and age. Interviewers asked participants to navigate to and review a series of 4 pages and 3 posts on their assigned device and platform. Interviewers encouraged participants to ``think aloud,'' as they interacted with the stimuli during a brief observation period. Following each observation period, participants were asked probing questions. An analyst reviewed video recordings of the observation periods to abstract quantitative interaction data on whether a participant clicked on or viewed risk information at each location it appeared on each page. Participants' responses were organized in a metamatrix, which we used to conduct thematic analysis. Results: Observational data revealed that 59\% of participants using Facebook and 70\% of participants using Instagram viewed risk information in at least 1 possible location on average across all pages tested during the observation period. There was not a single location across the Facebook pages that participants commonly clicked on to view risk information. However, a video with scrolling risk information attracted more views than other features. On Instagram, at least half of the participants consistently clicked on the highlighted story with risk information across the pages. Although thematic analysis showed that most participants were able to identify the official pages and risk information for each drug, auto-scrolling text and text size posed barriers to identification and comprehensive review for some participants. Participants generally found it more difficult to identify the drugs' indications than risks. Participants using Instagram more frequently reported challenges identifying risks and indications compared to those using Facebook. Conclusions: UI or UX design features can facilitate or pose barriers to users' identification, review, and comprehension of the risk information provided on prescription drugs' social media pages and posts. ",
doi="10.2196/67361",
url="https://www.jmir.org/2025/1/e67361"
}


@Article{info:doi/10.2196/67658,
author="Tistad, Malin
and Hultman, Lill
and Wohlin Wottrich, Annica
and von Koch, Lena",
title="The Lived Experience of Participating in Online Peer-To-Peer Groups After Acquired Brain Injury: Phenomenological Study",
journal="J Med Internet Res",
year="2025",
month="Mar",
day="25",
volume="27",
pages="e67658",
keywords="compassion",
keywords="experiential knowledge",
keywords="fatigue",
keywords="self-compassion",
keywords="stroke",
keywords="social media",
keywords="meaning",
keywords="interview",
keywords="normalization",
abstract="Background: Stroke and other acquired brain injuries (ABIs) can present challenging experiences for individuals, both in recovery of functions affected by visible or invisible impairments and in learning to live with the new situation. Research has shown that sharing experiences face-to-face in peer groups can be beneficial during recovery. However, there is limited knowledge about the lived experiences of people with ABI who participate in online peer-to-peer groups. Objective: The aim of our study was to explore the lived experiences of participating in online peer-to-peer groups for people with ABI, where participants themselves set the agenda. Methods: Members of 2 Facebook groups (FBGs) for people with ABI were invited to participate in this study, and 20 individuals were included (14 women and 6 men; age range 24-74 years). One FBG focused on stroke and the other on fatigue caused by ABI. One group was private, and the other group was public. Data were collected through semistructured interviews, in which participants were encouraged to describe their experiences of engaging in FBGs in detail. The interviews were conducted over telephone or Zoom and digitally recorded. The audio recordings were then transcribed verbatim, resulting in 224 pages of text, and analyzed using the empirical phenomenological psychological method. Results: The analysis presented a common meaning structure with 1 main characteristic that is, ``validating self,'' common for all 20 participants, and 3 subcharacteristics, that is, ``learning---having one's own experiences confirmed,'' ``adjusting self---building competence and self-compassion,'' and ``supporting others---becoming a valued lived-experience expert/authority.'' Together, the subcharacteristics reflected a process of validating self from newcomer to lived-experience expert or authority. In this process, members of FBGs moved from being newcomers with pronounced needs for support and to learn and to have their experiences confirmed by others with similar experiences. Thus, participants were building competence and developing self-compassion. Gradually, they assumed the role of advisors, mentors, or coaches, acknowledging their experiences and competence as valuable to others, thereby validating themselves as compassionate lived-experience experts or authorities in supporting others. Conclusions: Participation in online peer-to-peer groups can offer unique opportunities for individuals with ABI to validate self through processes that involve learning, developing self-compassion and compassion for others, and offering support to others with similar experiences. Given that rehabilitation after an ABI is often of limited duration and that positive experiences can be achieved over time through involvement in digital peer-to-peer support, health care professionals should assist patients by providing information and directing them to digital networks for people with ABI. However, when recommending the use of online peer-to-peer support, impairments and insufficient digital competence that may complicate or prevent the use of social media should be assessed and support provided when relevant. ",
doi="10.2196/67658",
url="https://www.jmir.org/2025/1/e67658",
url="http://www.ncbi.nlm.nih.gov/pubmed/40131323"
}


@Article{info:doi/10.2196/57812,
author="Farsi, Sara
and Sabbahi, Alaa
and Sait, Deyala
and Kabli, Raghad
and Abduljabar, Ghaliah",
title="Ethical Use of Social Media and Sharing of Patient Information by Medical Students at a University Hospital in Saudi Arabia: Cross-Sectional Survey",
journal="JMIR Med Educ",
year="2025",
month="Mar",
day="24",
volume="11",
pages="e57812",
keywords="e-professionalism",
keywords="professionalism",
keywords="social media",
keywords="medical education",
keywords="curriculum development",
keywords="privacy",
keywords="confidentiality",
keywords="ethics",
keywords="patient confidentiality",
keywords="cross-sectional",
keywords="questionnaire",
abstract="Background: Social media (SM) has become an integral part of many medical students' lives, blurring the lines between their personal and professional identities as many aspects of their medical careers appear online. Physicians must understand how to responsibly navigate these sites. Objective: This study aimed to identify how medical students use SM and their awareness and adherence to ethical guidelines of e-professionalism. Methods: This is a cross-sectional study delivered as an online voluntary survey to senior medical students at King AbdulAziz University Hospital in Jeddah, Saudi Arabia. We investigated how many students used SM, their privacy settings, their possible breaches of ethical standards, and their portrayal of their training institute online. Results: A total of 400/1546 (26\%) senior medical students responded to our survey. Among the participants, 95/400 (24\%) had public SM accounts, while 162/400 (41\%) had both private and public accounts. As for breaches in e-professionalism, 11/400 (3\%) participants posted a picture of a patient on SM without their permission, while 75/400 (20\%) posted part of an excised organ or x-ray on SM without their permission, and 60/400 (16\%) discussed a patient. With regards to sharing medical school information, 108/400 (29\%) discussed an incident at their medical school, and 119/400 (31\%) participants shared a lecture online without the presenter's permission. Approximately 66\% of the participants reported that they were unaware if their institution had a professional code of conduct for SM use, and 259/371 (70\%) did not receive training on the professional use of SM. Conclusions: Medical students must be taught to recognize inappropriate online behavior, understand their role as representatives of their medical school, and know the potential repercussions of unprofessional conduct on SM. This could be accomplished by providing workshops, regular seminars on e-professionalism, and including principles of SM conduct in existing ethics courses. ",
doi="10.2196/57812",
url="https://mededu.jmir.org/2025/1/e57812"
}


@Article{info:doi/10.2196/63584,
author="Bataineh, S. Bara
and Marti, Nathan C.
and Murthy, Dhiraj
and Badillo, David
and Chow, Sherman
and Loukas, Alexandra
and Wilkinson, V. Anna",
title="Vaping, Acculturation, and Social Media Use Among Mexican American College Students: Protocol for a Mixed Methods Web-Based Cohort Study",
journal="JMIR Res Protoc",
year="2025",
month="Mar",
day="24",
volume="14",
pages="e63584",
keywords="vaping",
keywords="social media",
keywords="Mexican American",
keywords="college students",
keywords="marketing",
keywords="acculturation",
keywords="protocol",
keywords="artificial intelligence",
abstract="Background: The tobacco industry has a history of targeting minority communities, including Hispanic individuals, by promoting vaping through social media. This marketing increases the risk of vaping among Hispanic young adults, including college students. In Texas, college enrollment among Mexican Americans has significantly increased over recent years. However, little research exists on the link between social media and vaping and the underlying mechanisms (ie, outcome expectations, attitudes, and beliefs) explaining how vaping-related social media impacts vaping among Mexican American college students. Moreover, there is limited knowledge about how acculturation moderates the association between social media and vaping. Hispanic individuals, particularly Mexican Americans, are the largest ethnic group in Texas colleges; thus, it is crucial to understand the impact of social media and acculturation on their vaping behaviors. Objective: We outline the mixed methods used in Project Vaping, Acculturation, and Media Study (VAMoS). We present descriptive analyses of the participants enrolled in the study, highlight methodological strengths, and discuss lessons learned during the implementation of the study protocol related to recruitment and data collection and management. Methods: Project VAMoS is being conducted with Mexican American students attending 1 of 6 Texas-based colleges: University of Texas (UT) Arlington, UT Dallas, UT El Paso, UT Rio Grande Valley, UT San Antonio, and the University of Houston System. This project has 2 phases. Phase 1 included an ecological momentary assessment (EMA) study and qualitative one-on-one interviews (years 1-2), and phase 2 includes cognitive interviews and a 4-wave web-based survey study (years 2-4) with objective assessments of vaping-related social media content to which participants are exposed. Descriptive statistics summarized participants' characteristics in the EMA and web-based survey. Results: The EMA analytic sample comprised 51 participants who were primarily female (n=37, 73\%), born in the United States (n=48, 94\%), of middle socioeconomic status (n=38, 75\%), and aged 21 years on average (SD 1.7 years). The web-based survey cohort comprised 1492 participants self-identifying as Mexican American; Tejano, Tejana, or Tejanx; or Chicano, Chicana, or Chicanx heritage who were primarily female (n=1042, 69.8\%), born in the United States (n=1366, 91.6\%), of middle socioeconomic status (n=1174, 78.7\%), and aged 20.1 years on average at baseline (SD 2.2 years). Of the baseline cohort, the retention rate in wave 2 was 74.7\% (1114/1492). Conclusions: Project VAMoS is one of the first longitudinal mixed methods studies exploring the impact of social media and acculturation on vaping behaviors specifically targeting Mexican American college students. Its innovative approach to objectively measuring social media exposure and engagement related to vaping enhances the validity of self-reported data beyond what national surveys can achieve. The results can be used to develop evidence-based, culturally relevant interventions to prevent vaping among this rapidly growing minority population. International Registered Report Identifier (IRRID): DERR1-10.2196/63584 ",
doi="10.2196/63584",
url="https://www.researchprotocols.org/2025/1/e63584"
}


@Article{info:doi/10.2196/64679,
author="Grimes, Robert David
and Gorski, H. David",
title="Quantifying Public Engagement With Science and Malinformation on COVID-19 Vaccines: Cross-Sectional Study",
journal="J Med Internet Res",
year="2025",
month="Mar",
day="21",
volume="27",
pages="e64679",
keywords="misinformation",
keywords="altmetrics",
keywords="disinformation",
keywords="malinformation",
keywords="public engagement",
keywords="medical journals",
keywords="medicoscientific",
keywords="public health",
keywords="altmetric analysis",
keywords="comparative analysis",
keywords="social media",
keywords="Twitter",
keywords="vaccine",
keywords="digital health",
keywords="mHealth",
keywords="mobile health",
keywords="health informatics",
abstract="Background: Medical journals are critical vanguards of research, and previous years have seen increasing public interest in and engagement with medicoscientific findings. How findings propagate and are understood and what harms erroneous claims might cause to public health remain unclear, especially on publicly contentious topics like COVID-19 vaccines. Gauging the engagement of the public with medical science and quantifying propagation patterns of medicoscientific papers are thus important undertakings. In contrast to misinformation and disinformation, which pivot on falsehood, the more nuanced issue of malinformation, where ostensibly true information is presented out of context or selectively curated to cause harm and misconception, has been less researched. As findings and facts can be selectively marshaled to present a misleading picture, it is crucial to consider this issue and its potential ramifications. Objective: This study aims to quantify patterns of public engagement with medical research and the vectors of propagation taken by a high-profile incidence of medical malinformation. Methods: In this work, we undertook an analysis of all altmetric engagements over a decade for 5 leading general-purpose medical journals, constituting approximately 9.8 million engagements with 84,529 papers. We identify and examine the proliferation of sentiment concerning a high-profile publication containing vaccine-negative malinformation. Engagement with this paper, with the highest altmetric score of any paper in an academic journal ever released, was tracked across media outlets worldwide and in social media users on Twitter (subsequently rebranded as X). Vectoring media sources were analyzed, and manual sentiment analysis on high-engagement Twitter shares of the paper was undertaken, contrasted with users' prior vaccine sentiment. Results: Results of this analysis suggested that this COVID-19 scientific malinformation was much more likely to be engaged and amplified with negative by vaccine-negative Twitter accounts than neutral ones (odds ratio 58.2, 95\% CI 9.7-658.0; P<.001), often alluding to the ostensible prestige of medical journals. Malinformation was frequently invoked by conspiracy theory websites and non-news sources (71/181 citations, 39.2\%) on the internet to cast doubt on the efficacy of vaccination, many of whom tended to cite the paper repeatedly (51/181, 28.2\%). Conclusions: Our findings suggest growing public interest in medical science and present evidence that medical and scientific journals need to be aware of not only the potential overt misinformation but also the more insidious impact of malinformation. Also, we discuss how journals and scientific communicators can reduce the influence of malinformation on public understanding. ",
doi="10.2196/64679",
url="https://www.jmir.org/2025/1/e64679"
}


@Article{info:doi/10.2196/59687,
author="Parveen, Sana
and Pereira, Garcia Agustin
and Garzon-Orjuela, Nathaly
and McHugh, Patricia
and Surendran, Aswathi
and Vornhagen, Heike
and Vellinga, Akke",
title="COVID-19 Public Health Communication on X (Formerly Twitter): Cross-Sectional Study of Message Type, Sentiment, and Source",
journal="JMIR Form Res",
year="2025",
month="Mar",
day="19",
volume="9",
pages="e59687",
keywords="public health communication",
keywords="surveillance",
keywords="COVID-19",
keywords="SARS-CoV-2",
keywords="coronavirus",
keywords="respiratory",
keywords="infectious",
keywords="pulmonary",
keywords="pandemic",
keywords="public health messaging",
keywords="healthcare information",
keywords="social media",
keywords="tweets",
keywords="text mining",
keywords="data mining",
keywords="social marketing",
keywords="infoveillance",
keywords="intervention planning",
abstract="Background: Social media can be used to quickly disseminate focused public health messages, increasing message reach and interaction with the public. Social media can also be an indicator of people's emotions and concerns. Social media data text mining can be used for disease forecasting and understanding public awareness of health-related concerns. Limited studies explore the impact of type, sentiment and source of tweets on engagement. Thus, it is crucial to research how the general public reacts to various kinds of messages from different sources. Objective: The objective of this paper was to determine the association between message type, user (source) and sentiment of tweets and public engagement during the COVID-19 pandemic. Methods: For this study, 867,485 tweets were extracted from January 1, 2020 to March 31, 2022 from Ireland and the United Kingdom. A 4-step analytical process was undertaken, encompassing sentiment analysis, bio-classification (user), message classification and statistical analysis. A combination of manual content analysis with abductive coding and machine learning models were used to categorize sentiment, user category and message type for every tweet. A zero-inflated negative binomial model was applied to explore the most engaging content mix. Results: Our analysis resulted in 12 user categories, 6 message categories, and 3 sentiment classes. Personal stories and positive messages have the most engagement, even though not for every user group; known persons and influencers have the most engagement with humorous tweets. Health professionals receive more engagement with advocacy, personal stories/statements and humor-based tweets. Health institutes observe higher engagement with advocacy, personal stories/statements, and tweets with a positive sentiment. Personal stories/statements are not the most often tweeted category (22\%) but have the highest engagement (27\%). Messages centered on shock/disgust/fear-based (32\%) have a 21\% engagement. The frequency of informative/educational communications is high (33\%) and their engagement is 16\%. Advocacy message (8\%) receive 9\% engagement. Humor and opportunistic messages have engagements of 4\% and 0.5\% and low frequenciesof 5\% and 1\%, respectively. This study suggests the optimum mix of message type and sentiment that each user category should use to get more engagement. Conclusions: This study provides comprehensive insight into Twitter (rebranded as X in 2023) users' responses toward various message type and sources. Our study shows that audience engages with personal stories and positive messages the most. Our findings provide valuable guidance for social media-based public health campaigns in developing messages for maximum engagement. ",
doi="10.2196/59687",
url="https://formative.jmir.org/2025/1/e59687"
}


@Article{info:doi/10.2196/59944,
author="Wang, Yijun
and Zheng, Han
and Zhou, Yuxin
and Chukwusa, Emeka
and Koffman, Jonathan
and Curcin, Vasa",
title="Promoting Public Engagement in Palliative and End-of-Life Care Discussions on Chinese Social Media: Model Development and Analysis",
journal="J Med Internet Res",
year="2025",
month="Mar",
day="18",
volume="27",
pages="e59944",
keywords="palliative care",
keywords="end-of-life care",
keywords="health promotion",
keywords="social media",
keywords="China",
keywords="Weibo",
keywords="public engagement",
keywords="elaboration likelihood model",
keywords="ELM",
abstract="Background: In Chinese traditional culture, discussions surrounding death are often considered taboo, leading to a poor quality of death, and limited public awareness and knowledge about palliative and end-of-life care (PEoLC). However, the increasing prevalence of social media in health communication in China presents an opportunity to promote and educate the public about PEoLC through online discussions. Objective: This study aimed to examine the factors influencing public engagement in PEoLC discussions on a Chinese social media platform and develop practice recommendations to promote such engagement. Methods: We gathered 30,811 PEoLC-related posts on Weibo, the largest social media platform in China. Guided by the elaboration likelihood model, our study examined factors across 4 dimensions: content theme, mood, information richness, and source credibility. Content theme was examined using thematic analysis, while sentiment analysis was used to determine the mood of the posts. The impact of potential factors on post engagement was quantified using negative binomial regression. Results: Organizational accounts exhibited lower engagement compared to individual accounts (incidence rate ratio [IRR]<1; P<.001), suggesting an underuse of organizational accounts in advocating for PEoLC on Weibo. Posts centered on PEoLC-related entertainment (films, television shows, and books; IRR=1.37; P<.001) or controversial social news (IRR=1.64; P<.001) garnered more engagement, primarily published by individual accounts. An interaction effect was observed between content theme and post mood, with posts featuring more negative sentiment generally attracting higher public engagement, except for educational-related posts (IRR=2.68; P<.001). Conclusions: Overall, organizations faced challenges in capturing public attention and involving the public when promoting PEoLC on Chinese social media platforms. It is imperative to move beyond a traditional mode to incorporate cultural elements of social media, such as engaging influencers, leveraging entertainment content and social news, or using visual elements, which can serve as effective catalysts in attracting public attention. The strategies developed in this study are particularly pertinent to nonprofit organizations and academics aiming to use social media for PEoLC campaigns, fundraising efforts, or research dissemination. ",
doi="10.2196/59944",
url="https://www.jmir.org/2025/1/e59944"
}


@Article{info:doi/10.2196/49464,
author="Shah, Ali Hurmat
and Househ, Mowafa",
title="Understanding Loneliness Through Analysis of Twitter and Reddit Data: Comparative Study",
journal="Interact J Med Res",
year="2025",
month="Mar",
day="14",
volume="14",
pages="e49464",
keywords="health informatics",
keywords="loneliness informatics",
keywords="loneliness theory",
keywords="health effects",
keywords="loneliness interventions",
keywords="social media",
keywords="lonely",
keywords="loneliness",
keywords="isolation",
keywords="mental health",
keywords="natural language processing",
keywords="tweet",
keywords="tweets",
keywords="comparative analysis",
abstract="Background: Loneliness is a global public health issue contributing to a variety of mental and physical health issues. It increases the risk of life-threatening conditions and contributes to the?burden on the economy in terms of the number of productive days lost. Loneliness is a highly varied concept, which is associated with multiple factors. Objective: This study aimed to understand loneliness through a comparative analysis of loneliness data on Twitter and Reddit, which are popular social media platforms. These platforms differ in terms of their use, as Twitter allows only short posts, while Reddit allows long posts in a forum setting. Methods: We collected global data on loneliness in October 2022. Twitter posts containing the words ``lonely,'' ``loneliness,'' ``alone,'' ``solitude,'' and ``isolation'' were collected. Reddit posts were extracted in March 2023. Using natural language processing techniques (valence aware dictionary for sentiment reasoning [VADER] tool from the natural language toolkit [NLTK]), the study identified and extracted relevant keywords and phrases related to loneliness from user-generated content on both platforms. The study used both sentiment analysis and the number of occurrences of a topic. Quantitative analysis was performed to determine the number of occurrences of a topic in tweets and posts, and overall meaningful topics were reported under a category. Results: The extracted data were subjected to comparative analysis to identify common themes and trends related to loneliness across Twitter and Reddit. A total of 100,000 collected tweets and 10,000 unique Reddit posts, including comments, were analyzed. The results of the study revealed the relationships of various social, political, and personal-emotional themes with the expression of loneliness on social media. Both platforms showed similar patterns in terms of themes and categories of discussion in conjunction with loneliness-related content. Both Reddit and Twitter addressed loneliness, but they differed in terms of focus. Reddit discussions were predominantly centered on personal-emotional themes, with a higher occurrence of these topics. Twitter, while still emphasizing personal-emotional themes, included a broader range of categories. Both platforms aligned with psychological linguistic features related to the self-expression of mental health issues. The key difference was in the range of topics, with Twitter having a wider variety of topics and Reddit having more focus on personal-emotional aspects. Conclusions: Reddit posts provide detailed insights into data about the expression of loneliness, although at the cost of the diversity of themes and categories, which can be inferred from the data. These insights can guide future research using social media data to understand loneliness. The findings provide the basis for further comparative investigation of the expression of loneliness on different social media platforms and online platforms. ",
doi="10.2196/49464",
url="https://www.i-jmr.org/2025/1/e49464"
}


@Article{info:doi/10.2196/57414,
author="Lin, Shuangquan
and Duan, Lingxing
and Xu, Xiangda
and Cao, Haichao
and Lu, Xiongbing
and Wen, Xi
and Wei, Shanzun",
title="Analyzing Online Search Trends for Kidney, Prostate, and Bladder Cancers in China: Infodemiology Study Using Baidu Search Data (2011-2023)",
journal="JMIR Cancer",
year="2025",
month="Mar",
day="14",
volume="11",
pages="e57414",
keywords="bladder cancer",
keywords="kidney cancer",
keywords="prostate cancer",
keywords="Baidu Index",
keywords="infodemiology",
keywords="public interest",
keywords="patients' concern",
abstract="Background: Cancers of the bladder, kidney, and prostate are the 3 major genitourinary cancers that significantly contribute to the global burden of disease (GBD) and continue to show increasing rates of morbidity and mortality worldwide. In mainland China, understanding the cancer burden on patients and their families is crucial; however, public awareness and concerns about these cancers, particularly from the patient's perspective, remain predominantly focused on financial costs. A more comprehensive exploration of their needs and concerns has yet to be fully addressed. Objective: This study aims to analyze trends in online searches and user information--seeking behaviors related to bladder, kidney, and prostate cancers---encompassing descriptive terms (eg, ``bladder cancer,'' ``kidney cancer,'' ``prostate cancer'') as well as related synonyms and variations---on both national and regional scales. This study leverages data from mainland China's leading search engine to explore the implications of these search patterns for addressing user needs and improving health management. Methods: The study analyzed Baidu Index search trends for bladder, kidney, and prostate cancers (from January 2011 to August 2023) at national and provincial levels. Search volume data were analyzed using the joinpoint regression model to calculate annual percentage changes (APCs) and average APCs (AAPCs), identifying shifts in public interest. User demand was assessed by categorizing the top 10 related terms weekly into 13 predefined topics, including diagnosis, treatment, and traditional Chinese medicine. Data visualization and statistical analyses were performed using Prism 9. Results revealed keyword trends, demographic distributions, and public information needs, offering insights into health communication and management strategies based on online information-seeking behavior. Results: Three cancer topics were analyzed using 39 search keywords, yielding a total Baidu Search Index (BSI) of 43,643,453. From 2011 to 2015, the overall APC was 15.2\% (P<.05), followed by --2.8\% from 2015 to 2021, and 8.9\% from 2021 to 2023, with an AAPC of 4.9\%. Bladder, kidney, and prostate cancers exhibited AAPCs of 2.8\%, 3.9\%, and 6.8\%, respectively (P<.05). The age distribution of individuals searching for these cancer topics varied across the topics. Geographically, searches for cancer were predominantly conducted by people from East China, who accounted for approximately 30\% of each cancer search query. Regarding user demand, the total BSI for relevant user demand terms from August 2022 to August 2023 was 676,526,998 out of 2,570,697,380 (15.74\%), representing only a limited total cancer-related search volume. Conclusions: Online searches and inquiries related to genitourinary cancers are on the rise. The depth of users' information demands appears to be influenced by regional economic levels. Cancer treatment decision-making may often involve a family-centered approach. Insights from internet search data can help medical professionals better understand public interests and concerns, enabling them to provide more targeted and reliable health care services. ",
doi="10.2196/57414",
url="https://cancer.jmir.org/2025/1/e57414"
}


@Article{info:doi/10.2196/66054,
author="Tieu, Vivian
and Kim, Sungjin
and Seok, Minji
and Ballas, Leslie
and Kamrava, Mitchell
and Atkins, M. Katelyn",
title="Gender Differences in X (Formerly Twitter) Use Among Oncology Physicians at National Cancer Institute--Designated Cancer Centers: Cross-Sectional Study",
journal="J Med Internet Res",
year="2025",
month="Mar",
day="11",
volume="27",
pages="e66054",
keywords="social media",
keywords="gender disparities",
keywords="gender differences",
keywords="cross-sectional study",
keywords="twitter",
keywords="oncology",
doi="10.2196/66054",
url="https://www.jmir.org/2025/1/e66054"
}


@Article{info:doi/10.2196/58882,
author="Kramer, L. Melissa
and Polo, Medina Jose
and Kumar, Nishant
and Mulgirigama, Aruni
and Benkiran, Amina",
title="Living With and Managing Uncomplicated Urinary Tract Infection: Mixed Methods Analysis of Patient Insights From Social Media",
journal="J Med Internet Res",
year="2025",
month="Mar",
day="11",
volume="27",
pages="e58882",
keywords="acute cystitis",
keywords="bladder infection",
keywords="HCP interactions",
keywords="urology",
keywords="patient experience",
keywords="patient insights",
keywords="social media",
keywords="uncomplicated urinary tract infection",
keywords="urinary tract infection",
keywords="urinary",
keywords="women",
keywords="quality of life",
keywords="disease management",
keywords="cystitis",
keywords="healthcare professional",
keywords="self-management",
keywords="patient behavior",
keywords="UTI",
abstract="Background: Uncomplicated urinary tract infections (uUTIs) affect more than half of women in their lifetime and can impact on quality of life. We analyzed social media posts discussing uUTIs to gather insights into the patient experience, including aspects of their disease management journey and associated opinions and concerns. Objective: This study aims to gather patient experience insights by analyzing social media posts that discussed uUTI. Methods: A search string (``urinary tract infection'' [UTI] or ``bladder infection'' or ``cystitis'' or ``UTI'' not ``interstitial cystitis'') was used to identify posts from public blogs and patient forums (June 2021 to June 2023). Posts were excluded if they were not written in English or discussed complicated UTI (posts that mentioned ``pregnancy'' or ``pregnant'' or ``trimester'' or ``catheter'' or ``interstitial''). Posts were limited to publicly available sources and anonymized. The primary objective was to gather patient perspectives on key elements of the uUTI experience, including health care professional (HCP) interactions, diagnosis, treatment, and recurrence. Results: In total, more than 42,000 unique posts were identified (mostly from reddit.com; 29,506/42,265, 70\%) and >3600 posts were analyzed. Posts were most commonly from users in the United States (6707/11,180, 60\%), the United Kingdom (2261/11,180, 20\%), Canada (509/11,180, 5\%), Germany (356/11,180, 3\%), or India (320/11,180, 3\%). Six main themes were identified: symptom awareness and information seeking, HCP interactions, diagnosis and management challenges, management with antibiotics, self-management, and challenges with recurrent UTI. Most posts highlighted the importance of seeking professional medical advice, while some patients raised concerns regarding their HCP interactions and lack of shared decision-making. Patients searched for advice and guidance on the web prior to consulting an HCP, described their symptoms, and discussed lifestyle adjustments. Most patients tried self-management and shared their experiences with nonprescribed treatment options. There was general agreement among posts that antibiotics are necessary to cure UTIs and prevent associated complications. Conclusions: Social media posts provide valuable insight into the experiences and opinions of patients with uUTIs in Canada, Germany, India, the United Kingdom, and the United States. The insights from this study provide a more complete picture of patient behaviors and highlight the potential for HCP and patient education, as well as better communication through shared decision-making to improve care. ",
doi="10.2196/58882",
url="https://www.jmir.org/2025/1/e58882"
}


@Article{info:doi/10.2196/62913,
author="Grygarov{\'a}, Dominika
and Havl{\'i}k, Marek
and Ad{\'a}mek, Petr
and Hor{\'a}{\v c}ek, Ji?{\'i}
and Jur{\'i}{\v c}kov{\'a}, Veronika
and Hlinka, Jaroslav
and Kesner, Ladislav",
title="Beliefs in Misinformation About COVID-19 and the Russian Invasion of Ukraine Are Linked: Evidence From a Nationally Representative Survey Study",
journal="JMIR Infodemiology",
year="2025",
month="Mar",
day="10",
volume="5",
pages="e62913",
keywords="misinformation",
keywords="COVID-19",
keywords="war in Ukraine",
keywords="political trust",
keywords="digital media",
keywords="belief rigidity",
keywords="vaccine hesitancy",
keywords="war",
keywords="political",
keywords="trust",
keywords="belief",
keywords="survey",
keywords="questionnaire",
keywords="national",
keywords="false",
keywords="association",
keywords="correlation",
keywords="correlation analysis",
keywords="public opinion",
keywords="media",
keywords="news",
keywords="health information",
keywords="public health",
keywords="COVID",
keywords="propaganda",
abstract="Background: Detrimental effects of misinformation were observed during the COVID-19 pandemic. Presently, amid Russia's military aggression in Ukraine, another wave of misinformation is spreading on the web and impacting our daily lives, with many citizens and politicians embracing Russian propaganda narratives. Despite the lack of an objective connection between these 2 societal issues, anecdotal observations suggest that supporters of misinformation regarding COVID-19 (BM-C) have also adopted misinformation about the war in Ukraine (BM-U) while sharing similar media use patterns and political attitudes. Objective: The aim of this study was to determine whether there is a link between respondents' endorsement of the 2 sets of misinformation narratives, and whether some of the selected factors (media use, political trust, vaccine hesitancy, and belief rigidity) are associated with both BM-C and BM-U. Methods: We conducted a survey on a nationally representative sample of 1623 individuals in the Czech Republic. Spearman correlation analysis was performed to identify the relationship between BM-C and BM-U. In addition, multiple linear regression was used to determine associations between the examined factors and both sets of misinformation. Results: We discovered that BM-C and BM-U were moderately correlated (Spearman $\rho$=0.57; P<.001). Furthermore, increased trust in Russia and decreased trust in the local government, public media, and Western allies of the Czech Republic predicted both BM-C and BM-U. Media use indicating frustration with and avoidance of public or mainstream media, consumption of alternative information sources, and participation in web-based discussions indicative of epistemic bubbles predicted beliefs in misinformation narratives. COVID-19 vaccine refusal predicted only BM-C but not BM-U. However, vaccine refusers were overrepresented in the BM-U supporters (64/161, 39.8\%) and undecided (128/505, 25.3\%) individuals. Both beliefs were associated with belief rigidity. Conclusions: Our study provides empirical evidence that supporters of COVID-19 misinformation were susceptible to ideological misinformation aligning with Russian propaganda. Supporters of both sets of misinformation narratives were primarily linked by their shared trust or distrust in the same geopolitical actors and their distrust in the local government. ",
doi="10.2196/62913",
url="https://infodemiology.jmir.org/2025/1/e62913"
}


@Article{info:doi/10.2196/66321,
author="La Sala, Louise
and Sabo, Amanda
and Michail, Maria
and Thorn, Pinar
and Lamblin, Michelle
and Browne, Vivienne
and Robinson, Jo",
title="Online Safety When Considering Self-Harm and Suicide-Related Content: Qualitative Focus Group Study With Young People, Policy Makers, and Social Media Industry Professionals",
journal="J Med Internet Res",
year="2025",
month="Mar",
day="10",
volume="27",
pages="e66321",
keywords="young people",
keywords="suicide prevention",
keywords="self-harm",
keywords="social media",
keywords="online safety",
keywords="policy",
abstract="Background: Young people are disproportionately impacted by self-harm and suicide, and concerns exist regarding the role of social media and exposure to unsafe content. Governments and social media companies have taken various approaches to address online safety for young people when it comes to self-harm and suicide; however, little is known about whether key stakeholders believe current approaches are fit-for-purpose. Objective: From the perspective of young people, policy makers and professionals who work within the social media industry, this study aimed to explore (1) the perceived challenges and views regarding young people communicating on social media about self-harm and suicide, and (2) what more social media companies and governments could be doing to address these issues and keep young people safe online. Methods: This qualitative study involved 6 focus groups with Australian young people aged 12-25 years (n=7), Australian policy makers (n=14), and professionals from the global social media industry (n=7). Framework analysis was used to summarize and chart the data for each stakeholder group. Results: In total, 3 primary themes and six subthemes are presented: (1) challenges and concerns, including the reasons for, and challenges related to, online communication about self-harm and suicide as well as reasoning with a deterministic narrative of harm; (2) roles and responsibilities regarding online safety and suicide prevention, including who is responsible and where responsibility starts and stops, as well as the need for better collaborations; and (3) future approaches and potential solutions, acknowledging the limitations of current safety tools and policies, and calling for innovation and new ideas. Conclusions: Our findings highlight tensions surrounding roles and responsibilities in ensuring youth online safety and offer perspectives on how social media companies can support young people discussing self-harm and suicide online. They also support the importance of cross-industry collaborations and consideration of social media in future suicide prevention solutions intended to support young people. ",
doi="10.2196/66321",
url="https://www.jmir.org/2025/1/e66321"
}


@Article{info:doi/10.2196/64307,
author="Shao, Anqi
and Chen, Kaiping
and Johnson, Branden
and Miranda, Shaila
and Xing, Qidi",
title="Ubiquitous News Coverage and Its Varied Effects in Communicating Protective Behaviors to American Adults in Infectious Disease Outbreaks: Time-Series and Longitudinal Panel Study",
journal="J Med Internet Res",
year="2025",
month="Mar",
day="10",
volume="27",
pages="e64307",
keywords="risk communication",
keywords="panel study",
keywords="computational method",
keywords="intermedia agenda setting",
keywords="protective behaviors",
keywords="infectious disease",
abstract="Background: Effective communication is essential for promoting preventive behaviors during infectious disease outbreaks like COVID-19. While consistent news can better inform the public about these health behaviors, the public may not adopt them. Objective: This study aims to explore the role of different media platforms in shaping public discourse on preventive measures to infectious diseases such as quarantine and vaccination, and how media exposure influences individuals' intentions to adopt these behaviors in the United States. Methods: This study uses data from 3 selected top national newspapers in the United States, Twitter discussions, and a US nationwide longitudinal panel survey from February 2020 to April 2021. We used the Intermedia Agenda-Setting Theory and the Protective Action Decision Model to develop the theoretical framework. Results: We found a 2-way agenda flow between selected national newspapers and the social media platform Twitter, particularly in controversial topics like vaccination (F1,426=16.39; P<.001 for newspapers; F1,426=44.46; P<.001 for Twitter). Exposure to media coverage increased individuals' perceived benefits of certain behaviors like vaccination but did not necessarily translate into behavioral adoption. For example, while individuals' media exposure increased perceived benefits of mask-wearing ($\beta$=.057; P<.001 for household benefits; $\beta$=.049; P<.001 for community benefits), it was not consistently linked to higher intentions to wear masks ($\beta$=--.026; P=.04). Conclusions: This study integrates media flow across platforms with US national panel survey data, offering a comprehensive view of communication dynamics during the early stage of an infectious disease outbreak. The findings caution against a one-size-fits-all approach in communicating different preventive behaviors, especially where individual and community benefits may not always align. ",
doi="10.2196/64307",
url="https://www.jmir.org/2025/1/e64307"
}


@Article{info:doi/10.2196/63072,
author="Grutman, J. Aurora
and Perelmuter, Sara
and Perez, Abigail
and Meurer, Janine
and Contractor, Monica
and Mathews, Eva
and Shearer, Katie
and Burnett, A. Lindsey
and Uloko, Maria",
title="Understanding Patient Experiences of Vulvodynia Through Reddit: Qualitative Analysis",
journal="JMIR Infodemiology",
year="2025",
month="Mar",
day="6",
volume="5",
pages="e63072",
keywords="sexual health",
keywords="health literacy",
keywords="vulvodynia",
keywords="vestibulodynia",
keywords="pelvic pain",
keywords="Reddit",
abstract="Background: Vulvodynia is a chronic vulvar pain condition affecting up to 25\% of the US population. However, diagnosis and effective treatment remain elusive. Many individuals with vulvodynia face stigma and medical uncertainty, leading them to seek information and web-based support. Reddit is a popular social media platform where patients share health concerns and experiences. The anonymity and accessibility of this platform make it a valuable source of real-world patient perspectives that are often overlooked in clinical settings. Objective: This study evaluated Reddit content related to vulvodynia to explore how individuals with vulvodynia describe their symptoms, treatments, and personal experiences. Methods: The subreddits ``r/vulvodynia'' and ``r/vestibulodynia'' were selected for analysis in May 2023. Threads were sorted from the most popular to least popular, with ``popularity'' measured by upvotes. Opening threads from the top 70 posts in each subreddit were extracted and analyzed using inductive qualitative analysis to identify themes and sentiment analysis to evaluate attitudes. Results: In May 2023, the ``r/vulvodynia'' and ``r/vestibulodynia'' subreddits had a total of 7930 members (7245 and 685 members, respectively). Out of 140 analyzed threads, 77 (55\%) contained negative attitudes. A total of 50 (35.7\%) threads were seeking information or advice and 90 (64.3\%) included some form of peer support. Inductive thematic analysis identified 6 core themes: symptoms (n=86, 61.4\%), treatments (n=83, 59.3\%), sexuality (n=47, 33.6\%), erasure or disbelief (n=38, 27.1\%), representation or media (n=17, 12.1\%), and humor (n=15, 10.7\%). Threads that discussed treatments (48/83, 57.8\%), sexual experiences (25/47, 53.2\%), and representation (14/17, 82.4\%) had the highest proportions of positive attitudes, while threads that touched on erasure (21/38, 55.3\%), symptoms (51/86, 59.3\%), and humor (12/15, 80\%), had the highest proportion of negative attitudes. A multivariable logistic regression of valence on the themes revealed that posts referring to treatments (odds ratio 12.5, 95\% CI 3.7-42.2; P<.001) or representation (odds ratio 21.2, 95\% CI 4.2-106.0; P<.001) were associated with significantly increased odds of positive valence. Furthermore, it was noted that 3 of the 5 most frequently discussed treatments aligned with clinical guidelines from the American College of Obstetricians and Gynecologists, American Urological Association, and International Society for the Study of Vulvovaginal Disease. Despite this alignment, threads frequently mentioned alternative remedies and frustration with medical professionals related to diagnostic delays and perceived lack of understanding. Conclusions: This is the first study of Reddit discussions about vulvodynia. Findings suggest a gap between patient experiences and provider understanding, underscoring the need for improved patient education and greater clinician awareness of psychosocial factors in vulvodynia care. While limited by its sample size and lack of demographic data, this study highlights how web-based communities can help identify ways health care providers can better meet patient needs and how patients mutually support each other. ",
doi="10.2196/63072",
url="https://infodemiology.jmir.org/2025/1/e63072"
}


@Article{info:doi/10.2196/65632,
author="Harvey, Daisy
and Rayson, Paul
and Lobban, Fiona
and Palmier-Claus, Jasper
and Dolman, Clare
and Chataign{\'e}, Anne
and Jones, Steven",
title="Using Natural Language Processing Methods to Build the Hypersexuality in Bipolar Reddit Corpus: Infodemiology Study of Reddit",
journal="JMIR Infodemiology",
year="2025",
month="Mar",
day="6",
volume="5",
pages="e65632",
keywords="bipolar",
keywords="hypersexuality",
keywords="natural language processing",
keywords="Linguistic Inquiry and Word Count",
keywords="LIWC",
keywords="BERTopic",
keywords="topic modeling",
keywords="computational linguistics",
abstract="Background: Bipolar is a severe mental health condition affecting at least 2\% of the global population, with clinical observations suggesting that individuals experiencing elevated mood states, such as mania or hypomania, may have an increased propensity for engaging in risk-taking behaviors, including hypersexuality. Hypersexuality has historically been stigmatized in society and in health care provision, which makes it more difficult for service users to talk about their behaviors. There is a need for greater understanding of hypersexuality to develop better evidence-based treatment, support, and training for health professionals. Objective: This study aimed to develop and assess effective methodologies for identifying posts on Reddit related to hypersexuality posted by people with a self-reported bipolar diagnosis. Using natural language processing techniques, this research presents a specialized dataset, the Talking About Bipolar on Reddit Corpus (TABoRC). We used various computational tools to filter and categorize posts that mentioned hypersexuality, forming the Hypersexuality in Bipolar Reddit Corpus (HiB-RC). This paper introduces a novel methodology for detecting hypersexuality-related conversations on Reddit and offers both methodological insights and preliminary findings, laying the groundwork for further research in this emerging field. Methods: A toolbox of computational linguistic methods was used to create the corpora and infer demographic variables for the Redditors in the dataset. The key psychological domains in the corpus were measured using Linguistic Inquiry and Word Count, and a topic model was built using BERTopic to identify salient language clusters. This paper also discusses ethical considerations associated with this type of analysis. Results: The TABoRC is a corpus of 6,679,485 posts from 5177 Redditors, and the HiB-RC is a corpus totaling 2146 posts from 816 Redditors. The results demonstrate that, between 2012 and 2021, there was a 91.65\% average yearly increase in posts in the HiB-RC (SD 119.6\%) compared to 48.14\% in the TABoRC (SD 51.2\%) and an 86.97\% average yearly increase in users (SD 93.8\%) compared to 27.17\% in the TABoRC (SD 38.7\%). These statistics suggest that there was an increase in posting activity related to hypersexuality that exceeded the increase in general Reddit use over the same period. Several key psychological domains were identified as significant in the HiB-RC (P<.001), including more negative tone, more discussion of sex, and less discussion of wellness compared to the TABoRC. Finally, BERTopic was used to identify 9 key topics from the dataset. Conclusions: Hypersexuality is an important symptom that is discussed by people with bipolar on Reddit and needs to be systematically recognized as a symptom of this illness. This research demonstrates the utility of a computational linguistic framework and offers a high-level overview of hypersexuality in bipolar, providing empirical evidence that paves the way for a deeper understanding of hypersexuality from a lived experience perspective. ",
doi="10.2196/65632",
url="https://infodemiology.jmir.org/2025/1/e65632",
url="http://www.ncbi.nlm.nih.gov/pubmed/40053804"
}


@Article{info:doi/10.2196/64672,
author="DuPont-Reyes, J. Melissa
and Villatoro, P. Alice
and Tang, Lu",
title="Health Information Scanning and Seeking in Diverse Language, Cultural and Technological Media Among Latinx Adolescents: Cross-Sectional Study",
journal="J Med Internet Res",
year="2025",
month="Mar",
day="5",
volume="27",
pages="e64672",
keywords="adolescent behaviors",
keywords="mental health",
keywords="Latino",
keywords="social media",
keywords="adolescent",
keywords="media use",
keywords="internet use",
keywords="health information seeking",
keywords="health information scanning",
keywords="mobile phone",
abstract="Background: Continuous scientific and policy debate regarding the potential harm and/or benefit of media and social media on adolescent health has resulted, in part, from a deficiency in robust scientific evidence. Even with a lack of scientific consensus, public attitudes, and sweeping social media prohibitions have swiftly ensued. A focus on the diversity of adolescents around the world and their diverse use of language, culture, and social media is absent from these discussions. Objective: This study aims to guide communication policy and practice, including those addressing access to social media by adolescent populations. This study assesses physical and mental health information scanning and seeking behaviors across diverse language, cultural, and technological media and social media among Latinx adolescent residents in the United States. This study also explores how Latinx adolescents with mental health concerns use media and social media for support. Methods: In 2021, a cross-sectional survey was conducted among 701 US-based Latinx adolescents aged 13-20 years to assess their health-related media use. Assessments ascertained the frequency of media use and mental and physical health information scanning and seeking across various media technologies (eg, TV, podcasts, and social media) and language and cultural types (ie, Spanish, Latinx-tailored English, and general English). Linear regression models were used to estimate adjusted predicted means of mental and physical health information scanning and seeking across diverse language and cultural media types, net personal and family factors, in the full sample and by subsamples of mental health symptoms (moderate-high vs none-mild). Results: Among Latinx adolescents, media and social media use was similar across mental health symptoms. However, Latinx adolescents with moderate-high versus none-mild symptoms more often scanned general English media and social media for mental health information (P<.05), although not for physical health information. Also, Latinx adolescents with moderate-high versus none-mild symptoms more often sought mental health information on Latinx-tailored and general English media, and social media (P<.05); a similar pattern was found for physical health information seeking. In addition, Latinx adolescents with moderate-high versus none-mild symptoms often sought help from family and friends for mental and physical health problems and health care providers for mental health only (P<.05). Conclusions: While media and social media usage was similar across mental health, Latinx adolescents with moderate-high symptoms more often encountered mental health content in general English media and social media and turned to general English- and Latinx-tailored media and social media more often for their health concerns. Together these study findings suggest more prevalent and available mental health content in general English versus Spanish language and Latinx-tailored media and underscore the importance of providing accessible, quality health information across diverse language, cultural, and technological media and social networks as a viable opportunity to help improve adolescent health. ",
doi="10.2196/64672",
url="https://www.jmir.org/2025/1/e64672",
url="http://www.ncbi.nlm.nih.gov/pubmed/40053766"
}


@Article{info:doi/10.2196/63755,
author="Li, Wanxin
and Hua, Yining
and Zhou, Peilin
and Zhou, Li
and Xu, Xin
and Yang, Jie",
title="Characterizing Public Sentiments and Drug Interactions in the COVID-19 Pandemic Using Social Media: Natural Language Processing and Network Analysis",
journal="J Med Internet Res",
year="2025",
month="Mar",
day="5",
volume="27",
pages="e63755",
keywords="COVID-19",
keywords="natural language processing",
keywords="drugs",
keywords="social media",
keywords="pharmacovigilance",
keywords="public health",
abstract="Background: While the COVID-19 pandemic has induced massive discussion of available medications on social media, traditional studies focused only on limited aspects, such as public opinions, and endured reporting biases, inefficiency, and long collection times. Objective: Harnessing drug-related data posted on social media in real-time can offer insights into how the pandemic impacts drug use and monitor misinformation. This study aimed to develop a natural language processing (NLP) pipeline tailored for the analysis of social media discourse on COVID-19--related drugs. Methods: This study constructed a full pipeline for COVID-19--related drug tweet analysis, using pretrained language model--based NLP techniques as the backbone. This pipeline is architecturally composed of 4 core modules: named entity recognition and normalization to identify medical entities from relevant tweets and standardize them to uniform medication names for time trend analysis, target sentiment analysis to reveal sentiment polarities associated with the entities, topic modeling to understand underlying themes discussed by the population, and drug network analysis to dig potential adverse drug reactions (ADR) and drug-drug interactions (DDI). The pipeline was deployed to analyze tweets related to the COVID-19 pandemic and drug therapies between February 1, 2020, and April 30, 2022. Results: From a dataset comprising 169,659,956 COVID-19--related tweets from 103,682,686 users, our named entity recognition model identified 2,124,757 relevant tweets sourced from 1,800,372 unique users, and the top 5 most-discussed drugs: ivermectin, hydroxychloroquine, remdesivir, zinc, and vitamin D. Time trend analysis revealed that the public focused mostly on repurposed drugs (ie, hydroxychloroquine and ivermectin), and least on remdesivir, the only officially approved drug among the 5. Sentiment analysis of the top 5 most-discussed drugs revealed that public perception was predominantly shaped by celebrity endorsements, media hot spots, and governmental directives rather than empirical evidence of drug efficacy. Topic analysis obtained 15 general topics of overall drug-related tweets, with ``clinical treatment effects of drugs'' and ``physical symptoms'' emerging as the most frequently discussed topics. Co-occurrence matrices and complex network analysis further identified emerging patterns of DDI and ADR that could be critical for public health surveillance like better safeguarding public safety in medicines use. Conclusions: This study shows that an NLP-based pipeline can be a robust tool for large-scale public health monitoring and can offer valuable supplementary data for traditional epidemiological studies concerning DDI and ADR. The framework presented here aspires to serve as a cornerstone for future social media--based public health analytics. ",
doi="10.2196/63755",
url="https://www.jmir.org/2025/1/e63755",
url="http://www.ncbi.nlm.nih.gov/pubmed/40053730"
}


@Article{info:doi/10.2196/54543,
author="Zhang, Chunyan
and Wang, Ting
and Dong, Caixia
and Dai, Duwei
and Zhou, Linyun
and Li, Zongfang
and Xu, Songhua",
title="Exploring Psychological Trends in Populations With Chronic Obstructive Pulmonary Disease During COVID-19 and Beyond: Large-Scale Longitudinal Twitter Mining Study",
journal="J Med Internet Res",
year="2025",
month="Mar",
day="5",
volume="27",
pages="e54543",
keywords="COVID-19",
keywords="chronic obstructive pulmonary disease (COPD)",
keywords="psychological trends",
keywords="Twitter",
keywords="data mining",
keywords="deep learning",
abstract="Background: Chronic obstructive pulmonary disease (COPD) ranks among the leading causes of global mortality, and COVID-19 has intensified its challenges. Beyond the evident physical effects, the long-term psychological effects of COVID-19 are not fully understood. Objective: This study aims to unveil the long-term psychological trends and patterns in populations with COPD throughout the COVID-19 pandemic and beyond via large-scale Twitter mining. Methods: A 2-stage deep learning framework was designed in this study. The first stage involved a data retrieval procedure to identify COPD and non-COPD users and to collect their daily tweets. In the second stage, a data mining procedure leveraged various deep learning algorithms to extract demographic characteristics, hashtags, topics, and sentiments from the collected tweets. Based on these data, multiple analytical methods, namely, odds ratio (OR), difference-in-difference, and emotion pattern methods, were used to examine the psychological effects. Results: A cohort of 15,347 COPD users was identified from the data that we collected in the Twitter database, comprising over 2.5 billion tweets, spanning from January 2020 to June 2023. The attentiveness toward COPD was significantly affected by gender, age, and occupation; it was lower in females (OR 0.91, 95\% CI 0.87-0.94; P<.001) than in males, higher in adults aged 40 years and older (OR 7.23, 95\% CI 6.95-7.52; P<.001) than in those younger than 40 years, and higher in individuals with lower socioeconomic status (OR 1.66, 95\% CI 1.60-1.72; P<.001) than in those with higher socioeconomic status. Across the study duration, COPD users showed decreasing concerns for COVID-19 and increasing health-related concerns. After the middle phase of COVID-19 (July 2021), a distinct decrease in sentiments among COPD users contrasted sharply with the upward trend among non-COPD users. Notably, in the post-COVID era (June 2023), COPD users showed reduced levels of joy and trust and increased levels of fear compared to their levels of joy and trust in the middle phase of COVID-19. Moreover, males, older adults, and individuals with lower socioeconomic status showed heightened fear compared to their counterparts. Conclusions: Our data analysis results suggest that populations with COPD experienced heightened mental stress in the post-COVID era. This underscores the importance of developing tailored interventions and support systems that account for diverse population characteristics. ",
doi="10.2196/54543",
url="https://www.jmir.org/2025/1/e54543",
url="http://www.ncbi.nlm.nih.gov/pubmed/40053739"
}


@Article{info:doi/10.2196/64667,
author="Biliotti, Carolina
and Fraccaroli, Nicol{\`o}
and Puliga, Michelangelo
and Bargagli-Stoffi, J. Falco
and Riccaboni, Massimo",
title="The Impact of Stay-At-Home Mandates on Uncertainty and Sentiments: Quasi-Experimental Study",
journal="J Med Internet Res",
year="2025",
month="Mar",
day="4",
volume="27",
pages="e64667",
keywords="lockdown policy",
keywords="sentiment analysis",
keywords="uncertainty",
keywords="social media",
keywords="quasi-experiment",
abstract="Background: As the spread of the SARS-CoV-2 virus coincided with lockdown measures, it is challenging to distinguish public reactions to lockdowns from responses to COVID-19 itself. Beyond the direct impact on health, lockdowns may have worsened public sentiment toward politics and the economy or even heightened dissatisfaction with health care, imposing a significant cost on both the public and policy makers. Objective: This study aims to analyze the causal effect of COVID-19 lockdown policies on various dimensions of sentiment and uncertainty, using the Italian lockdown of February 2020 as a quasi-experiment. At the time of implementation, communities inside and just outside the lockdown area were equally exposed to COVID-19, enabling a quasi-random distribution of the lockdown. Additionally, both areas had similar socioeconomic and demographic characteristics before the lockdown, suggesting that the delineation of the strict lockdown zone approximates a randomized experiment. This approach allows us to isolate the causal effects of the lockdown on public emotions, distinguishing the impact of the policy itself from changes driven by the virus's spread. Methods: We used Twitter data (N=24,261), natural language models, and a difference-in-differences approach to compare changes in sentiment and uncertainty inside (n=1567) and outside (n=22,694) the lockdown areas before and after the lockdown began. By fine-tuning the AlBERTo (Italian BERT optimized) pretrained model, we analyzed emotions expressed in tweets from 1124 unique users. Additionally, we applied dictionary-based methods to categorize tweets into 4 dimensions---economy, health, politics, and lockdown policy---to assess the corresponding emotional reactions. This approach enabled us to measure the direct impact of local policies on public sentiment using geo-referenced social media and can be easily adapted for other policy impact analyses. Results: Our analysis shows that the lockdown had no significant effect on economic uncertainty (b=0.005, SE 0.007, t125=0.70; P=.48) or negative economic sentiment (b=--0.011, SE 0.0089, t125=--1.32; P=.19). However, it increased uncertainty about health (b=0.036, SE 0.0065, t125=5.55; P<.001) and lockdown policy (b=0.026, SE 0.006, t125=4.47; P<.001), as well as negative sentiment toward politics (b=0.025, SE 0.011, t125=2.33; P=.02), indicating that lockdowns have broad externalities beyond health. Our key findings are confirmed through a series of robustness checks. Conclusions: Our findings reveal that lockdowns have broad externalities extending beyond health. By heightening health concerns and negative political sentiment, policy makers have struggled to secure explicit public support for government measures, which may discourage future leaders from implementing timely stay-at-home policies. These results highlight the need for authorities to leverage such insights to enhance future policies and communication strategies, reducing uncertainty and mitigating social panic. ",
doi="10.2196/64667",
url="https://www.jmir.org/2025/1/e64667",
url="http://www.ncbi.nlm.nih.gov/pubmed/40053818"
}


@Article{info:doi/10.2196/63631,
author="Kim, Kwanho
and Kim, Soojong",
title="Large Language Models' Accuracy in Emulating Human Experts' Evaluation of Public Sentiments about Heated Tobacco Products on Social Media: Evaluation Study",
journal="J Med Internet Res",
year="2025",
month="Mar",
day="4",
volume="27",
pages="e63631",
keywords="heated tobacco products",
keywords="artificial intelligence",
keywords="large language models",
keywords="social media",
keywords="sentiment analysis",
keywords="ChatGPT",
keywords="generative pre-trained transformer",
keywords="GPT",
keywords="LLM",
keywords="NLP",
keywords="natural language processing",
keywords="machine learning",
keywords="language model",
keywords="sentiment",
keywords="evaluation",
keywords="tobacco",
keywords="alternative",
keywords="prevention",
keywords="nicotine",
keywords="OpenAI",
abstract="Background: Sentiment analysis of alternative tobacco products discussed on social media is crucial in tobacco control research. Large language models (LLMs) are artificial intelligence models that were trained on extensive text data to emulate the linguistic patterns of humans. LLMs may hold the potential to streamline the time-consuming and labor-intensive process of human sentiment analysis. Objective: This study aimed to examine the accuracy of LLMs in replicating human sentiment evaluation of social media messages relevant to heated tobacco products (HTPs). Methods: GPT-3.5 and GPT-4 Turbo (OpenAI) were used to classify 500 Facebook (Meta Platforms) and 500 Twitter (subsequently rebranded X) messages. Each set consisted of 200 human-labeled anti-HTPs, 200 pro-HTPs, and 100 neutral messages. The models evaluated each message up to 20 times to generate multiple response instances reporting its classification decisions. The majority of the labels from these responses were assigned as a model's decision for the message. The models' classification decisions were then compared with those of human evaluators. Results: GPT-3.5 accurately replicated human sentiment evaluation in 61.2\% of Facebook messages and 57\% of Twitter messages. GPT-4 Turbo demonstrated higher accuracies overall, with 81.7\% for Facebook messages and 77\% for Twitter messages. GPT-4 Turbo's accuracy with 3 response instances reached 99\% of the accuracy achieved with 20 response instances. GPT-4 Turbo's accuracy was higher for human-labeled anti- and pro-HTP messages compared with neutral messages. Most of the GPT-3.5 misclassifications occurred when anti- or pro-HTP messages were incorrectly classified as neutral or irrelevant by the model, whereas GPT-4 Turbo showed improvements across all sentiment categories and reduced misclassifications, especially in incorrectly categorized messages as irrelevant. Conclusions: LLMs can be used to analyze sentiment in social media messages about HTPs. Results from GPT-4 Turbo suggest that accuracy can reach approximately 80\% compared with the results of human experts, even with a small number of labeling decisions generated by the model. A potential risk of using LLMs is the misrepresentation of the overall sentiment due to the differences in accuracy across sentiment categories. Although this issue could be reduced with the newer language model, future efforts should explore the mechanisms underlying the discrepancies and how to address them systematically. ",
doi="10.2196/63631",
url="https://www.jmir.org/2025/1/e63631",
url="http://www.ncbi.nlm.nih.gov/pubmed/40053746"
}


@Article{info:doi/10.2196/67515,
author="Stimpson, P. Jim
and Srivastava, Aditi
and Tamirisa, Ketan
and Kaholokula, Keawe?aimoku Joseph
and Ortega, N. Alexander",
title="Crisis Communication About the Maui Wildfires on TikTok: Content Analysis of Engagement With Maui Wildfire--Related Posts Over 1 Year",
journal="JMIR Form Res",
year="2025",
month="Mar",
day="4",
volume="9",
pages="e67515",
keywords="social media",
keywords="public health",
keywords="disasters",
keywords="Hawaii",
keywords="media",
keywords="post",
keywords="communication",
keywords="disaster",
keywords="disaster communication",
keywords="wildfire",
keywords="information",
keywords="dissemination",
keywords="engagement",
keywords="content analysis",
keywords="content",
keywords="metrics",
keywords="misinformation",
keywords="community",
keywords="support",
abstract="Background: The August 2023 wildfire in the town of L?hain? on the island of Maui in Hawai?i caused catastrophic damage, affecting thousands of residents, and killing 102 people. Social media platforms, particularly TikTok, have become essential tools for crisis communication during disasters, providing real-time crisis updates, mobilizing relief efforts, and addressing misinformation. Understanding how disaster-related content is disseminated and engaged with on these platforms can inform strategies for improving emergency communication and community resilience. Objective: Guided by Social-Mediated Crisis Communication theory, this study examined TikTok posts related to the Maui wildfires to assess content themes, public engagement, and the effectiveness of social media in disseminating disaster-related information. Methods: TikTok posts related to the Maui wildfires were collected from August 8, 2023, to August 9, 2024. Using TikTok's search functionality, we identified and reviewed public posts that contained relevant hashtags. Posts were categorized into 3 periods: during the disaster (August 8 to August 31, 2023), the immediate aftermath (September 1 to December 31, 2023), and the long-term recovery (January 1 to August 9, 2024). Two researchers independently coded the posts into thematic categories, achieving an interrater reliability of 87\%. Engagement metrics (likes and shares) were analyzed to assess public interaction with different themes. Multivariable linear regression models were used to examine the associations between log-transformed likes and shares and independent variables, including time intervals, video length, the inclusion of music or effects, content themes, and hashtags. Results: A total of 275 TikTok posts were included in the analysis. Most posts (132/275, 48\%) occurred in the immediate aftermath, while 76 (27.6\%) were posted during the long-term recovery phase, and 24.4\% (n=67) were posted during the event. Posts during the event garnered the highest average number of likes (mean 75,092, SD 252,759) and shares (mean 10,928, SD 55,308). Posts focused on ``Impact \& Damage'' accounted for the highest engagement, representing 36.8\% (4,090,574/11,104,031) of total likes and 61.2\% (724,848/1,184,049) of total shares. ``Tourism Impact'' (2,172,991/11,104,031, 19.6\% of likes; 81,372/1,184,049, 6.9\% of shares) and ``Relief Efforts'' (509,855/11,104,031, 4.6\% of likes; 52,587/1,184,049, 4.4\% of shares) were also prominent themes. Regression analyses revealed that videos with ``Misinformation \& Fake News'' themes had the highest engagement per post, with a 4.55 coefficient for log-shares (95\% CI 2.44-6.65), while videos about ``Tourism Impact'' and ``Relief Efforts'' also showed strong engagement (coefficients for log-likes: 2.55 and 1.76, respectively). Conclusions: TikTok is an influential tool for disaster communication, amplifying both critical disaster updates and misinformation, highlighting the need for strategic content moderation and evidence-based messaging to enhance the platform's role in crisis response. Public health officials, emergency responders, and policy makers can leverage TikTok's engagement patterns to optimize communication strategies, improve real-time risk messaging, and support long-term community resilience. ",
doi="10.2196/67515",
url="https://formative.jmir.org/2025/1/e67515"
}


@Article{info:doi/10.2196/67794,
author="Wellman, L. Mariah
and Owens, M. Camilla
and Holton, E. Avery
and Kaphingst, A. Kimberly",
title="Examining BRCA Previvors' Social Media Content Creation as a Form of Self and Community Care: Qualitative Interview Study",
journal="J Med Internet Res",
year="2025",
month="Mar",
day="3",
volume="27",
pages="e67794",
keywords="BRCA",
keywords="breast cancer",
keywords="genetic testing",
keywords="social media",
keywords="breast cancer gene",
keywords="content creation",
keywords="self care",
keywords="community care",
keywords="qualitative interview",
keywords="qualitative",
keywords="interview",
keywords="previvors",
keywords="cancer previvors",
keywords="genetic mutations",
keywords="online",
keywords="content",
keywords="interviews",
keywords="thematic analysis",
abstract="Background: Genetic testing has become a common way of identifying a woman's risk of developing hereditary breast and ovarian cancer; however, not all medical providers have the necessary information to support patients interested in genetic testing, nor do they always have the proper information for patients once they have been diagnosed. Therefore, many ``previvors''---the name given to those who have tested positive for the BRCA genetic mutation---have taken to social media to inform others about the importance of genetic testing and explain to them how to understand their test results. Historically, those desiring to speak about their medical issues online have sought out structured support groups or chat rooms; however, many previvors today are instead posting on their own personal social media accounts and creating more niche communities. Objective: This study aimed to examine why BRCA previvors are sharing content on their personal social media accounts and how posting online in this way serves a purpose for their larger community. Methods: A total of 16 semistructured interviews were conducted with individuals who posted about their experience being diagnosed with the BRCA genetic mutation and their subsequent treatment on their personal social media accounts, specifically for followers interested in their medical journey. The interviews were recorded, transcribed, and coded by an experienced qualitative researcher and a graduate student using inductive techniques, and a reflexive thematic analysis was applied to the transcripts. Results: The results suggest BRCA previvors want to control the narrative around their personalized medical experiences rather than participating in existing groups or chat rooms. Controlling their own story, rather than adding to existing narratives, gives previvors a sense of control. It also allows them to set boundaries around the types of experiences they have online when sharing their medical journey. Finally, previvors said they feel they are serving the larger BRCA community by each sharing their individual journeys, to hopefully avoid stereotyping and homogenizing the experience of patients with BRCA genetic mutations. Conclusions: Research with the objective of understanding the experiences of BRCA previvors should include exploring how and why they talk about their journeys, especially due to the lack of knowledge BRCA previvors say many of their medical providers have. We suggest further research should examine how other patients with the BRCA genetic mutation, especially racial and ethnic minority patients, are navigating their own content creation, especially considering content moderation policies that social media platforms are continuing to implement that directly impact users' ability to share about their medical experiences. ",
doi="10.2196/67794",
url="https://www.jmir.org/2025/1/e67794",
url="http://www.ncbi.nlm.nih.gov/pubmed/40053732"
}


@Article{info:doi/10.2196/60891,
author="Dupuis, Roxanne
and Musicus, A. Aviva
and Edghill, Brittany
and Keteku, Emma
and Bragg, A. Marie",
title="How TikTok Influencers Disclose Food and Beverage Brand Partnerships: Descriptive Study",
journal="J Med Internet Res",
year="2025",
month="Feb",
day="28",
volume="27",
pages="e60891",
keywords="social media",
keywords="social media marketing",
keywords="social media influencer",
keywords="food and beverage marketing",
keywords="adolescent health",
abstract="Background: Food and beverage marketing is an important influence on the health and diets of adolescents. Food and beverage companies spend billions of dollars annually on advertisements to promote their products and are increasingly focusing on social media influencers. Influencer product endorsements blur the line between entertainment and marketing. Objective: This study aimed to quantify how often TikTok influencers promote products from food and beverage brands and document the range of ways they disclose brand relationships in their content. Methods: We collected up to 100 videos posted on or before July 1, 2022, from each of the top 100 influencers on TikTok in the United States and recorded information about the influencer (eg, number of followers) and video (eg, number of views and likes). For each video that contained food or beverage products, we identified the main product featured. A team of research assistants then coded each video for how the product was featured (ie, in the video, audio, or caption) and, for branded products, whether the video was accompanied by any disclosures of brand relationships. Average pairwise percentage agreement among coders was 92\%, and average pairwise Cohen $\kappa$ was 0.82. Results: Among the 8871 videos from 97 influencers that made up the final analytical sample, we identified 1360 videos (15.3\%) that featured at least one food or beverage product. These 1360 videos were viewed >9 million times and received >1 million likes each. Nearly half (n=648, 47.6\%) of the videos featured a branded product. Most videos featuring a branded product did not contain a brand relationship disclosure (n=449, 69.3\%). Among videos that disclosed a brand relationship, influencers used 10 different types of disclosures. Tagging a brand in the video's caption was the most common disclosure method (n=182, 28.1\%). Six types of caption hashtags were used to disclose brand relationships, including \#[brandname] (n=63, 9.7\%) and \#ad (n=30, 4.6\%). Only 1 video (0.2\%) made use of TikTok's official disclosure label and only 1 video (0.2\%) verbally mentioned a contractual agreement with a brand. Conclusions: Among the food and beverage videos with disclosures we identified, the most frequently used mechanism---tagging the brand---did not clearly differentiate between sponsored content and the influencer trying to attract a brand or followers who may like that brand. Social media users, particularly adolescents, need clearer, more robust disclosures from influencers to protect against the undue influence of food marketing. These findings may also inform calls for the Children's Food and Beverage Advertising Initiative---the largest self-regulatory pledge to reduce unhealthy food marketing---to include older adolescents, who are heavily targeted by food and beverage companies on social media. ",
doi="10.2196/60891",
url="https://www.jmir.org/2025/1/e60891",
url="http://www.ncbi.nlm.nih.gov/pubmed/40053812"
}


@Article{info:doi/10.2196/54847,
author="Huang, Mengxia Nova
and Wong, Ze Liang
and Ho, S. Shirley
and Timothy, Bryan",
title="Understanding Challenges and Emotions of Informal Caregivers of General Older Adults and People With Alzheimer Disease and Related Dementia: Comparative Study",
journal="J Med Internet Res",
year="2025",
month="Feb",
day="28",
volume="27",
pages="e54847",
keywords="informal caregivers",
keywords="older adults",
keywords="Alzheimer disease and related dementia",
keywords="online support communities",
keywords="Reddit",
abstract="Background: Faced with multiple challenges, informal caregivers often turn to online support communities for information and support. While scholarly attention has focused on experiences expressed by informal caregivers in these communities, how caregivers' challenges and emotional expressions vary across different health contexts remains understudied. Objective: We aimed to examine and compare the challenges discussed by informal caregivers of general older adults and those of patients with Alzheimer disease and related dementia, as well as their emotional expressions, on Reddit. In addition, we examined how informal caregivers expressed their emotions in response to various challenges. Methods: We collected posts from 6 subreddits, including 3 subreddits on caregiving for older adults and 3 on caregiving for patients with Alzheimer disease and related dementia. Using topic modeling, we identified topics discussed by caregivers in the collected posts. We further used deep reading to contextualize these topics and understand the challenges behind them, conducted sentiment analysis to investigate their emotional expressions, and used Spearman rank-order correlation to examine the relationship between the obtained topics and emotions. Results: In total, 3028 posts were retrieved, including 1552 from older adult--related subreddits and 1476 from Alzheimer disease--related subreddits; 18 key topics were identified, with the most frequent topics being expressing feelings (2178/3028, 71.93\%) and seeking advice and support (1982/3028, 65.46\%). Other topics covered various challenges in caregiving, such as duration of medical care (1954/3028, 64.53\%), sleep and incontinence (1536/3028, 50.73\%), financial issues (1348/3028, 44.52\%), and nursing home (1221/3028, 40.32\%). There was a positive, negligible correlation between expressing feelings and seeking advice and support ($\rho$=0.09, P<.001). Other topics also showed positive, negligible or weak correlations with these 2 topics but in distinct patterns. Posts from older adult--related subreddits were more focused on practical caregiving issues and seeking advice and support, whereas posts from Alzheimer disease--related subreddits emphasized health- and medical-related topics and expressing feelings. Caregivers in both contexts predominantly expressed negative emotions (older adults: 1263/1552, 81.38\%; Alzheimer disease: 1247/1476, 84.49\%), with caregivers in Alzheimer disease--related subreddits exhibiting slightly greater fear and sadness (P<.001). Specific challenges were significantly correlated with negative emotions: duration of medicalcare was positively, weakly correlated with anger ($\rho$=0.25, P<.001), fear ($\rho$=0.25, P<.001), and sadness ($\rho$=0.22, P<.001). Medical appointments were positively, negligibly correlated with anger ($\rho$=0.10, P<.001), fear ($\rho$=0.09, P<.001), and sadness ($\rho$=0.06, P<.001). Sleep and incontinence ($\rho$=0.14, P<.001) and finances ($\rho$=0.24, P<.001) were positively, weakly correlated with anger. Conclusions: By identifying the challenges and feelings expressed by caregivers for general older adults and caregivers for patients with Alzheimer disease and related dementia, our findings could inform health practitioners and policy makers in developing more targeted support interventions for informal caregivers in different contexts. ",
doi="10.2196/54847",
url="https://www.jmir.org/2025/1/e54847",
url="http://www.ncbi.nlm.nih.gov/pubmed/40053723"
}


@Article{info:doi/10.2196/64838,
author="Hwang, Jeong Hee
and Kim, Nara
and You, Yun Jeong
and Ryu, Ri Hye
and Kim, Seo-Young
and Yoon Park, Han Jung
and Lee, Won Ki",
title="Harnessing Social Media Data to Understand Information Needs About Kidney Diseases and Emotional Experiences With Disease Management: Topic and Sentiment Analysis",
journal="J Med Internet Res",
year="2025",
month="Feb",
day="25",
volume="27",
pages="e64838",
keywords="kidney diseases",
keywords="online health communities",
keywords="topic modeling",
keywords="sentiment analysis",
keywords="disease management",
keywords="patient support",
abstract="Background: Kidney diseases encompass a variety of conditions, including chronic kidney disease, acute kidney injury, glomerulonephritis, and polycystic kidney disease. These diseases significantly impact patients' quality of life and health care costs, often necessitating substantial lifestyle changes, especially regarding dietary management. However, patients frequently receive ambiguous or conflicting dietary advice from health care providers, leading them to seek information and support from online health communities. Objective: This study aimed to analyze social media data to better understand the experiences, challenges, and concerns of patients with kidney disease and their caregivers in South Korea. Specifically, it explored how online communities assist in disease management and examined the sentiment surrounding dietary management. Methods: Data were collected from KidneyCafe, a prominent South Korean online community for patients with kidney disease hosted on the Naver platform. A total of 124,211 posts from 10 disease-specific boards were analyzed using latent Dirichlet allocation for topic modeling and Bidirectional Encoder Representations From Transformers--based sentiment analysis. In addition, Efficiently Learning an Encoder That Classifies Token Replacements Accurately--based classification was used to further analyze posts related to disease management. Results: The analysis identified 6 main topics within the community: family health and support, medication and side effects, examination and diagnosis, disease management, surgery for dialysis, and costs and insurance. Sentiment analysis revealed that posts related to the medication and side effects and surgery for dialysis topics predominantly expressed negative sentiments. Both significant negative sentiments concerning worries about kidney transplantation among family members and positive sentiments regarding physical improvements after transplantation were expressed in posts about family health and support. For disease management, 7 key subtopics were identified, with inquiries about dietary management being the leading subtopic. Conclusions: The findings highlight the critical role of online communities in providing support and information for patients with kidney disease and their caregivers. The insights gained from this study can inform health care providers, policy makers, and support organizations to better address the needs of patients with kidney disease, particularly in areas related to dietary management and emotional support. ",
doi="10.2196/64838",
url="https://www.jmir.org/2025/1/e64838",
url="http://www.ncbi.nlm.nih.gov/pubmed/39998877"
}


@Article{info:doi/10.2196/64451,
author="Liu, Xingyun
and Liu, Miao
and Kang, Xin
and Han, Nuo
and Liao, Yuehan
and Ren, Zhihong",
title="More Cyberbullying, Less Happiness, and More Injustice---Psychological Changes During the Pericyberbullying Period: Quantitative Study Based on Social Media Data",
journal="J Med Internet Res",
year="2025",
month="Feb",
day="25",
volume="27",
pages="e64451",
keywords="cyberbullying",
keywords="pericyberbullying period",
keywords="social media",
keywords="well-being",
keywords="morality",
keywords="suicide risk",
keywords="personality traits",
abstract="Background: The phenomenon of cyberbullying is becoming increasingly severe, and many studies focus on the negative psychological impacts of cyberbullying survivors. However, current survey methods cannot provide direct and reliable evidence of the short-term psychological effects of cyberbullying survivors, as it is impractical to measure psychological changes before and after such an unpredictable event in a short period. Objective: This study aims to explore the psychological impacts of cyberbullying on survivors during the pericyberbullying period, defined as the critical time frame surrounding the first cyberbullying incident, encompassing the psychological changes before, during, and after the event. Methods: We collected samples from 60 cyberbullying survivors (experimental group, 94/120, 78\% female) and 60 individuals who have not experienced cyberbullying (control group, matched by sex, location, and number of followers) on Sina Weibo, a social media platform developed by Sina Corporation. During the pericyberbullying period, we retrospectively measured psychological traits 3 months before and after the first cyberbullying incident for both groups. Social media data and predictive models were used to identify survivors' internal psychological traits, including happiness, suicide risk, personality traits, and moral perceptions of the external environment. Network analysis was then performed to explore the interplay between cyberbullying experiences and psychological characteristics. Results: During the pericyberbullying period, survivors exhibited significantly reduced happiness (t59=2.14; P=.04), marginally increased suicide risk, and significant changes in the Big 5 personality traits, including decreased conscientiousness (t59=2.27; P=.03), agreeableness (t59=2.79; P=.007), and extraversion (t59=2.26; P=.03), alongside increased neuroticism (t59=--3.42; P=.001). Regarding moral perceptions of the external environment, survivors showed significant increases in communicative moral motivation (t59=--2.62; P=.011) and FairnessVice (t59=--2.20; P=.03), with a marginal rise in PurityVice (t59=--1.88; P=.07). In contrast, the control group exhibited no significant changes during the same time frame. Additionally, network analysis revealed that beyond cyberbullying experiences, core psychological characteristics in the network were neuroticism, conscientiousness, and Oxford Happiness. Conclusions: By leveraging noninvasive retrospective social media data, this study provides novel insights into the short-term psychological impacts of cyberbullying during the pericyberbullying period. The findings highlight the need for timely interventions focusing on enhancing survivors' happiness, reducing suicide risk, adjusting personality traits, and rebuilding moral cognition to mitigate the negative effects of cyberbullying. ",
doi="10.2196/64451",
url="https://www.jmir.org/2025/1/e64451",
url="http://www.ncbi.nlm.nih.gov/pubmed/39998871"
}


@Article{info:doi/10.2196/59387,
author="Rivera, M. Yonaira
and Corpuz, Kathryna
and Karver, Sanchez Tahilin",
title="Engagement With and Use of Health Information on Social Media Among US Latino Individuals: National Cross-Sectional Survey Study",
journal="J Med Internet Res",
year="2025",
month="Feb",
day="24",
volume="27",
pages="e59387",
keywords="Latinos",
keywords="health misinformation",
keywords="engagement",
keywords="utilization",
keywords="social media",
keywords="health information",
keywords="United States",
keywords="national",
keywords="trends",
keywords="survey",
keywords="pandemic",
keywords="non-Latino whites",
abstract="Background: During the COVID-19 pandemic, US Latino individuals were more likely to report accessing coronavirus information on social media than other groups, despite copious amounts of health misinformation documented on these platforms. Among the existing literature on factors associated with engagement and use of health information, racial minority status has been associated with greater susceptibility to health misinformation. However, literature to date has not reported national trends on how Latino individuals engage with or use health information on social media compared to non-Latino White (NLW) individuals, nor whether perceptions of the amount of health misinformation on social media influence health information engagement and usage. Objective: This study aimed to examine differences in engagement with and use of health information on social media among Latino and NLW individuals in the United States. Methods: We examined a nationally representative cross-sectional sample of Latino (n=827) and NLW (n=2563) respondents of the 2022 Health Information National Trends Survey who used social media in 2022 to assess differences in engagement with and use of health information. Items related to the perceived quantity of health misinformation on social media, social media use frequency, health information engagement (sharing content; watching videos), and health information usage (health decision-making; discussions with health care providers) were selected to conduct weighted bivariate analyses and logistic regressions. Results: Latino individuals perceive lower amounts of health misinformation on social media (28.9\% perceived little to no misinformation vs 13.6\% NLW individuals, P<.001). Latino audiences also reported higher health information engagement compared to NLW individuals (20\% vs 10.2\% shared information several times a month or more, P<.001; 42.4\% vs 27.2\% watched videos several times a month or more, P<.001), as well as higher information usage for health decision-making (22.8\% vs 13.7\%, P=.003). When controlling for ethnicity and other sociodemographic variables, perceiving lower amounts of health misinformation on social media was associated with higher odds of watching videos more frequently, making health decisions, and discussing health-related content with a health care provider (P<.001). Furthermore, Latino audiences were 1.85 times more likely to watch videos (P<.001), when controlling for the perceived amount of health misinformation and other sociodemographic variables. Finally, when compared to NLW individuals perceiving little to no health misinformation, Latino audiences perceiving little to no health misinformation were 2.91 times more likely to watch videos (P<.001). Conclusions: The findings suggest that Latino individuals engage with visual health (mis)information at higher rates. Digital health literacy interventions should consider video formats and preferred social media platforms among Latino individuals. Further research is warranted to understand sociocultural factors important to Latino social media users when consuming health information, as these may impact the success of digital media literacy interventions that teach users how to navigate misinformation online. ",
doi="10.2196/59387",
url="https://www.jmir.org/2025/1/e59387"
}


@Article{info:doi/10.2196/63407,
author="Chen, Yidi
and Zheng, Lei
and Ma, Jinjin
and Zhu, Huanya
and Gan, Yiqun",
title="The Mediating Role of Meaning-Making in the Relationship Between Mental Time Travel and Positive Emotions in Stress-Related Blogs: Big Data Text Analysis Research",
journal="J Med Internet Res",
year="2025",
month="Feb",
day="21",
volume="27",
pages="e63407",
keywords="stress",
keywords="meaning-making",
keywords="mental time travel",
keywords="big data",
keywords="mini meta-analysis",
keywords="text analysis",
keywords="coping mechanisim",
keywords="Weibo",
keywords="post",
keywords="web crawler",
keywords="positive emotion",
keywords="emotion",
keywords="meta-analysis",
keywords="anxiety",
keywords="depression",
keywords="mental health",
keywords="ecological momentary assessment",
keywords="EMA",
keywords="stress model",
keywords="natural language processing",
keywords="NLP",
abstract="Background: Given the ubiquity of stress, a key focus of stress research is exploring how to better coexist with stress. Objective: This study conducted text analysis on stress-related Weibo posts using a web crawler to investigate whether these posts contained positive emotions, as well as elements of mental time travel and meaning-making. A mediation model of mental time travel, meaning-making, and positive emotions was constructed to examine whether meaning-making triggered by mental time travel can foster positive emotions under stress. Methods: Using Python 3.8, the original public data from active Weibo users were crawled, yielding 331,711 stress-related posts. To avoid false positives, these posts were randomly divided into two large samples for cross-validation (sample 1: n=165,374; sample 2: n=166,337). Google's natural language processing application programming interface was used for word segmentation, followed by text and mediation analysis using the Chinese psychological analysis system ``Wenxin.'' A mini--meta-analysis of the mediation path coefficients was conducted. Text analysis identified mental time travel words, meaning-making words, and positive emotion words in stress-related posts. Results: The constructed mediation model of mental time travel words (time words), meaning-making words (causal and insightful words), and positive poststress emotions validated positive adaptation following stress. A mini--meta-analysis of two different mediation models constructed in the two subsamples indicated a stable mediation effect across the 2 random subsamples. The combined effect size (B) obtained was .013 (SE 0.003, 95\% CI 0.007-0.018; P<.001), demonstrating that meaning-making triggered by mental time travel in stress-related blog posts can predict positive emotions under stress. Conclusions: Individuals can adapt positively to stress by engaging in meaning-making processes that are triggered by mental time travel and reflected in their social media posts. The study's mediation model confirmed that mental time travel leads to meaning-making, which fosters positive emotional responses to stress. Mental time travel serves as a psychological strategy to facilitate positive adaptation to stressful situations. ",
doi="10.2196/63407",
url="https://www.jmir.org/2025/1/e63407",
url="http://www.ncbi.nlm.nih.gov/pubmed/39900590"
}


@Article{info:doi/10.2196/59417,
author="Jandu, Simi
and Carey, L. Jennifer",
title="Exploring Social Media Use Among Medical Students Applying for Residency Training: Cross-Sectional Survey Study",
journal="JMIR Med Educ",
year="2025",
month="Feb",
day="21",
volume="11",
pages="e59417",
keywords="social media",
keywords="residency recruitment",
keywords="Instagram",
keywords="Reddit",
keywords="medical students",
keywords="student",
keywords="residency",
keywords="residency training",
keywords="social media engagement",
keywords="training programs",
keywords="social media usage",
keywords="cross-sectional survey",
keywords="survey",
keywords="residency training program",
keywords="thematic analysis",
abstract="Background: Since the COVID-19 pandemic, residency candidates have moved from attending traditional in-person interviews to virtual interviews with residency training programs. This transition spurred increased social media engagement by residency candidates, in an effort to learn about prospective programs, and by residency programs, to improve recruitment efforts. There is a paucity of literature on the effectiveness of social media outreach and its impact on candidates' perceptions of residency programs. Objective: We aimed to determine patterns of social media platform usage among prospective residency candidates and social media's influence on students' perceptions of residency programs. Methods: A cross-sectional survey was administered anonymously to fourth-year medical students who successfully matched to a residency training program at a single institution in 2023. These data were analyzed using descriptive statistics, as well as thematic analysis for open-ended questions. Results: Of the 148 eligible participants, 69 (46.6\%) responded to the survey, of whom 45 (65.2\%) used social media. Widely used social media platforms were Instagram (19/40, 47.5\%) and Reddit (18/40, 45\%). Social media influenced 47.6\% (20/42) of respondents' opinions of programs and had a moderate or major effect on 26.2\% (11/42) of respondents' decisions on program ranking. Resident-faculty relations and social events showcasing camaraderie and wellness were the most desired content. Conclusions: Social media is used by the majority of residency candidates during the residency application process and influences residency program ranking. This highlights the importance of residency programs in leveraging social media usage to recruit applicants and provide information that allows the candidate to better understand the program. ",
doi="10.2196/59417",
url="https://mededu.jmir.org/2025/1/e59417"
}


@Article{info:doi/10.2196/55861,
author="Escamilla-Sanchez, Alejandro
and L{\'o}pez-Villodres, Antonio Juan
and Alba-Tercedor, Carmen
and Ortega-Jim{\'e}nez, Victoria Mar{\'i}a
and Rius-D{\'i}az, Francisca
and Sanchez-Varo, Raquel
and Berm{\'u}dez, Diego",
title="Instagram as a Tool to Improve Human Histology Learning in Medical Education: Descriptive Study",
journal="JMIR Med Educ",
year="2025",
month="Feb",
day="19",
volume="11",
pages="e55861",
keywords="medical education",
keywords="medical students",
keywords="histology",
keywords="pathology",
keywords="e-learning",
keywords="computer-based",
keywords="social media",
keywords="Instagram",
keywords="Meta",
keywords="community-oriented",
keywords="usability",
keywords="utility",
keywords="accessibility",
abstract="Background: Student development is currently taking place in an environment governed by new technologies and social media. Some platforms, such as Instagram or X (previously known as ``Twitter''), have been incorporated as additional tools for teaching and learning processes in higher education, especially in the framework of image-based applied disciplines, including radiology and pathology. Nevertheless, the role of social media in the teaching of core subjects such as histology has hardly been studied, and there are very few reports on this issue. Objective: The aim of this work was to investigate the impact of implementing social media on the ability to learn human histology. For this purpose, a set of voluntary e-learning activities was shared on Instagram as a complement to traditional face-to-face teaching. Methods: The proposal included questionnaires based on multiple-choice questions, descriptions of histological images, and schematic diagrams about the subject content. These activities were posted on an Instagram account only accessible by second-year medical students from the University of Malaga. In addition, students could share their own images taken during the laboratory practice and interact with their peers. Results: Of the students enrolled in Human Histology 2, 85.6\% (143/167) agreed to participate in the platform. Most of the students valued the initiative positively and considered it an adequate instrument to improve their final marks. Specifically, 68.5\% (98/143) of the student body regarded the multiple-choice questions and image-based questions as the most useful activities. Interestingly, there were statistically significant differences between the marks on the final exam (without considering other evaluation activities) for students who participated in the activity compared with those who did not or barely participated in the activity (P<.001). There were no significant differences by degree of participation between the more active groups. Conclusions: These results provide evidence that incorporating social media may be considered a useful, easy, and accessible tool to improve the learning of human histology in the context of medical degrees. ",
doi="10.2196/55861",
url="https://mededu.jmir.org/2025/1/e55861"
}


@Article{info:doi/10.2196/63344,
author="Srivastava, Aditi
and Stimpson, P. Jim",
title="Instagram Posts Promoting Colorectal Cancer Awareness: Content Analysis of Themes and Engagement During Colorectal Cancer Awareness Month",
journal="JMIR Form Res",
year="2025",
month="Feb",
day="19",
volume="9",
pages="e63344",
keywords="social media",
keywords="colorectal neoplasms",
keywords="early detection of cancer",
keywords="public health",
keywords="health inequities",
keywords="harnessing",
keywords="Instagram",
keywords="colorectal cancer",
keywords="colorectal cancer awareness",
keywords="content analysis",
keywords="cancer-related deaths",
keywords="detection",
keywords="screening",
keywords="mortality",
keywords="post",
keywords="early detection",
abstract="Background: Colorectal cancer (CRC) is a leading cause of cancer-related deaths worldwide, with early detection and screening being critical for reducing mortality. Social media platforms like Instagram offer a unique opportunity to raise awareness about CRC, particularly during designated awareness months. However, there is limited research on the effectiveness of CRC-related content on Instagram. Objective: This study aims to examine how Instagram is used to raise awareness about CRC during Colorectal Cancer Awareness Month by analyzing the thematic content and engagement metrics of related posts. The research seeks to identify the prevalent themes, assess audience interaction with these messages, and highlight areas for improvement in leveraging Instagram as a tool for cancer awareness campaigns. Methods: A total of 150 Instagram posts were collected based on their use of specific hashtags related to CRC awareness (\#colorectalcancer, \#colorectalcancerawareness, \#colorectalcancerawarenessmonth) during March 2024. The text and images in the posts were categorized into themes such as screening and early detection, symptoms, general awareness, risk factors, individual's experiences, representation of racial and ethnic minoritized communities, and representation of women. Engagement metrics, including the number of likes and comments, were also analyzed. Two researchers independently coded the posts, achieving high interrater reliability (Cohen $\kappa$=0.93). Results: Organizational accounts were more active, contributing 82\% (n=123) of the 150 posts, compared to 18\% (n=27) from individual users. The most frequently mentioned theme was screening and early detection, which made up 37.3\% (n=56) of all posts. General awareness came in second at 19.3\% (n=29), and risk factors came in third at 12\% (n=18). Posts about individual experiences and general awareness received the highest engagement, indicating the effectiveness of personal narratives and broad informational content. Themes related to symptoms and representation of racial and ethnic minoritized communities and women were underrepresented. Conclusions: This study highlights the potential of Instagram as a platform for promoting CRC awareness, particularly through posts about screening and early detection and personal experiences. However, there is a need for more inclusive and diverse content to ensure a broader reach and impact. ",
doi="10.2196/63344",
url="https://formative.jmir.org/2025/1/e63344"
}


@Article{info:doi/10.2196/55468,
author="Frederiksen, Steen Kristian
and Hahn-Pedersen, Julie
and Crawford, Rebecca
and Morrison, Ross
and Jeppesen, Rose
and Doward, Lynda
and Weidner, Wendy",
title="Traversing Shifting Sands---the Challenges of Caring for Someone With Alzheimer's Disease and the Impact on Care Partners: Social Media Content Analysis",
journal="J Med Internet Res",
year="2025",
month="Feb",
day="18",
volume="27",
pages="e55468",
keywords="Alzheimer disease",
keywords="caregiver",
keywords="burden",
keywords="health-related quality of life",
keywords="social media",
abstract="Background: Social media data provide a valuable opportunity to explore the effects that Alzheimer disease (AD) has on care partners, including the aspects of providing care that have the greatest impacts on their lives and well-being and their priorities for their loved ones' treatment. Objective: The objective of this social media review was to gain insight into the impact of caring for someone with AD, focusing particularly on impacts on psychological and emotional well-being, social functioning, daily life and ability to work, health-related quality of life, social functioning, and relationships. Methods: We reviewed social media posts from 4 sources---YouTube (Google), Alzheimer's Association, Alzheimer Society of Canada, and Dementia UK---to gain insights into the impact of AD on care partners. English-language posts uploaded between May 2011 and May 2021 that discussed the impact of AD on care partners were included and analyzed thematically. Results: Of the 279 posts identified, 55 posts, shared by 70 contributors (4 people living with AD and 66 care partners or family members), met the review criteria. The top 3 reported or observed impacts of AD discussed by contributors were psychological and emotional well-being (53/70, 76\%), social life and relationships (37/70, 53\%), and care partner overall health-related quality of life (27/70, 39\%). An important theme that emerged was the emotional distress and sadness (24/70, 34\%) associated with the care partners' experience of ``living bereavement'' or ``anticipatory grief.'' Contributors also reported impacts on care partners' daily life (9/70, 13\%) and work and employment (8/70, 11\%). Care partners' emotional distress was also exacerbated by loved ones' AD-related symptoms (eg, altered behavior and memory loss). Caregiving had long-term consequences for care partners, including diminished personal well-being, family and personal sacrifices, loss of employment, and unanticipated financial burdens. Conclusions: Insights from social media emphasized the psychological, emotional, professional, and financial impacts on individuals providing informal care for a person with AD and the need for improved care partner support. A comprehensive understanding of care partners' experiences is needed to capture the true impact of AD. ",
doi="10.2196/55468",
url="https://www.jmir.org/2025/1/e55468"
}


@Article{info:doi/10.2196/65031,
author="Joshi, Aditya
and Kaune, Federico Diego
and Leff, Phillip
and Fraser, Emily
and Lee, Sarah
and Harrison, Morgan
and Hazin, Moustafa",
title="Self-Reported Side Effects Associated With Selective Androgen Receptor Modulators: Social Media Data Analysis",
journal="J Med Internet Res",
year="2025",
month="Feb",
day="18",
volume="27",
pages="e65031",
keywords="selective androgen receptor modulator",
keywords="SARM",
keywords="liver toxicity",
keywords="social media",
keywords="data analysis",
keywords="anabolic",
keywords="muscle",
keywords="bone",
keywords="toxicities",
keywords="self-report",
keywords="side effect",
keywords="retrospective analysis",
keywords="public post",
keywords="Reddit",
keywords="androgen receptor ligands",
keywords="drug",
doi="10.2196/65031",
url="https://www.jmir.org/2025/1/e65031"
}


@Article{info:doi/10.2196/65699,
author="King, C. Abby
and Doueiri, N. Zakaria
and Kaulberg, Ankita
and Goldman Rosas, Lisa",
title="The Promise and Perils of Artificial Intelligence in Advancing Participatory Science and Health Equity in Public Health",
journal="JMIR Public Health Surveill",
year="2025",
month="Feb",
day="14",
volume="11",
pages="e65699",
keywords="digital health",
keywords="artificial intelligence",
keywords="community-based participatory research",
keywords="citizen science",
keywords="health equity",
keywords="societal trends",
keywords="public health",
keywords="viewpoint",
keywords="policy makers",
keywords="public participation",
keywords="information technology",
keywords="micro-level data",
keywords="macro-level data",
keywords="LLM",
keywords="natural language processing",
keywords="machine learning",
keywords="language model",
keywords="Our Voice",
doi="10.2196/65699",
url="https://publichealth.jmir.org/2025/1/e65699"
}


@Article{info:doi/10.2196/56251,
author="Beckett, Darcy
and Curtis, Rachel
and Szeto, Kimberley
and Maher, Carol",
title="Changing User Experience of Wearable Activity Monitors Over 7 Years: Repeat Cross-Sectional Survey Study",
journal="J Med Internet Res",
year="2025",
month="Feb",
day="13",
volume="27",
pages="e56251",
keywords="cross-sectional survey",
keywords="activity tracker",
keywords="user experience",
keywords="physical activity",
keywords="sleep",
keywords="diet",
keywords="health behaviour",
keywords="wearable activity trackers",
keywords="cohort",
keywords="Apple",
keywords="Fitbit",
keywords="preferences",
keywords="reliability",
keywords="accessibility",
keywords="lifestyle",
keywords="mobile phone",
abstract="Background: Lifestyle behaviors, including physical inactivity, sedentary behavior, poor sleep, and unhealthy diet, significantly impact global population health. Wearable activity trackers (WATs) have emerged as tools to enhance health behaviors; however, their effectiveness and continued use depend on their user experience. Objective: This study aims to explore changes in user experiences, preferences, and perceived impacts of WATs from 2016 to 2023. Methods: We conducted a cross-sectional online survey among an international cohort of adults (n=475, comprising 387 current and 88 former WAT users). Results were compared with a 2016 cross-sectional online survey (n=237, comprising 200 current and 37 former WAT users) using descriptive statistics and chi-square tests. The survey examined brand preference, feature usefulness, motivations, perceived health behavior change, social sharing behaviors, and technical issues. Results: In 2023, Apple (210/475, 44\%) and Fitbit (101/475, 21\%) were the most commonly used devices, compared with the 2016 survey where Fitbit (160/237, 68\%) and Garmin devices (39/237, 17\%) were most common. The median usage duration in 2023 was 18 months, significantly longer than the 7 months reported in 2016, with most users planning ongoing use. Users in both survey years reported greater improvements in physical activity than diet or sleep, despite lower improvement in physical activity in 2023 compared with 2016, contrasted with greater perceived improvements in diet and sleep. Social media sharing of WAT data notably rose to 73\% (283/387) in 2023 from 35\% (70/200) in 2016. However, reports of technical issues and discomfort increased, alongside a decrease in overall positive experiences. There was also a noticeable shift in discontinuation reasons, from having learned everything possible in 2016 to dissatisfaction in 2023. Conclusions: The study highlights significant shifts in WAT usage, including extended use and evolving preferences for brands and features. The rise in social media sharing indicates a deeper integration of WATs into everyday life. However, user feedback points to a need for enhanced design and functionality despite technological progress. These findings illustrate WAT's potential in health promotion, emphasizing the need for user-focused design in diverse populations to fully realize their benefits in enhancing health behaviors. ",
doi="10.2196/56251",
url="https://www.jmir.org/2025/1/e56251"
}


@Article{info:doi/10.2196/66702,
author="He, Lin
and Jiang, Shaoqiang
and Jiang, Tingting
and Chen, Wanjun
and Zheng, Jinlei
and Wang, Hui
and Chai, Chengliang",
title="A Comparison of Mobile Social Media Promotion and Volunteer-Driven Strategies for Community Organizations Recruiting Men Who Have Sex with Men for HIV Testing in Zhejiang Province, China: Cross-Sectional Study Based on a Large-Scale Survey",
journal="J Med Internet Res",
year="2025",
month="Feb",
day="13",
volume="27",
pages="e66702",
keywords="men who have sex with men",
keywords="MSM",
keywords="internet",
keywords="recruit",
keywords="HIV testing",
keywords="community organization",
keywords="strategy",
keywords="China",
keywords="mobile phone",
abstract="Background: China has recently implemented a strategy to promote and facilitate community organization involvement in HIV prevention among men who have sex with men (MSM). Although community-based strategies have been shown to increase HIV testing uptake, the relative effectiveness of mobile social media promotion compared with volunteer-driven recruitment remains underexplored. Limited research has investigated how these strategies differentially affect MSM who have not undergone previous HIV testing. Objective: This study aimed to compare the differences between a mobile social media promotion strategy and a volunteer-driven strategy for community organizations to recruit MSM for HIV testing. Methods: A cross-sectional study was conducted from July to December 2023 among MSM in Zhejiang Province, China. Participants aged 16 years with an HIV-negative or unknown status were recruited either through a mobile social media promotion strategy or through a volunteer-driven strategy by a community organization. They completed a questionnaire that collected information on demographics, sexual behavior, and HIV testing history. All participants were tested for HIV after completing the questionnaire. A multivariate logistic regression model was used to identify factors associated with recruitment through mobile social media promotion. Results: The study included 4600 MSM, of whom 3035 (66\%) were recruited through the mobile social media strategy. Overall, 1.4\% (66/4600) of participants tested positive for HIV, and 18.8\% (865/4600) underwent HIV testing for the first time. Recruitment via the mobile social media promotion strategy was significantly associated with several factors: having only gay sexual partners (adjusted OR [aOR] 1.23, 95\% CI 1.05-1.45), having more than 2 sexual partners in the past 3 months (aOR 1.74, 95\% CI 1.42-2.11), frequently using rush poppers during sex (aOR 1.39, 95\% CI 1.14-1.99), having a history of sexually transmitted infections (aOR 1.56, 95\% CI 1.02-2.39), having awareness of pre-exposure prophylaxis (aOR 1.42, 95\% CI 1.19-1.71), having awareness of postexposure prophylaxis (PEP; aOR 1.49, 95\% CI 1.24-1.79), using mail-in HIV self-testing kits (aOR 2.02, 95\% CI 1.77-2.31), testing HIV-positive (aOR 2.02, 95\% CI 1.10-3.72), and first-time HIV testing (aOR 1.28, 95\% CI 1.09-1.52). Conclusions: Community organizations play a critical role in expanding HIV testing and identifying undiagnosed individuals infected with HIV. Compared to the volunteer-driven outreach, mobile social media promotion strategies had a higher proportion of first-time testers and a higher rate of HIV positivity. We recommend prioritizing mobile social media strategies in regions with limited LGBTQ+ organizations or HIV health services to increase HIV testing coverage and interventions among MSM. ",
doi="10.2196/66702",
url="https://www.jmir.org/2025/1/e66702"
}


@Article{info:doi/10.2196/56038,
author="Li, Xiancheng
and Vaghi, Emanuela
and Pasi, Gabriella
and Coulson, S. Neil
and De Simoni, Anna
and Viviani, Marco
and ",
title="Understanding the Engagement and Interaction of Superusers and Regular Users in UK Respiratory Online Health Communities: Deep Learning--Based Sentiment Analysis",
journal="J Med Internet Res",
year="2025",
month="Feb",
day="13",
volume="27",
pages="e56038",
keywords="social media",
keywords="online health communities",
keywords="social network analysis",
keywords="sentiment analysis",
keywords="bio-bidirectional encoder representations from transformers",
keywords="asthma",
keywords="chronic obstructive pulmonary disease",
abstract="Background: Online health communities (OHCs) enable people with long-term conditions (LTCs) to exchange peer self-management experiential information, advice, and support. Engagement of ``superusers,'' that is, highly active users, plays a key role in holding together the community and ensuring an effective exchange of support and information. Further studies are needed to explore regular users' interactions with superusers, their sentiments during interactions, and their ultimate impact on the self-management of LTCs. Objective: This study aims to gain a better understanding of sentiment distribution and the dynamic of sentiment of posts from 2 respiratory OHCs, focusing on regular users' interaction with superusers. Methods: We conducted sentiment analysis on anonymized data from 2 UK respiratory OHCs hosted by Asthma UK (AUK), and the British Lung Foundation (BLF) charities between 2006-2016 and 2012-2016, respectively, using the Bio-Bidirectional Encoder Representation from Transformers (BioBERT), a pretrained language representation model. Given the scarcity of health-related labeled datasets, BioBERT was fine-tuned on the COVID-19 Twitter Dataset. Positive, neutral, and negative sentiments were categorized as 1, 0, and --1, respectively. The average sentiment of aggregated posts by regular users and superusers was then calculated. Superusers were identified based on a definition already used in our previous work (ie, ``the 1\% users with the largest number of posts over the observation period'') and VoteRank, (ie, users with the best spreading ability). Sentiment analyses of posts by superusers defined with both approaches were conducted for correlation. Results: The fine-tuned BioBERT model achieved an accuracy of 0.96. The sentiment of posts was predominantly positive (60\% and 65\% of overall posts in AUK and BLF, respectively), remaining stable over the years. Furthermore, there was a tendency for sentiment to become more positive over time. Overall, superusers tended to write shorter posts characterized by positive sentiment (63\% and 67\% of all posts in AUK and BLF, respectively). Superusers defined by posting activity or VoteRank largely overlapped (61\% in AUK and 79\% in BLF), showing that users who posted the most were also spreaders. Threads initiated by superusers typically encouraged regular users to reply with positive sentiments. Superusers tended to write positive replies in threads started by regular users whatever the type of sentiment of the starting post (ie, positive, neutral, or negative), compared to the replies by other regular users (62\%, 51\%, 61\% versus 55\%, 45\%, 50\% in AUK; 71\%, 62\%, 64\% versus 65\%, 56\%, 57\% in BLF, respectively; P<.001, except for neutral sentiment in AUK, where P=.36). Conclusions: Network and sentiment analyses provide insight into the key sustaining role of superusers in respiratory OHCs, showing they tend to write and trigger regular users' posts characterized by positive sentiment. ",
doi="10.2196/56038",
url="https://www.jmir.org/2025/1/e56038"
}


@Article{info:doi/10.2196/66696,
author="Chen, Sihui
and Ngai, Bik Cindy Sing
and Cheng, Cecilia
and Hu, Yangna",
title="Analyzing Themes, Sentiments, and Coping Strategies Regarding Online News Coverage of Depression in Hong Kong: Mixed Methods Study",
journal="J Med Internet Res",
year="2025",
month="Feb",
day="13",
volume="27",
pages="e66696",
keywords="online news coverage",
keywords="depression",
keywords="natural language processing",
keywords="NLP",
keywords="latent Dirichlet allocation",
keywords="LDA",
keywords="sentiment",
keywords="coping strategies",
keywords="content analysis",
abstract="Background: Depression, a highly prevalent global mental disorder, has prompted significant research concerning its association with social media use and its impact during Hong Kong's social unrest and COVID-19 pandemic. However, other mainstream media, specifically online news, has been largely overlooked. Despite extensive research conducted in countries, such as the United States, Australia, and Canada, to investigate the latent subthemes, sentiments, and coping strategies portrayed in depression-related news, the landscape in Hong Kong remains unexplored. Objective: This study aims to uncover the latent subthemes presented in the online news coverage of depression in Hong Kong, examine the sentiment conveyed in the news, and assess whether coping strategies have been provided in the news for individuals experiencing depression. Methods: This study used natural language processing (NLP) techniques, namely the latent Dirichlet allocation topic modeling and the Valence Aware Dictionary and Sentiment Reasoner (VADER) sentiment analysis, to fulfill the first and second objectives. Coping strategies were rigorously assessed and manually labeled with designated categories by content analysis. The online news was collected from February 2019 to May 2024 from Hong Kong mainstream news websites to examine the latest portrayal of depression, particularly during and after the social unrest and the COVID-19 pandemic. Results: In total, 2435 news articles were retained for data analysis after the news screening process. A total of 7 subthemes were identified based on the topic modeling results. Societal system, law enforcement, global recession, lifestyle, leisure, health issues, and US politics were the latent subthemes. Moreover, the overall news exhibited a slightly positive sentiment. The correlations between the sentiment scores and the latent subthemes indicated that the societal system, law enforcement, health issues, and US politics revealed negative tendencies, while the remainder leaned toward a positive sentiment. The coping strategies for depression were substantially lacking; however, the categories emphasizing information on skills and resources and individual adjustment to cope with depression emerged as the priority focus. Conclusions: This pioneering study used a mixed methods approach where NLP was used to investigate latent subthemes and underlying sentiment in online news. Content analysis was also performed to examine available coping strategies. The findings of this research enhance our understanding of how depression is portrayed through online news in Hong Kong and the preferable coping strategies being used to mitigate depression. The potential impact on readers was discussed. Future research is encouraged to address the mentioned implications and limitations, with recommendations to apply advanced NLP techniques to a new mental health issue case or language. ",
doi="10.2196/66696",
url="https://www.jmir.org/2025/1/e66696",
url="http://www.ncbi.nlm.nih.gov/pubmed/39946170"
}


@Article{info:doi/10.2196/62703,
author="Fridman, Ilona
and Boyles, Dahlia
and Chheda, Ria
and Baldwin-SoRelle, Carrie
and Smith, B. Angela
and Elston Lafata, Jennifer",
title="Identifying Misinformation About Unproven Cancer Treatments on Social Media Using User-Friendly Linguistic Characteristics: Content Analysis",
journal="JMIR Infodemiology",
year="2025",
month="Feb",
day="12",
volume="5",
pages="e62703",
keywords="linguistic characteristics",
keywords="linguistic features",
keywords="cancer",
keywords="Linguistic Inquiry and Word Count",
keywords="misinformation",
keywords="X",
keywords="Twitter",
keywords="alternative therapy",
keywords="oncology",
keywords="social media",
keywords="natural language processing",
keywords="machine learning",
keywords="synthesis",
keywords="review methodology",
keywords="search",
keywords="literature review",
abstract="Background: Health misinformation, prevalent in social media, poses a significant threat to individuals, particularly those dealing with serious illnesses such as cancer. The current recommendations for users on how to avoid cancer misinformation are challenging because they require users to have research skills. Objective: This study addresses this problem by identifying user-friendly characteristics of misinformation that could be easily observed by users to help them flag misinformation on social media. Methods: Using a structured review of the literature on algorithmic misinformation detection across political, social, and computer science, we assembled linguistic characteristics associated with misinformation. We then collected datasets by mining X (previously known as Twitter) posts using keywords related to unproven cancer therapies and cancer center usernames. This search, coupled with manual labeling, allowed us to create a dataset with misinformation and 2 control datasets. We used natural language processing to model linguistic characteristics within these datasets. Two experiments with 2 control datasets used predictive modeling and Lasso regression to evaluate the effectiveness of linguistic characteristics in identifying misinformation. Results: User-friendly linguistic characteristics were extracted from 88 papers. The short-listed characteristics did not yield optimal results in the first experiment but predicted misinformation with an accuracy of 73\% in the second experiment, in which posts with misinformation were compared with posts from health care systems. The linguistic characteristics that consistently negatively predicted misinformation included tentative language, location, URLs, and hashtags, while numbers, absolute language, and certainty expressions consistently predicted misinformation positively. Conclusions: This analysis resulted in user-friendly recommendations, such as exercising caution when encountering social media posts featuring unwavering assurances or specific numbers lacking references. Future studies should test the efficacy of the recommendations among information users. ",
doi="10.2196/62703",
url="https://infodemiology.jmir.org/2025/1/e62703"
}


@Article{info:doi/10.2196/68881,
author="Liu, Junyu
and Niu, Qian
and Nagai-Tanima, Momoko
and Aoyama, Tomoki",
title="Understanding Human Papillomavirus Vaccination Hesitancy in Japan Using Social Media: Content Analysis",
journal="J Med Internet Res",
year="2025",
month="Feb",
day="11",
volume="27",
pages="e68881",
keywords="human papillomavirus",
keywords="HPV",
keywords="HPV vaccine",
keywords="vaccine confidence",
keywords="large language model",
keywords="stance analysis",
keywords="topic modeling",
abstract="Background: Despite the reinstatement of proactive human papillomavirus (HPV) vaccine recommendations in 2022, Japan continues to face persistently low HPV vaccination rates, which pose significant public health challenges. Misinformation, complacency, and accessibility issues have been identified as key factors undermining vaccine uptake. Objective: This study aims to examine the evolution of public attitudes toward HPV vaccination in Japan by analyzing social media content. Specifically, we investigate the role of misinformation, public health events, and cross-vaccine attitudes (eg, COVID-19 vaccines) in shaping vaccine hesitancy over time. Methods: We collected tweets related to the HPV vaccine from 2011 to 2021. Natural language processing techniques and large language models (LLMs) were used for stance analysis of the collected data. Time series analysis and latent Dirichlet allocation topic modeling were used to identify shifts in public sentiment and topic trends over the decade. Misinformation within opposed-stance tweets was detected using LLMs. Furthermore, we analyzed the relationship between attitudes toward HPV and COVID-19 vaccines through logic analysis. Results: Among the tested models, Gemini 1.0 pro (Google) achieved the highest accuracy (0.902) for stance analysis, improving to 0.968 with hyperparameter tuning. Time series analysis identified significant shifts in public stance in 2013, 2016, and 2020, corresponding to key public health events and policy changes. Topic modeling revealed that discussions around vaccine safety peaked in 2015 before declining, while topics concerning vaccine effectiveness exhibited an opposite trend. Misinformation in topic ``Scientific Warnings and Public Health Risk'' in the sopposed-stance tweets reached a peak of 2.84\% (47/1656) in 2012 and stabilized at approximately 0.5\% from 2014 onward. The volume of tweets using HPV vaccine experiences to argue stances on COVID-19 vaccines was significantly higher than the reverse. Conclusions: Based on observation on the public attitudes toward HPV vaccination from social media contents over 10 years, our findings highlight the need for targeted public health interventions to address vaccine hesitancy in Japan. Although vaccine confidence has increased slowly, sustained efforts are necessary to ensure long-term improvements. Addressing misinformation, reducing complacency, and enhancing vaccine accessibility are key strategies for improving vaccine uptake. Some evidence suggests that confidence in one vaccine may positively influence perceptions of other vaccines. This study also demonstrated the use of LLMs in providing a comprehensive understanding of public health attitudes. Future public health strategies can benefit from these insights by designing effective interventions to boost vaccine confidence and uptake. ",
doi="10.2196/68881",
url="https://www.jmir.org/2025/1/e68881"
}


@Article{info:doi/10.2196/58227,
author="Ivanitskaya, V. Lana
and Erzikova, Elina",
title="Visualizing YouTube Commenters' Conceptions of the US Health Care System: Semantic Network Analysis Method for Evidence-Based Policy Making",
journal="JMIR Infodemiology",
year="2025",
month="Feb",
day="11",
volume="5",
pages="e58227",
keywords="social media",
keywords="semantic network",
keywords="health system",
keywords="health policy",
keywords="ideology",
keywords="VOSviewer",
keywords="health care reform",
keywords="health services",
keywords="health care workforce",
keywords="health insurance",
abstract="Background: The challenge of extracting meaningful patterns from the overwhelming noise of social media to guide decision-makers remains largely unresolved. Objective: This study aimed to evaluate the application of a semantic network method for creating an interactive visualization of social media discourse surrounding the US health care system. Methods: Building upon bibliometric approaches to conducting health studies, we repurposed the VOSviewer software program to analyze 179,193 YouTube comments about the US health care system. Using the overlay-enhanced semantic network method, we mapped the contents and structure of the commentary evoked by 53 YouTube videos uploaded in 2014 to 2023 by right-wing, left-wing, and centrist media outlets. The videos included newscasts, full-length documentaries, political satire, and stand-up comedy. We analyzed term co-occurrence network clusters, contextualized with custom-built information layers called overlays, and performed tests of the semantic network's robustness, representativeness, structural relevance, semantic accuracy, and usefulness for decision support. We examined how the comments mentioning 4 health system design concepts---universal health care, Medicare for All, single payer, and socialized medicine---were distributed across the network terms. Results: Grounded in the textual data, the macrolevel network representation unveiled complex discussions about illness and wellness; health services; ideology and society; the politics of health care agendas and reforms, market regulation, and health insurance; the health care workforce; dental care; and wait times. We observed thematic alignment between the network terms, extracted from YouTube comments, and the videos that elicited these comments. Discussions about illness and wellness persisted across time, as well as international comparisons of costs of ambulances, specialist care, prescriptions, and appointment wait times. The international comparisons were linked to commentaries with a higher concentration of British-spelled words, underscoring the global nature of the US health care discussion, which attracted domestic and global YouTube commenters. Shortages of nurses, nurse burnout, and their contributing factors (eg, shift work, nurse-to-patient staffing ratios, and corporate greed) were covered in comments with many likes. Comments about universal health care had much higher use of ideological terms than comments about single-payer health systems. Conclusions: YouTube users addressed issues of societal and policy relevance: social determinants of health, concerns for populations considered vulnerable, health equity, racism, health care quality, and access to essential health services. Versatile and applicable to health policy studies, the method presented and evaluated in our study supports evidence-based decision-making and contextualized understanding of diverse viewpoints. Interactive visualizations can help to uncover large-scale patterns and guide strategic use of analytical resources to perform qualitative research. ",
doi="10.2196/58227",
url="https://infodemiology.jmir.org/2025/1/e58227",
url="http://www.ncbi.nlm.nih.gov/pubmed/39932770"
}


@Article{info:doi/10.2196/60948,
author="Wu, Xingyue
and Lam, Sing Chun
and Hui, Ho Ka
and Loong, Ho-fung Herbert
and Zhou, Rui Keary
and Ngan, Chun-Kit
and Cheung, Ting Yin",
title="Perceptions in 3.6 Million Web-Based Posts of Online Communities on the Use of Cancer Immunotherapy: Data Mining Using BERTopic",
journal="J Med Internet Res",
year="2025",
month="Feb",
day="10",
volume="27",
pages="e60948",
keywords="social media",
keywords="cancer",
keywords="immunotherapy",
keywords="perceptions",
keywords="data mining",
keywords="oncology",
keywords="web-based",
keywords="lifestyle",
keywords="therapeutic intervention",
keywords="leukemia",
keywords="lymphoma",
keywords="survival",
keywords="treatment",
keywords="health information",
keywords="decision-making",
keywords="online community",
keywords="machine learning",
abstract="Background: Immunotherapy has become a game changer in cancer treatment. The internet has been used by patients as a platform to share personal experiences and seek medical guidance. Despite the increased utilization of immunotherapy in clinical practice, few studies have investigated the perceptions about its use by analyzing social media data. Objective: This study aims to use BERTopic (a topic modeling technique that is an extension of the Bidirectional Encoder Representation from Transformers machine learning model) to explore the perceptions of online cancer communities regarding immunotherapy. Methods: A total of 4.9 million posts were extracted from Facebook, Twitter, Reddit, and 16 online cancer-related forums. The textual data were preprocessed by natural language processing. BERTopic modeling was performed to identify topics from the posts. The effectiveness of isolating topics from the posts was evaluated using 3 metrics: topic diversity, coherence, and quality. Sentiment analysis was performed to determine the polarity of each topic and categorize them as positive or negative. Based on the topics generated through topic modeling, thematic analysis was conducted to identify themes associated with immunotherapy. Results: After data cleaning, 3.6 million posts remained for modeling. The highest overall topic quality achieved by BERTopic was 70.47\% (topic diversity: 87.86\%; topic coherence: 80.21\%). BERTopic generated 14 topics related to the perceptions of immunotherapy. The sentiment score of around 0.3 across the 14 topics suggested generally positive sentiments toward immunotherapy within the online communities. Six themes were identified, primarily covering (1) hopeful prospects offered by immunotherapy, (2) perceived effectiveness of immunotherapy, (3) complementary therapies or self-treatments, (4) financial and mental impact of undergoing immunotherapy, (5) impact on lifestyle and time schedules, and (6) side effects due to treatment. Conclusions: This study provides an overview of the multifaceted considerations essential for the application of immunotherapy as a therapeutic intervention. The topics and themes identified can serve as supporting information to facilitate physician-patient communication and the decision-making process. Furthermore, this study also demonstrates the effectiveness of BERTopic in analyzing large amounts of data to identify perceptions underlying social media and online communities. ",
doi="10.2196/60948",
url="https://www.jmir.org/2025/1/e60948"
}


@Article{info:doi/10.2196/70071,
author="BinHamdan, Hamdan Rahaf
and Alsadhan, Abdulrahman Salwa
and Gazzaz, Zohair Arwa
and AlJameel, Hassan AlBandary",
title="Social Media Use and Oral Health--Related Misconceptions in Saudi Arabia: Cross-Sectional Study",
journal="JMIR Form Res",
year="2025",
month="Feb",
day="10",
volume="9",
pages="e70071",
keywords="social media",
keywords="oral health",
keywords="health misinformation",
keywords="digital health",
keywords="Saudi Arabia",
keywords="public health",
keywords="Instagram",
keywords="Snapchat",
keywords="TikTok",
keywords="Twitter",
abstract="Background: Social media has become a central tool in health communication, offering both opportunities and challenges. In Saudi Arabia, where platforms like WhatsApp, Snapchat, and Instagram are widely used, the quality and credibility of oral health information shared digitally remain critical issues. Misconceptions about oral health can negatively influence individuals' behaviors and oral health outcomes. Objective: This study aimed to describe the patterns of social media use and estimate the prevalence of oral health--related misconceptions among adults in Saudi Arabia. Additionally, it assessed the associations between engagement with oral health information, self-reported oral health, and the presence and count of these misconceptions. Methods: A cross-sectional survey was conducted over 10 weeks, targeting adults aged 15 years and older in Saudi Arabia. Data were collected from a total sample size (n=387) via a questionnaire distributed through targeted advertisements on Instagram, TikTok, Snapchat, and X (Twitter). The prevalence of oral health--related misconceptions was estimated using descriptive statistics, including counts and percentages. Chi-square tests described sociodemographic, social media engagement, and self-reported oral health. Logistic and Poisson regression analyses were used to assess associations between engagement and self-reported oral health with misconceptions. Logistic regression models provided odds ratios and adjusted odds ratios with 95\% CI to assess the presence of oral health misconceptions. Poisson regression was used to calculate mean ratios and adjusted mean ratios (AMRs) for the count of misconceptions. Results: WhatsApp (n=344, 89.8\%) and Instagram (n=304, 78.9\%) were the most frequently used social media platforms daily. Common oral health misconceptions included beliefs that ``Pregnancy causes calcium loss in teeth'' (n=337, 87\%) and ``Dental treatment should be avoided during pregnancy'' (n=245, 63.3\%). Following dental-specific accounts was significantly associated with lower odds of having any misconceptions (adjusted odds ratio 0.41, 95\% CI 0.22-0.78) and a lower count of misconceptions (AMR 0.87, 95\% CI 0.77-0.98). Conversely, trust in social media as a source of oral health information was associated with a higher count of misconceptions (AMR 1.16, 95\% CI 1.02-1.31). Conclusions: Social media platforms are essential yet double-edged tools for oral health information dissemination in Saudi Arabia. Participants who followed dental-specific accounts had significantly lower misconceptions, while trust in social media as a source of information was linked to higher counts of misconceptions. These findings highlight the importance of promoting credible content from verified sources to combat misconceptions. Strategic collaborations with dental professionals are necessary to enhance the dissemination of accurate oral health information and public awareness and reduce the prevalence of oral health--related misconceptions. ",
doi="10.2196/70071",
url="https://formative.jmir.org/2025/1/e70071"
}


@Article{info:doi/10.2196/60862,
author="Hao, Haijing
and Lee, W. Yang
and Sharko, Marianne
and Li, Qilu
and Zhang, Yiye",
title="Privacy Concerns Versus Personalized Health Content---Pregnant Individuals' Willingness to Share Personal Health Information on Social Media: Survey Study",
journal="JMIR Form Res",
year="2025",
month="Feb",
day="10",
volume="9",
pages="e60862",
keywords="privacy concerns",
keywords="trust",
keywords="pregnancy",
keywords="health information seeking",
keywords="pregnant women",
keywords="maternal",
keywords="maternity",
keywords="childbearing",
keywords="web-based information",
keywords="health information",
keywords="mental health",
keywords="internet",
keywords="social support",
keywords="technology",
keywords="mobile health",
keywords="mHealth",
keywords="digital health",
keywords="health informatics",
keywords="social media",
abstract="Background: Often lacking immediate access to care providers, pregnant individuals frequently turn to web-based sources for information to address their evolving physical and mental health needs. Social media has gained increasing prominence as a source of news and information despite privacy concerns and unique risks posed to the pregnant population. Objectives: This study investigated the extent to which patients may be willing to disclose personal health information to social media companies in exchange for more personalized health content. Methods: We designed and deployed an electronic survey to pregnant individuals worldwide electronically in 2023. We used the classical Internet Users' Information Privacy Concerns (IUIPC) model to examine how privacy concerns modulate pregnant individuals' behaviors and beliefs regarding risk and trust when using social media for health purposes. Results were analyzed using partial least squares structural equation modeling. Results: Among 317 respondents who initiated the survey, 84\% (265/317) of the respondents remained in the study, providing complete responses. Among them, 54.7\% (145/265) indicated willingness to provide their personalized health information for receiving personalized health content via social media, while 26\% (69/265) were uncertain and 19.3\% (51/265) were opposed. Our estimated IUIPC model results are statistically significant and qualitatively align with the classic IUIPC model for the general population, which was previously found in an e-commerce context. The structural model revealed that privacy concerns (IUIPC) negatively affected trusting beliefs ($\beta$=?0.408; P<.001) and positively influenced risk beliefs ($\beta$=0.442; P<.001). Trusting beliefs negatively impacted risk beliefs ($\beta$=?o.362; P<.001) and positively affected the intention to disclose personal health information ($\beta$=o.266; P<.001). Risk beliefs negatively influenced the intention to disclose ($\beta$=?0.281; P<.001). The model explained 41.5\% of the variance in the intention to disclose personal health information (R{\texttwosuperior}=0.415). In parallel with pregnant individuals' willingness to share, we find that they have heightened privacy concerns and their use of social media for information seeking is largely impacted by their trust in the platforms. This heightened concern significantly affects both their trusting beliefs, making them less inclined to trust social media companies, and their risk beliefs, leading them to perceive greater risks in sharing personal health information. However, within this population, an increase in trust toward social media companies leads to a more substantial decrease in perceived risks than what has been previously observed in the general population. Conclusions: We find that more than half of the pregnant individuals are open to sharing their personal health information to receive personalized content about health via social media, although they have more privacy concerns than the general population. This study emphasizes the need for policy regarding the protection of health data on social media for the pregnant population and beyond. ",
doi="10.2196/60862",
url="https://formative.jmir.org/2025/1/e60862"
}


@Article{info:doi/10.2196/66446,
author="Zhang, Zhongmin
and Xu, Hengyi
and Pan, Jing
and Song, Fujian
and Chen, Ting",
title="Spatiotemporal Characteristics and Influential Factors of Electronic Cigarette Web-Based Attention in Mainland China: Time Series Observational Study",
journal="J Med Internet Res",
year="2025",
month="Feb",
day="10",
volume="27",
pages="e66446",
keywords="electronic cigarettes",
keywords="Baidu index",
keywords="web-based attention",
keywords="spatiotemporal characteristics",
keywords="China",
abstract="Background: The popularity of electronic cigarettes (e-cigarettes) has steadily increased, prompting a considerable number of individuals to search for relevant information on them. Previous e-cigarette infodemiology studies have focused on assessing the quality and reliability of website content and quantifying the impact of policies. In reality, most low-income countries and low- and middle-income countries have not yet conducted e-cigarette use surveillance. Data sourced from web-based search engines related to e-cigarettes have the potential to serve as cost-effective supplementary means to traditional monitoring approaches. Objective: This study aimed to analyze the spatiotemporal distribution characteristics and associated sociodemographic factors of e-cigarette searches using trends from the Baidu search engine. Methods: The query data related to e-cigarettes for 31 provinces in mainland China were retrieved from the Baidu index database from January 1, 2015, to December 31, 2022. Concentration ratio methods and spatial autocorrelation analysis were applied to analyze the temporal aggregation and spatial aggregation of the e-cigarette Baidu index, respectively. A variance inflation factor test was performed to avoid multicollinearity. A spatial panel econometric model was developed to assess the determinants of e-cigarette web-based attention. Results: The daily average Baidu index for e-cigarettes increased from 53,234.873 in 2015 to 85,416.995 in 2021 and then declined to 52,174.906 in 2022. This index was concentrated in the southeastern coastal region, whereas the hot spot shifted to the northwestern region after adjusting for population size. Positive spatial autocorrelation existed in the per capita Baidu index of e-cigarettes from 2015 to 2022. The results of the local Moran's I showed that there were mainly low-low cluster areas of the per capita Baidu index, especially in the central region. Furthermore, the male-female ratio, the proportion of high school and above education, and the per capita gross regional domestic product were positively correlated with the per capita Baidu index for e-cigarettes. A higher urbanization rate was associated with a reduced per capita Baidu index. Conclusions: With the increasing popularity of web-based searches for e-cigarettes, a targeted e-cigarette health education program for individuals in the northwest, males, rural populations, high school and above educated individuals, and high-income groups is warranted. ",
doi="10.2196/66446",
url="https://www.jmir.org/2025/1/e66446",
url="http://www.ncbi.nlm.nih.gov/pubmed/39928402"
}


@Article{info:doi/10.2196/53434,
author="Alshanik, Farah
and Khasawneh, Rawand
and Dalky, Alaa
and Qawasmeh, Ethar",
title="Unveiling Topics and Emotions in Arabic Tweets Surrounding the COVID-19 Pandemic: Topic Modeling and Sentiment Analysis Approach",
journal="JMIR Infodemiology",
year="2025",
month="Feb",
day="10",
volume="5",
pages="e53434",
keywords="topic modeling",
keywords="sentiment analysis",
keywords="COVID-19",
keywords="social media",
keywords="Twitter",
keywords="public discussion",
abstract="Background: The worldwide effects of the COVID-19 pandemic have been profound, and the Arab world has not been exempt from its wide-ranging consequences. Within this context, social media platforms such as Twitter have become essential for sharing information and expressing public opinions during this global crisis. Careful investigation of Arabic tweets related to COVID-19 can provide invaluable insights into the common topics and underlying sentiments that shape discussions about the COVID-19 pandemic. Objective: This study aimed to understand the concerns and feelings of Twitter users in Arabic-speaking countries about the COVID-19 pandemic. This was accomplished through analyzing the themes and sentiments that were expressed in Arabic tweets about the COVID-19 pandemic. Methods: In this study, 1 million Arabic tweets about COVID-19 posted between March 1 and March 31, 2020, were analyzed. Machine learning techniques, such as topic modeling and sentiment analysis, were applied to understand the main topics and emotions that were expressed in these tweets. Results: The analysis of Arabic tweets revealed several prominent topics related to COVID-19. The analysis identified and grouped 16 different conversation topics that were organized into eight themes: (1) preventive measures and safety, (2) medical and health care aspects, (3) government and social measures, (4) impact and numbers, (5) vaccine development and research, (6) COVID-19 and religious practices, (7) global impact of COVID-19 on sports and countries, and (8) COVID-19 and national efforts. Across all the topics identified, the prevailing sentiments regarding the spread of COVID-19 were primarily centered around anger, followed by disgust, joy, and anticipation. Notably, when conversations revolved around new COVID-19 cases and fatalities, public tweets revealed a notably heightened sense of anger in comparison to other subjects. Conclusions: The study offers valuable insights into the topics and emotions expressed in Arabic tweets related to COVID-19. It demonstrates the significance of social media platforms, particularly Twitter, in capturing the Arabic-speaking community's concerns and sentiments during the COVID-19 pandemic. The findings contribute to a deeper understanding of the prevailing discourse, enabling stakeholders to tailor effective communication strategies and address specific public concerns. This study underscores the importance of monitoring social media conversations in Arabic to support public health efforts and crisis management during the COVID-19 pandemic. ",
doi="10.2196/53434",
url="https://infodemiology.jmir.org/2025/1/e53434",
url="http://www.ncbi.nlm.nih.gov/pubmed/39928401"
}


@Article{info:doi/10.2196/64069,
author="Liu, Yingxin
and Zhang, Jingyi
and Thabane, Lehana
and Bai, Xuerui
and Kang, Lili
and Lip, H. Gregory Y.
and Van Spall, C. Harriette G.
and Xia, Min
and Li, Guowei",
title="Data-Sharing Statements Requested from Clinical Trials by Public, Environmental, and Occupational Health Journals: Cross-Sectional Study",
journal="J Med Internet Res",
year="2025",
month="Feb",
day="7",
volume="27",
pages="e64069",
keywords="data sharing",
keywords="clinical trial",
keywords="public health",
keywords="International Committee of Medical Journal Editors",
keywords="ICMJE",
keywords="journal request",
keywords="clinical trials",
keywords="decision-making",
keywords="occupational health",
keywords="health informatics",
keywords="patient data",
abstract="Background: Data sharing plays a crucial role in health informatics, contributing to improving health information systems, enhancing operational efficiency, informing policy and decision-making, and advancing public health surveillance including disease tracking. Sharing individual participant data in public, environmental, and occupational health trials can help improve public trust and support by enhancing transparent reporting and reproducibility of research findings. The International Committee of Medical Journal Editors (ICMJE) requires all papers to include a data-sharing statement. However, it is unclear whether journals in the field of public, environmental, and occupational health adhere to this requirement. Objective: This study aims to investigate whether public, environmental, and occupational health journals requested data-sharing statements from clinical trials submitted for publication. Methods: In this bibliometric survey of ``Public, Environmental, and Occupational Health'' journals, defined by the Journal Citation Reports (as of June 2023), we included 202 journals with clinical trial reports published between 2019 and 2022. The primary outcome was a journal request for a data-sharing statement, as identified in the paper submission instructions. Multivariable logistic regression analysis was conducted to evaluate the relationship between journal characteristics and journal requests for data-sharing statements, with results presented as odds ratios (ORs) and corresponding 95\% CIs. We also investigated whether the journals included a data-sharing statement in their published trial reports. Results: Among the 202 public, environmental, and occupational health journals included, there were 68 (33.7\%) journals that did not request data-sharing statements. Factors significantly associated with journal requests for data-sharing statements included open access status (OR 0.43, 95\% CI 0.19-0.97), high journal impact factor (OR 2.31, 95\% CI 1.15-4.78), endorsement of Consolidated Standards of Reporting Trials (OR 2.43, 95\% CI 1.25-4.79), and publication in the United Kingdom (OR 7.18, 95\% CI 2.61-23.4). Among the 134 journals requesting data-sharing statements, 26.9\% (36/134) did not have statements in their published trial reports. Conclusions: Over one-third of the public, environmental, and occupational health journals did not request data-sharing statements in clinical trial reports. Among those journals that requested data-sharing statements in their submission guidance pages, more than one quarter published trial reports with no data-sharing statements. These results revealed an inadequate practice of requesting data-sharing statements by public, environmental, and occupational health journals, requiring more effort at the journal level to implement ICJME recommendations on data-sharing statements. ",
doi="10.2196/64069",
url="https://www.jmir.org/2025/1/e64069"
}


@Article{info:doi/10.2196/64739,
author="Oono, Fumi
and Matsumoto, Mai
and Ogata, Risa
and Suga, Mizuki
and Murakami, Kentaro",
title="Description of Weight-Related Content and Recommended Dietary Behaviors for Weight Loss Frequently Reposted on X (Twitter) in English and Japanese: Content Analysis",
journal="J Med Internet Res",
year="2025",
month="Feb",
day="7",
volume="27",
pages="e64739",
keywords="social networking service",
keywords="X, Twitter",
keywords="web-based health information",
keywords="dieting",
keywords="weight loss",
keywords="content analysis",
keywords="digital health",
keywords="weight control",
keywords="weight",
keywords="social media",
keywords="diet",
keywords="dietary behavior",
keywords="obesity",
keywords="eating disorders",
keywords="public perceptions",
abstract="Background: Both obesity and underweight are matters of global concern. Weight-related content frequently shared on social media can reflect public recognition and affect users' behaviors and perceptions. Although X (Twitter) is a popular social media platform, few studies have revealed the content of weight-related posts or details of dietary behaviors for weight loss shared on X. Objective: This study aims to describe body weight--related content frequently reposted on X, with a particular focus on dietary behaviors for weight loss, in English and Japanese. Methods: We collected English and Japanese X posts related to human body weight having over 100 reposts in July 2023 using an application programming interface tool. Two independent researchers categorized the contents of the posts into 7 main categories and then summarized recommended weight loss strategies. Results: We analyzed 815 English and 1213 Japanese posts. The most popular main category of the content was ``how to change weight'' in both languages. The Japanese posts were more likely to mention ``how to change weight'' (n=571, 47.1\%) and ``recipes to change weight'' (n=114, 9.4\%) than the English posts (n=195, 23.9\% and n=10, 1.2\%, respectively), whereas the English posts were more likely to mention ``will or experience to change weight'' (n=167, 20.5\%), ``attitudes toward weight status'' (n=78, 9.6\%), and ``public health situation'' (n=44, 5.4\%) than Japanese posts. Among 146 English and 541 Japanese posts about weight loss strategies, the predominant strategies were diet (n=76, 52.1\% in English and n=170, 31.4\% in Japanese) and physical activities (n=56, 38.4\% and n=295, 54.5\%, respectively). The proportion of posts mentioning both diet and physical activity was smaller in Japanese (n=62, 11.5\%) than in English (n=31, 21.2\%). Among 76 English and 170 Japanese posts about dietary behaviors for weight loss, more than 60\% of posts recommended increasing intakes of specific nutrients or food groups in both languages. The most popular dietary component recommended to increase was vegetables in both English (n=31, 40.8\%) and Japanese (n=48, 28.2\%), followed by protein and fruits in English and grains or potatoes and legumes in Japanese. Japanese posts were less likely to mention reducing energy intake; meal timing or eating frequency; or reducing intakes of specific nutrients or food groups than the English posts. The most popular dietary component recommended to decrease was alcohol in English and confectioneries in Japanese. Conclusions: This study characterized user interest in weight management and suggested the potential of X as an information source for weight management. Although weight loss strategies related to diet and physical activity were popular in both English and Japanese, some differences in the details of the strategies were present, indicating that X users are exposed to different information in English and Japanese. ",
doi="10.2196/64739",
url="https://www.jmir.org/2025/1/e64739",
url="http://www.ncbi.nlm.nih.gov/pubmed/39918849"
}


@Article{info:doi/10.2196/59872,
author="Ahmed, Wasim
and Hardey, Mariann
and Vidal-Alaball, Josep",
title="Organ Donation Conversations on X and Development of the OrgReach Social Media Marketing Strategy: Social Network Analysis",
journal="J Med Internet Res",
year="2025",
month="Feb",
day="6",
volume="27",
pages="e59872",
keywords="organ donation",
keywords="organ transplant",
keywords="social media",
keywords="health",
keywords="social network analysis",
keywords="marketing strategy",
keywords="awareness",
keywords="public health",
keywords="health information",
keywords="qualitative",
keywords="thematic analysis",
keywords="NodeXL Pro",
keywords="algorithm",
keywords="elite tier",
keywords="digital health",
keywords="United Kingdom",
keywords="X",
abstract="Background: The digital landscape has become a vital platform for public health discourse, particularly concerning important topics like organ donation. With a global rise in organ transplant needs, fostering public understanding and positive attitudes toward organ donation is critical. Social media platforms, such as X, contain conversations from the public, and key stakeholders maintain an active presence on the platform. Objective: The goal is to develop insights into organ donation discussions on a popular social media platform (X) and understand the context in which users discussed organ donation advocacy. We investigate the influence of prominent profiles on X and meta-level accounts, including those seeking health information. We use credibility theory to explore the construction and impact of credibility within social media contexts in organ donation discussions. Methods: Data were retrieved from X between October 2023 and May 2024, covering a 7-month period. The study was able to retrieve a dataset with 20,124 unique users and 33,830 posts. The posts were analyzed using social network analysis and qualitative thematic analysis. NodeXL Pro was used to retrieve and analyze the data, and a network visualization was created by drawing upon the Clauset-Newman-Moore cluster algorithm and the Harel-Koren Fast Multiscale layout algorithm. Results: This analysis reveals an ``elite tier'' shaping the conversation, with themes reflecting existing societal sensitivities around organ donation. We demonstrate how prominent social media profiles act as information intermediaries, navigating the tension between open dialogue and negative perceptions. We use our findings, social credibility theory, and review of existing literature to develop the OrgReach Social Media Marketing Strategy for Organ Donation Awareness. The OrgReach strategy developed is based on 5 C's (Create, Connect, Collaborate, Correct, and Curate), 2 A's (Access and Analyse), and 3 R's (Recognize, Respond, and Reevaluate). Conclusions: The study highlights the crucial role of analyzing social media data by drawing upon social networks and topic analysis to understand influence and network communication patterns. By doing so, the study proposes the OrgReach strategy that can feed into the marketing strategies for organ donation outreach and awareness. ",
doi="10.2196/59872",
url="https://www.jmir.org/2025/1/e59872"
}


@Article{info:doi/10.2196/63864,
author="Tong, Chau
and Margolin, Drew
and Niederdeppe, Jeff
and Chunara, Rumi
and Liu, Jiawei
and Jih-Vieira, Lea
and King, J. Andy",
title="Colorectal Cancer Racial Equity Post Volume, Content, and Exposure: Observational Study Using Twitter Data",
journal="J Med Internet Res",
year="2025",
month="Feb",
day="3",
volume="27",
pages="e63864",
keywords="racial equity information",
keywords="information exposure",
keywords="health disparities",
keywords="colorectal cancer",
keywords="cancer communication",
keywords="Twitter",
keywords="X",
abstract="Background: Racial inequity in health outcomes, particularly in colorectal cancer (CRC), remains one of the most pressing issues in cancer communication and public health. Social media platforms like Twitter (now X) provide opportunities to disseminate health equity information widely, yet little is known about the availability, content, and reach of racial health equity information related to CRC on these platforms. Addressing this gap is essential to leveraging social media for equitable health communication. Objective: This study aims to analyze the volume, content, and exposure of CRC racial health equity tweets from identified CRC equity disseminator accounts on Twitter. These accounts were defined as those actively sharing information related to racial equity in CRC outcomes. By examining the behavior and impact of these disseminators, this study provides insights into how health equity content is shared and received on social media. Methods: We identified accounts that posted CRC-related content on Twitter between 2019 and 2021. Accounts were classified as CRC equity disseminators (n=798) if they followed at least 2 CRC racial equity organization accounts. We analyzed the volume and content of racial equity--related CRC tweets (n=1134) from these accounts and categorized them by account type (experts vs nonexperts). Additionally, we evaluated exposure by analyzing follower reach (n=6,266,269) and the role of broker accounts---accounts serving as unique sources of CRC racial equity information to their followers. Results: Among 19,559 tweets posted by 798 CRC equity disseminators, only 5.8\% (n=1134) mentioned racially and ethnically minoritized groups. Most of these tweets (641/1134, 57\%) addressed disparities in outcomes, while fewer emphasized actionable content, such as symptoms (11/1134, 1\%) or screening procedures (159/1134, 14\%). Expert accounts (n=479; 716 tweets) were more likely to post CRC equity tweets compared with nonexpert accounts (n=319; 418 tweets). Broker accounts (n=500), or those with a substantial portion of followers relying on them for equity-related information, demonstrated the highest capacity for exposing followers to CRC equity content, thereby extending the reach of these critical messages to underserved communities. Conclusions: This study emphasizes the critical roles played by expert and broker accounts in disseminating CRC racial equity information on social media. Despite the limited volume of equity-focused content, broker accounts were crucial in reaching otherwise unexposed audiences. Public health practitioners should focus on encouraging equity disseminators to share more actionable information, such as symptoms and screening benefits, and implement measures to amplify the reach of such content on social media. Strengthening these efforts could help bridge disparities in cancer outcomes among racially minoritized groups. ",
doi="10.2196/63864",
url="https://www.jmir.org/2025/1/e63864"
}


@Article{info:doi/10.2196/58539,
author="Arifi, Dorian
and Resch, Bernd
and Santillana, Mauricio
and Guan, Wendy Weihe
and Knoblauch, Steffen
and Lautenbach, Sven
and Jaenisch, Thomas
and Morales, Ivonne
and Havas, Clemens",
title="Geosocial Media's Early Warning Capabilities Across US County-Level Political Clusters: Observational Study",
journal="JMIR Infodemiology",
year="2025",
month="Jan",
day="30",
volume="5",
pages="e58539",
keywords="spatiotemporal epidemiology",
keywords="geo-social media data",
keywords="digital disease surveillance",
keywords="political polarization",
keywords="epidemiological early warning",
keywords="digital early warning",
abstract="Background: The novel coronavirus disease (COVID-19) sparked significant health concerns worldwide, prompting policy makers and health care experts to implement nonpharmaceutical public health interventions, such as stay-at-home orders and mask mandates, to slow the spread of the virus. While these interventions proved essential in controlling transmission, they also caused substantial economic and societal costs and should therefore be used strategically, particularly when disease activity is on the rise. In this context, geosocial media posts (posts with an explicit georeference) have been shown to provide a promising tool for anticipating moments of potential health care crises. However, previous studies on the early warning capabilities of geosocial media data have largely been constrained by coarse spatial resolutions or short temporal scopes, with limited understanding of how local political beliefs may influence these capabilities. Objective: This study aimed to assess how the epidemiological early warning capabilities of geosocial media posts for COVID-19 vary over time and across US counties with differing political beliefs. Methods: We classified US counties into 3 political clusters, democrat, republican, and swing counties, based on voting data from the last 6 federal election cycles. In these clusters, we analyzed the early warning capabilities of geosocial media posts across 6 consecutive COVID-19 waves (February 2020-April 2022). We specifically examined the temporal lag between geosocial media signals and surges in COVID-19 cases, measuring both the number of days by which the geosocial media signals preceded the surges in COVID-19 cases (temporal lag) and the correlation between their respective time series. Results: The early warning capabilities of geosocial media data differed across political clusters and COVID-19 waves. On average, geosocial media posts preceded COVID-19 cases by 21 days in republican counties compared with 14.6 days in democrat counties and 24.2 days in swing counties. In general, geosocial media posts were preceding COVID-19 cases in 5 out of 6 waves across all political clusters. However, we observed a decrease over time in the number of days that posts preceded COVID-19 cases, particularly in democrat and republican counties. Furthermore, a decline in signal strength and the impact of trending topics presented challenges for the reliability of the early warning signals. Conclusions: This study provides valuable insights into the strengths and limitations of geosocial media data as an epidemiological early warning tool, particularly highlighting how they can change across county-level political clusters. Thus, these findings indicate that future geosocial media based epidemiological early warning systems might benefit from accounting for political beliefs. In addition, the impact of declining geosocial media signal strength over time and the role of trending topics for signal reliability in early warning systems need to be assessed in future research. ",
doi="10.2196/58539",
url="https://infodemiology.jmir.org/2025/1/e58539"
}


@Article{info:doi/10.2196/54601,
author="Trevena, William
and Zhong, Xiang
and Alvarado, Michelle
and Semenov, Alexander
and Oktay, Alp
and Devlin, Devin
and Gohil, Yogesh Aarya
and Chittimouju, Harsha Sai",
title="Using Large Language Models to Detect and Understand Drug Discontinuation Events in Web-Based Forums: Development and Validation Study",
journal="J Med Internet Res",
year="2025",
month="Jan",
day="30",
volume="27",
pages="e54601",
keywords="natural language processing",
keywords="large language models",
keywords="ChatGPT",
keywords="drug discontinuation events",
keywords="zero-shot classification",
keywords="artificial intelligence",
keywords="AI",
abstract="Background: The implementation of large language models (LLMs), such as BART (Bidirectional and Auto-Regressive Transformers) and GPT-4, has revolutionized the extraction of insights from unstructured text. These advancements have expanded into health care, allowing analysis of social media for public health insights. However, the detection of drug discontinuation events (DDEs) remains underexplored. Identifying DDEs is crucial for understanding medication adherence and patient outcomes. Objective: The aim of this study is to provide a flexible framework for investigating various clinical research questions in data-sparse environments. We provide an example of the utility of this framework by identifying DDEs and their root causes in an open-source web-based forum, MedHelp, and by releasing the first open-source DDE datasets to aid further research in this domain. Methods: We used several LLMs, including GPT-4 Turbo, GPT-4o, DeBERTa (Decoding-Enhanced Bidirectional Encoder Representations from Transformer with Disentangled Attention), and BART, among others, to detect and determine the root causes of DDEs in user comments posted on MedHelp. Our study design included the use of zero-shot classification, which allows these models to make predictions without task-specific training. We split user comments into sentences and applied different classification strategies to assess the performance of these models in identifying DDEs and their root causes. Results: Among the selected models, GPT-4o performed the best at determining the root causes of DDEs, predicting only 12.9\% of root causes incorrectly (hamming loss). Among the open-source models tested, BART demonstrated the best performance in detecting DDEs, achieving an F1-score of 0.86, a false positive rate of 2.8\%, and a false negative rate of 6.5\%, all without any fine-tuning. The dataset included 10.7\% (107/1000) DDEs, emphasizing the models' robustness in an imbalanced data context. Conclusions: This study demonstrated the effectiveness of open- and closed-source LLMs, such as GPT-4o and BART, for detecting DDEs and their root causes from publicly accessible data through zero-shot classification. The robust and scalable framework we propose can aid researchers in addressing data-sparse clinical research questions. The launch of open-access DDE datasets has the potential to stimulate further research and novel discoveries in this field. ",
doi="10.2196/54601",
url="https://www.jmir.org/2025/1/e54601",
url="http://www.ncbi.nlm.nih.gov/pubmed/39883487"
}


@Article{info:doi/10.2196/55309,
author="Chan, J. Garrett
and Fung, Mark
and Warrington, Jill
and Nowak, A. Sarah",
title="Understanding Health-Related Discussions on Reddit: Development of a Topic Assignment Method and Exploratory Analysis",
journal="JMIR Form Res",
year="2025",
month="Jan",
day="29",
volume="9",
pages="e55309",
keywords="digital health",
keywords="internet",
keywords="open data",
keywords="social networking",
keywords="social media",
abstract="Background: Social media has become a widely used way for people to share opinions about health care and medical topics. Social media data can be leveraged to understand patient concerns and provide insight into why patients may turn to the internet instead of the health care system for health advice. Objective: This study aimed to develop a method to investigate Reddit posts discussing health-related conditions. Our goal was to characterize these topics and identify trends in these social media--based medical discussions. Methods: Using an initial query, we collected 1 year of Reddit posts containing the phrases ``get tested'' and ``get checked.'' These posts were manually reviewed, and subreddits containing irrelevant posts were excluded from analysis. This selection of posts was manually read by the investigators to categorize posts into topics. A script was developed to automatically assign topics to additional posts based on keywords. Topic and keyword selections were refined based on manual review for more accurate topic assignment. Topic assignment was then performed on the entire 1-year Reddit dataset containing 347,130 posts. Related topics were grouped into broader medical disciplines. Analysis of the topic assignments was then conducted to assess condition and medical topic frequencies in medical condition--focused subreddits and general subreddits. Results: We created an automated algorithm to assign medical topics to Reddit posts. By iterating through multiple rounds of topic assignment, we improved the accuracy of the algorithm. Ultimately, this algorithm created 82 topics sorted into 17 broader medical disciplines. Of all topics, sexually transmitted infections (STIs), eye disorders, anxiety, and pregnancy had the highest post frequency overall. STIs comprised 7.44\% (5876/78,980) of posts, and anxiety comprised 5.43\% (4289/78,980) of posts. A total of 34\% (28/82) of the topics comprised 80\% (63,184/78,980) of all posts. Of the medical disciplines, those with the most posts were?psychiatry and mental health;?genitourinary and reproductive health; infectious diseases;?and endocrinology, nutrition, and metabolism. Psychiatry and mental health comprised 26.6\% (21,009/78,980) of posts, and genitourinary and reproductive health comprised 13.6\% (10,741/78,980) of posts. Overall, most posts were also classified under these 4 medical disciplines. During analysis, subreddits were also classified as general if they did not focus on a specific health issue and topic-specific if they discussed a specific medical issue. Topics that appeared most frequently in the top 5 in general subreddits included addiction and drug anxiety, attention-deficit/hyperactivity disorder, abuse, and STIs. In topic-specific subreddits, most posts were found to discuss the topic of that subreddit. Conclusions: Certain health topics and medical disciplines are predominant on Reddit. These include topics such as STIs, eye disorders, anxiety, and pregnancy. Most posts were classified under the medical disciplines of psychiatry and mental health, as well as genitourinary and reproductive health. ",
doi="10.2196/55309",
url="https://formative.jmir.org/2025/1/e55309",
url="http://www.ncbi.nlm.nih.gov/pubmed/39879094"
}


@Article{info:doi/10.2196/52886,
author="Spiegel, Y. Daphna
and Friesner, D. Isabel
and Zhang, William
and Zack, Travis
and Yan, Gianna
and Willcox, Julia
and Prionas, Nicolas
and Singer, Lisa
and Park, Catherine
and Hong, C. Julian",
title="Exploring the Social Media Discussion of Breast Cancer Treatment Choices: Quantitative Natural Language Processing Study",
journal="JMIR Cancer",
year="2025",
month="Jan",
day="28",
volume="11",
pages="e52886",
keywords="breast cancer",
keywords="social media",
keywords="patient decision-making",
keywords="natural language processing",
keywords="breast conservation",
keywords="mastectomy",
abstract="Background: Early-stage breast cancer has the complex challenge of carrying a favorable prognosis with multiple treatment options, including breast-conserving surgery (BCS) or mastectomy. Social media is increasingly used as a source of information and as a decision tool for patients, and awareness of these conversations is important for patient counseling. Objective: The goal of this study was to compare sentiments and associated emotions in social media discussions surrounding BCS and mastectomy using natural language processing (NLP). Methods: Reddit posts and comments from the Reddit subreddit r/breastcancer and associated metadata were collected using pushshift.io. Overall, 105,231 paragraphs across 59,416 posts and comments from 2011 to 2021 were collected and analyzed. Paragraphs were processed through the Apache Clinical Text Analysis Knowledge Extraction System and identified as discussing BCS or mastectomy based on physician-defined Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT) concepts. Paragraphs were analyzed with a VADER (Valence Aware Dictionary for Sentiment Reasoning) compound sentiment score (ranging from ?1 to 1, corresponding to negativity or positivity) and GoEmotions scores (0?1) corresponding to the intensity of 27 different emotions and neutrality. Results: Of the 105,231 paragraphs, there were 7306 (6.94\% of those analyzed) paragraphs mentioning BCS and mastectomy (2729 and 5476, respectively). Discussion of both increased over time, with BCS outpacing mastectomy. The median sentiment score for all discussions analyzed in aggregate became more positive over time. In specific analyses by topic, positive sentiments for discussions with mastectomy mentions increased over time; however, discussions with BCS-specific mentions did not show a similar trend and remained overall neutral. Compared to BCS, conversations about mastectomy tended to have more positive sentiments. The most commonly identified emotions included neutrality, gratitude, caring, approval, and optimism. Anger, annoyance, disappointment, disgust, and joy increased for BCS over time. Conclusions: Patients are increasingly participating in breast cancer therapy discussions with a web-based community. While discussions surrounding mastectomy became increasingly positive, BCS discussions did not show the same trend. This mirrors national clinical trends in the United States, with the increasing use of mastectomy over BCS in early-stage breast cancer. Recognizing sentiments and emotions surrounding the decision-making process can facilitate patient-centric and emotionally sensitive treatment recommendations. ",
doi="10.2196/52886",
url="https://cancer.jmir.org/2025/1/e52886"
}


@Article{info:doi/10.2196/64561,
author="Sablewski, Armin
and Eimer, Christine
and Nemeth, Marcus
and Miller, Clemens",
title="Preoperative Anxiety Management Practices in Pediatric Anesthesia: Comparative Analysis of an Online Survey Presented to Experts and Social Media Users",
journal="JMIR Pediatr Parent",
year="2025",
month="Jan",
day="27",
volume="8",
pages="e64561",
keywords="pediatric anesthesia",
keywords="pharmacological interventions",
keywords="nonpharmacological interventions",
keywords="preoperative",
keywords="anxiety",
keywords="anxiety management",
keywords="practices",
keywords="anesthesia",
keywords="comparative analysis",
keywords="online survey",
keywords="preoperative anxiety",
keywords="challenges",
keywords="postoperative outcome",
keywords="pediatric",
keywords="infant",
keywords="baby",
keywords="neonatal",
keywords="toddler",
keywords="child",
keywords="social media",
keywords="survey",
keywords="anesthesia provider",
abstract="Background: Managing preoperative anxiety in pediatric anesthesia is challenging, as it impacts patient cooperation and postoperative outcomes. Both pharmacological and nonpharmacological interventions are used to reduce children's anxiety levels. However, the optimal approach remains debated, with evidence-based guidelines still lacking. Health care professionals using social media as a source of medical expertise may offer insights into their management approaches. Objective: A public survey targeting health care professionals was disseminated via social media platforms to evaluate current practices in anxiety management in children. The same questions were posed during an annual meeting of pediatric anesthesiologists with their responses serving as reference. The primary objective was to compare pediatric anesthesia expertise between the groups, while secondary objectives focused on identifying similarities and differences in preoperative anxiety management strategies hypothesizing expertise differences between the groups. Methods: Two surveys were conducted. The first survey targeted 100 attendees of the German Scientific Working Group on Pediatric Anesthesia in June 2023 forming the ``Expert Group'' (EG). The second open survey was disseminated on social media using a snowball sampling approach, targeting followers of a pediatric anesthesia platform to form the ``Social Media Group'' (SG). The answers to the 24 questions were compared and statistically analyzed. Questions were grouped into 5 categories (pediatric anesthesia expertise, representativity, structural conditions, practices of pharmacological management, and practices in nonpharmacological management). Results: A total of 194 responses were analyzed (82 in EG and 112 in SG). The EG cohort exhibited significantly greater professional experience in pediatric anesthesia than the SG cohort (median 19 vs 10 y, P<.001), higher specialist status (97.6\% vs 64.6\%, P<.001), and a greater pediatric anesthesia volume (43.9\% vs 12\% with more than 500 cases per year, P<.001). Regarding the representativity, 2 items out of 4 were statistically significant (level of care of institution, annual caseload of institution). Regarding the overall anxiety management practices used, there is a heterogeneous response pattern within both groups. Conclusions: Despite heterogeneous approaches, health care professionals using social media demonstrated less expertise in pediatric anesthesia but showed minimal differences in the daily management of preoperative anxiety compared with pediatric anesthesia experts. Our study highlights the potential for meaningful use of social media but future studies should explore the impact of social media health care professionals' knowledge in other specific topics. Additionally, regarding preoperative anxiety, further recommendations are needed that could help to standardize and improve anxiety levels in children. ",
doi="10.2196/64561",
url="https://pediatrics.jmir.org/2025/1/e64561"
}


@Article{info:doi/10.2196/58656,
author="Kahlawi, Adham
and Masri, Firas
and Ahmed, Wasim
and Vidal-Alaball, Josep",
title="Cross-Cultural Sense-Making of Global Health Crises: A Text Mining Study of Public Opinions on Social Media Related to the COVID-19 Pandemic in Developed and Developing Economies",
journal="J Med Internet Res",
year="2025",
month="Jan",
day="27",
volume="27",
pages="e58656",
keywords="COVID-19",
keywords="SARS-CoV-2",
keywords="pandemic",
keywords="citizen opinion",
keywords="text mining",
keywords="LDA",
keywords="health crisis",
keywords="developing economies",
keywords="Italy",
keywords="Egypt",
keywords="UK",
keywords="dataset",
keywords="content analysis",
keywords="social media",
keywords="twitter",
keywords="tweet",
keywords="sentiment",
keywords="attitude",
keywords="perception",
keywords="perspective",
keywords="machine learning",
keywords="latent Dirichlet allocation",
keywords="vaccine",
keywords="vaccination",
keywords="public health",
keywords="infectious",
abstract="Background: The COVID-19 pandemic reshaped social dynamics, fostering reliance on social media for information, connection, and collective sense-making. Understanding how citizens navigate a global health crisis in varying cultural and economic contexts is crucial for effective crisis communication. Objective: This study examines the evolution of citizen collective sense-making during the COVID-19 pandemic by analyzing social media discourse across Italy, the United Kingdom, and Egypt, representing diverse economic and cultural contexts. Methods: A total of 755,215 social media posts from X (formerly Twitter) were collected across 3 time periods: the virus' emergence (February 15 to March 31, 2020), strict lockdown (April 1 to May 30, 2020), and the vaccine rollout (December 1, 2020 to January 15, 2021). In total, 284,512 posts from Italy, 261,978 posts from the United Kingdom, and 209,725 posts from Egypt were analyzed using the latent Dirichlet allocation algorithm to identify key thematic topics and track shifts in discourse across time and regions. Results: The analysis revealed significant regional and temporal differences in collective sense-making during the pandemic. In Italy and the United Kingdom, public discourse prominently addressed pragmatic health care measures and government interventions, reflecting higher institutional trust. By contrast, discussions in Egypt were more focused on religious and political themes, highlighting skepticism toward governmental capacity and reliance on alternative frameworks for understanding the crisis. Over time, all 3 countries displayed a shift in discourse toward vaccine-related topics during the later phase of the pandemic, highlighting its global significance. Misinformation emerged as a recurrent theme across regions, demonstrating the need for proactive measures to ensure accurate information dissemination. These findings emphasize the role of cultural, economic, and institutional factors in shaping public responses during health crises. Conclusions: Crisis communication is influenced by cultural, economic, and institutional contexts, as evidenced by regional variations in citizen engagement. Transparent and culturally adaptive communication strategies are essential to combat misinformation and build public trust. This study highlights the importance of tailoring crisis responses to local contexts to improve compliance and collective resilience. ",
doi="10.2196/58656",
url="https://www.jmir.org/2025/1/e58656"
}


@Article{info:doi/10.2196/66769,
author="Couto, Leticia",
title="The Development of an Instagram Reel-Based Bystander Intervention Message Among College Students: Formative Survey and Mixed Methods Pilot Study",
journal="JMIR Form Res",
year="2025",
month="Jan",
day="27",
volume="9",
pages="e66769",
keywords="bystander intervention",
keywords="message development",
keywords="sexual health",
keywords="college",
keywords="student",
keywords="sexual violence",
keywords="bystander",
keywords="reel-based",
keywords="Instagram",
keywords="social media",
keywords="short message",
keywords="formative research",
keywords="mixed methods",
keywords="social norms",
keywords="perceived behavior",
keywords="qualitative",
keywords="behavioral health",
keywords="digital health",
abstract="Background: Bystander intervention is a common method to address the ubiquitous issue that is sexual violence across college campuses. Short messages that incentivize bystander intervention behavior can be another tool to fight sexual violence. Objective: This study aimed to conduct formative research surrounding social norms and bystander barriers to pilot and develop Instagram (Meta) reel-based messages addressing bystander intervention among college students. Methods: The first step was to conduct a formative survey to identify peer norms and actual behavior of the intended population. Once that data were collected, a mixed methods message pilot was conducted by a survey where participants randomly saw 5 of the 12 messages developed, assessing them for credibility, perceived message effect, and intended audience. Results: The formative survey was conducted among 195 college students from the same institution, and the pilot test was conducted among 107 college students. The formative survey indicated a discrepancy between perceived peer behavior and actual behavior of the participants in all 3 measures, allowing for the development of normative messaging. The pilot testing indicated the credibility was acceptable (eg, mean 3.94, SD 1.15 on a 5-point scale) as well as the perceived message effect (eg, mean 4.26, SD 0.94 on a 5-point scale). Intended audiences were also identified and reached. Qualitative results indicated that the messages may have lacked credibility, although the quantitative results suggest otherwise. Conclusions: Participants understood the messages concerned bystander intervention, and perceived message effects results indicated the messages to be effective in assisting bystander intervention engagement by normative messaging. Messages were considered credible and reached the intended audience. The qualitative results provided further insights on how the messages can be adapted before being tested for effects. Future research should focus on further adapting the messages and testing their effects among the studied population. ",
doi="10.2196/66769",
url="https://formative.jmir.org/2025/1/e66769"
}


@Article{info:doi/10.2196/65631,
author="Kuo, Hsin-Yu
and Chen, Su-Yen",
title="Predicting User Engagement in Health Misinformation Correction on Social Media Platforms in Taiwan: Content Analysis and Text Mining Study",
journal="J Med Internet Res",
year="2025",
month="Jan",
day="23",
volume="27",
pages="e65631",
keywords="health misinformation",
keywords="misinformation correction",
keywords="fact-checking",
keywords="content analysis",
keywords="text mining",
keywords="fuzzy-trace theory",
keywords="social media",
keywords="large language models",
keywords="user engagement",
keywords="health communication",
abstract="Background: Health misinformation undermines responses to health crises, with social media amplifying the issue. Although organizations work to correct misinformation, challenges persist due to reasons such as the difficulty of effectively sharing corrections and information being overwhelming. At the same time, social media offers valuable interactive data, enabling researchers to analyze user engagement with health misinformation corrections and refine content design strategies. Objective: This study aimed to identify the attributes of correction posts and user engagement and investigate (1) the trend of user engagement with health misinformation correction during 3 years of the COVID-19 pandemic; (2) the relationship between post attributes and user engagement in sharing and reactions; and (3) the content generated by user comments serving as additional information attached to the post, affecting user engagement in sharing and reactions. Methods: Data were collected from the Facebook pages of a fact-checking organization and a health agency from January 2020 to December 2022. A total of 1424 posts and 67,378 corresponding comments were analyzed. The posts were manually annotated by developing a research framework based on the fuzzy-trace theory, categorizing information into ``gist'' and ``verbatim'' representations. Three types of gist representations were examined: risk (risks associated with misinformation), awareness (awareness of misinformation), and value (value in health promotion). Furthermore, 3 types of verbatim representations were identified: numeric (numeric and statistical bases for correction), authority (authority from experts, scholars, or institutions), and facts (facts with varying levels of detail). The basic metrics of user engagement included shares, reactions, and comments as the primary dependent variables. Moreover, this study examined user comments and classified engagement as cognitive (knowledge-based, critical, and bias-based) or emotional (positive, negative, and neutral). Statistical analyses were performed to explore the impact of post attributes on user engagement. Results: On the basis of the results of the regression analysis, risk ($\beta$=.07; P=.001), awareness ($\beta$=.09; P<.001), and facts ($\beta$=.14; P<.001) predicted higher shares; awareness ($\beta$=.07; P=.001) and facts ($\beta$=.24; P<.001) increased reactions; and awareness ($\beta$=.06; P=.005), numeric representations ($\beta$=.06; P=.02), and facts ($\beta$=.19; P<.001) increased comments. All 3 gist representations significantly predicted shares (risk: $\beta$=.08; P<.001, awareness: $\beta$=.08; P<.001, and value: $\beta$=.06; P<.001) and reactions (risk: $\beta$=.04; P=.007, awareness: $\beta$=.06; P<.001, and value: $\beta$=.05; P<.001) when considering comment content. In addition, comments with bias-based engagement ($\beta$=--.11; P=.001) negatively predicted shares. Generally, posts providing gist attributes, especially awareness of misinformation, were beneficial for user engagement in misinformation correction. Conclusions: This study enriches the theoretical understanding of the relationship between post attributes and user engagement within web-based communication efforts to correct health misinformation. These findings provide a foundation for designing more effective content approaches to combat misinformation and strengthen public health communication. ",
doi="10.2196/65631",
url="https://www.jmir.org/2025/1/e65631",
url="http://www.ncbi.nlm.nih.gov/pubmed/39847418"
}


@Article{info:doi/10.2196/65561,
author="Iyer, S. Maya
and Moe, Aubrey
and Massick, Susan
and Davis, Jessica
and Ballinger, Megan
and Townsend, Kristy",
title="Development of the Big Ten Academic Alliance Collaborative for Women in Medicine and Biomedical Science: ``We Built the Airplane While Flying It''",
journal="JMIR Form Res",
year="2025",
month="Jan",
day="23",
volume="9",
pages="e65561",
keywords="collaborative",
keywords="gender equity",
keywords="women in medicine",
keywords="women in science",
keywords="biomedical science",
keywords="women",
keywords="women+",
keywords="gender",
keywords="medicine",
keywords="university",
keywords="faculty",
keywords="accessibility",
keywords="career",
keywords="equity",
keywords="networking",
keywords="opportunity",
keywords="retaining",
keywords="programming",
keywords="Big Ten Academic Alliance",
keywords="BTAA",
keywords="academic alliance",
doi="10.2196/65561",
url="https://formative.jmir.org/2025/1/e65561"
}


@Article{info:doi/10.2196/58310,
author="Lamprell, Klay
and Pulido, Fajardo Diana
and Arnolda, Gaston
and Easpaig, Giolla Br{\'o}na Nic
and Tran, Yvonne
and Braithwaite, Jeffrey",
title="From Stories to Solutions: A Research Cycle Framework for Enhancing Trustworthiness in Studies of Online Patient Narratives",
journal="J Med Internet Res",
year="2025",
month="Jan",
day="23",
volume="27",
pages="e58310",
keywords="online research",
keywords="exploratory study",
keywords="patient experience",
keywords="patient narratives",
keywords="narrative analysis",
keywords="mixed methods",
keywords="young-onset colorectal cancer",
keywords="cancer",
keywords="oncology",
keywords="internal medicine",
abstract="International Registered Report Identifier (IRRID): RR2-10.2196/25056 ",
doi="10.2196/58310",
url="https://www.jmir.org/2025/1/e58310",
url="http://www.ncbi.nlm.nih.gov/pubmed/39847425"
}


@Article{info:doi/10.2196/68198,
author="Bazzano, N. Alessandra
and Mantsios, Andrea
and Mattei, Nicholas
and Kosorok, R. Michael
and Culotta, Aron",
title="AI Can Be a Powerful Social Innovation for Public Health if Community Engagement Is at the Core",
journal="J Med Internet Res",
year="2025",
month="Jan",
day="22",
volume="27",
pages="e68198",
keywords="Artificial Intelligence",
keywords="Generative Artificial Intelligence",
keywords="Citizen Science",
keywords="Community Participation",
keywords="Innovation Diffusion",
doi="10.2196/68198",
url="https://www.jmir.org/2025/1/e68198",
url="http://www.ncbi.nlm.nih.gov/pubmed/39841529"
}


@Article{info:doi/10.2196/65372,
author="Liao, Jiaman
and Huang, Xueliang
and Huang, Hao
and Shen, Cuina
and Li, Lixia
and Li, Yushao
and Zhan, Yiqiang",
title="Analysis of ``Dr Ding Xiang'' on WeChat in China to Determine Factors Influencing Readership on Medical Social Media: Observational Study",
journal="J Med Internet Res",
year="2025",
month="Jan",
day="20",
volume="27",
pages="e65372",
keywords="WeChat Official Accounts",
keywords="Dr Ding Xiang",
keywords="health communication",
keywords="information dissemination",
keywords="readership analysis",
abstract="Background: With the rapid expansion of social media platforms, the demand for health information has increased substantially, leading to innovative approaches and new opportunities in health education. Objective: This study aims to analyze the characteristics of articles published on the ``Dr Ding Xiang'' WeChat official account (WOA), one of the most popular institutional accounts on the WeChat platform, to identify factors influencing readership engagement and to propose strategies for enhancing the effectiveness of health information dissemination. Methods: A total of 5286 articles published on the ``Dr Ding Xiang'' WOA from January 2021 to December 2021 were collected and analyzed. Additionally, a random sample of 324 articles was selected for detailed text analysis. Univariate analysis was conducted using the chi-square test, and multivariate analysis was performed using multivariable logistic regression. Results: In 2021, the total number of reads for ``Dr Ding Xiang'' articles reached 323,479,841, with an average of 61,196 reads per article. Articles exceeding 100,000 reads accounted for 33.90\% of the total. Most articles were published during the time slots of 8:00-10:00 AM, 11:30 AM to 1:30 PM, and 8:30-10:30 PM. Analysis indicated that the order of publication, style of the title sentence, number of likes, number of in-views, total likes on comments, and number of replies to comments were significantly associated with an article's number of reads. Text analysis further revealed that the article's reasoning approaches and concluding methods also had a significant impact on readership. Conclusions: To enhance readership and the effectiveness of health communication, health-focused WOAs should consider key factors such as optimal publication timing, engaging title design, and effective content structuring. Attention to these elements can improve user engagement and support the broader dissemination of health information. ",
doi="10.2196/65372",
url="https://www.jmir.org/2025/1/e65372"
}


@Article{info:doi/10.2196/56945,
author="Leaune, Edouard
and Bislimi, Kushtrim
and Lau-Ta{\"i}, Pauline
and Rouz{\'e}, H{\'e}lo{\"i}se
and Chalancon, Benoit
and Lestienne, Laur{\`e}ne
and Grandgenevre, Pierre
and Morgi{\`e}ve, Margot
and Laplace, Nathalie
and Vaiva, Guillaume
and Haesebaert, Julie
and Poulet, Emmanuel",
title="Codeveloping an Online Resource for People Bereaved by Suicide: Mixed Methods User-Centered Study",
journal="JMIR Ment Health",
year="2025",
month="Jan",
day="20",
volume="12",
pages="e56945",
keywords="suicide bereavement",
keywords="social media",
keywords="mixed methods",
keywords="participatory",
keywords="user-centered",
keywords="mobile phone",
keywords="online resource",
keywords="suicide",
keywords="risk",
keywords="suicidal behaviors",
keywords="mental health",
keywords="impairments",
keywords="adaptive online resource",
keywords="Information System Research",
keywords="France",
abstract="Background: Although suicide bereavement is highly distressing and is associated with an increased risk of suicidal behaviors and mental and physical health impairments, those bereaved by suicide encounter difficulties accessing support. Digital resources offer new forms of support for bereaved people. However, digital resources dedicated to those bereaved by suicide are still limited. Objective: This paper aimed to develop and implement an evidence-based, innovative, and adaptive online resource for people bereaved by suicide, based on their needs and expectations. Methods: We performed a mixed methods, participatory, user-centered study seeking to build resources from the perspectives of people bereaved by suicide and professionals or volunteers working in the field of postvention. We used the Information System Research framework, which uses a three-stage research cycle, including (1) the relevance cycle, (2) the design cycle, and (3) the rigor cycle, and the Design Science Research framework. Results: A total of 478 people participated in the study, including 451 people bereaved by suicide, 8 members of charities, and 19 mental health professionals working in the field of postvention. The development stage of the resource lasted 18 months, from October 2021 to March 2023. A total of 9 focus groups, 1 online survey, 30 usability tests, and 30 semistructured interviews were performed. A website for people bereaved by suicide named ``espoir-suicide'' was developed that includes (1) evidence-based information on suicide prevention and bereavement, (2) testimonies of people bereaved by suicide, (3) a delayed chat to ask questions on suicide and bereavement to a specialized team of mental health professionals, and (4) an interactive nationwide resource directory. The mean system usability score was 90.3 out of 100 for 30 participants, with 93\% (n=28) of them having a rating above 80. Since the implementation of espoir-suicide in March 2023, a total of 19,400 connections have been recorded, 117 local resources have been registered nationwide, and 73 questions have been posted in the chat. Conclusions: The use of a mixed methods, participatory, user-centered design allowed us to implement an evidence-based, innovative, and functional website for people bereaved by suicide that was highly relevant for fulfilling the needs and expectations of French people bereaved by suicide. International Registered Report Identifier (IRRID): RR2-10.3389/fpsyt.2021.770154 ",
doi="10.2196/56945",
url="https://mental.jmir.org/2025/1/e56945"
}


@Article{info:doi/10.2196/65434,
author="Bouktif, Salah
and Khanday, Din Akib Mohi Ud
and Ouni, Ali",
title="Explainable Predictive Model for Suicidal Ideation During COVID-19: Social Media Discourse Study",
journal="J Med Internet Res",
year="2025",
month="Jan",
day="17",
volume="27",
pages="e65434",
keywords="COVID-19",
keywords="suicide",
keywords="social networking sites",
keywords="deep learning",
keywords="explainable artificial intelligence",
keywords="suicidal ideation",
keywords="artificial intelligence",
keywords="AI",
keywords="social media",
keywords="predictive model",
keywords="mental health",
keywords="pandemic",
keywords="natural language processing",
keywords="NLP",
keywords="suicidal thought",
keywords="deep neural network approach",
abstract="Background: Studying the impact of COVID-19 on mental health is both compelling and imperative for the health care system's preparedness development. Discovering how pandemic conditions and governmental strategies and measures have impacted mental health is a challenging task. Mental health issues, such as depression and suicidal tendency, are traditionally explored through psychological battery tests and clinical procedures. To address the stigma associated with mental illness, social media is used to examine language patterns in posts related to suicide. This strategy enhances the comprehension and interpretation of suicidal ideation. Despite easy expression via social media, suicidal thoughts remain sensitive and complex to comprehend and detect. Suicidal ideation captures the new suicidal statements used during the COVID-19 pandemic that represents a different context of expressions. Objective: In this study, our aim was to detect suicidal ideation by mining textual content extracted from social media by leveraging state-of-the-art natural language processing (NLP) techniques. Methods: The work was divided into 2 major phases, one to classify suicidal ideation posts and the other to extract factors that cause suicidal ideation. We proposed a hybrid deep learning--based neural network approach (Bidirectional Encoder Representations from Transformers [BERT]+convolutional neural network [CNN]+long short-term memory [LSTM]) to classify suicidal and nonsuicidal posts. Two state-of-the-art deep learning approaches (CNN and LSTM) were combined based on features (terms) selected from term frequency--inverse document frequency (TF-IDF), Word2vec, and BERT. Explainable artificial intelligence (XAI) was used to extract key factors that contribute to suicidal ideation in order to provide a reliable and sustainable solution. Results: Of 348,110 records, 3154 (0.9\%) were selected, resulting in 1338 (42.4\%) suicidal and 1816 (57.6\%) nonsuicidal instances. The CNN+LSTM+BERT model achieved superior performance, with a precision of 94\%, a recall of 95\%, an F1-score of 94\%, and an accuracy of 93.65\%. Conclusions: Considering the dynamic nature of suicidal behavior posts, we proposed a fused architecture that captures both localized and generalized contextual information that is important for understanding the language patterns and predict the evolution of suicidal ideation over time. According to Local Interpretable Model-Agnostic Explanations (LIME) and Shapley Additive Explanations (SHAP) XAI algorithms, there was a drift in the features during and before COVID-19. Due to the COVID-19 pandemic, new features have been added, which leads to suicidal tendencies. In the future, strategies need to be developed to combat this deadly disease. ",
doi="10.2196/65434",
url="https://www.jmir.org/2025/1/e65434"
}


@Article{info:doi/10.2196/54209,
author="Hswen, Yulin
and Qin, Qiuyuan
and Smith, Pressley
and Swierczynski, Alison
and Bauer, Stuart
and Ladson, Erika
and Garrett, Leigh Amanda
and Brownstein, A. Catherine",
title="Sentiments of Individuals with Interstitial Cystitis/Bladder Pain Syndrome Toward Pentosan Polysulfate Sodium: Infodemiology Study",
journal="JMIR Form Res",
year="2025",
month="Jan",
day="17",
volume="9",
pages="e54209",
keywords="interstitial cystitis",
keywords="IC",
keywords="painful bladder syndrome",
keywords="bladder pain syndrome",
keywords="BPS",
keywords="social media",
keywords="social network",
keywords="pain",
keywords="treatment",
keywords="chronic condition",
keywords="chronic disease",
keywords="chronic illness",
keywords="Elmiron",
keywords="pentosan polysulfate sodium",
keywords="PPS",
keywords="internet forum",
abstract="Background: Interstitial cystitis/bladder pain syndrome (IC/BPS) is a multifactorial, chronic syndrome involving urinary frequency, urgency, and bladder discomfort. These IC/BPS symptoms can significantly impact individuals' quality of life, affecting their mental, physical, sexual, and financial well-being. Individuals sometimes rely on peer-to-peer support to understand the disease and find methods of alleviating symptoms. The only US Food and Drug Administration--approved medication to treat IC/BPS is pentosan polysulfate sodium (PPS). However, ocular pigmentary maculopathy has been described in some individuals, with greater severity associated with prolonged PPS exposure. Objective: While prior research has separately assessed the benefits and side effects of PPS, this study sought to identify (1) sentiments of individuals with IC/BPS toward PPS and (2) topics discussed by individuals with IC/BPS in conjunction with PPS through use of an internet peer-to-peer forum. Methods: Data were collected from Inspire---an anonymous web-based health community where individuals gather by condition to find support and information. Sentiment analysis and percentages of negative, positive, and neutral sentiment for PPS discussions encompassing each topic was conducted using VADER (Valence Aware Dictionary for Sentiment Reasoning). Topic modeling was conducted using latent Dirichlet allocation. Words with the highest probability were ranked to categorize each topic, and authors manually investigated and labeled discussions. Results: There were 354 forum posts related to PPS. Topic modeling with latent Dirichlet allocation revealed 5 topic categories: ``ineffectiveness or discontinued use,'' ``alternative treatments,'' ``personal treatment suggestions based on experience,'' ``severe side effects,'' and ``risk of long-term use.'' Topics related to ``severe side effects'' and ``risk of long-term use'' garnered less discussion, with the former also having the lowest positive sentiment (4.28, 14.29\%). The topic ``ineffectiveness or discontinued use'' was most frequently discussed. This topic also had the highest percentage of negative posts (52/152, 34.21\%). However, the average compound score was within the neutral compound score range (?0.094, SD 0.625). In addition, forum data highlighted individuals' acknowledgment of the efficacy of PPS in improving their quality of life, with statements such as ``saved my sanity'' being representative. The overall compound individuals' sentiment toward PPS was ?0.083, split across 32.49\% (115/354) negative, 22.03\% (78/354) positive, and 45.48\% (161/354) neutral sentiment categories. Conclusions: The overall authentic sentiment toward PPS is broad but balances to neutral. This neutral sentiment suggests that while some individuals express concerns about the side effects and long-term risks associated with PPS, others appreciate its positive impact on their quality of life. This research confirms that individuals with IC/BPS actively engage with health forums like Inspire to seek information, share their experiences, and explore different treatment options. As IC/BPS remains a complex syndrome, this study highlights the value of patient-led discussions in informing treatment decisions. Furthermore, these findings suggest that health care providers might benefit from considering the insights shared on peer-to-peer forums to better understand individual preferences, concerns, and expectations. ",
doi="10.2196/54209",
url="https://formative.jmir.org/2025/1/e54209"
}


@Article{info:doi/10.2196/60398,
author="Macapagal, Kathryn
and Zapata, Pablo Juan
and Ma, Junye
and Gordon, D. Jacob
and Owens, Christopher
and Valadez-Tapia, Silvia
and Cummings, Peter
and Walter, Nathan
and Pickett, Jim",
title="Sexual and Gender Minority Adolescents' Preferences for HIV Pre-Exposure Prophylaxis Social Marketing Campaigns: Qualitative Preimplementation Study",
journal="JMIR Form Res",
year="2025",
month="Jan",
day="17",
volume="9",
pages="e60398",
keywords="social marketing campaigns",
keywords="sexual and gender minority",
keywords="adolescent",
keywords="HIV",
keywords="pre-exposure prophylaxis",
keywords="PrEP",
keywords="human-centered design",
keywords="implementation science",
keywords="dissemination",
abstract="Background: Sexual and gender minority (SGM) adolescents in the United States are disproportionately affected by HIV. Pre-exposure prophylaxis (PrEP) is a highly effective biomedical HIV prevention method, but its awareness and uptake among SGM adolescents are low. There are no adolescent-centered PrEP social marketing campaigns in the United States that have the potential to increase awareness and interest in PrEP. Objective: To address this gap, this qualitative study aims to examine SGM adolescents' needs and preferences regarding adolescent-centered PrEP social marketing campaigns. Methods: SGM adolescents from Chicago and its surrounding areas participated in web-based asynchronous focus groups from February to May 2021. Questions elicited their preferences for content, design, and delivery of SGM adolescent--centered PrEP campaigns. We used rapid qualitative data analysis and organized the findings around key components of social marketing, known as the 4 Ps: product, price, place, and promotion. Results: Participants (N=56) were aged 14 to 19 years (mean 18.16, SD 1.22 y), and 64\% (36/56) of them identified as a racial or ethnic minority. Among the 56 participants, 70\% (n=39) were aware of PrEP; however, 95\% (n=53) did not know that PrEP could be prescribed to those aged under 18 years. Adolescents expressed a need for PrEP campaign messaging that provides simple, accurate, and easily accessible information (eg, what is PrEP, for whom PrEP is indicated, and where and how to access PrEP). For product and price, SGM adolescents wanted a campaign to address barriers to, costs of, and how to access PrEP and desired to know about other adolescents' PrEP experiences to improve campaign relatability. For place and promotion, participants preferred digital campaigns on social media to reduce the possibility of embarrassment and stigma and increase the accessibility of health content. Conclusions: These findings lay the groundwork for designing adolescent-centered educational PrEP campaigns that prioritize both user preferences in PrEP marketing design and strategies to overcome common barriers to PrEP awareness. ",
doi="10.2196/60398",
url="https://formative.jmir.org/2025/1/e60398"
}


@Article{info:doi/10.2196/60413,
author="Zheng, Yi Wu
and Shvetcov, Artur
and Slade, Aimy
and Jenkins, Zoe
and Hoon, Leonard
and Whitton, Alexis
and Logothetis, Rena
and Ravindra, Smrithi
and Kurniawan, Stefanus
and Gupta, Sunil
and Huckvale, Kit
and Stech, Eileen
and Agarwal, Akash
and Funke Kupper, Joost
and Cameron, Stuart
and Rosenberg, Jodie
and Manoglou, Nicholas
and Senadeera, Manisha
and Venkatesh, Svetha
and Mouzakis, Kon
and Vasa, Rajesh
and Christensen, Helen
and Newby, M. Jill",
title="Recruiting Young People for Digital Mental Health Research: Lessons From an AI-Driven Adaptive Trial",
journal="J Med Internet Res",
year="2025",
month="Jan",
day="14",
volume="27",
pages="e60413",
keywords="recruitment",
keywords="Facebook",
keywords="retention, COVID-19",
keywords="artificial intelligence",
abstract="Background: With increasing adoption of remote clinical trials in digital mental health, identifying cost-effective and time-efficient recruitment methodologies is crucial for the success of such trials. Evidence on whether web-based recruitment methods are more effective than traditional methods such as newspapers, media, or flyers is inconsistent. Here we present insights from our experience recruiting tertiary education students for a digital mental health artificial intelligence--driven adaptive trial---Vibe Up. Objective: We evaluated the effectiveness of recruitment via Facebook and Instagram compared to traditional methods for a treatment trial and compared different recruitment methods' retention rates. With recruitment coinciding with COVID-19 lockdowns across Australia, we also compared the cost-effectiveness of social media recruitment during and after lockdowns. Methods: Recruitment was completed for 2 pilot trials and 6 minitrials from June 2021 to May 2022. To recruit participants, paid social media advertising on Facebook and Instagram was used, alongside mailing lists of university networks and student organizations or services, media releases, announcements during classes and events, study posters or flyers on university campuses, and health professional networks. Recruitment data, including engagement metrics collected by Meta (Facebook and Instagram), advertising costs, and Qualtrics data on recruitment methods and survey completion rates, were analyzed using RStudio with R (version 3.6.3; R Foundation for Statistical Computing). Results: In total, 1314 eligible participants (aged 22.79, SD 4.71 years; 1079, 82.1\% female) were recruited to 2 pilot trials and 6 minitrials. The vast majority were recruited via Facebook and Instagram advertising (n=1203; 92\%). Pairwise comparisons revealed that the lead institution's website was more effective in recruiting eligible participants than Facebook (z=3.47; P=.003) and Instagram (z=4.23; P<.001). No differences were found between recruitment methods in retaining participants at baseline, at midpoint, and at study completion. Wilcoxon tests found significant differences between lockdown (pilot 1 and pilot 2) and postlockdown (minitrials 1-6) on costs incurred per link click (lockdown: median Aus \$0.35 [US \$0.22], IQR Aus \$0.27-\$0.47 [US \$0.17-\$0.29]; postlockdown: median Aus \$1.00 [US \$0.62], IQR Aus \$0.70-\$1.47 [US \$0.44-\$0.92]; W=9087; P<.001) and the amount spent per hour to reach the target sample size (lockdown: median Aus \$4.75 [US \$2.95], IQR Aus \$1.94-6.34 [US \$1.22-\$3.97]; postlockdown: median Aus \$13.29 [US \$8.26], IQR Aus \$4.70-25.31 [US \$2.95-\$15.87]; W=16044; P<.001). Conclusions: Social media advertising via Facebook and Instagram was the most successful strategy for recruiting distressed tertiary students into this artificial intelligence--driven adaptive trial, providing evidence for the use of this recruitment method for this type of trial in digital mental health research. No recruitment method stood out in terms of participant retention. Perhaps a reflection of the added distress experienced by young people, social media recruitment during the COVID-19 lockdown period was more cost-effective. Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12621001092886; https://tinyurl.com/39f2pdmd;  Australian New Zealand Clinical Trials Registry ACTRN12621001223820; https://tinyurl.com/bdhkvucv ",
doi="10.2196/60413",
url="https://www.jmir.org/2025/1/e60413"
}


@Article{info:doi/10.2196/60292,
author="Li, Min
and Gu, Dongxiao
and Li, Rui
and Gu, Yadi
and Liu, Hu
and Su, Kaixiang
and Wang, Xiaoyu
and Zhang, Gongrang",
title="The Impact of Linguistic Signals on Cognitive Change in Support Seekers in Online Mental Health Communities: Text Analysis and Empirical Study",
journal="J Med Internet Res",
year="2025",
month="Jan",
day="14",
volume="27",
pages="e60292",
keywords="mental health",
keywords="online communities",
keywords="cognitive change",
keywords="signaling theory",
keywords="text analysis",
abstract="Background: In online mental health communities, the interactions among members can significantly reduce their psychological distress and enhance their mental well-being. The overall quality of support from others varies due to differences in people's capacities to help others. This results in some support seekers' needs being met, while others remain unresolved. Objective: This study aimed to examine which characteristics of the comments posted to provide support can make support seekers feel better (ie, result in cognitive change). Methods: We used signaling theory to model the factors affecting cognitive change and used consulting strategies from the offline, face-to-face psychological counseling process to construct 6 characteristics: intimacy, emotional polarity, the use of first-person words, the use of future-tense words, specificity, and language style. Through text mining and natural language processing (NLP) technology, we identified linguistic features in online text and conducted an empirical analysis using 12,868 online mental health support reply data items from Zhihu to verify the effectiveness of those features. Results: The findings showed that support comments are more likely to alter support seekers' cognitive processes if those comments have lower intimacy ($\beta$intimacy=--1.706, P<.001), higher positive emotional polarity ($\beta$emotional\_polarity=.890, P<.001), lower specificity ($\beta$specificity=--.018, P<.001), more first-person words ($\beta$first-person=.120, P<.001), more future- and present-tense words ($\beta$future-words=.301, P<.001), and fewer function words ($\beta$linguistic\_style=--.838, P<.001). The result is consistent with psychotherapists' psychotherapeutic strategy in offline counseling scenarios. Conclusions: Our research contributes to both theory and practice by proposing a model to reveal the factors that make support seekers feel better. The findings have significance for support providers. Additionally, our study offers pointers for managing and designing online communities for mental health. ",
doi="10.2196/60292",
url="https://www.jmir.org/2025/1/e60292"
}


@Article{info:doi/10.2196/54489,
author="Shmueli-Scheuer, Michal
and Silverman, Yedidya
and Halperin, Israel
and Gepner, Yftach",
title="Analysis of Reddit Discussions on Motivational Factors for Physical Activity: Cross-Sectional Study",
journal="J Med Internet Res",
year="2025",
month="Jan",
day="13",
volume="27",
pages="e54489",
keywords="motivation",
keywords="physical activity",
keywords="social media",
keywords="Reddit",
keywords="adherence",
abstract="Background: Despite the ample benefits of physical activity (PA), many individuals do not meet the minimum PA recommended by health organizations. Structured questionnaires and interviews are commonly used to study why individuals perform PA and their strategies to adhere to PA. However, certain biases are inherent to these tools that limit what can be concluded from their results. Collecting data from social media channels can complement these studies and provide a more comprehensive overview of PA motives and adherence strategies. Objective: This study aims to investigate motives for engaging in PA, as well as the associated strategies to achieve these goals, as stated by a large number of people on a social media site. Methods: We searched for users' responses regarding PA motives and adherence strategies in Reddit forums dedicated to PA and analyzed the data using (1) unsupervised clustering to identify topics from the textual comments and (2) supervised classification to classify the comments into the detected topics. A panel of experts participated in both steps for annotation and validation purposes. Results: We analyzed 1577 unique user comments (representing 1577 individual users); of those, 1247 were linked to physical appearance (mentioned in 298/1247, 23.9\% of the comments) and improving physical (235/1247, 18.9\%) and mental health (211/1247, 16.9\%), indicating these as the main motivational factors. The main strategies people used to adhere to PA were habit formation (373/1247, 30\%), goal setting (173/1247, 13.9\%), enjoyable activities (151/1247, 12.1\%), socializing (121/1247, 9.7\%), using media (111/1247, 8.9\%), using different apps to monitor PA (35/1247, 2.8\%), and financial commitment (32/1247, 2.5\%). Conclusions: This study presented a novel approach using a language model to investigate why people engage in PA and the strategies they use to adhere to PA using wide-scale, self-disclosed content from popular social media channels. ",
doi="10.2196/54489",
url="https://www.jmir.org/2025/1/e54489"
}


@Article{info:doi/10.2196/50862,
author="Lang, A. Iain
and King, Angela
and Boddy, Kate
and Stein, Ken
and Asare, Lauren
and Day, Jo
and Liabo, Kristin",
title="Jargon and Readability in Plain Language Summaries of Health Research: Cross-Sectional Observational Study",
journal="J Med Internet Res",
year="2025",
month="Jan",
day="13",
volume="27",
pages="e50862",
keywords="readability",
keywords="jargon",
keywords="reading",
keywords="accessibility",
keywords="health research",
keywords="science communication",
keywords="public understanding of science",
keywords="open science",
keywords="patient and public involvement",
keywords="health literacy",
keywords="plain language summary",
keywords="health communication",
abstract="Background: The idea of making science more accessible to nonscientists has prompted health researchers to involve patients and the public more actively in their research. This sometimes involves writing a plain language summary (PLS), a short summary intended to make research findings accessible to nonspecialists. However, whether PLSs satisfy the basic requirements of accessible language is unclear. Objective: We aimed to assess the readability and level of jargon in the PLSs of research funded by the largest national clinical research funder in Europe, the United Kingdom's National Institute for Health and Care Research (NIHR). We also aimed to assess whether readability and jargon were influenced by internal and external characteristics of research projects. Methods: We downloaded the PLSs of all NIHR National Journals Library reports from mid-2014 to mid-2022 (N=1241) and analyzed them using the Flesch Reading Ease (FRE) formula and a jargon calculator (the De-Jargonizer). In our analysis, we included the following study characteristics of each PLS: research topic, funding program, project size, length, publication year, and readability and jargon scores of the original funding proposal. Results: Readability scores ranged from 1.1 to 70.8, with an average FRE score of 39.0 (95\% CI 38.4-39.7). Moreover, 2.8\% (35/1241) of the PLSs had an FRE score classified as ``plain English'' or better; none had readability scores in line with the average reading age of the UK population. Jargon scores ranged from 76.4 to 99.3, with an average score of 91.7 (95\% CI 91.5-91.9) and 21.7\% (269/1241) of the PLSs had a jargon score suitable for general comprehension. Variables such as research topic, funding program, and project size significantly influenced readability and jargon scores. The biggest differences related to the original proposals: proposals with a PLS in their application that were in the 20\% most readable were almost 3 times more likely to have a more readable final PLS (incidence rate ratio 2.88, 95\% CI 1.86-4.45). Those with the 20\% least jargon in the original application were more than 10 times as likely to have low levels of jargon in the final PLS (incidence rate ratio 13.87, 95\% CI 5.17-37.2). There was no observable trend over time. Conclusions: Most of the PLSs published in the NIHR's National Journals Library have poor readability due to their complexity and use of jargon. None were readable at a level in keeping with the average reading age of the UK population. There were significant variations in readability and jargon scores depending on the research topic, funding program, and other factors. Notably, the readability of the original funding proposal seemed to significantly impact the final report's readability. Ways of improving the accessibility of PLSs are needed, as is greater clarity over who and what they are for. ",
doi="10.2196/50862",
url="https://www.jmir.org/2025/1/e50862"
}


@Article{info:doi/10.2196/57263,
author="Kallout, Julien
and Lamer, Antoine
and Grosjean, Julien
and Kerdelhu{\'e}, Ga{\'e}tan
and Bouzill{\'e}, Guillaume
and Clavier, Thomas
and Popoff, Benjamin",
title="Contribution of Open Access Databases to Intensive Care Medicine Research: Scoping Review",
journal="J Med Internet Res",
year="2025",
month="Jan",
day="9",
volume="27",
pages="e57263",
keywords="intensive care unit",
keywords="ICU",
keywords="big data",
keywords="databases",
keywords="open access",
keywords="Amsterdam University Medical Centers Database",
keywords="AmsterdamUMCdb",
keywords="eICU Collaborative Research Database",
keywords="eICU-CRD",
keywords="database",
keywords="screening",
keywords="descriptive analysis",
abstract="Background: Intensive care units (ICUs) handle the most critical patients with a high risk of mortality. Due to those conditions, close monitoring is necessary and therefore, a large volume of data is collected. Collaborative ventures have enabled the emergence of large open access databases, leading to numerous publications in the field. Objective: The aim of this scoping review is to identify the characteristics of studies using open access intensive care databases and to describe the contribution of these studies to intensive care research. Methods: The research was conducted using 3 databases (PubMed--MEDLINE, Embase, and Web of Science) from the inception of each database to August 1, 2022. We included original articles based on 4 open databases of patients admitted to ICUs: Amsterdam University Medical Centers Database, eICU Collaborative Research Database, High time resolution ICU dataset, Medical Information Mart for Intensive Care (II to IV). A double-blinded screening for eligibility was performed, first on the title and abstract and subsequently on the full-text articles. Characteristics relating to publication journals, study design, and statistical analyses were extracted and analyzed. Results: We observed a consistent increase in the number of publications from these databases since 2016. The Medical Information Mart for Intensive Care databases were the most frequently used. The highest contributions came from China and the United States, with 689 (52.7\%) and 370 (28.3\%) publications respectively. The median impact factor of publications was 3.8 (IQR 2.8-5.8). Topics related to cardiovascular and infectious diseases were predominant, accounting for 333 (25.5\%) and 324 (24.8\%) articles, respectively. Logistic regression emerged as the most commonly used statistical model for both inference and prediction questions, featuring in 396 (55.5\%) and 281 (47.5\%) studies, respectively. A majority of the inference studies yielded statistically significant results (84.0\%). In prediction studies, area under the curve was the most frequent performance measure, with a median value of 0.840 (IQR 0.780-0.890). Conclusions: The abundance of scientific outputs resulting from these databases, coupled with the diversity of topics addressed, highlight the importance of these databases as valuable resources for clinical research. This suggests their potential impact on clinical practice within intensive care settings. However, the quality and clinical relevance of these studies remains highly heterogeneous, with a majority of articles being published in low--impact factor journals. ",
doi="10.2196/57263",
url="https://www.jmir.org/2025/1/e57263"
}


@Article{info:doi/10.2196/58902,
author="Cummins, A. Jack
and Gottlieb, J. Daniel
and Sofer, Tamar
and Wallace, A. Danielle",
title="Applying Natural Language Processing Techniques to Map Trends in Insomnia Treatment Terms on the r/Insomnia Subreddit: Infodemiology Study",
journal="J Med Internet Res",
year="2025",
month="Jan",
day="9",
volume="27",
pages="e58902",
keywords="insomnia",
keywords="natural language processing",
keywords="NLP",
keywords="social media",
keywords="cognitive behavioral therapy",
keywords="CBT",
keywords="sleep initiation",
keywords="sleep disorder",
keywords="easly awakening",
keywords="sleep aids",
keywords="benzodiazepines",
keywords="trazodone",
keywords="antidepressants",
keywords="melatonin",
keywords="treatment",
abstract="Background: People share health-related experiences and treatments, such as for insomnia, in digital communities. Natural language processing tools can be leveraged to understand the terms used in digital spaces to discuss insomnia and insomnia treatments. Objective: The aim of this study is to summarize and chart trends of insomnia treatment terms on a digital insomnia message board. Methods: We performed a natural language processing analysis of the r/insomnia subreddit. Using Pushshift, we obtained all r/insomnia subreddit comments from 2008 to 2022. A bag of words model was used to identify the top 1000 most frequently used terms, which were manually reduced to 35 terms related to treatment and medication use. Regular expression analysis was used to identify and count comments containing specific words, followed by sentiment analysis to estimate the tonality (positive or negative) of comments. Data from 2013 to 2022 were visually examined for trends. Results: There were 340,130 comments on r/insomnia from 2008, the beginning of the subreddit, to 2022. Of the 35 top treatment and medication terms that were identified, melatonin, cognitive behavioral therapy for insomnia (CBT-I), and Ambien were the most frequently used (n=15,005, n=13,461, and n=11,256 comments, respectively). When the frequency of individual terms was compared over time, terms related to CBT-I increased over time (doubling from approximately 2\% in 2013-2014 to a peak of over 5\% of comments in 2018); in contrast, terms related to nonprescription over-the-counter (OTC) sleep aids (such as Benadryl or melatonin) decreased over time. CBT-I--related terms also had the highest positive sentiment and showed a spike in frequency in 2017. Terms with the most positive sentiment included ``hygiene'' (median sentiment 0.47, IQR 0.31-0.88), ``valerian'' (median sentiment 0.47, IQR 0-0.85), and ``CBT'' (median sentiment 0.42, IQR 0.14-0.82). Conclusions: The Reddit r/insomnia discussion board provides an alternative way to capture trends in both prescription and nonprescription sleep aids among people experiencing sleeplessness and using social media. This analysis suggests that language related to CBT-I (with a spike in 2017, perhaps following the 2016 recommendations by the American College of Physicians for CBT-I as a treatment for insomnia), benzodiazepines, trazodone, and antidepressant medication use has increased from 2013 to 2022. The findings also suggest that the use of OTC or other alternative therapies, such as melatonin and cannabis, among r/insomnia Reddit contributors is common and has also exhibited fluctuations over time. Future studies could consider incorporating alternative data sources in addition to prescription medication to track trends in prescription and nonprescription sleep aid use. Additionally, future prospective studies of insomnia should consider collecting data on the use of OTC or other alternative therapies, such as cannabis. More broadly, digital communities such as r/insomnia may be useful in understanding how social and societal factors influence sleep health. ",
doi="10.2196/58902",
url="https://www.jmir.org/2025/1/e58902"
}


@Article{info:doi/10.2196/60109,
author="Singh, Tavleen
and Roberts, Kirk
and Fujimoto, Kayo
and Wang, Jing
and Johnson, Constance
and Myneni, Sahiti",
title="Toward Personalized Digital Experiences to Promote Diabetes Self-Management: Mixed Methods Social Computing Approach",
journal="JMIR Diabetes",
year="2025",
month="Jan",
day="7",
volume="10",
pages="e60109",
keywords="digital health communities",
keywords="diabetes self-management",
keywords="behavior change",
keywords="affiliation exposure",
keywords="social networks",
keywords="deep learning",
abstract="Background: Type 2 diabetes affects nearly 34.2 million adults and is the seventh leading cause of death in the United States. Digital health communities have emerged as avenues to provide social support to individuals engaging in diabetes self-management (DSM). The analysis of digital peer interactions and social connections can improve our understanding of the factors underlying behavior change, which can inform the development of personalized DSM interventions. Objective: Our objective is to apply our methodology using a mixed methods approach to (1) characterize the role of context-specific social influence patterns in DSM and (2) derive interventional targets that enhance individual engagement in DSM. Methods: Using the peer messages from the American Diabetes Association support community for DSM (n={\textasciitilde}73,000 peer interactions from 2014 to 2021), (1) a labeled set of peer interactions was generated (n=1501 for the American Diabetes Association) through manual annotation, (2) deep learning models were used to scale the qualitative codes to the entire datasets, (3) the validated model was applied to perform a retrospective analysis, and (4) social network analysis techniques were used to portray large-scale patterns and relationships among the communication dimensions (content and context) embedded in peer interactions. Results: The affiliation exposure model showed that exposure to community users through sharing interactive communication style speech acts had a positive association with the engagement of community users. Our results also suggest that pre-existing users with type 2 diabetes were more likely to stay engaged in the community when they expressed patient-reported outcomes and progress themes (communication content) using interactive communication style speech acts (communication context). It indicates the potential for targeted social network interventions in the form of structural changes based on the user's context and content exchanges with peers, which can exert social influence to modify user engagement behaviors. Conclusions: In this study, we characterize the role of social influence in DSM as observed in large-scale social media datasets. Implications for multicomponent digital interventions are discussed. ",
doi="10.2196/60109",
url="https://diabetes.jmir.org/2025/1/e60109"
}


@Article{info:doi/10.2196/54241,
author="Brzozowska, Martyna Justyna
and Gotlib, Joanna",
title="Social Media Potential and Impact on Changing Behaviors and Actions in Skin Health Promotion: Systematic Review",
journal="J Med Internet Res",
year="2025",
month="Jan",
day="6",
volume="27",
pages="e54241",
keywords="skin",
keywords="social media",
keywords="prevention",
keywords="behavioral intervention",
keywords="skin cancer",
keywords="sun protection",
keywords="acne",
abstract="Background: Social media is used as a tool for information exchange, entertainment, education, and intervention. Intervention efforts attempt to engage users in skin health. Objective: This review aimed to collect and summarize research assessing the impact of social media on skin health promotion activities undertaken by social media users. Methods: In accordance with the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines, the following scientific databases were searched: Scopus, Web of Science, PubMed, Academic Search Ultimate (via EBSCO), Academic Research Source eJournals (via EBSCO), ERIC (via EBSCO), Health Source: Consumer Edition (via EBSCO), and Health Source: Nursing/Academic Edition (via EBSCO). Using ProQuest Dissertations and Theses, OpenGrey, Grey Literature Report, and MedNar, the search was supplemented with gray literature. Articles on skin care, skin health, skin diseases, skin protection, and educational activities promoting healthy skin on social media were selected for review (search date: February 6, 2023). The following qualification criteria were used: original research; research conducted on social media; and research topics regarding educational activities in skin health promotion, skin care, skin health, skin diseases, and skin protection. To assess the risk of bias, the following tools were used: the Cochrane Collaboration tool for risk-of-bias assessment (randomized controlled trials and quasi-experimental studies) and the Centre for Evidence-Based Medicine checklist (cross-sectional studies). Results: Altogether, 1558 works were considered, of which 23 (1.48\%) qualified, with 3 (13\%) studies on acne and 20 (87\%) on skin cancer, sunscreen, and tanning. Social media interventions were dealt with in 65\% (15/23) of the studies. The review made it possible to investigate cognitive and cognitive-behavioral interventions. In both observational and interventional studies, the most frequently discussed topics were skin exposure and protection against UV radiation and skin cancer. The analyzed research showed that social media is a source of information. Visualization has a strong impact on users. The involvement of social media users is measured through the amount of content shared and contributes to changing attitudes and behaviors regarding skin health. Conclusions: This review outlined the impact of social media, despite its heterogeneity, on users' skin health behaviors, attitudes, and actions. It identified strategies for digital interventions to promote skin health. In health sciences, a standardized tool is needed to assess the quality of social media digital interventions. This review has several limitations: only articles written in English were considered; ongoing studies were omitted; and there was a small number of interventional studies on acne and a lack of research on daily skin care, education, and antiaging activities on social media. Another limitation, resulting from the topic being too broad, was a failure to perform quantitative data analysis, resulting in the studies that qualified for the review being heterogeneous. ",
doi="10.2196/54241",
url="https://www.jmir.org/2025/1/e54241"
}


@Article{info:doi/10.2196/66121,
author="Acosta, Macadaeg Joseph
and Detsomboonrat, Palinee
and Pisarnturakit, Pantuwadee Pagaporn
and Urwannachotima, Nipaporn",
title="The Use of Social Media on Enhancing Dental Care and Practice Among Dental Professionals: Cross-Sectional Survey Study",
journal="JMIR Form Res",
year="2025",
month="Jan",
day="3",
volume="9",
pages="e66121",
keywords="social media",
keywords="oral health promotion",
keywords="oral health education",
keywords="dentists",
keywords="dental practice",
keywords="dental professionals",
keywords="dental practitioners",
abstract="Background: As digitalization continues to advance globally, the health care sector, including dental practice, increasingly recognizes social media as a vital tool for health care promotion, patient recruitment, marketing, and communication strategies. Objective: This study aimed to investigate the use of social media and assess its impact on enhancing dental care and practice among dental professionals in the Philippines. Methods: A cross-sectional survey was conducted among dental practitioners in the Philippines. The study used a 23-item questionnaire, which included 5 questions on dentists' background and demographic information and 18 questions regarding the use, frequency, and purpose of social media in patient advising and quality of care improvement. Data were analyzed using SPSS software, with frequency distributions and $\chi$2 tests used to assess the association between social media use and demographic variables and the impact on dental practice. Results: The 265 dental practitioners in this study were predominantly female (n=204, 77\%) and aged between 20?30 years (n=145, 54.7\%). Most of the participants were general practitioners (n=260, 98.1\%) working in a private practice (n=240, 90.6\%), with 58.5\% (n=155) having 0?5 years of clinical experience. Social media use was significantly higher among younger practitioners (20?30 years old) compared to older age groups (P<.001), though factors such as sex, dental specialty, and years of clinical practice did not significantly influence use. The majority (n=179, 67.5\%) reported using social media in their practice, primarily for oral health promotion and education (n=191, 72.1\%), connecting with patients and colleagues (n=165, 62.3\%), and marketing (n=150, 56.6\%). Facebook (n=179, 67.5\%) and YouTube (n=163, 61.5\%) were the most frequented platforms for clinical information, with Twitter (subsequently rebranded X) being the least used (n=4, 1.5\%). Despite widespread social media engagement, only 8.7\% (n=23) trusted the credibility of web-based information, and 63.4\% (n=168) perceived a potential impact on the patient-dentist relationship due to patients seeking information on the internet. Social media was also perceived to enhance practice quality, with users reporting significant improvements in patient care (P=.001). Conclusions: The findings highlight that social media is widely used among younger dental practitioners, primarily for education, communication, and marketing purposes. While social media use is associated with perceived improvements in practice quality and patient care, trust in information on social media remains low, and concerns remain regarding its effect on patient relationships. It is recommended to establish enhanced guidelines and provide reliable web-based resources to help dental practitioners use social media effectively and responsibly. ",
doi="10.2196/66121",
url="https://formative.jmir.org/2025/1/e66121"
}


@Article{info:doi/10.2196/59786,
author="Mendez, R. Samuel
and Munoz-Najar, Sebastian
and Emmons, M. Karen
and Viswanath, Kasisomayajula",
title="US State Public Health Agencies' Use of Twitter From 2012 to 2022: Observational Study",
journal="J Med Internet Res",
year="2025",
month="Jan",
day="3",
volume="27",
pages="e59786",
keywords="social media",
keywords="health communication",
keywords="Twitter",
keywords="tweet",
keywords="public health",
keywords="state government",
keywords="government agencies",
keywords="information technology",
keywords="data science",
keywords="communication tool",
keywords="COVID-19 pandemic",
keywords="data collection",
keywords="theoretical framework",
keywords="message",
keywords="interaction",
abstract="Background: Twitter (subsequently rebranded as X) is acknowledged by US health agencies, including the US Centers for Disease Control and Prevention (CDC), as an important public health communication tool. However, there is a lack of data describing its use by state health agencies over time. This knowledge is important amid a changing social media landscape in the wake of the COVID-19 pandemic. Objective: The study aimed to describe US state health agencies' use of Twitter from 2012 through 2022. Furthermore, we organized our data collection and analysis around the theoretical framework of the networked public to contribute to the broader literature on health communication beyond a single platform. Methods: We used Twitter application programming interface data as indicators of state health agencies' engagement with the 4 key qualities of communication in a networked public: scalability, persistence, replicability, and searchability. To assess scalability, we calculated tweet volume and audience engagement metrics per tweet. To assess persistence, we calculated the portion of tweets that were manual retweets or included an account mention. To assess replicability, we calculated the portion of tweets that were retweets or quote tweets. To assess searchability, we calculated the portion of tweets using at least 1 hashtag. Results: We observed a COVID-19 pandemic--era shift in state health agency engagement with scalability. The overall volume of tweets increased suddenly from less than 50,000 tweets in 2019 to over 94,000 in 2020, resulting in an average of 5.3 per day. Though mean tweets per day fell in 2021 and 2022, this COVID-19 pandemic--era low was still higher than the pre--COVID-19 pandemic peak. We also observed a more fragmented approach to searchability aligning with the start of the COVID-19 pandemic. More state-specific hashtags were among the top 10 during the COVID-19 pandemic, compared with more general hashtags related to disease outbreaks and natural disasters in years before. We did not observe such a clear COVID-19 pandemic--era shift in engagement with replicability. The portion of tweets mentioning a CDC account gradually rose and fell around a peak of 7.0\% in 2018. Similarly, the rate of retweets of a CDC account rose and fell gradually around a peak of 5.4\% in 2018. We did not observe a clear COVID-19 pandemic--era shift in persistence. The portion of tweets mentioning any account reached a maximum of 21\% in 2013. It oscillated for much of the study period before dropping off in 2021 and reaching a minimum of 10\% in 2022. Before 2018, the top 10 mentioned accounts included at least 2 non-CDC or corporate accounts. From 2018 onward, state agencies were much more prominent. Conclusions: Overall, we observed a more fragmented approach to state health agency communication on Twitter during the pandemic, prioritizing volume over searchability, formally replicating existing messages, and leaving traces of interactions with other accounts. ",
doi="10.2196/59786",
url="https://www.jmir.org/2025/1/e59786",
url="http://www.ncbi.nlm.nih.gov/pubmed/39752190"
}


@Article{info:doi/10.2196/54506,
author="Montoya, Alana
and Mao, Lingchao
and Drewnowski, Adam
and Chen, Joshua
and Shi, Ella
and Liang, Aileen
and Weiner, J. Bryan
and Su, Yanfang",
title="Influencers in Policy Fields on Social Media: Global Longitudinal Study of Dietary Sodium Reduction Posts, 2006-2022",
journal="J Med Internet Res",
year="2024",
month="Dec",
day="30",
volume="26",
pages="e54506",
keywords="policy field",
keywords="sodium intake",
keywords="sodium consumption",
keywords="cardiovascular disease",
keywords="social media",
keywords="health education",
keywords="health promotion",
keywords="dissemination",
keywords="influence",
keywords="Twitter",
keywords="X",
keywords="activity",
keywords="priority",
keywords="originality",
keywords="popularity",
abstract="Background: Excessive sodium intake is a major concern for global public health. Despite multiple dietary guidelines, population sodium intakes are above recommended levels. Lack of health literacy could be one contributing issue and contemporary health literacy is largely shaped by social media. Objective: This study aims to quantify the posting behaviors and influence patterns on dietary sodium--related content by influencers in the policy field on X (formerly Twitter) across time. Methods: We first identified X users with a scope of work related to dietary sodium and retrieved their posts (formerly Tweets) from 2006 to 2022. Users were categorized into the policy groups of outer-setting organization, inner-setting organization, or individual, based on their role in the conceptual policy field. Network analysis was used to analyze interactions among users and identify the top influencers in each policy group. A 4D influence framework was applied to measure the overall influence, activity, priority, originality, and popularity scores. These measures were used to reveal the user-level, group-level, and temporal patterns of sodium-related influence. Results: We identified 78 users with content related to dietary sodium, with 1,099,605 posts in total and 14,732 dietary sodium posts. There was an increasing volume of sodium posts from 2010 to 2015; however, the trend has been decreasing since 2016, especially among outer-setting organizations. The top influencers from the three policy groups were the World Health Organization (WHO), the American Heart Association, and Tom Frieden. Simon Capewell and the WHO ranked the highest in activity; the World Action on Salt, Sugar, and Health and Action on Salt had the highest priority for dietary sodium content; General Mills and Tom Frieden had the highest originality; and WHO, Harvard University School of Medicine, and Tom Frieden received the highest popularity. Outer-setting organizations tend to interact with more users in the network compared to inner-setting organizations and individuals, while inner-setting organizations tend to receive more engagements from other users in the network than the other two groups. Monthly patterns showed a significant peak in the number of sodium posts in March compared with other months. Conclusions: Despite the increased use of social media, recent trends of sodium intake education on social media are decreasing and the priority of sodium among other topics is low. To improve policy implementation effectiveness and meet recommended dietary targets, there is an increasing need for health leaders to consistently and collectively advocate for sodium intake reduction on social media. ",
doi="10.2196/54506",
url="https://www.jmir.org/2024/1/e54506"
}


@Article{info:doi/10.2196/52448,
author="Matthes, Nina
and Willem, Theresa
and Buyx, Alena
and Zimmermann, M. Bettina",
title="Social Media Recruitment as a Potential Trigger for Vulnerability: Multistakeholder Interview Study",
journal="JMIR Hum Factors",
year="2024",
month="Dec",
day="30",
volume="11",
pages="e52448",
keywords="vulnerability",
keywords="social media",
keywords="clinical study enrollment",
keywords="clinical study recruitment",
keywords="clinical trials",
keywords="stigma",
keywords="discrimination",
keywords="injustice",
keywords="recruitment",
keywords="clinical study",
keywords="hepatitis B",
keywords="TherVacB",
keywords="clinical research",
keywords="attitudes",
keywords="patient privacy",
keywords="utilization",
abstract="Background: More clinical studies use social media to increase recruitment accrual. However, empirical analyses focusing on the ethical aspects pertinent when targeting patients with vulnerable characteristics are lacking. Objective: This study aims to explore expert and patient perspectives on vulnerability in the context of social media recruitment and seeks to explore how social media can reduce or amplify vulnerabilities. Methods: As part of an international consortium that tests a therapeutic vaccine against hepatitis B (TherVacB), we conducted 30 qualitative interviews with multidisciplinary experts in social media recruitment (from the fields of clinical research, public relations, psychology, ethics, philosophy, law, and social sciences) about the ethical, legal, and social challenges of social media recruitment. We triangulated the expert assessments with the perceptions of 6 patients with hepatitis B regarding social media usage and attitudes relative to their diagnosis. Results: Experts perceived social media recruitment as beneficial for reaching hard-to-reach populations and preserving patient privacy. Features that may aggravate existing vulnerabilities are the acontextual point of contact, potential breaches of user privacy, biased algorithms disproportionately affecting disadvantaged groups, and technological barriers such as insufficient digital literacy skills and restricted access to relevant technology. We also report several practical recommendations from experts to navigate these triggering effects of social media recruitment, including transparent communication, addressing algorithm bias, privacy education, and multichannel recruitment. Conclusions: Using social media for clinical study recruitment can mitigate and aggravate potential study participants' vulnerabilities. Researchers should anticipate and address the outlined triggering effects within this study's design and proactively define strategies to overcome them. We suggest practical recommendations to achieve this. ",
doi="10.2196/52448",
url="https://humanfactors.jmir.org/2024/1/e52448"
}


@Article{info:doi/10.2196/49567,
author="Luo, Waylon
and Jin, Ruoming
and Kenne, Deric
and Phan, NhatHai
and Tang, Tang",
title="An Analysis of the Prevalence and Trends in Drug-Related Lyrics on Twitter (X): Quantitative Approach",
journal="JMIR Form Res",
year="2024",
month="Dec",
day="30",
volume="8",
pages="e49567",
keywords="Twitter (X)",
keywords="popular music",
keywords="big data analysis",
keywords="music",
keywords="lyrics",
keywords="big data",
keywords="substance abuse",
keywords="tweet",
keywords="social media",
keywords="drug",
keywords="alcohol",
abstract="Background: The pervasiveness of drug culture has become evident in popular music and social media. Previous research has examined drug abuse content in both social media and popular music; however, to our knowledge, the intersection of drug abuse content in these 2 domains has not been explored. To address the ongoing drug epidemic, we analyzed drug-related content on Twitter (subsequently rebranded X), with a specific focus on lyrics. Our study provides a novel finding on the prevalence of drug abuse by defining a new subcategory of X content: ``tweets that reference established drug lyrics.'' Objective: We aim to investigate drug trends in popular music on X, identify and classify popular drugs, and analyze related artists' gender, genre, and popularity. Based on the collected data, our goal is to create a prediction model for future drug trends and gain a deeper understanding of the characteristics of users who cite drug lyrics on X. Methods: X data were collected from 2015 to 2017 through the X streaming application programming interface (API). Drug lyrics were obtained from the Genius lyrics database using the Genius API based on drug keywords. The Smith-Waterman text-matching algorithm is used to detect the drug lyrics in posts. We identified famous drugs in lyrics that were posted. Consequently, the analysis was extended to related artists, songs, genres, and popularity on X. The frequency of drug-related lyrics on X was aggregated into a time-series, which was then used to create prediction models using linear regression, Facebook Prophet, and NIXTLA TimeGPT-1. In addition, we analyzed the number of followers of users posting drug-related lyrics to explore user characteristics. Results: We analyzed over 1.97 billion publicly available posts from 2015 to 2017, identifying more than 157 million that matched drug-related keywords. Of these, 150,746 posts referenced drug-related lyrics. Cannabinoids, opioids, stimulants, and hallucinogens were the most cited drugs in lyrics on X. Rap and hip-hop dominated, with 91.98\% of drug-related lyrics from these genres and 84.21\% performed by male artists. Predictions from all 3 models, linear regression, Facebook Prophet, and NIXTLA TimeGPT-1, indicate a slight decline in the prevalence of drug-related lyrics on X over time. Conclusions: Our study revealed 2 significant findings. First, we identified a previously unexamined subset of drug-related content on X: drug lyrics, which could play a critical role in models predicting the surge in drug-related incidents. Second, we demonstrated the use of cutting-edge time-series forecasting tools, including Facebook Prophet and NIXTLA TimeGPT-1, in accurately predicting these trends. These insights contribute to our understanding of how social media shapes public behavior and sentiment toward drug use. ",
doi="10.2196/49567",
url="https://formative.jmir.org/2024/1/e49567"
}


@Article{info:doi/10.2196/57833,
author="Doyle, A. Tom
and Vershaw, L. Samantha
and Conboy, Erin
and Halverson, E. Colin M.",
title="Improving Social Media-Based Support Groups for the Rare Disease Community: Interview Study With Patients and Parents of Children with Rare and Undiagnosed Diseases",
journal="JMIR Hum Factors",
year="2024",
month="Dec",
day="30",
volume="11",
pages="e57833",
keywords="social media",
keywords="rare disease",
keywords="support groups",
keywords="pediatric rare disease",
keywords="Ehlers-Danlos syndrome",
keywords="collagen disease",
keywords="fibrillar collagen",
keywords="cutis elastica",
keywords="connective tissue disorders",
keywords="hyperelasticity",
keywords="hypermobility of joints, inherited",
keywords="genetic disorder",
keywords="genetics",
keywords="pediatric",
abstract="Background: The rarity that is inherent in rare disease (RD) often means that patients and parents of children with RDs feel uniquely isolated and therefore are unprepared or unsupported in their care. To overcome this isolation, many within the RD community turn to the internet, and social media groups in particular, to gather useful information about their RDs. While previous research has shown that social media support groups are helpful for those affected by RDs, it is unclear what these groups are particularly useful or helpful for patients and parents of children with RDs. Objective: This study aimed to identify what specific features of disease-related support groups (DRSGs) the RD community finds particularly useful or supportive and provide a set of recommendations to improve social media--based RD support groups based on this information. Methods: Semistructured qualitative interviews were performed with patients and parents of patients with RDs. Interview participants had to be at least 18 years of age at the time of the interview, be seen by a genetics specialist at a partner health care institution and be proficient in the English language. Social media use was not a prerequisite for participation, so interview participants ranged from extensive users of social media to those who chose to remain off all social media. All interviews were conducted by phone, recorded, and then transcribed. Interview transcripts were then coded using the 6 steps outlined by Braun and Clarke. Three researchers (TAD, SLV, and CMEH) performed initial coding. After this, the study team conducted a review of themes and all members of the team agreed upon a final analysis and presentation of data. Results: We conducted 31 interviews (mean age 40, SD 10.04 years; n=27, 87\% were women; n=30, 97\% were non-Hispanic White). Thematic analysis revealed that social media DRSG users identified the informational usefulness of these groups as being related to the gathering and sharing of specific information about an RD, clarification about the importance and meaning of certain symptoms, and obtaining insight into an RD's progression and prognosis. Participants also identified that DRSGs were useful sources of practical information, such as tips and tricks about managing RD-related issues and concerns. In addition, participants found DRSGs to be a useful space for sharing their disease-related stories but also highlighted a feeling of exhaustion from overexposure and overuse of DRSGs. Conclusions: This study identifies the usefulness of DRSGs for the RD community and provides a set of recommendations to improve future instances of DRSGs. These recommendations can be used to create DRSGs that are less prone to splintering into other DRSGs, thus minimizing the risk of having important RD-related information unhelpfully dispersed amongst a multitude of support groups. ",
doi="10.2196/57833",
url="https://humanfactors.jmir.org/2024/1/e57833",
url="http://www.ncbi.nlm.nih.gov/pubmed/39752188"
}


@Article{info:doi/10.2196/55300,
author="Peerawong, Thanarpan
and Phenwan, Tharin
and Makita, Meiko
and Supanichwatana, Sojirat
and Puttarak, Panupong
and Siammai, Naowanit
and Sunthorn, Prakaidao",
title="Evaluating Online Cannabis Health Information for Thai Breast Cancer Survivors Using the Quality Evaluation Scoring Tool (QUEST): Mixed Method Study",
journal="JMIR Cancer",
year="2024",
month="Dec",
day="24",
volume="10",
pages="e55300",
keywords="cannabis",
keywords="medical cannabis",
keywords="Thailand",
keywords="critical discourse analysis",
keywords="mixed method study",
keywords="breast cancer",
keywords="digital literacy",
keywords="legislation",
keywords="health literacy",
abstract="Background: Following medical cannabis legalization in Thailand in 2019, more people are seeking medical cannabis--related information, including women living with breast cancer. The extent to which they access cannabis-related information from internet sources and social media platforms and the quality of such content are relatively unknown and need further evaluation. Objective: This study aims to analyze the factors determining cannabis-related content quality for breast cancer care from internet sources and on social media platforms and examine the characteristics of such content accessed and consumed by Thai breast cancer survivors. Methods: A mixed methods study was conducted between January 2021 and May 2022, involving a breast cancer survivor support group. The group identified medical cannabis--related content from frequently accessed internet sources and social media platforms. The contents were categorized based on content creators, platforms, content category, and upload dates. Four researchers used the Quality Evaluation Scoring Tool (QUEST) to assess content quality, with scores ranging from 0 to 28. Contents were expert-rated as either high or poor. The QUEST interobserver reliability was analyzed. Receiver-operating characteristic curve analysis with the Youden index was used to determine the QUEST score cut-off point. Statistical significance was set at P<.05. Fairclough Critical Discourse Analysis was undertaken to examine the underlying discourses around poor-quality content. Results: Sixty-two Thai-language cannabis-related items were evaluated. The content sources were categorized as follows: news channels (21/62, 34\%), government sources (16/62, 26\%), health care providers (12/62, 19\%), and alternative medicine providers (12/62, 19\%). Most of the contents (30/62, 48\%) were uploaded to YouTube, whereas 31\% (19/62) appeared on websites and Facebook. Forty of 62 content items (64\%) were news-related and generic cannabis advertisements while 8 of 62 (13\%) content items had no identifiable date. The interobserver QUEST score correlation was 0.86 (P<.001). The mean QUEST score was 12.1 (SD 7.6). Contents were considered ``high'' when the expert rating was >3. With a QUEST score of 15 as the threshold, the sensitivity and specificity for differentiating between high and poor content quality were 81\% and 98\%, respectively. Content creation was the only significant factor between high- and poor-quality content. Poor-quality contents were primarily created by alternative medicine providers and news channels. Two discourses were identified: advocacy for cannabis use normalization and cannabis romanticization as a panacea. These discourses overly normalize and romanticize the use of cannabis, focusing on indications and instructions for cannabis use, and medical cannabis promotion, while neglecting discussions on cannabis contraindications and potential side effects. Conclusions: The varying quality of medical cannabis--related information on internet sources and social media platforms accessed and shared by Thai breast cancer survivors is an issue of concern. Given that content creators are the sole predictive factors of high content quality, future studies should examine a wider range of cannabis-related sources accessible to both the public and patients to gain a more comprehensive understanding of the issue. ",
doi="10.2196/55300",
url="https://cancer.jmir.org/2024/1/e55300"
}


@Article{info:doi/10.2196/52651,
author="Ahmed, Furqan
and Ahmad, Ghufran
and Eisinger, Katharina
and Khan, Asad Muhammad
and Brand, Tilman",
title="Promoting Comprehensive Sexuality Education in Pakistan Using a Cocreated Social Media Intervention: Development and Pilot Testing Study",
journal="JMIR Form Res",
year="2024",
month="Dec",
day="20",
volume="8",
pages="e52651",
keywords="digital health interventions",
keywords="sexuality education",
keywords="social media",
keywords="influencer marketing",
keywords="community readiness",
abstract="Background: Comprehensive sexuality education (CSE) is a curriculum-based approach to learning and teaching about sexuality that focuses on the cognitive, emotional, physical, and social domains. The United Nations Educational, Scientific, and Cultural Organization (UNESCO) CSE guideline emphasizes gender issues and is firmly rooted in a human rights--based approach to sexuality. A recent cross-sectional community readiness assessment in Islamabad, Pakistan, found that the community is at the denial or resistant stage when it comes to implementing school-based sexuality education. The reluctance was attributed to a lack of understanding and widespread misconceptions about CSE. Objective: This study aims to use the cocreation process to develop, pilot, and evaluate an intervention based on community readiness level to respond to community resistance by introducing CSE content, its anticipated benefits, and addressing prevalent misconceptions through awareness and promotion content for digital social media platforms. Methods: For the development of the intervention (audio-video content), focus group discussion sessions with key stakeholders were held. Two videos were created in partnership with social media influencers and subsequently shared on Facebook, YouTube, and Instagram. A comprehensive process and performance evaluation of the videos and intervention development phase was conducted to evaluate audience exposure, reach, engagement, demographics, retention, and in-depth insights. The videos were uploaded to social media platforms in June and July 2021, and the data used to assess their performance was obtained in February 2022. Results: With a total reach (number of people who have contact with the videos) of 432,457 and 735,563 for the first and second videos, respectively, on all social media platforms, we concluded that social media platforms provide an opportunity to communicate, promote, and engage with important stakeholders to raise awareness and obtain support for CSE. According to the findings, the public is responsive to CSE promotion content developed for social media platforms, with a total engagement (the number of people who participate in creating, sharing, and using the content) of 11,578. The findings revealed that male viewers predominated across all social media platforms. Punjab province had the largest audience share on Instagram (51.9\% for the first video, 52.7\% for the second) and Facebook (44.3\% for the first video and 48.4\% for the second). YouTube had the highest audience retention, with viewers watching an average of 151 seconds (45\%) of the first video and 163 seconds (38\%) of the second. With a net sentiment score of 0.83 (minimum=?3, maximum=5), end-user participation was also positive, and audience feedback highlighted the reasons for positive and negative criticism. Conclusions: To promote sexuality education in Pakistan, it is vital to overcome opposition through sensitizing the society, and digital social media platforms offer a unique, though underused, chance to do so through reliable influencer marketing. ",
doi="10.2196/52651",
url="https://formative.jmir.org/2024/1/e52651"
}


@Article{info:doi/10.2196/48627,
author="Lazard, J. Allison
and Vereen, N. Rhyan
and Zhou, Jieni
and Nichols, B. Hazel
and Pulido, Marlyn
and Swift, Catherine
and Dasgupta, Nabarun
and Fredrickson, L. Barbara",
title="Designing Positive Psychology Interventions for Social Media: Cross-Sectional Web-Based Experiment With Young Adults With Cancer",
journal="JMIR Cancer",
year="2024",
month="Dec",
day="20",
volume="10",
pages="e48627",
keywords="young adult",
keywords="cancer survivors",
keywords="social media",
keywords="positive psychology",
keywords="acceptability",
keywords="feasibility",
keywords="youth",
keywords="cancer",
keywords="psychosocial",
keywords="self-efficacy",
keywords="social connection",
keywords="positive emotion",
keywords="emotion",
keywords="social engagement",
abstract="Background: Young adults (ages 18?39 years) with cancer face unique risks for negative psychosocial outcomes. These risks could be lessened with positive psychology interventions adapted for social media if intervention messages encourage intentions to do the activities and positive message reactions and if young adults with cancer perceive few downsides. Objective: This study aimed to assess whether social media messages from evidence-based positive psychology interventions encouraged intentions to do the intervention activities and intended positive message reactions, overall and among sociodemographic or cancer characteristic subgroups. We also aimed to identify perceived downsides of the activity that would negatively impact the interventions' feasibility. Methods: Young adults (ages 18?39 years, cancer diagnosis ages 15?39 years) were randomized to a between-persons web-based experiment. Participants viewed a social media message with social context cues (vs not) for 1 of 2 types of intervention (acts of kindness vs social connectedness). Participants reported intentions to do the activity, along with their perceived social presence in the message (how much they felt the sense of others) and forecasted positivity resonance (whether they would experience socially connected positive emotions when doing the activity), with 5-point items. Participants also reported their self-efficacy (how certain they can do the intervention activity) with a 0?100 item and potential downsides of the activity categorically. Results: More than 4 out of 5 young adults with cancer (N=396) reported they ``somewhat'' (coded as 3) to ``extremely'' (5) intended to do the intervention activity (336/396, 84.8\%; mean ranged from 3.4?3.6, SD 0.9-1.0), perceived social presence in the messages (350/396, 88.4\%; mean 3.8, SD 0.7), and forecasted positivity resonance (349/396, 88.1\%; mean 3.8?3.9, SD 0.8). Participants reported having self-efficacy to complete the activity (mean 70.7\% of possible 100\%, SD 15.4\%?17.2\%). Most (320/396, 80.8\%) did not think of the downsides of the interventions. Messages with social context cues (vs not) and both intervention types were rated similarly (all P>.05). Black young adults reported lower intentions, perceived social presence, and forecasted positivity resonance than White young adults (all P<.001). Participants in active treatment (vs completed) reported greater intentions to do the activities (P<.001). Conclusions: Positive psychology intervention messages adapted for social media were perceived as acceptable and feasible among young adults with cancer. The social media--based messages encouraged increasing one's social connectedness and performing acts of kindness. Young adults with cancer also predicted they would have feelings of positive social engagement (positivity resonance) when doing the interventions---the key ingredient for experiencing the health benefits of these activities. This study provides promising evidence for the development of age-appropriate, highly scalable interventions to improve psychosocial health among young adults with cancer. ",
doi="10.2196/48627",
url="https://cancer.jmir.org/2024/1/e48627"
}


@Article{info:doi/10.2196/58757,
author="Onishi, Ryuta",
title="Parental Information-Use Strategies in a Digital Parenting Environment and Their Associations With Parental Social Support and Self-Efficacy: Cross-Sectional Study",
journal="JMIR Pediatr Parent",
year="2024",
month="Dec",
day="19",
volume="7",
pages="e58757",
keywords="parenting",
keywords="information use",
keywords="digital society",
keywords="online information",
keywords="social support",
keywords="self-efficacy",
keywords="parents",
keywords="surveys",
keywords="information seeking",
keywords="information behaviors",
keywords="resources",
keywords="children",
keywords="youth",
keywords="pediatric",
abstract="Background: In today's digital society, the acquisition of parenting information through online platforms such as social networking sites (SNSs) has become widespread. Amid the mix of online and offline information sources, there is a need to discover effective information-seeking methods for solving parenting problems. Objective: This study aimed to identify patterns of information use among parents of young children in the digital age and elucidate the characteristics of these patterns through a comparative analysis of parental social support and self-efficacy. Methods: An internet-based survey was administered to fathers and mothers of children aged 0-3 years. Convenience sampling, facilitated by an internet-based survey company, was adopted, and data from 227 fathers and 206 mothers were analyzed. The survey included questions on personal characteristics, frequency of use of different sources of parenting information (websites, SNSs, parenting apps, family, friends, and professionals), availability of parental social support, and parental self-efficacy. The Partitioning Around Medoids (PAM) clustering algorithm was used to identify patterns in parenting information use. Results: A total of 4 clusters were identified: multisource gatherers (n=161), offline-centric gatherers (n=105), online-centric gatherers (n=86), and minimal information gatherers (n=68). The availability of parental social support was perceived to be relatively higher among multisource and offline-centric gatherers compared with online-centric and minimal information gatherers. Parental self-efficacy was highest among multisource gatherers, followed by offline-centric and online-centric gatherers, and lowest among minimal information gatherers. Conclusions: This study contributes to the evidence that online information can effectively complement offline information in addressing parenting challenges, although its ability to fully replace offline sources remains limited. Parenting support professionals are encouraged to understand parents' current information use strategies and actively foster their social relationships, helping them to adopt more diverse and comprehensive approaches to information use. ",
doi="10.2196/58757",
url="https://pediatrics.jmir.org/2024/1/e58757"
}


@Article{info:doi/10.2196/53696,
author="Khoshnaw, Sara
and Panzarasa, Pietro
and De Simoni, Anna",
title="Metaphor Diffusion in Online Health Communities: Infodemiology Study in a Stroke Online Health Community",
journal="JMIR Cardio",
year="2024",
month="Dec",
day="17",
volume="8",
pages="e53696",
keywords="online health community",
keywords="social capital",
keywords="metaphor",
keywords="stroke",
keywords="OHC",
keywords="novelty",
keywords="passive analysis",
keywords="stroke survivor",
keywords="self-promotion",
keywords="post-stroke",
keywords="information diffusion",
abstract="Background: Online health communities (OHCs) enable patients to create social ties with people with similar health conditions outside their existing social networks. Harnessing mechanisms of information diffusion in OHCs has attracted attention for its ability to improve illness self-management without the use of health care resources. Objective: We aimed to analyze the novelty of a metaphor used for the first time in an OHC, assess how it can facilitate self-management of post-stroke symptoms, describe its appearance over time, and classify its diffusion mechanisms. Methods: We conducted a passive analysis of posts written by UK stroke survivors and their family members in an online stroke community between 2004 and 2011. Posts including the term ``legacy of stroke'' were identified. Information diffusion was classified according to self-promotion or viral spread mechanisms and diffusion depth (the number of users the information spreads out to). Linguistic analysis was performed through the British National Corpus and the Google search engine. Results: Post-stroke symptoms were referred to as ``legacy of stroke.'' This metaphor was novel and appeared for the first time in the OHC in the second out of a total of 3459 threads. The metaphor was written by user A, who attributed it to a stroke consultant explaining post-stroke fatigue. This user was a ``superuser'' (ie, a user with high posting activity) and self-promoted the metaphor throughout the years in response to posts written by other users, in 51 separate threads. In total, 7 users subsequently used the metaphor, contributing to its viral diffusion, of which 3 were superusers themselves. Superusers achieved the higher diffusion depths (maximum of 3). Of the 7 users, 3 had been part of threads where user A mentioned the metaphor, while 2 users had been part of discussion threads in unrelated conversations. In total, 2 users had not been part of threads with any of the other users, suggesting that the metaphor was acquired through prior lurking activity. Conclusions: Metaphors that are considered helpful by patients with stroke to come to terms with their symptoms can diffuse in OHCs through both self-promotion and social (or viral) spreading, with the main driver of diffusion being the superuser trait. Lurking activity (the most common behavior in OHCs) contributed to the diffusion of information. As an increasing number of patients with long-term conditions join OHCs to find others with similar health-related concerns, improving clinicians' and researchers' awareness of the diffusion of metaphors that facilitate self-management in health social media may be beneficial beyond the individual patient. ",
doi="10.2196/53696",
url="https://cardio.jmir.org/2024/1/e53696"
}


@Article{info:doi/10.2196/57154,
author="Mabaso, Siza Wakithi
and Hein, Sascha
and Pavarini, Gabriela
and 
and Fazel, Mina",
title="Exploring the Relationship Between Public Social Media Accounts, Adolescent Mental Health, and Parental Guidance in England: Large Cross-Sectional School Survey Study",
journal="J Med Internet Res",
year="2024",
month="Dec",
day="17",
volume="26",
pages="e57154",
keywords="social media",
keywords="adolescent health",
keywords="privacy",
keywords="parental guidance",
keywords="mood disorders",
keywords="adolescent",
keywords="anxiety",
keywords="depression",
keywords="cross-sectional",
keywords="mental health",
keywords="public",
keywords="account",
keywords="school-going",
keywords="school",
keywords="England",
keywords="survey",
keywords="logistic regression",
keywords="observational",
abstract="Background: Although associations between social media use and adolescent mental health have been described, more information is needed on the potential components characterizing this complex exposure, in particular, those related to maintaining a public social media account. Objective: This study aims to investigate the association between having a public social media account and anxiety and depression in school-going adolescents. Methods: Overall, 80 secondary schools and further education colleges in England were sampled using a cross-sectional web-based survey as part of the 2023 OxWell Student Survey. Social media exposure was categorized among the adolescents as having a public social media account versus not having a public social media account. The risk of clinical anxiety and depression was determined using the Revised Child Anxiety and Depression Scale-11. Adolescents self-reported the content and platforms accessed in the previous 24 hours. Associations between having a public social media account and symptoms of anxiety and depression were assessed using logistic regression controlling for age, sex, the experience of being bullied, parental guidance of online behavior (describing perceived parental approaches to adolescents' online activity), the proportion of close friendships engaged with online, poverty status, and placement in statutory care. Age, sex, and parental guidance of online behavior were assessed for primary association effect modification. Results: Data collected from 16,655 adolescents (aged 11-18 y) were analyzed. Of these 16,655 adolescents, 6734 (40.43\%) had a public social media account, while 9921 (59.57\%) either had a private social media account or no social media account. Moreover, 32.6\% (5429/16,655) of the adolescents screened positive for symptoms of anxiety and depression. Those with a public social media account had higher odds of anxiety and depression (odds ratio [OR] 1.41, 95\% CI 1.32-1.50) than those without a public social media account in an unadjusted and fully adjusted model (OR 1.39, 95\% CI 1.29-1.49). Adolescents reporting active parental guidance had lower odds of anxiety and depression (OR 0.85, 95\% CI 0.75-0.93) than those reporting no parental guidance, and these parental approaches to online behaviors significantly modified the association between having a public social media account and symptoms of anxiety and depression (P=.004; $\chi$22=11.1). Conclusions: Our OxWell study findings suggest a potential mental health risk for adolescents with a public social media account. We show evidence indicating some protection from anxiety and depression among adolescents who do not have a public social media account and those reporting some form of parental guidance of their online behavior. This was pronounced in adolescents reporting active parental guidance compared to stricter regulatory approaches or no guidance at all. The specific roles that social media account choices and parental guidance of online behavior may play in supporting the mental health of adolescents are highlighted for further investigation. International Registered Report Identifier (IRRID): RR2-10.1136/bmjopen-2021-052717 ",
doi="10.2196/57154",
url="https://www.jmir.org/2024/1/e57154",
url="http://www.ncbi.nlm.nih.gov/pubmed/39688898"
}


@Article{info:doi/10.2196/58510,
author="Alfozan, Mohammed
and Alshahrani, Saad
and Alasmi, Raed",
title="Emerging Use of Social Media in Clinical Urology Practice in the 21st Century: Survey Study",
journal="JMIR Form Res",
year="2024",
month="Dec",
day="16",
volume="8",
pages="e58510",
keywords="delivery of health care",
keywords="social media",
keywords="urologists",
keywords="urology",
keywords="Saudi Arabia",
keywords="professional communication",
keywords="physician behavior",
abstract="Background: Social media (So-Me) platforms are valuable resources for health care professionals and academics to discover, discuss, and distribute current advances in research and clinical practices, including technology trends. Objective: This study aims to assess the role of So-Me in urological practice in Saudi Arabia. It explores the influence of digital platforms on patient interaction, professional communication, decision-making, and education. Methods: The survey was conducted among 145 urologists from July 2021 to July 2022 following institutional review board approval. A questionnaire designed using the SurveyMonkey platform examined urologists' knowledge of So-Me. The survey was conducted using the CHERRIES (Checklist for Reporting Results of Internet E-Surveys) guidelines and was open for 17 weeks. Data analysis was performed using SPSS 21.0. Results: Of the 145 participants, 70\% (n=102) were Saudi Arabians. The most common age groups were 30?40 (n=68, 46.8\%) and 41?50 (n=61, 42.2\%) years, with a gender distribution of 44.8\% (n=65) women and 55.2\% (n=80) men. A total of 61.5\% (n=89) of urologists reported using So-Me accounts for professional purposes, with 54.9\% (n=80) sharing health-related information. Social media enhanced patient connections beyond clinic visits for 55.8\% (n=81) of respondents, while 57.2\% (n=83) used it to provide educational resources. Additionally, 56.5\% (n=82) believed So-Me facilitated patient feedback and improved their practice. In terms of professional communication, 60.6\% (n=88) of urologists agreed that So-Me facilitated collaboration with colleagues, while 63.3\% (n=92) used it to stay updated on the latest advances in urology. Furthermore, 62\% (n=90) followed professional societies or journals on So-Me, and 63.3\% (n=92) used it for continuing medical education. A majority (n=94, 64.7\%) reported that So-Me influenced treatment decisions based on new research findings, and 85.3\% (n=124) learned about novel technologies and treatment options through these platforms. Regression analysis showed a significant positive correlation between gender and social media usage patterns (R=0.653, R2=0.426), indicating that approximately 42.6\% of the differences in usage patterns can be attributed to gender. However, the Pearson $\chi$2 analysis showed that gender did not significantly affect most aspects of social media use, except information sharing and participating in online discussions (both P<.05). Conclusions: This study highlights the widespread use of So-Me among urologists in Saudi Arabia, underscoring its role in enhancing patient interaction, professional development, and clinical decision-making. Strategically designed health care programs using social media could improve and modernize professional and patient-centered care in Saudi Arabia through legislative assistance and guidelines. ",
doi="10.2196/58510",
url="https://formative.jmir.org/2024/1/e58510"
}


@Article{info:doi/10.2196/52997,
author="Fan, Lizhou
and Li, Lingyao
and Hemphill, Libby",
title="Toxicity on Social Media During the 2022 Mpox Public Health Emergency: Quantitative Study of Topical and Network Dynamics",
journal="J Med Internet Res",
year="2024",
month="Dec",
day="12",
volume="26",
pages="e52997",
keywords="social media",
keywords="network analysis",
keywords="pandemic risk",
keywords="health care analytics",
keywords="infodemiology",
keywords="infoveillance",
keywords="health communication",
keywords="mpox",
abstract="Background: Toxicity on social media, encompassing behaviors such as harassment, bullying, hate speech, and the dissemination of misinformation, has become a pressing social concern in the digital age. Its prevalence intensifies during periods of social crises and unrest, eroding a sense of safety and community. Such toxic environments can adversely impact the mental well-being of those exposed and further deepen societal divisions and polarization. The 2022 mpox outbreak, initially called ``monkeypox'' but later renamed to reduce stigma and address societal concerns, provides a relevant context for this issue. Objective: In this study, we conducted a comprehensive analysis of the toxic online discourse surrounding the 2022 mpox outbreak. We aimed to dissect its origins, characterize its nature and content, trace its dissemination patterns, and assess its broader societal implications, with the goal of providing insights that can inform strategies to mitigate such toxicity in future crises. Methods: We collected >1.6 million unique tweets and analyzed them with 5 dimensions: context, extent, content, speaker, and intent. Using topic modeling based on bidirectional encoder representations from transformers and social network community clustering, we delineated the toxic dynamics on Twitter. Results: By categorizing topics, we identified 5 high-level categories in the toxic online discourse on Twitter, including disease (20,281/43,521, 46.6\%), health policy and health care (8400/43,521, 19.3\%), homophobia (10,402/43,521, 23.9\%), politics (2611/43,521, 6\%), and racism (1784/43,521, 4.1\%). Across these categories, users displayed negativity or controversial views on the mpox outbreak, highlighting the escalating political tensions and the weaponization of stigma during this infodemic. Through the toxicity diffusion networks of mentions (17,437 vertices with 3628 clusters), retweets (59,749 vertices with 3015 clusters), and the top users with the highest in-degree centrality, we found that retweets of toxic content were widespread, while influential users rarely engaged with or countered this toxicity through retweets. Conclusions: Our study introduces a comprehensive workflow that combines topical and network analyses to decode emerging social issues during crises. By tracking topical dynamics, we can track the changing popularity of toxic content on the internet, providing a better understanding of societal challenges. Network dynamics highlight key social media influencers and their intentions, suggesting that engaging with these central figures in toxic discourse can improve crisis communication and guide policy making. ",
doi="10.2196/52997",
url="https://www.jmir.org/2024/1/e52997"
}


@Article{info:doi/10.2196/60033,
author="Niu, Zheyu
and Hao, Yijie
and Yang, Faji
and Jiang, Qirong
and Jiang, Yupeng
and Zhang, Shizhe
and Song, Xie
and Chang, Hong
and Zhou, Xu
and Zhu, Huaqiang
and Gao, Hengjun
and Lu, Jun",
title="Quality of Pancreatic Neuroendocrine Tumor Videos Available on TikTok and Bilibili: Content Analysis",
journal="JMIR Form Res",
year="2024",
month="Dec",
day="11",
volume="8",
pages="e60033",
keywords="pancreatic neuroendocrine tumors",
keywords="short videos",
keywords="quality analysis",
keywords="TikTok",
keywords="Bilibili",
keywords="social media",
abstract="Background: Disseminating disease knowledge through concise videos on various platforms is an innovative and efficient approach. However, it remains uncertain whether pancreatic neuroendocrine tumor (pNET)-related videos available on current short video platforms can effectively convey accurate and impactful information to the general public. Objective: Our study aims to extensively analyze the quality of pNET-related videos on TikTok and Bilibili, intending to enhance the development of pNET-related social media content to provide the general public with more comprehensive and suitable avenues for accessing pNET-related information. Methods: A total of 168 qualifying videos pertaining to pNETs were evaluated from the video-sharing platforms Bilibili and TikTok. Initially, the fundamental information conveyed in the videos was documented. Subsequently, we discerned the source and content type of each video. Following that, the Global Quality Scale (GQS) and modified DISCERN (mDISCERN) scale were employed to appraise the educational value and quality of each video. A comparative evaluation was conducted on the videos obtained from these two platforms. Results: The number of pNET-related videos saw a significant increase since 2020, with 9 videos in 2020, 19 videos in 2021, 29 videos in 2022, and 106 videos in 2023. There were no significant improvements in the mean GQS or mDISCERN scores from 2020 to 2023, which were 3.22 and 3.00 in 2020, 3.33 and 2.94 in 2021, 2.83 and 2.79 in 2022, and 2.78 and 2.94 in 2023, respectively. The average quality scores of the videos on Bilibili and Tiktok were comparable, with GQS and mDISCERN scores of 2.98 on Bilibili versus 2.77 on TikTok and 2.82 on Bilibili versus 3.05 on TikTok, respectively. The source and format of the videos remained independent factors affecting the two quality scores. Videos that were uploaded by professionals (hazard ratio=7.02, P=.002) and recorded in specialized popular science formats (hazard ratio=12.45, P<.001) tended to exhibit superior quality. Conclusions: This study demonstrates that the number of short videos on pNETs has increased in recent years, but video quality has not improved significantly. This comprehensive analysis shows that the source and format of videos are independent factors affecting video quality, which provides potential measures for improving the quality of short videos. ",
doi="10.2196/60033",
url="https://formative.jmir.org/2024/1/e60033"
}


@Article{info:doi/10.2196/50449,
author="Szeto, D. Mindy
and Alhanshali, Lina
and Rundle, W. Chandler
and Adelman, Madeline
and Hook Sobotka, Michelle
and Woolhiser, Emily
and Wu, Jieying
and Presley, L. Colby
and Maghfour, Jalal
and Meisenheimer, John
and Anderson, B. Jaclyn
and Dellavalle, P. Robert",
title="Dermatologic Data From the Global Burden of Disease Study 2019 and the PatientsLikeMe Online Support Community: Comparative Analysis",
journal="JMIR Dermatol",
year="2024",
month="Dec",
day="11",
volume="7",
pages="e50449",
keywords="Global Burden of Disease",
keywords="GBD",
keywords="PatientsLikeMe",
keywords="PLM",
keywords="online support communities",
keywords="forums",
keywords="users",
keywords="social media",
keywords="internet",
keywords="demographics",
keywords="lived experience",
keywords="disability-adjusted life year",
keywords="DALY",
keywords="prevalence",
keywords="dermatology",
keywords="comparative analysis",
doi="10.2196/50449",
url="https://derma.jmir.org/2024/1/e50449"
}


@Article{info:doi/10.2196/54321,
author="Walsh, Julia
and Cave, Jonathan
and Griffiths, Frances",
title="Combining Topic Modeling, Sentiment Analysis, and Corpus Linguistics to Analyze Unstructured Web-Based Patient Experience Data: Case Study of Modafinil Experiences",
journal="J Med Internet Res",
year="2024",
month="Dec",
day="11",
volume="26",
pages="e54321",
keywords="unstructured text",
keywords="natural language processing",
keywords="NLP",
keywords="topic modeling",
keywords="sentiment analysis",
keywords="corpus linguistics",
keywords="social media data",
keywords="patient experience",
keywords="unsupervised",
keywords="modafinil",
abstract="Background: Patient experience data from social media offer patient-centered perspectives on disease, treatments, and health service delivery. Current guidelines typically rely on systematic reviews, while qualitative health studies are often seen as anecdotal and nongeneralizable. This study explores combining personal health experiences from multiple sources to create generalizable evidence. Objective: The study aims to (1) investigate how combining unsupervised natural language processing (NLP) and corpus linguistics can explore patient perspectives from a large unstructured dataset of modafinil experiences, (2) compare findings with Cochrane meta-analyses on modafinil's effectiveness, and (3) develop a methodology for analyzing such data. Methods: Using 69,022 posts from 790 sources, we used a variety of NLP and corpus techniques to analyze the data, including data cleaning techniques to maximize post context, Python for NLP techniques, and Sketch Engine for linguistic analysis. We used multiple topic mining approaches, such as latent Dirichlet allocation, nonnegative matrix factorization, and word-embedding methods. Sentiment analysis used TextBlob and Valence Aware Dictionary and Sentiment Reasoner, while corpus methods including collocation, concordance, and n-gram generation. Previous work had mapped topic mining to themes, such as health conditions, reasons for taking modafinil, symptom impacts, dosage, side effects, effectiveness, and treatment comparisons. Results: Key findings of the study included modafinil use across 166 health conditions, most frequently narcolepsy, multiple sclerosis, attention-deficit disorder, anxiety, sleep apnea, depression, bipolar disorder, chronic fatigue syndrome, fibromyalgia, and chronic disease. Word-embedding topic modeling mapped 70\% of posts to predefined themes, while sentiment analysis revealed 65\% positive responses, 6\% neutral responses, and 28\% negative responses. Notably, the perceived effectiveness of modafinil for various conditions strongly contrasts with the findings of existing randomized controlled trials and systematic reviews, which conclude insufficient or low-quality evidence of effectiveness. Conclusions: This study demonstrated the value of combining NLP with linguistic techniques for analyzing large unstructured text datasets. Despite varying opinions, findings were methodologically consistent and challenged existing clinical evidence. This suggests that patient-generated data could potentially provide valuable insights into treatment outcomes, potentially improving clinical understanding and patient care. ",
doi="10.2196/54321",
url="https://www.jmir.org/2024/1/e54321"
}


@Article{info:doi/10.2196/60530,
author="Goethals, Luc
and Prokofieva Nelson, Victoria
and Fenouillet, Fabien
and Chevreul, Karine
and Bergerat, Manon
and Lebreton, Christine
and Refes, Yacine
and Blangis, Flora
and Chalumeau, Martin
and Le Roux, Enora",
title="Characteristics and Popularity of Videos of Abusive Head Trauma Prevention: Systematic Appraisal",
journal="J Med Internet Res",
year="2024",
month="Dec",
day="10",
volume="26",
pages="e60530",
keywords="abusive head trauma",
keywords="child physical abuse",
keywords="shaken baby syndrome",
keywords="SBS",
keywords="primary prevention",
keywords="web-based videos",
keywords="digital tools",
keywords="head trauma",
keywords="prevention",
keywords="video",
keywords="internet",
keywords="infant",
keywords="mortality",
keywords="morbidity",
keywords="parent",
keywords="caregivers",
keywords="communication",
abstract="Background: Numerous strategies for preventing abusive head trauma (AHT) have been proposed, but controlled studies failed to demonstrate their effectiveness. Digital tools may improve the effectiveness of AHT prevention strategies by reaching a large proportion of the adult population. Objective: This study aimed to describe the characteristics of videos of AHT prevention published on the internet, including their quality content, and to study their association with popularity. Methods: From a systematic appraisal performed in June 2023, we identified videos addressing the primary prevention of AHT in children younger than 2 years that were published in English or French on the internet by public organizations or mainstream associations. We analyzed the characteristics of the videos; their quality with the Global Quality Scale (GQS); and their association with an index of popularity, the Video Power Index, using multivariable quasi-Poisson modeling. Results: We included 53 (6.6\%) of the 804 videos identified. Videos were mainly published by public organizations (43/53, 81\%). The median time spent on the web was 6 (IQR 3-9) years, the median length was 202 (IQR 94-333) seconds, and the median GQS score was 4 (IQR 3-4). Infants were often depicted (42/53, 79\%), including while crying (35/53, 66\%) and being shaken (21/53, 40\%). The characterization of shaking as an abuse and its legal consequences were cited in 47\% (25/53) and 4\% (2/53) of videos, respectively. The main prevention strategies in the videos were to raise awareness of the noxious outcome of shaking (49/53, 93\%) and convince viewers of the effectiveness of coping strategies for infants' cries (45/53, 85\%). The Video Power Index was positively correlated with the GQS (r=0.38; P=.007) and was independently associated with depicting an infant being shaken (P=.03; $\beta$=1.74, 95\% CI 1.06-2.85) and the use of text or headers (P=.04; $\beta$=2.15, 95\% CI 1.08-4.26). Conclusions: AHT prevention videos had high quality but did not frequently deal with parental risk factors. The characteristics identified as being associated with the popularity of AHT prevention videos could help improve the impact of future prevention programs by enhancing their popularity. ",
doi="10.2196/60530",
url="https://www.jmir.org/2024/1/e60530"
}


@Article{info:doi/10.2196/58581,
author="Mora Pinzon, Maria
and Hills, Ornella
and Levy, George
and James, T. Taryn
and Benitez, Ashley
and Lawrence, Sacheen
and Ellis, Tiffany
and Washington, Venus
and Solorzano, Lizbeth
and Tellez-Giron, Patricia
and Cano Ospina, Fernando
and Metoxen, F. Melissa
and Gleason, E. Carey",
title="Implementation of a Social Media Strategy for Public Health Promotion in Black, American Indian or Alaska Native, and Hispanic or Latino Communities During the COVID-19 Pandemic: Cross-Sectional Study",
journal="J Med Internet Res",
year="2024",
month="Dec",
day="10",
volume="26",
pages="e58581",
keywords="health communications",
keywords="social media",
keywords="Hispanic",
keywords="Latino",
keywords="Black",
keywords="American Indian",
keywords="Alaska Native",
keywords="minority health",
keywords="health disparities",
keywords="COVID-19",
abstract="Background: Individuals identifying as Black, American Indian or Alaska Native, or Hispanic or Latino lack access to culturally appropriate accurate information and are the target of disinformation campaigns, which create doubt in science and health care providers and might play a role in sustaining health disparities related to the COVID-19 pandemic. Objective: This study aims to create and disseminate culturally and medically appropriate social media messages for Black, Latino, and American Indian or Alaska Native communities in Wisconsin and evaluate their reach and effectiveness in addressing the information needs of these communities. Methods: Our team identified relevant COVID-19 topics based on feedback from their respective community, developed lay format materials, and translated materials into culturally appropriate social media messages that community advocates delivered across their respective communities. Social media metrics (reach, engagement, and impressions) were collected using Sprout Social and Facebook Analytics. We hosted 9 focus groups with community members to learn about their social media use. These data were analyzed using an inductive approach, using NVivo software (release 1.7) to code content. Results: Between August 2021 and January 2023, we created 980 unique social media posts that reached 88,790 individuals and gathered >6700 engagements. Average reach per post was similar across the 3 communities, despite differences in the number of posts and followers on each page: 119.46 (Latino individuals), 111.74 (Black individuals), and 113.11 (Oneida Nation members). The type of posts that had higher engagement rate per reached person (ERR) varied across communities and platforms, with the highest being live videos for the Latino community on Facebook (ERR 9.4\%), videos for the Black community on Facebook (ERR 19.53\%), and social media messages for the Oneida Nation community (ERR 59.01\%). Conclusions: Our project presents a unique and effective model for health messages and highlights the need for tailoring social media messages and approaches for minoritized audiences (eg, age, gender, race, and ethnicity). Further research studies are needed to explore how specific types of information affect the dissemination of information and the implications for health communications. ",
doi="10.2196/58581",
url="https://www.jmir.org/2024/1/e58581"
}


@Article{info:doi/10.2196/63907,
author="Jeon, Sangha
and Charles, Turk Susan",
title="Internet-Based Social Activities and Cognitive Functioning 2 Years Later Among Middle-Aged and Older Adults: Prospective Cohort Study",
journal="JMIR Aging",
year="2024",
month="Dec",
day="10",
volume="7",
pages="e63907",
keywords="online social interaction",
keywords="cognitive health",
keywords="age differences",
keywords="Health and Retirement Study",
keywords="social activity",
keywords="internet use",
keywords="isolation",
abstract="Background: A number of studies document the benefits of face-to-face social interactions for cognitive functioning among middle-aged and older adults. Social activities in virtual worlds may confer similar if not enhanced cognitive benefits as face-to-face social activities, given that virtual interactions require the additional cognitive tasks of learning and navigating communicative tools and technology platforms. Yet, few studies have examined whether social activities in internet-based settings may have synergistic effects on cognitive functioning beyond those of face-to-face interactions. Objective: This study examined whether internet-based social activity participation is associated with concurrent and later cognitive functioning, after adjusting for face-to-face social activity participation and sociodemographic covariates. Methods: For cross-sectional analyses, we included 3650 adults aged 50 years and older who completed questions in the 2020 Health and Retirement Study about social activity participation, including specific internet-based social activities such as emailing or accessing social networks. Cognitive functioning was measured using the standardized cognitive tasks assessing working memory, episodic memory, and attention and processing speed. The longitudinal analyses included the 2034 participants who also completed follow-up cognitive assessments in 2022. Results: Our results revealed that those with higher levels of internet-based social activity participation had higher levels of concurrent cognitive functioning than those with low levels of internet-based social activity participation, after adjusting for demographic and health-related factors and face-to-face social activity participation (b=0.44, SE 0.07; P<.001). More internet-based social activity participation also predicted better cognitive functioning 2 years later, even when adjusting for baseline cognitive functioning and other covariates (b=0.35, SE 0.09; P<.001). Conclusions: Our findings suggest that greater engagement in internet-based social activities is associated with higher levels of concurrent cognitive functioning and slower cognitive decline in middle-aged and older adults. ",
doi="10.2196/63907",
url="https://aging.jmir.org/2024/1/e63907"
}


@Article{info:doi/10.2196/58688,
author="Liu, Xuan
and Chi, Xiaotong
and Chen, Ming
and Sun, Wen
and Li, Jia",
title="Spillover Effects of Paid Functions on Physicians' Unpaid Knowledge Activities: Quasi-Experimental Approach",
journal="J Med Internet Res",
year="2024",
month="Dec",
day="10",
volume="26",
pages="e58688",
keywords="health knowledge contribution",
keywords="economic incentives",
keywords="diversity",
keywords="propensity score matching",
keywords="multi-period difference in differences",
abstract="Background: To promote sustained contributions by physicians to online health care communities, these platforms have introduced a content payment model that offers economic incentives for physicians' online knowledge activities. However, the impact of these paid features on unpaid knowledge activities remains unexplored. Objective: This study investigated how the introduction of economic incentives in online medical communities affects physicians' unpaid knowledge activities in the community. Methods: The data for this study were obtained from the Haodf Online platform in China, which has implemented paid scenarios for its science popularization function, providing economic benefits to physicians. The dataset, which comprises panel data, includes 7453 physicians who participated in both paid and unpaid knowledge contributions on the website. This study examined the impact of paid knowledge activities on physicians' free knowledge contributions, focusing on dimensions including knowledge quantity, quality, and diversity. To address the timing discrepancies in physicians' participation in paid activities, we used a quasi-experimental design that combined the approach of propensity score matching and multi-period difference in differences. Results: In the balance test results of the propensity score matching, the absolute values of the SDs of all matching variables were mostly <5\% after matching, ensuring the accuracy of the results obtained from the difference in differences method. This study found that participation in paid knowledge activities had a positive spillover effect on physicians' free knowledge contributions, which manifested in the increase in post quantity (473.1\%; P<.001), article length (108\%; P=.009), function word frequency (0.6\%; P=.001), causal word frequency (0.2\%; P<.001), and content information entropy (6.6\%; P=.006). The paid function led to a decrease in the consistency between titles and content (--115.5\%; P<.001). Conclusions: The findings of this study contribute to the existing literature on the impact of economic incentives in the medical context. For the platform, providing economic incentives to physicians can have positive significance in promoting the development of the platform's knowledge ecosystem and can effectively encourage physicians to contribute to both paid and free knowledge activities. This study provides a valuable reference for the platform to introduce a paid knowledge model, which is beneficial to the sustainable development of the platform. ",
doi="10.2196/58688",
url="https://www.jmir.org/2024/1/e58688",
url="http://www.ncbi.nlm.nih.gov/pubmed/39656521"
}


@Article{info:doi/10.2196/60283,
author="Muenster, Mika Roxana
and Gangi, Kai
and Margolin, Drew",
title="Alternative Health and Conventional Medicine Discourse About Cancer on TikTok: Computer Vision Analysis of TikTok Videos",
journal="J Med Internet Res",
year="2024",
month="Dec",
day="9",
volume="26",
pages="e60283",
keywords="misinformation",
keywords="social media",
keywords="TikTok",
keywords="alternative health",
keywords="cancer",
keywords="computer vision",
abstract="Background: Health misinformation is abundant online and becoming an increasingly pressing concern for both oncology practitioners and patients with cancer. On social media platforms, including the popular audiovisual app TikTok, the flourishing alternative health industry is further contributing to the spread of misleading and often harmful information, endangering patients' health and outcomes and sowing distrust of the medical community. The prevalence of false and potentially dangerous treatments on a platform that is used as a quasi--search engine by young people poses a serious risk to the health of patients with cancer. Objective: This study seeks to examine how cancer discourse on TikTok differs between alternative health and conventional medicine videos. It aims to look beyond mere facts and falsehoods that TikTok users may utter to understand the visual language and format used in the support of both misleading and truthful narratives, as well as other messages. Methods: Using computer vision analysis and subsequent qualitative close reading of 831 TikTok videos, this study examined how alternative health and conventional medicine videos on cancer differ with regard to the visual language used. Videos were examined for the length of time and prominence in which faces are displayed, as well as for the background setting, location, and dominant color scheme. Results: The results show that the alt-health and conventional health samples made different use of the audiovisual affordances of TikTok. First, videos from the alternative health sample were more likely to contain a single face that was prominently featured (making up at least 7.5\% of the image) for a substantial period of time (35\% of the shots), with these testimonial-style videos making up 28.5\% (93/326) of the sample compared to 18.6\% (94/505) of the conventional medicine sample. Alternative health videos predominantly featured cool tones (P<.001) and were significantly more likely to be filmed outdoors (P<.001), whereas conventional medicine videos were more likely to be shot indoors and feature warm tones such as red, orange, or yellow. Conclusions: The findings of this study contribute to an increased understanding of misinformation as not merely a matter of individual falsehoods but also a phenomenon whose effects might be transported through emotive as well as rational means. They also point to influencer practices and style being an important contributing factor in the declining health of the information environment around cancer and its treatment. The results suggest that public health efforts must extend beyond correcting false statements by injecting factual information into the online cancer discourse and look toward incorporating both visual and rational strategies. ",
doi="10.2196/60283",
url="https://www.jmir.org/2024/1/e60283"
}


@Article{info:doi/10.2196/56970,
author="Bostock, CS Emmanuelle
and Nevarez-Flores, G. Adriana
and Neil, L. Amanda
and Pontes, M. Halley
and Kirkby, C. Kenneth",
title="Self-Induced Mania Methods and Motivations Reported in Online Forums: Observational Qualitative Study",
journal="J Particip Med",
year="2024",
month="Dec",
day="6",
volume="16",
pages="e56970",
keywords="bipolar disorder",
keywords="mania",
keywords="hypomania",
keywords="self-induced",
keywords="online forums",
keywords="consumer reports",
abstract="Background: In bipolar disorder (BD), mania may be self-induced by manipulation of specific precipitants, as reported in case studies. Another potential source of information on the self-induction of mania is the online postings of users with lived experience of mania. Objective: The primary aim of this study is to examine the range of methods used to self-induce mania or hypomania described by users of online forums with self-reported BD. Second, we summarize the motivations of users to engage in these behaviors. Methods: We conducted an observational study of online forum posts that discussed self-induction of mania or hypomania, either in the posters themselves or observed firsthand in others. Posts were identified using Google advanced search operators, then extracted and coded for content in NVivo (version 12 for Mac; QSR International). A total of 44 online forum threads were identified discussing self-induced mania (n=25) or hypomania (n=19). These forums contained 585 posts by 405 usernames, of which 126 usernames discussed methods for self-induction across 327 posts (number of methods per username: median 2, IQR 1-4; range 1-11). Results: In total, 36 methods were grouped by the authors. The most frequently reported were sleep reduction (n=50), caffeine (n=37), and cessation of medication (n=27). Twenty-six usernames reported their motivation to self-induce mania or hypomania; almost three-quarters (n=19) reported a desire to end a depressive episode. Almost a third of usernames (118/405) explicitly discouraged other forum users from self-inducing mania or hypomania. Conclusions: Online forums provide an additional and valuable source of information about triggers for mania that may inform relapse prevention in BD. The online forum conversations investigated were generally responsible and included cautionary advice not to pursue these methods. ",
doi="10.2196/56970",
url="https://jopm.jmir.org/2024/1/e56970"
}


@Article{info:doi/10.2196/57687,
author="Orr, Noreen
and Rogers, Morwenna
and Stein, Abigail
and Thompson Coon, Jo
and Stein, Kenneth",
title="Reviewing the Evidence Base for Topical Steroid Withdrawal Syndrome in the Research Literature and Social Media Platforms: An Evidence Gap Map",
journal="J Med Internet Res",
year="2024",
month="Dec",
day="6",
volume="26",
pages="e57687",
keywords="topical steroid withdrawal syndrome",
keywords="evidence gap map",
keywords="social media",
keywords="blogs",
keywords="Instagram",
keywords="Reddit",
keywords="topical corticosteroids",
abstract="Background: Within the dermatological community, topical steroid withdrawal syndrome (TSWS) is a medically contested condition with a limited research base. Published studies on TSWS indicate that it is a distinct adverse effect of prolonged use of topical corticosteroids, but there is a paucity of high-quality research evidence. Among the ``patient community,'' awareness has been increasing, with rapid growth in social media posts on TSWS and the introduction of online communities such as the International Topical Steroid Awareness Network. This evidence gap map (EGM) was developed in response to recent calls for research to better understand TSWS and aims to be an important resource to guide both researchers and clinicians in the prioritization of research topics for further research. Objective: This study aims to identify the range, extent, and type of evidence on TSWS in the research literature and social media platforms using an EGM. Methods: The MEDLINE and Embase (Ovid), CINAHL (EBSCOhost), and ProQuest Dissertations \& Theses and Conference Proceedings Citation Index (CPCI-Science and CPCI-Social Science \& Humanities via Web of Science) databases were searched. The final search was run in November 2023. Study titles, abstracts, and full texts were screened by 2 reviewers, and a third was consulted to resolve any differences. Blogging sites WordPress, Medium, and Blogspot and Google were searched; Instagram and Reddit were searched for the 100 most recent posts on specific dates in February 2023. Blog titles, Instagram posts, and Reddit posts were screened for relevance by 2 reviewers. A data extraction tool was developed on EPPI-Reviewer, and data extraction was undertaken by one reviewer and checked by a second; any inconsistencies were resolved through discussion. We did not undertake quality appraisal of the included studies. EPPI-Reviewer and EPPI-Mapper were used to generate the interactive EGM. Results: Overall, 81 academic publications and 223 social media posts were included in the EGM. The research evidence mainly addressed the physical symptoms of TSWS (skin), treatments, and, to a lesser extent, risk factors and disease mechanisms. The social media evidence primarily focused on the physical symptoms (skin and nonskin), mental health symptoms, relationships, activities of everyday living, beliefs and attitudes, and treatments. Conclusions: The EGM shows that research evidence is growing on TSWS but remains lacking in several important areas: longer-term prospective observational studies to assess the safety of prolonged use of topical corticosteroids and to prevent addiction; qualitative research to understand the lived experience of TSWS; and longitudinal research on the patient's ``TSWS journey'' to healing. The inclusion of social media evidence is a methodological innovation in EGMs, recognizing the increased presence of \#topicalsteroidwithdrawal on social media and how it can be used to better understand the patient perspective and ultimately, provide better care for people with TSWS. ",
doi="10.2196/57687",
url="https://www.jmir.org/2024/1/e57687"
}


@Article{info:doi/10.2196/49927,
author="Kaminsky, Zachary
and McQuaid, J. Robyn
and Hellemans, GC Kim
and Patterson, R. Zachary
and Saad, Mysa
and Gabrys, L. Robert
and Kendzerska, Tetyana
and Abizaid, Alfonso
and Robillard, Rebecca",
title="Machine Learning--Based Suicide Risk Prediction Model for Suicidal Trajectory on Social Media Following Suicidal Mentions: Independent Algorithm Validation",
journal="J Med Internet Res",
year="2024",
month="Dec",
day="5",
volume="26",
pages="e49927",
keywords="suicide",
keywords="prediction",
keywords="social media",
keywords="machine learning",
keywords="suicide risk model",
keywords="validation",
keywords="natural language processing",
keywords="suicide risk",
keywords="Twitter",
keywords="suicidal ideation",
keywords="suicidal mention",
abstract="Background: Previous efforts to apply machine learning--based natural language processing to longitudinally collected social media data have shown promise in predicting suicide risk. Objective: Our primary objective was to externally validate our previous machine learning algorithm, the Suicide Artificial Intelligence Prediction Heuristic (SAIPH), against external survey data in 2 independent cohorts. A second objective was to evaluate the efficacy of SAIPH as an indicator of changing suicidal ideation (SI) over time. The tertiary objective was to use SAIPH to evaluate factors important for improving or worsening suicidal trajectory on social media following suicidal mention. Methods: Twitter (subsequently rebranded as X) timeline data from a student survey cohort and COVID-19 survey cohort were scored using SAIPH and compared to SI questions on the Beck Depression Inventory and the Self-Report version of the Quick Inventory of Depressive Symptomatology in 159 and 307 individuals, respectively. SAIPH was used to evaluate changing SI trajectory following suicidal mentions in 2 cohorts collected using the Twitter application programming interface. Results: An interaction of the mean SAIPH score derived from 12 days of Twitter data before survey completion and the average number of posts per day was associated with quantitative SI metrics in each cohort (student survey cohort interaction $\beta$=.038, SD 0.014; F4,94=3.3, P=.01; and COVID-19 survey cohort interaction $\beta$=.0035, SD 0.0016; F4,493=2.9, P=.03). The slope of average daily SAIPH scores was associated with the change in SI scores within longitudinally followed individuals when evaluating periods of 2 weeks or less ($\rho$=0.27, P=.04). Using SAIPH as an indicator of changing SI, we evaluated SI trajectory in 2 cohorts with suicidal mentions, which identified that those with responses within 72 hours exhibit a significant negative association of the SAIPH score with time in the 3 weeks following suicidal mention ($\rho$=--0.52, P=.02). Conclusions: Taken together, our results not only validate the association of SAIPH with perceived stress, SI, and changing SI over time but also generate novel methods to evaluate the effects of social media interactions on changing suicidal trajectory. ",
doi="10.2196/49927",
url="https://www.jmir.org/2024/1/e49927"
}


@Article{info:doi/10.2196/52551,
author="Pierce, Joni
and Conway, Mike
and Grace, Kathryn
and Mikal, Jude",
title="Identifying Factors Associated With Heightened Anxiety During Breast Cancer Diagnosis Through the Analysis of Social Media Data on Reddit: Mixed Methods Study",
journal="JMIR Cancer",
year="2024",
month="Dec",
day="5",
volume="10",
pages="e52551",
keywords="breast cancer",
keywords="anxiety",
keywords="NLP",
keywords="natural language processing",
keywords="mixed methods study",
keywords="cancer diagnosis",
keywords="social media apps",
keywords="descriptive analysis",
keywords="diagnostic progression",
keywords="patient-centered care",
abstract="Background: More than 85\% of patients report heightened levels of anxiety following breast cancer diagnosis. Anxiety may become amplified during the early stages of breast cancer diagnosis when ambiguity is high. High levels of anxiety can negatively impact patients by reducing their ability to function physically, make decisions, and adhere to treatment plans, with all these elements combined serving to diminish the quality of life. Objective: This study aimed to use individual social media posts about breast cancer experiences from Reddit (r/breastcancer) to understand the factors associated with breast cancer--related anxiety as individuals move from suspecting to confirming cancer diagnosis. Methods: We used a mixed method approach by combining natural language processing--based computational methods with descriptive analysis. Our team coded the entire corpus of 2170 unique posts from the r/breastcancer subreddit with respect to key variables, including whether the post was related to prediagnosis, diagnosis, or postdiagnosis concerns. We then used Linguistic Inquiry and Word Count (LIWC) to rank-order the codified posts as low, neutral, or high anxiety. High-anxiety posts were then retained for deep descriptive analysis to identify key themes relative to diagnostic progression. Results: After several iterations of data analysis and classification through both descriptive and computational methods, we identified a total of 448 high-anxiety posts across the 3 diagnostic categories. Our analyses revealed that individuals experience higher anxiety before a confirmed cancer diagnosis. Analysis of the high-anxiety posts revealed that the factors associated with anxiety differed depending on an individual's stage in the diagnostic process. Prediagnosis anxiety was associated with physical symptoms, cancer-related risk factors, communication, and interpreting medical information. During the diagnosis period, high anxiety was associated with physical symptoms, cancer-related risk factors, communication, and difficulty navigating the health care system. Following diagnosis, high-anxiety posts generally discussed topics related to treatment options, physical symptoms, emotional distress, family, and financial issues. Conclusions: This study has practical, theoretical, and methodological implications for cancer research. Content analysis reveals several possible drivers of anxiety at each stage (prediagnosis, during diagnosis, and postdiagnosis) and provides key insights into how clinicians can help to alleviate anxiety at all stages of diagnosis. Findings provide insights into cancer-related anxiety as a process beginning before engagement with the health care system: when an individual first notices possible cancer symptoms. Uncertainty around physical symptoms and risk factors suggests the need for increased education and improved access to trained medical staff who can assist patients with questions and concerns during the diagnostic process. Assistance in understanding technical reports, scheduling, and patient-centric clinician behavior may pinpoint opportunities for improved communication between patients and providers. ",
doi="10.2196/52551",
url="https://cancer.jmir.org/2024/1/e52551"
}


@Article{info:doi/10.2196/54092,
author="Na, Kilhoe
and Zimdars, Melissa
and Cullinan, E. Megan",
title="Understanding Membership in Alternative Health Social Media Groups and Its Association with COVID-19 and Influenza Vaccination: Web-Based Cross-Sectional Survey",
journal="JMIR Form Res",
year="2024",
month="Dec",
day="5",
volume="8",
pages="e54092",
keywords="alternative health",
keywords="social media",
keywords="misinformation",
keywords="vaccination",
keywords="COVID-19",
keywords="Coronavirus",
abstract="Background: Social media platforms have become home to numerous alternative health groups where people share health information and scientifically unproven treatments. Individuals share not only health information but also health misinformation in alternative health groups on social media. Yet, little research has been carried out to understand members of these groups. This study aims to better understand various characteristics of members in alternative health groups and the association between membership and attitudes toward vaccination and COVID-19 and influenza vaccination--related behaviors. Objective: This study aims to test hypotheses about different potential characteristics of members in alternative health groups and the association between membership and attitudes toward vaccination and vaccine-related behaviors. Methods: A web-based cross-sectional survey (N=1050) was conducted. Participants were recruited from 19 alternative health social media groups and Amazon's Mechanical Turk. A total of 596 participants were members of alternative health groups and 454 were nonmembers of alternative health groups. Logistic regressions were performed to test the hypotheses about the relationship between membership and the variables of interest. Results: Logistic regression revealed that there is a positive association between alternative health social media group membership and 3 personal characteristics: sharing trait (B=.83, SE=.11; P<.01; odds ratio [OR] 2.30, 95\% CI 1.85-2.86), fear of negative evaluations (B=.19, SE=.06; P<.001, OR 1.21, 95\% CI 1.06-1.37), and conspiratorial mentality (B=.33, SE=.08; P<.01; OR 1.40, 95\% CI 1.18-1.65). Also, the results indicate that there is a negative association between membership and 2 characteristics: health literacy (B=--1.09, SE=.17; P<.001; OR .33, 95\% CI 0.23-0.47) and attitudes toward vaccination (B=-- 2.33, SE=.09; P=.02; OR 0.79, 95\% CI 0.65-0.95). However, there is no association between membership and health consciousness (B=.12, SE=.10; P=.24; OR 1.13, 95\% CI 0.92-1.38). Finally, membership is negatively associated with COVID-19 vaccination status (B=--.84, SE=.17; P<.001; OR 48, 95\% CI 0.32-0.62), and influenza vaccination practice (B=--1.14, SE=.17; P<.001; OR .31, 95\% CI 0.22-0.45). Conclusions: Our findings indicate that people joining alternative health social media groups differ from nonmembers in different aspects, such as sharing, fear of negative evaluations, conspiratorial mentality, and health literacy. They also suggest that there is a significant relationship between membership and vaccination. By more thoroughly exploring the demographic, or by better understanding the people for whom interventions are designed, this study is expected to help researchers to more strategically and effectively develop and implement interventions. ",
doi="10.2196/54092",
url="https://formative.jmir.org/2024/1/e54092"
}


@Article{info:doi/10.2196/60050,
author="Ni, Congning
and Song, Qingyuan
and Chen, Qingxia
and Song, Lijun
and Commiskey, Patricia
and Stratton, Lauren
and Malin, Bradley
and Yin, Zhijun",
title="Sentiment Dynamics Among Informal Caregivers in Web-Based Alzheimer Communities: Systematic Analysis of Emotional Support and Interaction Patterns",
journal="JMIR Aging",
year="2024",
month="Dec",
day="4",
volume="7",
pages="e60050",
keywords="informal caregivers",
keywords="Alzheimer disease",
keywords="dementias",
keywords="web-based community",
keywords="sentiment analysis",
keywords="topic modeling",
keywords="caregiving",
keywords="carers",
keywords="family care",
keywords="support group",
keywords="peer support",
keywords="gerontology",
keywords="geriatrics",
keywords="aging",
keywords="attitudes",
keywords="opinion",
keywords="perceptions",
keywords="perspectives",
keywords="sentiment",
keywords="cognitive",
keywords="web-based communities",
keywords="Linguistic Inquiry and Word Count",
keywords="machine learning",
keywords="Valence Aware Dictionary for Sentiment Reasoning",
abstract="Background: Alzheimer disease and related dementias (ADRD) are a growing global health challenge. ADRD place significant physical, emotional, and financial burdens on informal caregivers and negatively affects their well-being. Web-based social media platforms have emerged as valuable sources of peer support for these caregivers. However, there has been limited investigation into how web-based peer support might influence their mental well-being. Objective: This study aims to examine the dynamics of sentiment scores, a major indicator of mental well-being, among informal ADRD caregivers, specifically how their sentiment changes as they participate in caregiving experience discussions within 2 ADRD web-based communities. Methods: We collected data from 2 large web-based ADRD caregiving communities, ALZConnected (from November 2011 to August 2022) and TalkingPoint (from March 2003 to November 2022). Using the Valence Aware Dictionary for Sentiment Reasoning and Linguistic Inquiry and Word Count, we calculated sentiment scores for each post and evaluated how the initial sentiment score of a topic initiator evolves within a discussion thread. Structured topic modeling and regression analysis were used to identify the primary topics consistently associated with sentiment changes within these threads. We investigated longitudinal sentiment trends to identify patterns of sentimental stability or enhancement due to prolonged engagement in web-based communities by plotting linear interpolation lines of the sentiment values of each individual user. Results: The ALZConnected dataset comprised 532,992 posts, consisting of 57,641 topic threads and 475,351 comments. The TalkingPoint dataset was composed of 846,344 posts, consisting of 81,068 topic threads and 765,276 comments. Our research revealed that topic initiators experienced a notable increase in sentiment as they engaged in subsequent discussions within their threads, with a significant uptick in positivity in the short term. This phenomenon is part of a broader trend of steadily rising positive sentiment among ADRD caregivers. Using structured topic modeling, we cataloged a diverse range of topics that included both emotional aspects, such as family emotions, and practical concerns, such as diagnosis and treatment and everyday care practices. We observed that sentiment scores were positively aligned with discussions about family and daily routines life (coefficient=3.53; P<.001), while topics related to illness (coefficient=--1.37; P<.001) and caregiving facilities (coefficient=--1.98; P<.001) tended to correlate with lower sentiment scores. This evidence highlights the significant impact that both the time of participation and the posting content have on the sentiment changes of caregivers. Conclusions: This study identifies sentiment changes among informal ADRD caregivers through their interactions in 2 extensive web-based communities. These findings emphasize the importance of early emotional support within a topic thread and demonstrate a predominantly positive sentiment in these communities over time. These further highlight the value of web-based peer support and its potential to enhance the emotional well-being of informal ADRD caregivers. ",
doi="10.2196/60050",
url="https://aging.jmir.org/2024/1/e60050",
url="http://www.ncbi.nlm.nih.gov/pubmed/39630495"
}


@Article{info:doi/10.2196/59249,
author="Chen, Xiao
and Shen, Zhiyun
and Guan, Tingyu
and Tao, Yuchen
and Kang, Yichen
and Zhang, Yuxia",
title="Analyzing Patient Experience on Weibo: Machine Learning Approach to Topic Modeling and Sentiment Analysis",
journal="JMIR Med Inform",
year="2024",
month="Nov",
day="29",
volume="12",
pages="e59249",
keywords="patient experience",
keywords="experience",
keywords="attitude",
keywords="opinion",
keywords="perception",
keywords="perspective",
keywords="machine learning",
keywords="natural language process",
keywords="NLP",
keywords="social media",
keywords="free-text",
keywords="unstructured",
keywords="Weibo",
keywords="spatiotemporal",
keywords="topic modeling",
keywords="sentiment",
abstract="Background: Social media platforms allow individuals to openly gather, communicate, and share information about their interactions with health care services, becoming an essential supplemental means of understanding patient experience. Objective: We aimed to identify common discussion topics related to health care experience from the public's perspective and to determine areas of concern from patients' perspectives that health care providers should act on. Methods: This study conducted a spatiotemporal analysis of the volume, sentiment, and topic of patient experience--related posts on the Weibo platform developed by Sina Corporation. We applied a supervised machine learning approach including human annotation and machine learning--based models for topic modeling and sentiment analysis of the public discourse. A multiclassifier voting method based on logistic regression, multinomial na{\"i}ve Bayes, and random forest was used. Results: A total of 4008 posts were manually classified into patient experience topics. A patient experience theme framework was developed. The accuracy, precision, recall, and F-measure of the method integrating logistic regression, multinomial na{\"i}ve Bayes, and random forest for patient experience themes were 0.93, 0.95, 0.80, 0.77, and 0.84, respectively, indicating a satisfactory prediction. The sentiment analysis revealed that negative sentiment posts constituted the highest proportion (3319/4008, 82.81\%). Twenty patient experience themes were discussed on the social media platform. The majority of the posts described the interpersonal aspects of care (2947/4008, 73.53\%); the five most frequently discussed topics were ``health care professionals' attitude,'' ``access to care,'' ``communication, information, and education,'' ``technical competence,'' and ``efficacy of treatment.'' Conclusions: Hospital administrators and clinicians should consider the value of social media and pay attention to what patients and their family members are communicating on social media. To increase the utility of these data, a machine learning algorithm can be used for topic modeling. The results of this study highlighted the interpersonal and functional aspects of care, especially the interpersonal aspects, which are often the ``moment of truth'' during a service encounter in which patients make a critical evaluation of hospital services. ",
doi="10.2196/59249",
url="https://medinform.jmir.org/2024/1/e59249"
}


@Article{info:doi/10.2196/59585,
author="Hall, A. Jeffrey",
title="Ten Myths About the Effect of Social Media Use on Well-Being",
journal="J Med Internet Res",
year="2024",
month="Nov",
day="25",
volume="26",
pages="e59585",
keywords="social media",
keywords="well-being",
keywords="health promotion",
keywords="depressive disorder",
keywords="depression",
keywords="anxiety",
keywords="adolescent",
keywords="mental health",
doi="10.2196/59585",
url="https://www.jmir.org/2024/1/e59585"
}


@Article{info:doi/10.2196/59742,
author="Yip, Yee Yan
and Makmor-Bakry, Mohd
and Chong, Wen Wei",
title="Elements Influencing User Engagement in Social Media Posts on Lifestyle Risk Factors: Systematic Review",
journal="J Med Internet Res",
year="2024",
month="Nov",
day="22",
volume="26",
pages="e59742",
keywords="chronic disease",
keywords="health promotion",
keywords="internet",
keywords="primary prevention",
keywords="social media",
keywords="systematic reviews",
keywords="health care professional",
keywords="health personnel",
keywords="user engagement",
keywords="lifestyle",
keywords="risk",
abstract="Background: The high prevalence of noncommunicable diseases and the growing importance of social media have prompted health care professionals (HCPs) to use social media to deliver health information aimed at reducing lifestyle risk factors. Previous studies have acknowledged that the identification of elements that influence user engagement metrics could help HCPs in creating engaging posts toward effective health promotion on social media. Nevertheless, few studies have attempted to comprehensively identify a list of elements in social media posts that could influence user engagement metrics. Objective: This systematic review aimed to identify elements influencing user engagement metrics in social media posts by HCPs aimed to reduce lifestyle risk factors. Methods: Relevant studies in English, published between January 2006 and June 2023 were identified from MEDLINE or OVID, Scopus, Web of Science, and CINAHL databases. Included studies were those that examined social media posts by HCPs aimed at reducing the 4 key lifestyle risk factors. Additionally, the studies also outlined elements in social media posts that influenced user engagement metrics. The titles, abstracts, and full papers were screened and reviewed for eligibility. Following data extraction, narrative synthesis was performed. All investigated elements in the included studies were categorized. The elements in social media posts that influenced user engagement metrics were identified. Results: A total of 19 studies were included in this review. Investigated elements were grouped into 9 categories, with 35 elements found to influence user engagement. The 3 predominant categories of elements influencing user engagement were communication using supportive or emotive elements, communication aimed toward behavioral changes, and the appearance of posts. In contrast, the source of post content, social media platform, and timing of post had less than 3 studies with elements influencing user engagement. Conclusions: Findings demonstrated that supportive or emotive communication toward behavioral changes and post appearance could increase postlevel interactions, indicating a favorable response from the users toward posts made by HCPs. As social media continues to evolve, these elements should be constantly evaluated through further research. ",
doi="10.2196/59742",
url="https://www.jmir.org/2024/1/e59742"
}


@Article{info:doi/10.2196/57747,
author="Afolabi, Aliyyat
and Cheung, Elaine
and Lyu, Chen Joanne
and Ling, M. Pamela",
title="Short-Form Video Informed Consent Compared With Written Consent for Adolescents and Young Adults: Randomized Experiment",
journal="JMIR Form Res",
year="2024",
month="Nov",
day="22",
volume="8",
pages="e57747",
keywords="health communication",
keywords="video informed consent",
keywords="randomized experiment",
keywords="informed consent",
keywords="adolescent",
keywords="video",
keywords="consent",
keywords="e-cigarette",
keywords="vaping",
keywords="health research",
keywords="social media",
keywords="vaping cessation",
keywords="smoking cessation",
abstract="Background: Adolescents and young adults have the highest prevalence of e-cigarette use (``vaping''), but they are difficult to enroll in health research studies. Previous studies have found that video consent can improve comprehension and make informed consent procedures more accessible, but the videos in previous studies are much longer than videos on contemporary social media platforms that are popular among young people. Objective: This study aimed to examine the effectiveness of a short-form (90-second) video consent compared with a standard written consent for a vaping cessation study for adolescents and young adults. Methods: We conducted a web-based experiment with 435 adolescents and young adults (aged 13-24 years) recruited by a web-based survey research provider. Each participant was randomly assigned to view either a short-form video consent or a written consent form describing a behavioral study of a social media--based vaping cessation program. Participants completed a postexposure survey measuring three outcomes: (1) comprehension of the consent information, (2) satisfaction with the consent process, and (3) willingness to participate in the described study. Independent sample 2-tailed t tests and chi-square tests were conducted to compare the outcomes between the 2 groups. Results: In total, 435 cases comprised the final analytic sample (video: n=215, 49.4\%; written: n=220, 50.6\%). There was no significant difference in characteristics between the 2 groups (all P>.05). Participants who watched the short-form video completed the consent review and postconsent survey process in less time (average 4.5 minutes) than those in the written consent group (5.1 minutes). A total of 83.2\% (179/215) of the participants in the video consent condition reported satisfaction with the overall consent process compared with 76.3\% (168/220) in the written consent condition (P=.047). There was no difference in the ability to complete consent unassisted and satisfaction with the amount of time between study conditions. There was no difference in the composite measure of overall comprehension, although in individual measures, participants who watched the short-form video consent performed better in 4 measures of comprehension about risk, privacy, and procedures, while participants who read the written document consent had better comprehension of 2 measures of study procedures. There was no difference between the groups in willingness to participate in the described study. Conclusions: Short-form informed consent videos had similar comprehension and satisfaction with the consent procedure among adolescents and young adults. Short-form informed consent videos may be a feasible and acceptable alternative to the standard written consent process, although video and written consent forms have different strengths with respect to comprehension. Because they match how young people consume media, short-form videos may be particularly well suited for adolescents and young adults participating in research. ",
doi="10.2196/57747",
url="https://formative.jmir.org/2024/1/e57747",
url="http://www.ncbi.nlm.nih.gov/pubmed/39576682"
}


@Article{info:doi/10.2196/56166,
author="Chen, Runnan
and Fu, Xiaorong
and Liu, Mochi
and Liao, Ke
and Bai, Lifei",
title="Online Depression Communities as a Complementary Approach to Improving the Attitudes of Patients With Depression Toward Medication Adherence: Cross-Sectional Survey Study",
journal="J Med Internet Res",
year="2024",
month="Nov",
day="19",
volume="26",
pages="e56166",
keywords="online depression communities",
keywords="attitudes",
keywords="institution-generated content",
keywords="user-generated content",
keywords="perceived social support",
keywords="antidepressants",
keywords="hopelessness",
keywords="cross-sectional study",
keywords="China",
keywords="health care system",
keywords="online health community",
keywords="depression",
keywords="medication adherence",
keywords="social support",
keywords="health care practitioner",
keywords="peer support",
abstract="Background: Lack of adherence to prescribed medication is common among patients with depression in China, posing serious challenges to the health care system. Online health communities have been found to be effective in enhancing patient compliance. However, empirical evidence supporting this effect in the context of depression treatment is absent, and the influence of online health community content on patients' attitudes toward medication adherence is also underexplored. Objective: This study aims to explore whether online depression communities (ODCs) can help ameliorate the problem of poor medication taking among patients with depression. Drawing on the stimulus-organism-response and feelings-as-information theories, we established a research model to examine the influence of useful institution-generated content (IGC) and positive user-generated content (UGC) on attitudes toward medication adherence when combined with the mediating role of perceived social support, perceived value of antidepressants, and the moderating role of hopelessness. Methods: A cross-sectional questionnaire survey method was used in this research. Participants were recruited from various Chinese ODCs, generating data for a main study and 2 robustness checks. Hierarchical multiple regression analyses and bootstrapping analyses were adopted as the primary methods to test the hypotheses. Results: We received 1515 valid responses in total, contributing to 5 different datasets: model IGC (n=353, 23.3\%), model UGC (n=358, 23.63\%), model IGC+UGC (n=270, 17.82\%), model IGC-B (n=266, 17.56\%), and model UGC-B (n=268, 17.69\%). Models IGC and UGC were used for the main study. Model IGC+UGC was used for robustness check A. Models IGC-B and UGC-B were used for robustness check B. Useful IGC and positive UGC were proven to have positive impact on the attitudes of patients with depression toward medication adherence through the mediations of perceived social support and perceived value of antidepressants. The findings corroborated the role of hopelessness in weakening or even negating the positive effects of ODC content on the attitudes of patients with depression toward medication adherence. Conclusions: This study provides the first empirical evidence demonstrating the relationship between ODC content and attitudes toward medication adherence, through which we offer a novel solution to the problem of poor medication adherence among patients with depression in China. Our findings also provide suggestions about how to optimize this new approach---health care practitioners should generate online content that precisely matches the informational needs of patients with depression, and ODC service providers should endeavor to regulate the community atmosphere. Nonetheless, we warn that ODC interventions cannot be used as the only approach to addressing the problem of poor medication taking among patients with severe depressive symptoms. ",
doi="10.2196/56166",
url="https://www.jmir.org/2024/1/e56166"
}


@Article{info:doi/10.2196/56675,
author="Helgeson, A. Scott
and Mudgalkar, M. Rohan
and Jacobs, A. Keith
and Lee, S. Augustine
and Sanghavi, Devang
and Moreno Franco, Pablo
and Brooks, S. Ian
and ",
title="Association Between X/Twitter and Prescribing Behavior During the COVID-19 Pandemic: Retrospective Ecological Study",
journal="JMIR Infodemiology",
year="2024",
month="Nov",
day="18",
volume="4",
pages="e56675",
keywords="social media",
keywords="infodemic",
keywords="COVID-19",
keywords="healthcare utilization",
keywords="misinformation",
keywords="disinformation",
keywords="Twitter",
keywords="hydroxychloroquine",
keywords="X",
keywords="drugs",
keywords="pharmacy",
keywords="pharmacology",
keywords="pharmacotherapy",
keywords="pharmaceuticals",
keywords="medication",
keywords="prescription",
keywords="sentiment",
keywords="SARS-CoV-2",
keywords="pandemic",
keywords="respiratory",
keywords="infectious",
abstract="Background: Social media has become a vital tool for health care providers to quickly share information. However, its lack of content curation and expertise poses risks of misinformation and premature dissemination of unvalidated data, potentially leading to widespread harmful effects due to the rapid and large-scale spread of incorrect information. Objective: We aim to determine whether social media had an undue association with the prescribing behavior of hydroxychloroquine, using the COVID-19 pandemic as the setting. Methods: In this retrospective study, we gathered the use of hydroxychloroquine in 48 hospitals in the United States between January and December 2020. Social media data from X/Twitter was collected using Brandwatch, a commercial aggregator with access to X/Twitter's data, and focused on mentions of ``hydroxychloroquine'' and ``Plaquenil.'' Tweets were categorized by sentiment (positive, negative, or neutral) using Brandwatch's sentiment analysis tool, with results classified by date. Hydroxychloroquine prescription data from the National COVID Cohort Collaborative for 2020 was used. Granger causality and linear regression models were used to examine relationships between X/Twitter mentions and prescription trends, using optimum time lags determined via vector auto-regression. Results: A total of 581,748 patients with confirmed COVID-19 were identified. The median daily number of positive COVID-19 cases was 1318.5 (IQR 1005.75-1940.3). Before the first confirmed COVID-19 case, hydroxychloroquine was prescribed at a median rate of 559 (IQR 339.25-728.25) new prescriptions per day. A day-of-the-week effect was noted in both prescriptions and case counts. During the pandemic in 2020, hydroxychloroquine prescriptions increased significantly, with a median of 685.5 (IQR 459.75-897.25) per day, representing a 22.6\% rise from baseline. The peak occurred on April 2, 2020, with 3411 prescriptions, a 397.6\% increase. Hydroxychloroquine mentions on X/Twitter peaked at 254,770 per day on April 5, 2020, compared to a baseline of 9124 mentions per day before January 21, 2020. During this study's period, 3,823,595 total tweets were recorded, with 10.09\% (n=386,115) positive, 37.87\% (n=1,448,030) negative, and 52.03\% (n=1,989,450) neutral sentiments. A 1-day lag was identified as the optimal time for causal association between tweets and hydroxychloroquine prescriptions. Univariate analysis showed significant associations across all sentiment types, with the largest impact from positive tweets. Multivariate analysis revealed only neutral and negative tweets significantly affected next-day prescription rates. Conclusions: During the first year of the COVID-19 pandemic, there was a significant association between X/Twitter mentions and the number of prescriptions of hydroxychloroquine. This study showed that X/Twitter has an association with the prescribing behavior of hydroxychloroquine. Clinicians need to be vigilant about their potential unconscious exposure to social media as a source of medical knowledge, and health systems and organizations need to be more diligent in identifying expertise, source, and quality of evidence when shared on social media platforms. ",
doi="10.2196/56675",
url="https://infodemiology.jmir.org/2024/1/e56675",
url="http://www.ncbi.nlm.nih.gov/pubmed/39556417"
}


@Article{info:doi/10.2196/59225,
author="Owen, David
and Lynham, J. Amy
and Smart, E. Sophie
and Pardi{\~n}as, F. Antonio
and Camacho Collados, Jose",
title="AI for Analyzing Mental Health Disorders Among Social Media Users: Quarter-Century Narrative Review of Progress and Challenges",
journal="J Med Internet Res",
year="2024",
month="Nov",
day="15",
volume="26",
pages="e59225",
keywords="mental health",
keywords="depression",
keywords="anxiety",
keywords="schizophrenia",
keywords="social media",
keywords="natural language processing",
keywords="narrative review",
abstract="Background: Mental health disorders are currently the main contributor to poor quality of life and years lived with disability. Symptoms common to many mental health disorders lead to impairments or changes in the use of language, which are observable in the routine use of social media. Detection of these linguistic cues has been explored throughout the last quarter century, but interest and methodological development have burgeoned following the COVID-19 pandemic. The next decade may see the development of reliable methods for predicting mental health status using social media data. This might have implications for clinical practice and public health policy, particularly in the context of early intervention in mental health care. Objective: This study aims to examine the state of the art in methods for predicting mental health statuses of social media users. Our focus is the development of artificial intelligence--driven methods, particularly natural language processing, for analyzing large volumes of written text. This study details constraints affecting research in this area. These include the dearth of high-quality public datasets for methodological benchmarking and the need to adopt ethical and privacy frameworks acknowledging the stigma experienced by those with a mental illness. Methods: A Google Scholar search yielded peer-reviewed articles dated between 1999 and 2024. We manually grouped the articles by 4 primary areas of interest: datasets on social media and mental health, methods for predicting mental health status, longitudinal analyses of mental health, and ethical aspects of the data and analysis of mental health. Selected articles from these groups formed our narrative review. Results: Larger datasets with precise dates of participants' diagnoses are needed to support the development of methods for predicting mental health status, particularly in severe disorders such as schizophrenia. Inviting users to donate their social media data for research purposes could help overcome widespread ethical and privacy concerns. In any event, multimodal methods for predicting mental health status appear likely to provide advancements that may not be achievable using natural language processing alone. Conclusions: Multimodal methods for predicting mental health status from voice, image, and video-based social media data need to be further developed before they may be considered for adoption in health care, medical support, or as consumer-facing products. Such methods are likely to garner greater public confidence in their efficacy than those that rely on text alone. To achieve this, more high-quality social media datasets need to be made available and privacy concerns regarding the use of these data must be formally addressed. A social media platform feature that invites users to share their data upon publication is a possible solution. Finally, a review of literature studying the effects of social media use on a user's depression and anxiety is merited. ",
doi="10.2196/59225",
url="https://www.jmir.org/2024/1/e59225"
}


@Article{info:doi/10.2196/57967,
author="Lu, Fangcao
and Tu, Caixie",
title="The Impact of Comment Slant and Comment Tone on Digital Health Communication Among Polarized Publics: A Web-Based Survey Experiment",
journal="J Med Internet Res",
year="2024",
month="Nov",
day="15",
volume="26",
pages="e57967",
keywords="comments slant",
keywords="incivility",
keywords="social media",
keywords="influence of presumed influence",
keywords="health compliance",
keywords="mask wearing",
keywords="web survey",
abstract="Background: Public attitudes toward health issues are becoming increasingly polarized, as seen in social media comments, which vary from supportive to oppositional and frequently include uncivil language. The combined effects of comment slant and comment tone on health behavior among a polarized public need further examination. Objective: This study aims to examine how social media users' prior attitudes toward mask wearing and their exposure to a mask-wearing--promoting post, synchronized with polarized and hostile discussions, affect their compliance with mask wearing. Methods: The study was a web-based survey experiment with participants recruited from Amazon Mechanical Turk. A total of 522 participants provided consent and completed the study. Participants were assigned to read a fictitious mask-wearing--promoting social media post with either civil anti--mask-wearing comments (130/522, 24.9\%), civil pro--mask-wearing comments (129/522, 24.7\%), uncivil anti--mask-wearing comments (131/522, 25.1\%), or uncivil pro--mask-wearing comments (132/522, 25.3\%). Following this, the participants were asked to complete self-assessed questionnaires. The PROCESS macro in SPSS (model 12; IBM Corp) was used to test the 3-way interaction effects between comment slant, comment tone, and prior attitudes on participants' presumed influence from the post and their behavioral intention to comply with mask-wearing. Results: Anti--mask-wearing comments led social media users to presume less influence about others' acceptance of masks (B=1.49; P<.001; 95\% CI 0.98-2.00) and resulted in decreased mask-wearing intention (B=0.07; P=.03; 95\% CI 0.01-0.13). Comment tone with incivility also reduced compliance with mask-wearing (B=--0.44; P=.02; 95\% CI --0.81 to --0.07). Furthermore, polarized attitudes had a direct impact (B=0.86; P<.001; 95\% CI 0.45-1.26) and also interacted with both the slant and tone of comments, influencing mask-wearing intention. Conclusions: Pro--mask-wearing comments enhanced presumed influence and compliance of mask-wearing, but incivility in the comments hindered this positive impact. Antimaskers showed increased compliance when they were unable to find civil support for their opinion in the social media environment. The findings suggest the need to correct and moderate uncivil language and misleading information in online comment sections while encouraging the posting of supportive and civil comments. In addition, information literacy programs are needed to prevent the public from being misled by polarized comments. ",
doi="10.2196/57967",
url="https://www.jmir.org/2024/1/e57967"
}


@Article{info:doi/10.2196/51870,
author="Ranker, R. Lynsie
and Tofu, Assefa David
and Lu, Manyuan
and Wu, Jiaxi
and Bhatnagar, Aruni
and Robertson, Marie Rose
and Wijaya, Derry
and Hong, Traci
and Fetterman, L. Jessica
and Xuan, Ziming",
title="Concurrent Mentions of Vaping and Alcohol on Twitter: Latent Dirichlet Analysis",
journal="J Med Internet Res",
year="2024",
month="Nov",
day="12",
volume="26",
pages="e51870",
keywords="e-cigarettes",
keywords="alcohol",
keywords="social media",
keywords="vape",
keywords="tweet",
keywords="vaping",
keywords="alcohol use",
keywords="co-use",
keywords="substance use disorder",
keywords="social networking site",
keywords="insight",
keywords="regulation",
keywords="youth",
keywords="vaping policy",
abstract="Background: Co-use of alcohol and e-cigarettes (often called vaping) has been linked with long-term health outcomes, including increased risk for substance use disorder. Co-use may have been exacerbated by the COVID-19 pandemic. Social networking sites may offer insights into current perspectives on polysubstance use. Objective: The aims of this study were to investigate concurrent mentions of vaping and alcohol on Twitter (subsequently rebranded X) during a time of changing vaping regulations in the United States and the emergence of the COVID-19 pandemic. Methods: Tweets including both vape- and alcohol-related terms posted between October 2019 and September 2020 were analyzed using latent Dirichlet allocation modeling. Distinct topics were identified and described. Results: Three topics were identified across 6437 tweets: (1) flavors and flavor ban (n=3334, 51.8\% of tweets), (2) co-use discourse (n=1119, 17.4\%), and (3) availability and access regulation (n=1984, 30.8\%). Co-use discussions often portrayed co-use as positive and prosocial. Tweets focused on regulation often used alcohol regulations for comparison. Some focused on the perceived overregulation of vaping (compared to alcohol), while others supported limiting youth access but not at the expense of adult access (eg, stronger age verification over product bans). Across topics, vaping was typically portrayed as less harmful than alcohol use. The benefits of flavors for adult smoking cessation were also discussed. The distribution of topics across time varied across both pre-- and post--regulatory change and pre-- and post--COVID-19 pandemic declaration periods, suggesting shifts in topic focus salience across time. Conclusions: Co-use discussions on social media during this time of regulatory change and social upheaval typically portrayed both vaping and alcohol use in a positive light. It also included debates surrounding the differences in regulation of the 2 substances---particularly as it related to limiting youth access. Emergent themes from the analysis suggest that alcohol was perceived as more harmful but less regulated and more accessible to underage youth than vaping products. Frequent discussions and comparisons of the 2 substances as it relates to their regulation emphasize the still-evolving vaping policy landscape. Social media content analyses during times of change may help regulators and policy makers to better understand and respond to common concerns and potential misconceptions surrounding drug-related policies and accessibility. ",
doi="10.2196/51870",
url="https://www.jmir.org/2024/1/e51870"
}


@Article{info:doi/10.2196/59772,
author="Agnello, Marie Danielle
and Balaskas, George
and Steiner, Artur
and Chastin, Sebastien",
title="Methods Used in Co-Creation Within the Health CASCADE Co-Creation Database and Gray Literature: Systematic Methods Overview",
journal="Interact J Med Res",
year="2024",
month="Nov",
day="11",
volume="13",
pages="e59772",
keywords="co-creation",
keywords="coproduction",
keywords="co-design",
keywords="methods",
keywords="participatory",
keywords="inventory",
keywords="text mining",
keywords="methodology",
keywords="research methods",
keywords="CASCADE",
abstract="Background: Co-creation is increasingly recognized for its potential to generate innovative solutions, particularly in addressing complex and wicked problems in public health. Despite this growing recognition, there are no standards or recommendations for method use in co-creation, leading to confusion and inconsistency. While some studies have examined specific methods, a comprehensive overview is lacking, limiting the collective understanding and ability to make informed decisions about the most appropriate methods for different contexts and research objectives. Objective: This study aimed to systematically compile and analyze methods used in co-creation to enhance transparency and deepen understanding of how co-creation is practiced. Methods: To enhance transparency and deepen understanding of how co-creation is practiced, this study systematically inventoried and analyzed methods used in co-creation. We conducted a systematic methods overview, applying 2 parallel processes: one within the peer-reviewed Health CASCADE Co-Creation Database and another within gray literature. An artificial intelligence--assisted recursive search strategy, coupled with a 2-step screening process, ensured that we captured relevant methods. We then extracted method names and conducted textual, comparative, and bibliometric analyses to assess the content, relationship between methods, fields of research, and the methodological underpinnings of the included sources. Results: We examined a total of 2627 academic papers and gray literature sources, with the literature primarily drawn from health sciences, medical research, and health services research. The dominant methodologies identified were co-creation, co-design, coproduction, participatory research methodologies, and public and patient involvement. From these sources, we extracted and analyzed 956 co-creation methods, noting that only 10\% (n=97) of the methods overlap between academic and gray literature. Notably, 91.3\% (230/252) of the methods in academic literature co-occurred, often involving combinations of multiple qualitative methods. The most frequently used methods in academic literature included surveys, focus groups, photo voice, and group discussion, whereas gray literature highlighted methods such as world caf{\'e}, focus groups, role-playing, and persona. Conclusions: This study presents the first systematic overview of co-creation methods, providing a clear understanding of the diverse methods currently in use. Our findings reveal a significant methodological gap between researchers and practitioners, offering insights into the relative prevalence and combinations of methods. By shedding light on these methods, this study helps bridge the gap and supports researchers in making informed decisions about which methods to apply in their work. Additionally, it offers a foundation for further investigation into method use in co-creation. This systematic investigation is a valuable resource for anyone engaging in co-creation or similar participatory methodologies, helping to navigate the diverse landscape of methods. ",
doi="10.2196/59772",
url="https://www.i-jmr.org/2024/1/e59772"
}


@Article{info:doi/10.2196/54841,
author="Calderon Ramirez, Lucrecia Claudia
and Farmer, Yanick
and Downar, James
and Frolic, Andrea
and Opatrny, Lucie
and Poirier, Diane
and Bravo, Gina
and L'Esp{\'e}rance, Audrey
and Gaucher, Nathalie
and Payot, Antoine
and Dahine, Joseph
and Tanuseputro, Peter
and Rousseau, Louis-Martin
and Dumez, Vincent
and Desc{\^o}teaux, Annie
and Dallaire, Clara
and Laporte, Karell
and Bouthillier, Marie-Eve",
title="Assessing the Quality of an Online Democratic Deliberation on COVID-19 Pandemic Triage Protocols for Access to Critical Care in an Extreme Pandemic Context: Mixed Methods Study",
journal="J Particip Med",
year="2024",
month="Nov",
day="11",
volume="16",
pages="e54841",
keywords="quality assessment",
keywords="online democratic deliberation",
keywords="COVID-19 triage or prioritization",
keywords="critical care",
keywords="clinical ethics",
abstract="Background: Online democratic deliberation (ODD) may foster public engagement in new health strategies by providing opportunities for knowledge exchange between experts, policy makers, and the public. It can favor decision-making by generating new points of view and solutions to existing problems. Deliberation experts recommend gathering feedback from participants to optimize future implementation. However, this online modality has not been frequently evaluated. Objective: This study aims to (1) assess the quality of an ODD held in Quebec and Ontario, Canada, on the topic of COVID-19 triage protocols for access to critical care in an extreme pandemic context and (2) determine its transformative aspect according to the perceptions of participants. Methods: We conducted a simultaneous ODD in Quebec and Ontario on May 28 and June 4, 2022, with a diversified target audience not working in the health care system. We used a thematic analysis for the transcripts of the deliberation and the written comments of the participants related to the quality of the process. Participants responded to a postdeliberation questionnaire to assess the quality of the ODD and identify changes in their perspectives on COVID-19 pandemic triage protocols after the deliberation exercise. Descriptive statistics were used. An index was calculated to determine equality of participation. Results: The ODD involved 47 diverse participants from the public (n=20, 43\% from Quebec and n=27, 57\% from Ontario). Five themes emerged: (1) process appreciation, (2) learning experience, (3) reflecting on the common good, (4) technological aspects, and (5) transformative aspects. A total of 46 participants responded to the questionnaire. Participants considered the quality of the ODD satisfactory in terms of process, information shared, reasoning, and videoconferencing. A total of 4 (80\%) of 5 participants reported at least 1 change of perspective on some of the criteria and values discussed. Most participants reported that the online modality was accessible and user-friendly. We found low polarization when calculating equal participation. Improvements identified were measures to replace participants when unable to connect and optimization of time during discussions. Conclusions: Overall, the participants perceived the quality of ODD as satisfactory. Some participants self-reported a change of opinion after deliberation. The online modality may be an acceptable alternative for democratic deliberation but with some organizational adaptations. ",
doi="10.2196/54841",
url="https://jopm.jmir.org/2024/1/e54841"
}


@Article{info:doi/10.2196/58176,
author="Zhang, Pengfei
and Kamitaki, K. Brad
and Do, Phu Thien",
title="Crowdsourcing Adverse Events Associated With Monoclonal Antibodies Targeting Calcitonin Gene--Related Peptide Signaling for Migraine Prevention: Natural Language Processing Analysis of Social Media",
journal="JMIR Form Res",
year="2024",
month="Nov",
day="8",
volume="8",
pages="e58176",
keywords="internet",
keywords="patient reported outcome",
keywords="headache",
keywords="health information",
keywords="Reddit",
keywords="registry",
keywords="monoclonal antibody",
keywords="crowdsourcing",
keywords="postmarketing",
keywords="safety",
keywords="surveillance",
keywords="migraine",
keywords="preventives",
keywords="prevention",
keywords="self-reported",
keywords="calcitonin gene--related peptide",
keywords="calcitonin",
keywords="therapeutics",
keywords="social media",
keywords="medication-related",
keywords="posts",
keywords="propranolol",
keywords="topiramate",
keywords="erenumab",
keywords="fremanezumab",
keywords="cross-sectional",
keywords="surveys",
abstract="Background: Clinical trials demonstrate the efficacy and tolerability of medications targeting calcitonin gene--related peptide (CGRP) signaling for migraine prevention. However, these trials may not accurately reflect the real-world experiences of more diverse and heterogeneous patient populations, who often have higher disease burden and more comorbidities. Therefore, postmarketing safety surveillance is warranted. Regulatory organizations encourage marketing authorization holders to screen digital media for suspected adverse reactions, applying the same requirements as for spontaneous reports. Real-world data from social media platforms constitute a potential venue to capture diverse patient experiences and help detect treatment-related adverse events. However, while social media holds promise for this purpose, its use in pharmacovigilance is still in its early stages. Computational linguistics, which involves the automatic manipulation and quantitative analysis of oral or written language, offers a potential method for exploring this content. Objective: This study aims to characterize adverse events related to monoclonal antibodies targeting CGRP signaling on Reddit, a large online social media forum, by using computational linguistics. Methods: We examined differences in word frequencies from medication-related posts on the Reddit subforum r/Migraine over a 10-year period (2010-2020) using computational linguistics. The study had 2 phases: a validation phase and an application phase. In the validation phase, we compared posts about propranolol and topiramate, as well as posts about each medication against randomly selected posts, to identify known and expected adverse events. In the application phase, we analyzed posts discussing 2 monoclonal antibodies targeting CGRP signaling---erenumab and fremanezumab---to identify potential adverse events for these medications. Results: From 22,467 Reddit r/Migraine posts, we extracted 402 (2\%) propranolol posts, 1423 (6.33\%) topiramate posts, 468 (2.08\%) erenumab posts, and 73 (0.32\%) fremanezumab posts. Comparing topiramate against propranolol identified several expected adverse events, for example, ``appetite,'' ``weight,'' ``taste,'' ``foggy,'' ``forgetful,'' and ``dizziness.'' Comparing erenumab against a random selection of terms identified ``constipation'' as a recurring keyword. Comparing erenumab against fremanezumab identified ``constipation,'' ``depression,'' ``vomiting,'' and ``muscle'' as keywords. No adverse events were identified for fremanezumab. Conclusions: The validation phase of our study accurately identified common adverse events for oral migraine preventive medications. For example, typical adverse events such as ``appetite'' and ``dizziness'' were mentioned in posts about topiramate. When we applied this methodology to monoclonal antibodies targeting CGRP or its receptor---fremanezumab and erenumab, respectively---we found no definite adverse events for fremanezumab. However, notable flagged words for erenumab included ``constipation,'' ``depression,'' and ``vomiting.'' In conclusion, computational linguistics applied to social media may help identify potential adverse events for novel therapeutics. While social media data show promise for pharmacovigilance, further work is needed to improve its reliability and usability. ",
doi="10.2196/58176",
url="https://formative.jmir.org/2024/1/e58176"
}


@Article{info:doi/10.2196/55555,
author="Tran, Thao Thi Phuong
and Vu, Trang Thu
and Li, Yachao
and Popova, Lucy",
title="Tobacco and Alcohol Content in Top Vietnamese YouTube Music Videos: Content Analysis",
journal="J Med Internet Res",
year="2024",
month="Nov",
day="8",
volume="26",
pages="e55555",
keywords="risk",
keywords="risk factor",
keywords="tobacco content",
keywords="alcohol content",
keywords="tobacco",
keywords="alcohol",
keywords="tobacco portrayal",
keywords="alcohol portrayal",
keywords="music video",
keywords="Vietnam",
keywords="Vietnamese",
keywords="YouTube",
keywords="social media",
keywords="socials",
keywords="youth",
keywords="adolescent",
keywords="teen",
keywords="teenager",
keywords="young adult",
abstract="Background: Seeing portrayals of tobacco and alcohol in music videos (MVs) may reduce perceived risks, increase susceptibility, and lead to the initiation of tobacco and alcohol use among adolescents and young adults. Previous studies have predominantly concentrated on assessing tobacco and alcohol contents in English-language MVs within Western countries. However, many other countries have not only been influenced by the English music market but have also produced music in their native languages, and this content remains underexamined. Objective: This study aims to investigate the prevalence of tobacco- and alcohol-related content in top Vietnamese MVs on YouTube from 2013 to 2021, to describe how tobacco and alcohol are portrayed in these MVs, and to examine associations between these portrayals and MV characteristics. Methods: A total of 410 Vietnamese MVs, including the top 40 or 50 most viewed released each year between 2013 and 2021, were analyzed. General information, such as the song name, its release date and ranking, age restriction, musical genre, and type of MV, was collected. We examined tobacco and alcohol content in the MVs, with specific details such as tobacco types, their brands, as well as the number, age, sex, and roles of individuals smoking or drinking. Results: Among the 410 MVs, 36 (8.8\%) contained tobacco-related content and 136 (33.2\%) featured alcohol-related content. Additionally, 28 (6.8\%) out of 410 MVs included both tobacco and alcohol content. The prevalence of videos with tobacco and alcohol content fluctuated over the years. In MVs with tobacco-related content, a higher proportion of hip-hop or rap songs contained tobacco-related content (n=6, 30\%) compared to other music genres. In MVs with tobacco-related content, cigarettes were the most frequently shown product (n=28, 77.8\%), and smoking scenes were often depicted at parties (n=13, 36.1\%) and during dancing and singing scenes (n=12, 33.3\%). Among the 31 MVs portraying actual tobacco use, tobacco use was typically depicted with 1 person, often a young adult male, while 38.7\% (n=12) showed singer(s) smoking. For MVs with alcohol-related content, there was a high proportion showing alcohol images at parties, bars, or pubs (n=96, 70.6\%). Among 87 MVs containing drinking scenes, 60.9\% (n=53) involved groups of young adults of both sexes, and 64\% (n=56) depicted singers drinking. Additionally, only 2 (5.6\%) MVs included health warnings about tobacco harm, and 2 MVs (1.5\%) included warnings about drinking restricted to individuals 18 years and above. Conclusions: The notable prevalence of tobacco and alcohol content in leading Vietnamese YouTube MVs raises concerns, especially as most of this content is portrayed without any warnings. The study underscores a regulatory gap in addressing such content on the internet, emphasizing the urgent need for stricter regulations and age restrictions on platforms such as YouTube. ",
doi="10.2196/55555",
url="https://www.jmir.org/2024/1/e55555"
}


@Article{info:doi/10.2196/51594,
author="Zhou, Xinyi
and Hao, Xinyu
and Chen, Yuhang
and Deng, Hui
and Fang, Ling
and Zhang, Lingyun
and Yan, Xiaotao
and Zheng, Pinpin
and Wang, Fan",
title="Social Media Marketing Strategies for Electronic Cigarettes: Content Analysis of Chinese Weibo Accounts",
journal="J Med Internet Res",
year="2024",
month="Nov",
day="7",
volume="26",
pages="e51594",
keywords="e-cigarette",
keywords="marketing strategy",
keywords="social media",
keywords="teenagers",
keywords="content analysis",
abstract="Background: E-cigarettes have gained popularity among teenagers due to extensive marketing strategies on social media platforms. This widespread promotion is a risk factor, as it fosters more positive attitudes toward e-cigarette use among teenagers and increases the perception that using e-cigarettes is normal. Therefore, the marketing of e-cigarettes on social media is a serious global health concern, and its strategies and impact should be clearly identified. Objective: This study examined how e-cigarette companies popularize their products via Weibo and identified the specific strategies influencing the effectiveness of their marketing. Methods: In phase 1, we conducted a search on Qcc.com and identified 32 e-cigarette brands with active Weibo accounts between October 1 and December 31, 2020, along with 863 Weibo posts. The data were investigated through content analysis. The codebook was developed into four categories: (1) product and features, (2) sales and promotions, (3) social contact and interaction, and (4) restrictions and warnings. To further understand the factors influencing e-cigarette brand marketing, we conducted a multiple linear regression analysis. Results: Marketing tactics by e-cigarette companies on Chinese social media were documented, including emphasizing attractive product features, using trendy characters, implicit promotions, downplaying health concerns, and engaging with Weibo users in various ways. Out of 863 posts, 449 (52\%) mentioned product characteristics. In 313 (36.3\%) posts, visible figures were used to attract attention. Product promotion was absent in 762 (88.3\%) posts, and purchase channels were not mentioned in 790 (98.3\%) posts. Social interaction--related posts received attention (n=548, 63.5\%), particularly those featuring hashtag content (n=538, 62.3\%). Most posts did not include claims for restrictions on teenagers' purchases or use (n=687, 79.6\%) or information on health warnings (n=839, 97.2\%). Multiple linear regression analysis identified marketing strategies that effectively increase the exposure of e-cigarette posts on Weibo. Posts including engagement via posts encouraging reposts, comments, and likes (P<.001) and engagement topics related to e-cigarette brands were positively correlated with the number of reposts (P=.009). Posts highlighting nonmonetary incentives (P=.004), posts with age restriction statements (P<.001), engaging via stories and idea collection (P<.001), and engagement topics related to products (P<.001) and current affairs (P=.002) had a positive effect on the number of comments. Engagement topics related to brands (P<.001) or interactive sweepstakes (P<.001) had a positive effect on the number of likes. Conclusions: E-cigarette posts on Weibo that focus on product features and social interaction attract public attention, especially from teenagers. Stricter regulations and monitoring should be adopted to restrict the social media marketing of e-cigarettes. ",
doi="10.2196/51594",
url="https://www.jmir.org/2024/1/e51594"
}


@Article{info:doi/10.2196/49761,
author="Woolard, Alix
and Paciente, Rigel
and Munro, Emily
and Wickens, Nicole
and Wells, Gabriella
and Ta, Daniel
and Mandzufas, Joelie
and Lombardi, Karen",
title="\#TraumaTok---TikTok Videos Relating to Trauma: Content Analysis",
journal="JMIR Form Res",
year="2024",
month="Nov",
day="7",
volume="8",
pages="e49761",
keywords="trauma",
keywords="traumatic events",
keywords="traumatic stress",
keywords="TikTok",
keywords="public health",
keywords="social media",
keywords="content analysis",
abstract="Background: Experiencing a traumatic event can significantly impact mental and emotional well-being. Social media platforms offer spaces for sharing stories, seeking support, and accessing psychoeducation. TikTok (ByteDance), a rapidly growing social media platform, is increasingly used for advice, validation, and information, although the content of this requires further study. Research is particularly needed to better understand TikTok content relating to trauma and the potential implications for young viewers, considering the distressing nature of the subject and the possibility of users experiencing vicarious trauma through exposure to these videos. Objective: This study aims to explore the content of trauma-related videos on TikTok, focusing on hashtags related to trauma. Specifically, this study analyzes how TikTok videos present information, advice, stories, and support relating to trauma. Methods: A quantitative cross-sectional descriptive content analysis was performed on TikTok in December 2022. A total of 5 hashtags related to trauma were selected: \#trauma, \#traumatized, \#traumatok, \#traumatic, and \#traumabond, with the top 50 videos from each hashtag analyzed (total N=250 videos). A standardized codebook was developed inductively to analyze the content of the videos, while an existing generic codebook was used to collect the video features (eg, age of people in the video) and metadata (likes, comments, and shares) for each video. Results: A total of 2 major content themes were identified, which were instructional videos (54/250, 21.6\%) and videos disclosing personal stories (168/250, 67.3\%). The videos garnered significant engagement, with a total of 296.6 million likes, 2.3 million comments, and 4.6 million shares, indicating that users find this content engaging and useful. Alarmingly, only 3.7\% (9/250) of videos included a trigger warning, despite many featuring highly distressing stories that young people and those with trauma may be exposed to. Conclusions: The study highlights the potential risks of vicarious trauma due to trauma dumping without trigger warnings on TikTok, and the need for further research to assess the accuracy of advice and information in these videos. However, it also underscores the platform's potential to foster social connections, provide validation, and reduce stigma around mental health issues. Public health professionals should leverage social media to disseminate accurate mental health information, while promoting user education and content moderation to mitigate potential harms. People often use social media, such as TikTok to share advice, stories, and support around mental health, including their experiences with trauma. Out of 250 videos, most were either giving advice (54/250, 21.6\%) or sharing personal experiences (168/250, 67.3\%). The study found many videos lacked warnings about upsetting content, which could potentially harm young viewers or people suffering from trauma. While TikTok can help people feel connected and reduce the stigma around mental health, it is important to seek support from professionals when needed. ",
doi="10.2196/49761",
url="https://formative.jmir.org/2024/1/e49761"
}


@Article{info:doi/10.2196/55086,
author="Chandrasekaran, Ranganathan
and Sadiq T, Muhammed
and Moustakas, Evangelos",
title="Racial and Demographic Disparities in Susceptibility to Health Misinformation on Social Media: National Survey-Based Analysis",
journal="J Med Internet Res",
year="2024",
month="Nov",
day="6",
volume="26",
pages="e55086",
keywords="health misinformation",
keywords="digital divide",
keywords="racial disparities",
keywords="social media",
keywords="national survey-based analysis",
keywords="health information",
keywords="interventions",
abstract="Background: Social media platforms have transformed the dissemination of health information, allowing for rapid and widespread sharing of content. However, alongside valuable medical knowledge, these platforms have also become channels for the spread of health misinformation, including false claims and misleading advice, which can lead to significant public health risks. Susceptibility to health misinformation varies and is influenced by individuals' cultural, social, and personal backgrounds, further complicating efforts to combat its spread. Objective: This study aimed to examine the extent to which individuals report encountering health-related misinformation on social media and to assess how racial, ethnic, and sociodemographic factors influence susceptibility to such misinformation. Methods: Data from the Health Information National Trends Survey (HINTS; Cycle 6), conducted by the National Cancer Institute with 5041 US adults between March and November 2022, was used to explore associations between racial and sociodemographic factors (age, gender, race/ethnicity, annual household income, marital status, and location) and susceptibility variables, including encounters with misleading health information on social media, difficulty in assessing information truthfulness, discussions with health providers, and making health decisions based on such information. Results: Over 35.61\% (1740/4959) of respondents reported encountering ``a lot'' of misleading health information on social media, with an additional 45\% (2256/4959) reporting seeing ``some'' amount of health misinformation. Racial disparities were evident in comparison with Whites, with non-Hispanic Black (odds ratio [OR] 0.45, 95\% CI 0.33-0.6, P<.01) and Hispanic (OR 0.54, 95\% CI 0.41-0.71, P<.01) individuals reporting lower odds of finding deceptive information, while Hispanic (OR 1.68, 95\% CI 1.48-1.98, P<.05) and non-Hispanic Asian (OR 1.96, 95\% CI 1.21-3.18, P<.01) individuals exhibited higher odds in having difficulties in assessing the veracity of health information found on social media. Hispanic and Asian individuals were more likely to discuss with providers and make health decisions based on social media information. Older adults aged ?75 years exhibited challenges in assessing health information on social media (OR 0.63, 95\% CI 0.43-0.93, P<.01), while younger adults (18-34) showed increased vulnerability to health misinformation. In addition, income levels were linked to higher exposure to health misinformation on social media: individuals with annual household incomes between US \$50,000 and US \$75,000 (OR 1.74, 95\% CI 1.14-2.68, P<.01), and greater than US \$75,000 (OR 1.78, 95\% CI 1.20-2.66, P<.01) exhibited greater odds, revealing complexities in decision-making and information access. Conclusions: This study highlights the pervasive presence of health misinformation on social media, revealing vulnerabilities across racial, age, and income groups, underscoring the need for tailored interventions. ",
doi="10.2196/55086",
url="https://www.jmir.org/2024/1/e55086"
}


@Article{info:doi/10.2196/64626,
author="McAlister, L. Kelsey
and Beatty, C. Clare
and Smith-Caswell, E. Jacqueline
and Yourell, L. Jacqlyn
and Huberty, L. Jennifer",
title="Social Media Use in Adolescents: Bans, Benefits, and Emotion Regulation Behaviors",
journal="JMIR Ment Health",
year="2024",
month="Nov",
day="4",
volume="11",
pages="e64626",
keywords="adolescent social media",
keywords="social media bans",
keywords="emotion regulation",
keywords="youth",
keywords="adolescent",
keywords="media use",
keywords="social platform",
keywords="social network",
keywords="self-regulation",
keywords="behavioral health",
keywords="mental health",
keywords="digital health",
keywords="technology",
keywords="digital literacy",
doi="10.2196/64626",
url="https://mental.jmir.org/2024/1/e64626"
}


@Article{info:doi/10.2196/60541,
author="Albert, L. Stephanie
and Massar, E. Rachel
and Cassidy, Omni
and Fennelly, Kayla
and Jay, Melanie
and Massey, M. Philip
and Bragg, A. Marie",
title="Body Positivity, Physical Health, and Emotional Well-Being Discourse on Social Media: Content Analysis of Lizzo's Instagram",
journal="JMIR Form Res",
year="2024",
month="Nov",
day="4",
volume="8",
pages="e60541",
keywords="weight stigma",
keywords="body positivity",
keywords="health at every size",
keywords="emotional well-being",
keywords="social media",
keywords="qualitative content analysis",
keywords="well-being",
keywords="influencers",
keywords="mental health outcomes",
keywords="psychological health",
keywords="body shaming",
keywords="bullying",
abstract="Background: Weight stigma is a fundamental cause of health inequality. Body positivity may be a counterbalance to weight stigma. Social media is replete with weight-stigmatizing content and is a driver of poor mental health outcomes; however, there remains a gap in understanding its potential to mitigate the prevalence and impact of harmful messaging and to promote positive effects on a large scale. Objective: We selected musical artist Lizzo, whose brand emphasizes body positivity and empowerment, for an instrumental case study on the discourse on social media and specifically Instagram. We focused on 3 domains, including body positivity, physical health, and emotional well-being. These domains challenge social norms around weight and body size and have the potential to positively affect the physical and psychological health of people with diverse body sizes. Methods: We evaluated posts by Lizzo, comments from Instagram users, and replies to comments over a 2-month period (October 11 to December 12, 2019). Two coders rated Lizzo's posts and Instagram users' comments for their sentiments on the 3 domains. Replies to Instagram users' comments were assessed for their reactions to comments (ie, did they oppose or argue against the comment or did they support or bolster the comment). Engagement metrics, including the number of ``likes,'' were also collected. Results: The final sample included 50 original posts by Lizzo, 250 comments from Instagram users, and 1099 replies to comments. A proportion of Lizzo's content included body positive sentiments (34\%) and emotional well-being (18\%); no posts dealt explicitly with physical health. A substantial amount Instagram users' comments and replies contained stigmatizing content including the use of nauseated and vomiting emojis, implications that Lizzo's body was shameful and should be hidden away, accusations that she was promoting obesity, and impeachments of Lizzo's health. In spite of the stigmatizing content, we also discovered content highlighting the beneficial nature of having positive representation of a Black woman living in a larger body who is thriving. Moreover, analysis of the discourse between users illustrated that stigmatizing expressions are being combated online, at least to some degree. Conclusions: This study demonstrates that Lizzo has exposed millions of social media users to messages about body positivity and provided more visibility for conversations about weight and shape. Future research should examine the extent to which body positive messages can lead to greater acceptance of individuals living in larger bodies. Instagram and other social media platforms should consider ways to reduce body-shaming content while finding ways to promote content that features diverse bodies. Shifting the landscape of social media could decrease stereotypes about weight and shape while increasing dialog about the need for greater acceptance and inclusion of people with diverse bodies. ",
doi="10.2196/60541",
url="https://formative.jmir.org/2024/1/e60541"
}


@Article{info:doi/10.2196/64221,
author="Nachman, Sophie
and Ortiz-Prado, Esteban
and Tucker, D. Joseph",
title="Video Abstracts in Research",
journal="J Med Internet Res",
year="2024",
month="Nov",
day="4",
volume="26",
pages="e64221",
keywords="video abstract",
keywords="abstract",
keywords="dissemination",
keywords="public engagement",
keywords="online",
keywords="videos",
keywords="public audience",
keywords="communication",
keywords="infographics",
keywords="health literacy",
keywords="patient education",
keywords="public health",
doi="10.2196/64221",
url="https://www.jmir.org/2024/1/e64221"
}


@Article{info:doi/10.2196/60282,
author="Haight, Macy
and Jacobs, R. Hayden
and Boltey, K. Sarah
and Murray, A. Kelly
and Hartwell, Micah",
title="US Public Interest in Merkel Cell Carcinoma Following Jimmy Buffett's Death and Implications for Continued Health Advocacy: Infodemiology Study of Google Trends",
journal="JMIR Dermatol",
year="2024",
month="Oct",
day="31",
volume="7",
pages="e60282",
keywords="skin cancer",
keywords="merkel cell carcinoma",
keywords="infodemiology",
keywords="cancer",
keywords="carcinoma",
keywords="cell carcinoma",
keywords="sunlight",
keywords="infodemiology study",
keywords="Google Trends",
keywords="temporal analysis",
keywords="United States",
keywords="USA",
keywords="sun",
doi="10.2196/60282",
url="https://derma.jmir.org/2024/1/e60282"
}


@Article{info:doi/10.2196/56950,
author="Yu, Yue
and Dykxhoorn, Jennifer
and Plackett, Ruth",
title="The Impact of Different Types of Social Media Use on the Mental Health of UK Adults: Longitudinal Observational Study",
journal="J Med Internet Res",
year="2024",
month="Oct",
day="30",
volume="26",
pages="e56950",
keywords="social media",
keywords="mental health",
keywords="depression",
keywords="anxiety",
keywords="mental disorders",
keywords="cohort studies",
keywords="United Kingdom",
keywords="longitudinal observational study",
abstract="Background: Previous studies have explored the association between social media use and mental health among adolescents. However, few studies using nationally representative longitudinal data have explored this relationship for adults and how the effect might change depending on how people use social media. Objective: This study investigated the longitudinal relationship between the frequency of viewing and posting on social media and mental health problems among UK adults. Methods: This study included 15,836 adults (aged 16 years and older) who participated in Understanding Society, a UK longitudinal survey. Social media use was measured with questions about the frequency of viewing social media and posting on social media in Understanding Society Wave 11 (2019-2021). We explored viewing and posting separately, as well as a combined exposure: (1) high viewing, high posting; (2) high viewing, low posting; (3) low viewing, high posting; and (4) low viewing, low posting. Mental health problems were measured in Wave 12 (2020-2022) using the General Health Questionnaire (GHQ-12), a validated scale for identifying symptoms of common mental health problems, where higher scores indicated more mental health problems (0 to 36). Unadjusted and adjusted linear regression models were estimated for viewing social media and posting on social media, adjusting for the baseline GHQ score, gender, age, ethnicity, employment, and education. We found no evidence for effect modification by gender and age so overall associations were reported. Results: In our adjusted models, we found no evidence of an association between the frequency of viewing social media and mental health problems in the following year. We found that adults who posted daily on social media had more mental health problems than those who never posted on social media, corresponding to a 0.35-point increase in GHQ score ($\beta$=0.35, 95\% CI 0.01-0.68; P=.04). When we considered both social media behaviors, we found that those who frequently viewed and posted on social media scored 0.31 points higher on the GHQ score ($\beta$=0.31, 95\% CI 0.04-0.58; P=.03) in the following year compared to those who rarely viewed or posted on social media. Conclusions: We found that a high frequency of posting on social media was associated with increased mental health problems a year later. However, we did not find evidence of a similar association based on the frequency of viewing social media content. This provides evidence that some types of active social media use (ie, posting) have a stronger link to mental health outcomes than some types of passive social media use (viewing). These results highlighted that the relationship between social media use and mental health is complex, and more research is needed to understand the mechanisms underlying these patterns to inform targeted interventions and policies. ",
doi="10.2196/56950",
url="https://www.jmir.org/2024/1/e56950"
}


@Article{info:doi/10.2196/52924,
author="Elhariry, Maiar
and Malhotra, Kashish
and Goyal, Kashish
and Bardus, Marco
and Team, CoMICs SIMBA and
and Kempegowda, Punith",
title="A SIMBA CoMICs Initiative to Cocreating and Disseminating Evidence-Based, Peer-Reviewed Short Videos on Social Media: Mixed Methods Prospective Study",
journal="JMIR Med Educ",
year="2024",
month="Oct",
day="30",
volume="10",
pages="e52924",
keywords="influencers",
keywords="social media",
keywords="public engagement",
keywords="apps",
keywords="healthcare",
keywords="medical students",
keywords="online medical information",
keywords="simulation",
keywords="peer-reviewed information",
abstract="Background: Social media is a powerful platform for disseminating health information, yet it is often riddled with misinformation. Further, few guidelines exist for producing reliable, peer-reviewed content. This study describes a framework for creating and disseminating evidence-based videos on polycystic ovary syndrome (PCOS) and thyroid conditions to improve health literacy and tackle misinformation. Objective: The study aims to evaluate the creation, dissemination, and impact of evidence-based, peer-reviewed short videos on PCOS and thyroid disorders across social media. It also explores the experiences of content creators and assesses audience engagement. Methods: This mixed methods prospective study was conducted between December 2022 and May 2023 and comprised five phases: (1) script generation, (2) video creation, (3) cross-platform publication, (4) process evaluation, and (5) impact evaluation. The SIMBA-CoMICs (Simulation via Instant Messaging for Bedside Application--Combined Medical Information Cines) initiative provides a structured process where medical concepts are simplified and converted to visually engaging videos. The initiative recruited medical students interested in making visually appealing and scientifically accurate videos for social media. The students were then guided to create video scripts based on frequently searched PCOS- and thyroid-related topics. Once experts confirmed the accuracy of the scripts, the medical students produced the videos. The videos were checked by clinical experts and experts with lived experience to ensure clarity and engagement. The SIMBA-CoMICs team then guided the students in editing these videos to fit platform requirements before posting them on TikTok, Instagram, YouTube, and Twitter. Engagement metrics were tracked over 2 months. Content creators were interviewed, and thematic analysis was performed to explore their experiences. Results: The 20 videos received 718 likes, 120 shares, and 54,686 views across all platforms, with TikTok (19,458 views) and Twitter (19,678 views) being the most popular. Engagement increased significantly, with follower growth ranging from 5\% on Twitter to 89\% on TikTok. Thematic analysis of interviews with 8 out of 38 participants revealed 4 key themes: views on social media, advice for using social media, reasons for participating, and reflections on the project. Content creators highlighted the advantages of social media, such as large outreach (12 references), convenience (10 references), and accessibility to opportunities (7 references). Participants appreciated the nonrestrictive participation criteria, convenience (8 references), and the ability to record from home using prewritten scripts (6 references). Further recommendations to improve the content creation experience included awareness of audience demographics (9 references), sharing content on multiple platforms (5 references), and collaborating with organizations (3 references). Conclusions: This study demonstrates the effectiveness of the SIMBA CoMICs initiative in training medical students to create accurate medical information on PCOS and thyroid disorders for social media dissemination. The model offers a scalable solution to combat misinformation and improve health literacy. ",
doi="10.2196/52924",
url="https://mededu.jmir.org/2024/1/e52924"
}


@Article{info:doi/10.2196/51655,
author="Guan, Jia-Lun
and Xia, Su-Hong
and Zhao, Kai
and Feng, Li-Na
and Han, Ying-Ying
and Li, Ji-Yan
and Liao, Jia-Zhi
and Li, Pei-Yuan",
title="Videos in Short-Video Sharing Platforms as Sources of Information on Colorectal Polyps: Cross-Sectional Content Analysis Study",
journal="J Med Internet Res",
year="2024",
month="Oct",
day="29",
volume="26",
pages="e51655",
keywords="colorectal polyps",
keywords="short videos",
keywords="health information",
keywords="quality assessment",
keywords="reliability",
abstract="Background: Short videos have demonstrated huge potential in disseminating health information in recent years. However, to our knowledge, no study has examined information about colorectal polyps on short-video sharing platforms. Objective: This study aimed to analyze the content and quality of colorectal polyps-related videos on short-video sharing platforms. Methods: The terms ``???'' (intestinal polyps) or ``????'' (colonic polyps) or ``????'' (rectal polyps) or ``?????'' (colorectal polyps) or ``????'' (polyps of large intestine) were used to search in TikTok (ByteDance), WeChat (Tencent Holdings Limited), and Xiaohongshu (Xingyin Information Technology Limited) between May 26 and June 8, 2024, and then the top 100 videos for each search term on different platforms were included and recorded. The Journal of American Medical Association (JAMA) score, the Global Quality Scale (GQS), the modified DISCERN, and the Patient Education Materials Assessment Tool (PEMAT) were used to evaluate the content and quality of selected videos by 2 independent researchers. SPSS (version 22.0; IBM Corp) and GraphPad Prism (version 9.0; Dotmatics) were used for analyzing the data. Descriptive statistics were generated, and the differences between groups were compared. Spearman correlation analysis was used to evaluate the relationship between quantitative variables. Results: A total of 816 eligible videos were included for further analysis, which mainly conveyed disease-related knowledge (n=635, 77.8\%). Most videos were uploaded by physicians (n=709, 86.9\%). These videos had an average JAMA score of 2.0 (SD 0.6), GQS score of 2.5 (SD 0.8), modified DISCERN score of 2.5 (SD 0.8), understandability of 80.4\% (SD 15.6\%), and actionability of 42.2\% (SD 36.1\%). Videos uploaded by news agencies were of higher quality and received more likes and comments (all P<.05). The number of collections and shares of videos about posttreatment caveats were more than those for other content (P=.03 and P=.006). There was a positive correlation between the number of likes, comments, collections, and shares (all P<.001). The duration and the number of fans were positively correlated with the quality of videos (all P<.05). Conclusions: There are numerous videos about colorectal polyps on short-video sharing platforms, but the reliability and quality of these videos are not good enough and need to be improved. ",
doi="10.2196/51655",
url="https://www.jmir.org/2024/1/e51655",
url="http://www.ncbi.nlm.nih.gov/pubmed/39470708"
}


@Article{info:doi/10.2196/55531,
author="Lee, Eun
and Kim, Heejun
and Esener, Yildiz
and McCall, Terika",
title="Internet-Based Social Connections of Black American College Students in Pre--COVID-19 and Peri--COVID-19 Pandemic Periods: Network Analysis",
journal="J Med Internet Res",
year="2024",
month="Oct",
day="28",
volume="26",
pages="e55531",
keywords="COVID-19 pandemic",
keywords="college students",
keywords="Black American",
keywords="African American",
keywords="social network analysis",
keywords="social media",
keywords="mental health",
keywords="depression",
abstract="Background: A global-scale pandemic, such as the COVID-19 pandemic, greatly impacted communities of color. Moreover, physical distancing recommendations during the height of the COVID-19 pandemic negatively affected people's sense of social connection, especially among young individuals. More research is needed on the use of social media and communication about depression, with a specific focus on young Black Americans. Objective: This paper aims to examine whether there are any differences in social-networking characteristics before and during the pandemic periods (ie, pre--COVID-19 pandemic vs peri--COVID-19 pandemic) among the students of historically black colleges and universities (HBCUs). For the study, the researchers focus on the students who have posted a depression-related tweet or have retweeted such posts on their timeline and also those who have not made such tweets. This is done to understand the collective patterns of both groups. Methods: This paper analyzed the social networks on Twitter (currently known as X; X Corp) of HBCU students through comparing pre--COVID-19 and peri--COVID-19 pandemic data. The researchers quantified the structural properties, such as reciprocity, homophily, and communities, to test the differences in internet-based socializing patterns between the depression-related and non--depression related groups for the 2 periods. Results: During the COVID-19 pandemic period, the group with depression-related tweets saw an increase in internet-based friendships, with the average number of friends rising from 1194 (SD 528.14) to 1371 (SD 824.61; P<.001). Their mutual relationships strengthened (reciprocity: 0.78-0.8; P=.01), and they showed higher assortativity with other depression-related group members (0.6-0.7; P<.001). In a network with only HBCU students, internet-based and physical affiliation memberships aligned closely during the peri--COVID-19 pandemic period, with membership entropy decreasing from 1.0 to 0.5. While users without depression-related tweets engaged more on the internet with other users who shared physical affiliations, those who posted depression-related tweets maintained consistent entropy levels (modularity: 0.75-0.76). Compared with randomized networks before and during the COVID-19 pandemic (P<.001), the users also exhibited high homophily with other members who posted depression-related tweets. Conclusions: The findings of this study provided insight into the social media activities of HBCU students' social networks and communication about depression on social media. Future social media interventions focused on the mental health of Black college students may focus on providing resources to students who communicate about depression. Efforts aimed at providing relevant resources and information to internet-based communities that share institutional affiliation may enhance access to social support, particularly for those who may not proactively seek assistance. This approach may contribute to increased social support for individuals within these communities, especially those with a limited social capacity. ",
doi="10.2196/55531",
url="https://www.jmir.org/2024/1/e55531"
}


@Article{info:doi/10.2196/58518,
author="Liu, Min
and Yuan, Shuo
and Li, Bingyan
and Zhang, Yuxi
and Liu, Jia
and Guan, Cuixia
and Chen, Qingqing
and Ruan, Jiayi
and Xie, Lunfang",
title="Chinese Public Attitudes and Opinions on Health Policies During Public Health Emergencies: Sentiment and Topic Analysis",
journal="J Med Internet Res",
year="2024",
month="Oct",
day="28",
volume="26",
pages="e58518",
keywords="public health emergencies",
keywords="nucleic acid testing",
keywords="governance strategies",
keywords="sentiment analysis",
keywords="LDA",
keywords="social media",
keywords="COVID-19",
keywords="opinion analysis",
abstract="Background: By the end of 2021, the new wave of COVID-19 sparked by the Omicron variant spread rapidly due to its highly contagious nature, affecting more than 170 countries worldwide. Nucleic acid testing became the gold standard for diagnosing novel coronavirus infections. As of July 2022, numerous cities and regions in China have implemented regular nucleic acid testing policies, which have had a significant impact on socioeconomics and people's lives. This policy has garnered widespread attention on social media platforms. Objective: This study took the newly issued regular nucleic acid testing policy during the COVID-19 pandemic as an example to explore the sentiment responses and fluctuations of netizens toward new policies during public health emergencies. It aimed to propose strategies for managing public opinion on the internet and provide recommendations for policy making and public opinion control. Methods: We collected blog posts related to nucleic acid testing on Weibo from April 1, 2022, to July 31, 2022. We used the topic modeling technique latent Dirichlet allocation (LDA) to identify the most common topics posted by users. We used Bidirectional Encoder Representations from Transformers (BERT) to calculate the sentiment score of each post. We used an autoregressive integrated moving average (ARIMA) model to examine the relationship between sentiment scores and changes over time. We compared the differences in sentiment scores across various topics, as well as the changes in sentiment before and after the announcement of the nucleic acid price reduction policy (May 22) and the lifting of the lockdown policy in Shanghai (June 1). Results: We collected a total of 463,566 Weibo posts, with an average of 3799.72 (SD 1296.06) posts published daily. The LDA topic extraction identified 8 topics, with the most numerous being the Shanghai outbreak, nucleic acid testing price, and transportation. The average sentiment score of the posts was 0.64 (SD 0.31), indicating a predominance of positive sentiment. For all topics, posts with positive sentiment consistently outnumbered those with negative sentiment ($\chi$27=24,844.4, P<.001). The sentiment scores of posts related to ``nucleic acid testing price'' decreased after May 22 compared with before (t120=3.882, P<.001). Similarly, the sentiment scores of posts related to the ``Shanghai outbreak'' decreased after June 1 compared with before (t120=11.943, P<.001). Conclusions: During public health emergencies, the topics of public concern were diverse. Public sentiment toward the regular nucleic acid testing policy was generally positive, but fluctuations occurred following the announcement of key policies. To understand the primary concerns of the public, the government needs to monitor social media posts by citizens. By promptly sharing information on media platforms and engaging in effective communication, the government can bridge the information gap between the public and government agencies, fostering a positive public opinion environment. ",
doi="10.2196/58518",
url="https://www.jmir.org/2024/1/e58518",
url="http://www.ncbi.nlm.nih.gov/pubmed/39466313"
}


@Article{info:doi/10.2196/58257,
author="Oan?, Iulian
and H{\^a}ncean, Marian-Gabriel
and Perc, Matja?
and Lerner, J{\"u}rgen
and Mih?il?, Bianca-Elena
and Geant?, Marius
and Molina, Luis Jos{\'e}
and Tinc?, Isabela
and Espina, Carolina",
title="Online Media Use and COVID-19 Vaccination in Real-World Personal Networks: Quantitative Study",
journal="J Med Internet Res",
year="2024",
month="Oct",
day="25",
volume="26",
pages="e58257",
keywords="vaccine hesitancy",
keywords="online media",
keywords="social media",
keywords="assortative mixing",
keywords="personal network analysis",
keywords="social network analysis",
keywords="Romania",
keywords="vaccination",
keywords="health information",
keywords="COVID-19",
abstract="Background: Most studies assessing the impact of online media and social media use on COVID-19 vaccine hesitancy predominantly rely on survey data, which often fail to capture the clustering of health opinions and behaviors within real-world networks. In contrast, research using social network analysis aims to uncover the diverse communities and discourse themes related to vaccine support and hesitancy within social media platforms. Despite these advancements, there is a gap in the literature on how a person's social circle affects vaccine acceptance, wherein an important part of social influence stems from offline interactions. Objective: We aimed to examine how online media consumption influences vaccination decisions within real-world social networks by analyzing unique quantitative network data collected from Romania, an Eastern European state and member of the European Union. Methods: We conducted 83 face-to-face interviews with participants from a living lab in Lere?ti, a small rural community in Romania, using a personal network analysis framework. This approach involved gathering data on both the respondents and individuals within their social circles (referred to as alters). After excluding cases with missing data, our analysis proceeded with 73\% (61/83) of the complete personal networks. To examine the hierarchical structure of alters nested within ego networks, we used a mixed multilevel logistic regression model with random intercepts. The model aimed to predict vaccination status among alters, with the focal independent variable being the respondents' preferred source of health and prevention information. This variable was categorized into 3 types: traditional media, online media (including social media), and a combination of both, with traditional media as the reference category. Results: In this study, we analyzed 61 personal networks, encompassing between 15 and 25 alters each, totaling 1280 alters with valid data across all variables of interest. Our primary findings indicate that alters within personal networks, whose respondents rely solely on online media for health information, exhibit lower vaccination rates (odds ratio [OR] 0.37, 95\% CI 0.15-0.92; P=.03). Conversely, the transition from exclusive traditional media use to a combination of both traditional and online media does not significantly impact vaccination rate odds (OR 0.75, 95\% CI 0.32-1.78; P=.52). In addition, our analysis revealed that alters in personal networks of respondents who received the vaccine are more likely to have received the vaccine themselves (OR 3.75, 95\% CI 1.79-7.85; P<.001). Conclusions: Real-world networks combine diverse human interactions and attributes along with consequences on health opinions and behaviors. As individuals' vaccination status is influenced by how their social alters use online media and vaccination behavior, further insights are needed to create tailored communication campaigns and interventions regarding vaccination in areas with low levels of digital health literacy and vaccination rates, as Romania exposes. ",
doi="10.2196/58257",
url="https://www.jmir.org/2024/1/e58257"
}


@Article{info:doi/10.2196/52129,
author="Kierstead, Elexis
and Silver, Nathan
and Amato, Michael",
title="Examining Quitting Experiences on Quit Vaping Subreddits From 2015 to 2021: Content Analysis",
journal="J Med Internet Res",
year="2024",
month="Oct",
day="25",
volume="26",
pages="e52129",
keywords="quitting vaping, social media, tobacco policy",
keywords="cessation",
keywords="e-cigarette",
keywords="electronic cigarette",
keywords="smoking",
keywords="vaping",
keywords="cessation programs",
keywords="social support",
keywords="peer support",
abstract="Background: Despite the prevalence of vaping nicotine, most nicotine cessation research remains focused on smoking cigarettes. However, the lived experience of quitting smoking is different from quitting vaping. As a result, research examining the unique experiences of those quitting vaping can better inform quitting resources and cessation programs specific to e-cigarette use. Examining Reddit forums (ie, subreddits) dedicated to the topics of quitting vaping nicotine can provide insight into the discussion around experiences on quitting vaping. Prior literature examining limited discussions around quitting vaping on Reddit has identified the sharing of barriers and facilitators for quitting, but more research is needed to investigate the content comprehensively across all subreddits. Objective: The objective of this study is to examine content across quit vaping subreddits since their inception to better understand quitting vaping within the context of the expanding nicotine market. Methods: All posts from January 2015 to October 2021 were scraped from all quit vaping subreddits: r/QuittingJuul, r/QuitVaping, r/quit\_vaping, and r/stopvaping (N=7110). Rolling weekly average post volume was calculated. A codebook informed by a latent Dirichlet allocation topic model was developed to characterize themes in a subsample of 695 randomly selected posts. Frequencies and percentages of posts containing each coded theme were assessed along with the number of upvotes and comments. Results: Post volume increased across all subreddits over time, spiking from August -- September of 2019 when vaping lung injury emerged. Just over 52\% of posts discussed seeking social support and 16.83\% discussed providing social support. Posts providing support received the most positive engagements (i.e. upvotes) of all coded categories. Posts also discussed physical and psychological symptoms of withdrawal (30.65\% and 18.85\%, respectively), strategies for quitting including: quitting cold turkey (38.33\%), using alternative nicotine products (17\%), and tapering down nicotine content (10.50\%). Most posts shared a personal narrative (92.37\%) and some discussed quit motivation (28.20\%) and relapse (14.99\%). Conclusions: This work identifies a desire for peer-to-peer support for quitting vaping, which reinforces existing literature and highlights characteristics of quitting vaping specific to a changing nicotine product environment. Given that posts providing social support were the most upvoted, this suggests that subreddit contributors are seeking support from their peers when discussing quitting vaping. Additionally, this analysis shows the sharing of barriers and facilitators for quitting, supporting findings from prior exploration of quit vaping subreddits. Finally, quitting vaping in an ever-growing nicotine market has led to the evolution of vaping-specific quit methods such as tapering down nicotine content. These findings have direct implications for quit vaping product implementation and development. ",
doi="10.2196/52129",
url="https://www.jmir.org/2024/1/e52129"
}


@Article{info:doi/10.2196/55372,
author="Mertens, Ellen
and Ye, Guoquan
and Beuckels, Emma
and Hudders, Liselot",
title="Parenting Information on Social Media: Systematic Literature Review",
journal="JMIR Pediatr Parent",
year="2024",
month="Oct",
day="23",
volume="7",
pages="e55372",
keywords="parenting",
keywords="social media",
keywords="parenting information",
keywords="systematic literature review",
keywords="bibliometric literature review",
keywords="thematic analysis",
abstract="Background: Social media has become extremely popular among parents to seek parenting information. Despite the increasing academic attention to the topic, studies are scattered across various disciplines. Therefore, this study broadens the scope of the existing reviews by transcending narrow academic subdomains and including all relevant research insights related to parents' information seeking on social media and its consequent effects. Objective: The aims of this systematic literature review were to (1) identify influential journals and scholars in the field; (2) examine the thematic evolution of research on parenting and social media; and (3) pinpoint research gaps, providing recommendations for future exploration. Methods: On the basis of a criteria for identifying scholarly publications, we selected 338 studies for this systematic literature review. We adopted a bibliometric analysis combined with a content thematic analysis to obtain data-driven insights with a profound understanding of the predominant themes in the realm of parenting and social media. Results: The analysis revealed a significant increase in research on parenting and social media since 2015, especially in the medical domain. The studies in our review spanned 232 different research fields, and the most prolific journal was JMIR Pediatrics and Parenting. The thematic analysis identified 4 emerging research themes in the studies: parenting motivations to seek information, nature of parenting content on social media, impact of parenting content, and interventions for parents on social media. Conclusions: This study provides critical insights into the current research landscape of parenting and social media. The identified themes, research gaps, and future research recommendations provide a foundation for future studies, guiding researchers toward valuable areas for exploration. ",
doi="10.2196/55372",
url="https://pediatrics.jmir.org/2024/1/e55372"
}


@Article{info:doi/10.2196/55149,
author="Clavier, Thomas
and Chevalier, Emma
and Demailly, Zo{\'e}
and Veber, Benoit
and Messaadi, Imad-Abdelkader
and Popoff, Benjamin",
title="Social Media Usage for Medical Education and Smartphone Addiction Among Medical Students: National Web-Based Survey",
journal="JMIR Med Educ",
year="2024",
month="Oct",
day="22",
volume="10",
pages="e55149",
keywords="medical student",
keywords="social network",
keywords="social media",
keywords="smartphone addiction",
keywords="medical education",
keywords="mobile addiction",
keywords="social networks",
abstract="Background: Social media (SoMe) have taken a major place in the medical field, and younger generations are increasingly using them as their primary source to find information. Objective: This study aimed to describe the use of SoMe for medical education among French medical students and assess the prevalence of smartphone addiction in this population. Methods: A cross-sectional web-based survey was conducted among French medical students (second to sixth year of study). The questionnaire collected information on SoMe use for medical education and professional behavior. Smartphone addiction was assessed using the Smartphone Addiction Scale Short-Version (SAS-SV) score. Results: A total of 762 medical students responded to the survey. Of these, 762 (100\%) were SoMe users, spending a median of 120 (IQR 60?150) minutes per day on SoMe; 656 (86.1\%) used SoMe for medical education, with YouTube, Instagram, and Facebook being the most popular platforms. The misuse of SoMe in a professional context was also identified; 27.2\% (207/762) of students posted hospital internship content, and 10.8\% (82/762) searched for a patient's name on SoMe. Smartphone addiction was prevalent among 29.1\% (222/762) of respondents, with a significant correlation between increased SoMe use and SAS-SV score (r=0.39, 95\% CI 0.33?0.45; P<.001). Smartphone-addicted students reported a higher impact on study time (211/222, 95\% vs 344/540, 63.6\%; P<.001) and a greater tendency to share hospital internship content on social networks (78/222, 35.1\% vs 129/540, 23.8\%; P=.002). Conclusions: Our findings reveal the extensive use of SoMe for medical education among French medical students, alongside a notable prevalence of smartphone addiction. These results highlight the need for medical schools and educators to address the responsible use of SoMe and develop strategies to mitigate the risks associated with excessive use and addiction. ",
doi="10.2196/55149",
url="https://mededu.jmir.org/2024/1/e55149"
}


@Article{info:doi/10.2196/50099,
author="Acero, Nicole
and Herrero, Emma
and Foncham, Juanita
and McIlvaine, Jamie
and Kayaalp, Emre
and Figueora, Melissa
and Oladipo, Francis Antonia",
title="Accuracy, Quality, and Misinformation of YouTube Abortion Procedural Videos: Cross-Sectional Study",
journal="J Med Internet Res",
year="2024",
month="Oct",
day="22",
volume="26",
pages="e50099",
keywords="abortion",
keywords="YouTube",
keywords="social media",
keywords="accuracy",
keywords="quality",
keywords="misinformation",
keywords="reliability",
keywords="obstetrics",
keywords="women's health",
keywords="reproductive",
keywords="patient education",
keywords="health information",
keywords="prochoice",
abstract="Background: The internet is often the first source patients turn to for medical information. YouTube is a commonly used internet-based resource for patients seeking to learn about medical procedures, including their risks, benefits, and safety profile. Abortion is a common yet polarizing medical procedure. People interested in obtaining an abortion are likely to use the internet to learn more about abortion procedures and may encounter misinformed and biased information. This is troubling as information found on the internet can significantly alter perceptions and understanding of these procedures. There is no current research that evaluates the accuracy, quality, and misinformation of instructional abortion videos available to patients. Objective: The purpose of this study was to assess if any given video can deliver accurate and quality information about this topic in an unbiased manner and to assess the level of factually incorrect, distorted, or medically irrelevant information in any given video. Methods: Procedural methods of abortion were queried on YouTube on August 22, 2022. The videos were screened with strict exclusion criteria. Videos were categorized into ``video slants'' based on the language and attitudes expressed in each video. Video accuracy was calculated using the Surgical Curriculum in Obstetrics and Gynecology (SCOG) checklist for each corresponding procedure. Video quality was calculated using the Laparoscopic Surgery Video Educational Guidelines (LAP-VEGaS) criteria. The level of misinformation was assessed with the evidence-based Anti-Choice Rubric, which scores the amount of factually incorrect, distorted, or medically irrelevant information in each video. Results: A total of 32 videos were analyzed and categorized into 3 ``video slant'' groups: neutral (n=23, 72\%), antichoice (n=4, 12\%), and prochoice (n=5, 16\%). Using the SCOG checklist, neutral videos had the highest median accuracy (45.9\%), followed by antichoice videos (24.6\%) and prochoice videos (18.5\%). None of the videos met the LAP-VEGaS quality control criteria, (score>11, indicating adequate quality). Neutral videos had a median score of 8.8 out of 18, with antichoice videos scoring 10.75 and prochoice videos scoring 6.2. Using the Anti-Choice Rubric, neutral videos mentioned only 1 factually incorrect piece of information. Antichoice videos mentioned 12 factually incorrect pieces of information, 8 distortions, and 3 medically irrelevant pieces of information. Prochoice videos did not mention any of the 3 themes. Conclusions: Using the SCOG checklist, the accuracy of instructional videos were inconsistent across the 3 identified ``video slants.'' Using LAP-VEGaS criteria, the quality of educational videos were also inconsistent across the 3 ``video slants.'' Prochoice videos had the lowest level of misinformation, with no mentions of any of the 3 themes. Antichoice videos had the highest levels of misinformation, with mentions in all 3 themes. Health care professionals should consider this when counseling patients who may watch YouTube videos for information regarding abortion procedures. ",
doi="10.2196/50099",
url="https://www.jmir.org/2024/1/e50099"
}


@Article{info:doi/10.2196/58309,
author="P{\'e}rez-P{\'e}rez, Mart{\'i}n
and Fernandez Gonzalez, Mar{\'i}a
and Rodriguez-Rajo, Javier Francisco
and Fdez-Riverola, Florentino",
title="Tracking the Spread of Pollen on Social Media Using Pollen-Related Messages From Twitter: Retrospective Analysis",
journal="J Med Internet Res",
year="2024",
month="Oct",
day="21",
volume="26",
pages="e58309",
keywords="pollen",
keywords="respiratory allergies",
keywords="Twitter",
keywords="large language model",
keywords="LLM",
keywords="knowledge reconstruction",
keywords="text mining",
abstract="Background: Allergy disorders caused by biological particles, such as the proteins in some airborne pollen grains, are currently considered one of the most common chronic diseases, and European Academy of Allergy and Clinical Immunology forecasts indicate that within 15 years 50\% of Europeans will have some kind of allergy as a consequence of urbanization, industrialization, pollution, and climate change. Objective: The aim of this study was to monitor and analyze the dissemination of information about pollen symptoms from December 2006 to January 2022. By conducting a comprehensive evaluation of public comments and trends on Twitter, the research sought to provide valuable insights into the impact of pollen on sensitive individuals, ultimately enhancing our understanding of how pollen-related information spreads and its implications for public health awareness. Methods: Using a blend of large language models, dimensionality reduction, unsupervised clustering, and term frequency--inverse document frequency, alongside visual representations such as word clouds and semantic interaction graphs, our study analyzed Twitter data to uncover insights on respiratory allergies. This concise methodology enabled the extraction of significant themes and patterns, offering a deep dive into public knowledge and discussions surrounding respiratory allergies on Twitter. Results: The months between March and August had the highest volume of messages. The percentage of patient tweets appeared to increase notably during the later years, and there was also a potential increase in the prevalence of symptoms, mainly in the morning hours, indicating a potential rise in pollen allergies and related discussions on social media. While pollen allergy is a global issue, specific sociocultural, political, and economic contexts mean that patients experience symptomatology at a localized level, needing appropriate localized responses. Conclusions: The interpretation of tweet information represents a valuable tool to take preventive measures to mitigate the impact of pollen allergy on sensitive patients to achieve equity in living conditions and enhance access to health information and services. ",
doi="10.2196/58309",
url="https://www.jmir.org/2024/1/e58309",
url="http://www.ncbi.nlm.nih.gov/pubmed/39432897"
}


@Article{info:doi/10.2196/50408,
author="Kang, Jeemin
and Szeto, D. Mindy
and Suh, Lois
and Olayinka, T. Jadesola
and Dellavalle, P. Robert",
title="Popular Skin-of-Color Dermatology Social Media Hashtags on TikTok From 2021 to 2022: Content Analysis",
journal="JMIR Dermatol",
year="2024",
month="Oct",
day="18",
volume="7",
pages="e50408",
keywords="dermatology",
keywords="dermatologist",
keywords="social media",
keywords="TikTok",
keywords="skin of color",
keywords="hashtag",
keywords="content analysis",
keywords="education",
keywords="influencers",
keywords="diversity",
keywords="inclusion",
keywords="disparities",
doi="10.2196/50408",
url="https://derma.jmir.org/2024/1/e50408"
}


@Article{info:doi/10.2196/57720,
author="Zhang, Baolu
and Kalampakorn, Surintorn
and Powwattana, Arpaporn
and Sillabutra, Jutatip
and Liu, Gang",
title="Oral Diabetes Medication Videos on Douyin: Analysis of Information Quality and User Comment Attitudes",
journal="JMIR Form Res",
year="2024",
month="Oct",
day="18",
volume="8",
pages="e57720",
keywords="diabetes",
keywords="oral diabetes medication",
keywords="information quality",
keywords="user comment attitude",
keywords="video analysis",
keywords="Douyin",
abstract="Background: Oral diabetes medications are important for glucose management in people with diabetes. Although there are many health-related videos on Douyin (the Chinese version of TikTok), the quality of information and the effects on user comment attitudes are unclear. Objective: The purpose of this study was to analyze the quality of information and user comment attitudes related to oral diabetes medication videos on Douyin. Methods: The key phrase ``oral diabetes medications'' was used to search Douyin on July 24, 2023, and the final samples included 138 videos. The basic information in the videos and the content of user comments were captured using Python. Each video was assigned a sentiment category based on the predominant positive, neutral, or negative attitude, as analyzed using the Weiciyun website. Two independent raters assessed the video content and information quality using the DISCERN (a tool for assessing health information quality) and PEMAT-A/V (Patient Education Materials Assessment Tool for Audiovisual Materials) instruments. Results: Doctors were the main source of the videos (136/138, 98.6\%). The overall information quality of the videos was acceptable (median 3, IQR 1). Videos on Douyin showed relatively high understandability (median 75\%, IQR 16.6\%) but poor actionability (median 66.7\%, IQR 48\%). Most content on oral diabetes medications on Douyin related to the mechanism of action (75/138, 54.3\%), precautions (70/138, 50.7\%), and advantages (68/138, 49.3\%), with limited content on indications (19/138, 13.8\%) and contraindications (14/138, 10.1\%). It was found that 10.1\% (14/138) of the videos contained misinformation, of which 50\% (7/14) were about the method of administration. Regarding user comment attitudes, the majority of videos garnered positive comments (81/138, 58.7\%), followed by neutral comments (46/138, 33.3\%) and negative comments (11/138, 8\%). Multinomial logistic regression revealed 2 factors influencing a positive attitude: user comment count (adjusted odds ratio [OR] 1.00, 95\% CI 1.00-1.00; P=.02) and information quality of treatment choices (adjusted OR 1.49, 95\% CI 1.09-2.04; P=.01). Conclusions: Despite most videos on Douyin being posted by doctors, with generally acceptable information quality and positive user comment attitudes, some content inaccuracies and poor actionability remain. Users show more positive attitudes toward videos with high-quality information about treatment choices. This study suggests that health care providers should ensure the accuracy and actionability of video content, enhance the information quality of treatment choices of oral diabetes medications to foster positive user attitudes, help users access accurate health information, and promote medication adherence. ",
doi="10.2196/57720",
url="https://formative.jmir.org/2024/1/e57720"
}


@Article{info:doi/10.2196/43954,
author="Simblett, Sara
and Dawe-Lane, Erin
and Gilpin, Gina
and Morris, Daniel
and White, Katie
and Erturk, Sinan
and Devonshire, Julie
and Lees, Simon
and Zormpas, Spyridon
and Polhemus, Ashley
and Temesi, Gergely
and Cummins, Nicholas
and Hotopf, Matthew
and Wykes, Til
and ",
title="Data Visualization Preferences in Remote Measurement Technology for Individuals Living With Depression, Epilepsy, and Multiple Sclerosis: Qualitative Study",
journal="J Med Internet Res",
year="2024",
month="Oct",
day="18",
volume="26",
pages="e43954",
keywords="mHealth",
keywords="qualitative",
keywords="technology",
keywords="depression",
keywords="epilepsy",
keywords="multiple sclerosis",
keywords="wearables",
keywords="devices",
keywords="smartphone apps",
keywords="application",
keywords="feedback",
keywords="users",
keywords="data",
keywords="data visualization",
keywords="mobile phone",
abstract="Background: Remote measurement technology (RMT) involves the use of wearable devices and smartphone apps to measure health outcomes in everyday life. RMT with feedback in the form of data visual representations can facilitate self-management of chronic health conditions, promote health care engagement, and present opportunities for intervention. Studies to date focus broadly on multiple dimensions of service users' design preferences and RMT user experiences (eg, health variables of perceived importance and perceived quality of medical advice provided) as opposed to data visualization preferences. Objective: This study aims to explore data visualization preferences and priorities in RMT, with individuals living with depression, those with epilepsy, and those with multiple sclerosis (MS). Methods: A triangulated qualitative study comparing and thematically synthesizing focus group discussions with user reviews of existing self-management apps and a systematic review of RMT data visualization preferences. A total of 45 people participated in 6 focus groups across the 3 health conditions (depression, n=17; epilepsy, n=11; and MS, n=17). Results: Thematic analysis validated a major theme around design preferences and recommendations and identified a further four minor themes: (1) data reporting, (2) impact of visualization, (3) moderators of visualization preferences, and (4) system-related factors and features. Conclusions: When used effectively, data visualizations are valuable, engaging components of RMT. Easy to use and intuitive data visualization design was lauded by individuals with neurological and psychiatric conditions. Apps design needs to consider the unique requirements of service users. Overall, this study offers RMT developers a comprehensive outline of the data visualization preferences of individuals living with depression, epilepsy, and MS. ",
doi="10.2196/43954",
url="https://www.jmir.org/2024/1/e43954"
}


@Article{info:doi/10.2196/57062,
author="Dougherty, Madeline
and Tompkins, Tamara
and Zibrowski, Elaine
and Cram, Jesse
and Ashe, C. Maureen
and Bhaskar, Le-Tien
and Card, George Kiffer
and Godfrey, Christina
and Hebert, Paul
and Lacombe, Ron
and Muhl, Caitlin
and Mulligan, Kate
and Mulvale, Gillian
and Nelson, A. Michelle L.
and Norman, Myrna
and Symes, Bobbi
and Teare, Gary
and Welch, Vivian
and Kothari, Anita",
title="Coproduction in Social Prescribing Initiatives: Protocol for a Scoping Review",
journal="JMIR Res Protoc",
year="2024",
month="Oct",
day="17",
volume="13",
pages="e57062",
keywords="social prescribing",
keywords="coproduction",
keywords="codevelopment",
keywords="policy",
keywords="social prescription",
keywords="nonmedical need",
keywords="social need",
keywords="clinical setting",
keywords="community programs",
keywords="health care system",
keywords="pilot-tested",
keywords="user involvement",
keywords="health education",
abstract="Background: Social prescribing (SP) takes a holistic approach to health by linking clients from clinical settings to community programs to address their nonmedical needs. The emerging evidence base for SP demonstrates variability in the design and implementation of different SP initiatives. To effectively address these needs, coproduction among clients, communities, stakeholders, and policy makers is important for tailoring SP initiatives for optimal uptake. Objective: This study aims to explore the role of coproduction in SP initiatives. The research question is as follows: How and for what purpose has coproduction been incorporated across a range of SP initiatives for different clients? Methods: A review of international literature will be conducted following the JBI guidelines for scoping reviews. We will search multiple databases including Scopus, MEDLINE, and the PAIS Index, as well as gray literature, from 2000 to 2023. The primary studies included will describe a nonmedical need for clients, a nonmedical SP program or initiative, coproduction of the SP program, and any follow-up. Review articles and commentaries will be excluded. Titles, abstracts, and full-text articles will be screened, and data will be extracted by at least 2 research team members using Covidence and a pilot-tested extraction template. Clients with lived experience will also participate in the research process. Findings will be descriptively summarized and thematically synthesized to answer the research question. Results: The project was funded in 2023, and the results are expected to be submitted for publication in early 2025. Conclusions: Descriptions of what coproduction is meant to accomplish may differ from theoretical aspirations. Continued understanding of how coproduction has been designed and executed across varied international SP models is important for framing engagement in practice for future SP arrangements and their evaluation. We anticipate this review will guide clients, communities, stakeholders, and policy makers in further developing SP practice within health care systems. Trial Registration: Open Science Framework Registries B8U4Z; https://osf.io/b8u4z International Registered Report Identifier (IRRID): DERR1-10.2196/57062 ",
doi="10.2196/57062",
url="https://www.researchprotocols.org/2024/1/e57062"
}


@Article{info:doi/10.2196/53488,
author="Deng, Tianjie
and Urbaczewski, Andrew
and Lee, Jin Young
and Barman-Adhikari, Anamika
and Dewri, Rinku",
title="Identifying Marijuana Use Behaviors Among Youth Experiencing Homelessness Using a Machine Learning--Based Framework: Development and Evaluation Study",
journal="JMIR AI",
year="2024",
month="Oct",
day="17",
volume="3",
pages="e53488",
keywords="machine learning",
keywords="youth experiencing homelessness",
keywords="natural language processing",
keywords="infodemiology",
keywords="social good",
keywords="digital intervention",
abstract="Background: Youth experiencing homelessness face substance use problems disproportionately compared to other youth. A study found that 69\% of youth experiencing homelessness meet the criteria for dependence on at least 1 substance, compared to 1.8\% for all US adolescents. In addition, they experience major structural and social inequalities, which further undermine their ability to receive the care they need. Objective: The goal of this study was to develop a machine learning--based framework that uses the social media content (posts and interactions) of youth experiencing homelessness to predict their substance use behaviors (ie, the probability of using marijuana). With this framework, social workers and care providers can identify and reach out to youth experiencing homelessness who are at a higher risk of substance use. Methods: We recruited 133 young people experiencing homelessness at a nonprofit organization located in a city in the western United States. After obtaining their consent, we collected the participants' social media conversations for the past year before they were recruited, and we asked the participants to complete a survey on their demographic information, health conditions, sexual behaviors, and substance use behaviors. Building on the social sharing of emotions theory and social support theory, we identified important features that can potentially predict substance use. Then, we used natural language processing techniques to extract such features from social media conversations and reactions and built a series of machine learning models to predict participants' marijuana use. Results: We evaluated our models based on their predictive performance as well as their conformity with measures of fairness. Without predictive features from survey information, which may introduce sex and racial biases, our machine learning models can reach an area under the curve of 0.72 and an accuracy of 0.81 using only social media data when predicting marijuana use. We also evaluated the false-positive rate for each sex and age segment. Conclusions: We showed that textual interactions among youth experiencing homelessness and their friends on social media can serve as a powerful resource to predict their substance use. The framework we developed allows care providers to allocate resources efficiently to youth experiencing homelessness in the greatest need while costing minimal overhead. It can be extended to analyze and predict other health-related behaviors and conditions observed in this vulnerable community. ",
doi="10.2196/53488",
url="https://ai.jmir.org/2024/1/e53488"
}


@Article{info:doi/10.2196/50057,
author="Wu, Manli
and Yan, Jun
and Qiao, Chongming
and Yan, Chu",
title="Impact of Concurrent Media Exposure on Professional Identity: Cross-Sectional Study of 1087 Medical Students During Long COVID",
journal="J Med Internet Res",
year="2024",
month="Oct",
day="17",
volume="26",
pages="e50057",
keywords="COVID-19",
keywords="media exposure",
keywords="social support",
keywords="professional identity",
keywords="medical students",
keywords="Stimulus-Organism-Response framework",
abstract="Background: Long COVID has widened the health gap across society and highlighted the vulnerabilities and risks faced by health care systems. For instance, the global trend of medical workers resigning has become a prominent topic on social media. In response to this severe social problem in global public health within the digital society, it is urgent to investigate how the professional identity of medical students, who are digital natives and the future workforce of medical practitioners, is affected by the media environment. Objective: This study aims to examine how media exposure relates to medical students' perceptions of informational and emotional support, and how these perceptions further influence the development of their professional identity. Methods: Building on the Stimulus-Organism-Response (SOR) framework, this study develops a theoretical model to illustrate how media exposure affects medical students' professional identity through the mediation of social support. Specifically, media exposure was assessed through online news media and social media exposure; social support was evaluated in terms of informational and emotional support; and professional identity was measured through medical students' sense of belonging and professional commitment. A survey was conducted at a medical school in China, yielding 1087 valid responses that were analyzed using SmartPLS 4.0. Results: Consistent with our expectations, online news media exposure was positively associated with both informational support ($\beta$=.163; P<.001) and emotional support ($\beta$=.084; P=.007). Similarly, social media exposure showed positive associations with informational support ($\beta$=.122; P<.001) and emotional support ($\beta$=.235; P<.001). Thereafter, informational support ($\beta$=.228; P<.001) and emotional support ($\beta$=.344; P<.001) were positively associated with students' sense of belonging. Meanwhile, both informational support ($\beta$=.245; P<.001) and emotional support ($\beta$=.412; P<.001) positively impacted medical students' professional commitment. In addition, a mediation test was conducted. The results confirmed that informational support and emotional support partially mediated the effect of online news media, while fully mediating the effect of social media on medical students' sense of belonging and professional commitment. Conclusions: This study finds that exposure to online news media and social media can enhance medical students' sense of belonging and professional commitment through the formation of informational and emotional support. It expands the discussion on the role of media in providing social support and facilitating the development of medical students' professional identity. This is a valuable contribution to addressing complex public health crises through effective media governance in the network era. ",
doi="10.2196/50057",
url="https://www.jmir.org/2024/1/e50057",
url="http://www.ncbi.nlm.nih.gov/pubmed/39418080"
}


@Article{info:doi/10.2196/58681,
author="Rachmayanti, D. Riris
and Dewi, Tetra Fatwa Sari
and Setiyawati, Diana
and Megatsari, Hario
and Diana, Rian
and Vinarti, Retno",
title="Using Digital Media to Improve Adolescent Resilience and Prevent Mental Health Problems: Protocol for a Scoping Review",
journal="JMIR Res Protoc",
year="2024",
month="Oct",
day="16",
volume="13",
pages="e58681",
keywords="adolescents",
keywords="digital media",
keywords="mental health",
keywords="resilience",
keywords="scoping review",
abstract="Background: Global databases show a high prevalence of mental health problems among adolescents (13.5\% among those aged 10-14 years and 14.65\% for those aged 15-19 years). Successful coping depends on risk and protective factors and how their interaction influences resilience. Higher resilience has been shown to correlate with fewer mental health problems. Digital mental health interventions may help address these problems. Objective: This protocol serves as a framework for planning a scoping review to map the types of digital communication media and their effectiveness in increasing resilience in youths. Methods: The Joanna Briggs Institute guidelines will be used: defining the research questions; identifying relevant studies; study selection (we will select articles based on titles and abstracts); charting the data; collating, summarizing, and reporting the results; and consultation. The synthesis will focus on the type of digital media used to increase adolescent resilience skills and the impact they have on adolescent resilience skills. Quantitative and qualitative analyses will be conducted. Results: The study selection based on keywords was completed in December 2023, the study screening and review were completed in February 2024, and the results manuscript is currently being prepared. This scoping review protocol was funded by the Center for Higher Education Funding and the Indonesia Endowment Fund for Education. Conclusions: The results of the study will provide a comprehensive overview of commonly used digital media types and their effectiveness in increasing youth resilience. Thus, the results of this scoping review protocol can serve as foundational evidence in deciding further research or interventions. This study may also be used as a guideline for mapping and identifying the type and impact of communication media used to increase adolescents' resilience skills. International Registered Report Identifier (IRRID): DERR1-10.2196/58681 ",
doi="10.2196/58681",
url="https://www.researchprotocols.org/2024/1/e58681"
}


@Article{info:doi/10.2196/54370,
author="Ar{\'e}valo Avalos, R. Marvyn
and Patel, Ashwin
and Duru, Haci
and Shah, Sanjiv
and Rivera, Madeline
and Sorrentino, Eleanor
and Dy, Marika
and Sarkar, Urmimala
and Nguyen, H. Kim
and Lyles, R. Courtney
and Aguilera, Adrian",
title="Implementation of a Technology-Enabled Diabetes Self-Management Peer Coaching Intervention for Patients With Poorly Controlled Diabetes: Quasi-Experimental Case Study",
journal="JMIR Diabetes",
year="2024",
month="Oct",
day="15",
volume="9",
pages="e54370",
keywords="type 2 diabetes",
keywords="type 1 diabetes",
keywords="diabetes experiences",
keywords="eHealth",
keywords="mHealth",
keywords="peer coaching",
keywords="peer coach",
keywords="peer support",
keywords="self-management",
keywords="social determinants of health",
keywords="behavioral determinants of health",
abstract="Background: Patients with diabetes experience worse health outcomes and greater health care expenditure. Improving diabetes outcomes requires involved self-management. Peer coaching programs can help patients engage in self-management while addressing individual and structural barriers. These peer coaching programs can be scaled with digital platforms to efficiently connect patients with peer supporters who can help with diabetes self-management. Objective: This study aimed to evaluate the implementation of a technology-enabled peer coaching intervention to support diabetes self-management among patients with uncontrolled diabetes. Methods: MetroPlusHealth, a predominant Medicaid health maintenance organization based in New York City, partnered with Pyx Health to enroll 300 Medicaid patients with uncontrolled diabetes into its 6-month peer coaching intervention. Pyx Health peer coaches conduct at least 2 evidence-based and goal-oriented coaching sessions per month with their assigned patients. These sessions are focused on addressing both behavioral and social determinants of health (SDoH) with the goal of helping patients increase their diabetes self-management literacy, implement self-management behaviors, and reduce barriers to ongoing self-care. Data analyzed in this study included patient demographic data, clinical data (patient's hemoglobin A1c [HbA1c]), and program implementation data including types of behavioral determinants of health and SDoH reported by patients and types of interventions used by peer coaches. Results: A total of 330 patients enrolled in the peer mentoring program and 2118 patients were considered to be on a waitlist group and used as a comparator. Patients who enrolled in the peer coaching program were older; more likely to be English speakers, female, and African American; and less likely to be White or Asian American or Pacific Islander than those in the waitlist condition, and had similar HbA1c laboratory results at baseline (intervention group 10.59 vs waitlist condition 10.62) Patients in the enrolled group had on average a --1.37 point reduction in the HbA1c score (n=70; pre: 10.99, post 9.62; P<.001), whereas patients in the waitlist group had a --0.16 reduction in the HbA1c score (n=207; pre 9.75, post 9.49; P<.001). Among a subsample of participants enrolled in the program with at least 2 HbA1c scores, we found that endorsement of emotional health issues ($\beta$=1.344; P=.04) and medication issues ($\beta$=1.36; P=.04) were significantly related to increases in HbA1c. Conclusions: This analysis of a technology-enabled 1-on-1 peer coaching program showed improved HbA1c levels for program participants relative to nonprogram participants. Results suggested participants with emotional stressors and medication management issues had worse outcomes and many preferred to connect through phone calls versus an app. These findings support the effectiveness of digital programs with multimodal approaches that include human support for improving diabetes self-management in a typically marginalized population with significant SDoH barriers. ",
doi="10.2196/54370",
url="https://diabetes.jmir.org/2024/1/e54370"
}


@Article{info:doi/10.2196/52354,
author="Kelsall, Clancy Nora
and Gimbrone, Catherine
and Olfson, Mark
and Gould, Madelyn
and Shaman, Jeffrey
and Keyes, Katherine",
title="Internet Search Activity for Intentional Self-Harm Forums After a High-Profile News Publication: Interrupted Time Series Analysis",
journal="J Med Internet Res",
year="2024",
month="Oct",
day="15",
volume="26",
pages="e52354",
keywords="suicide risk",
keywords="suicide",
keywords="journalism",
keywords="media",
keywords="self-harm",
keywords="Google Trends",
keywords="websites",
keywords="mental health",
keywords="depression",
keywords="quality of life",
keywords="harmful information",
doi="10.2196/52354",
url="https://www.jmir.org/2024/1/e52354",
url="http://www.ncbi.nlm.nih.gov/pubmed/39405095"
}


@Article{info:doi/10.2196/52142,
author="Correia, C{\'e}sar Jorge
and Ahmad, Shaharyar Sarmad
and Waqas, Ahmed
and Meraj, Hafsa
and Pataky, Zoltan",
title="Exploring Public Emotions on Obesity During the COVID-19 Pandemic Using Sentiment Analysis and Topic Modeling: Cross-Sectional Study",
journal="J Med Internet Res",
year="2024",
month="Oct",
day="11",
volume="26",
pages="e52142",
keywords="obesity",
keywords="Twitter",
keywords="infodemic",
keywords="attitude",
keywords="opinion",
keywords="perception",
keywords="perspective",
keywords="obese",
keywords="weight",
keywords="overweight",
keywords="social media",
keywords="tweet",
keywords="sentiment",
keywords="topic modeling",
keywords="BERT",
keywords="Bidirectional Encoder Representations from Transformers",
keywords="NLP",
keywords="natural language processing",
keywords="general public",
keywords="celebrities",
abstract="Background: Obesity is a chronic, multifactorial, and relapsing disease, affecting people of all ages worldwide, and is directly related to multiple complications. Understanding public attitudes and perceptions toward obesity is essential for developing effective health policies, prevention strategies, and treatment approaches. Objective: This study investigated the sentiments of the general public, celebrities, and important organizations regarding obesity using social media data, specifically from Twitter (subsequently rebranded as X). Methods: The study analyzes a dataset of 53,414 tweets related to obesity posted on Twitter during the COVID-19 pandemic, from April 2019 to December 2022. Sentiment analysis was performed using the XLM-RoBERTa-base model, and topic modeling was conducted using the BERTopic library. Results: The analysis revealed that tweets regarding obesity were predominantly negative. Spikes in Twitter activity correlated with significant political events, such as the exchange of obesity-related comments between US politicians and criticism of the United Kingdom's obesity campaign. Topic modeling identified 243 clusters representing various obesity-related topics, such as childhood obesity; the US President's obesity struggle; COVID-19 vaccinations; the UK government's obesity campaign; body shaming; racism and high obesity rates among Black American people; smoking, substance abuse, and alcohol consumption among people with obesity; environmental risk factors; and surgical treatments. Conclusions: Twitter serves as a valuable source for understanding obesity-related sentiments and attitudes among the public, celebrities, and influential organizations. Sentiments regarding obesity were predominantly negative. Negative portrayals of obesity by influential politicians and celebrities were shown to contribute to negative public sentiments, which can have adverse effects on public health. It is essential for public figures to be mindful of their impact on public opinion and the potential consequences of their statements. ",
doi="10.2196/52142",
url="https://www.jmir.org/2024/1/e52142"
}


@Article{info:doi/10.2196/51751,
author="Wright, L. Amy
and Willett, Jayne Ysabella
and Ferron, Mae Era
and Kumarasamy, Vithusa
and Lem, M. Sarah
and Ahmed, Ossaid",
title="Using Social Media to Recruit Participants in Health Care Research: Case Study",
journal="J Med Internet Res",
year="2024",
month="Oct",
day="11",
volume="26",
pages="e51751",
keywords="social media",
keywords="qualitative methods",
keywords="recruitment strategies",
keywords="healthcare research",
keywords="digital health",
keywords="internet",
keywords="",
doi="10.2196/51751",
url="https://www.jmir.org/2024/1/e51751"
}


@Article{info:doi/10.2196/58428,
author="Feng, Xiandong
and Hu, Yinhuan
and Pfaff, Holger
and Liu, Sha
and Xie, Jinzhu
and Zhang, Zemiao",
title="Exploring Client Preferences for Psychological Counselors in a Chinese Online Health Community: Longitudinal Study",
journal="J Med Internet Res",
year="2024",
month="Oct",
day="10",
volume="26",
pages="e58428",
keywords="signaling theory",
keywords="psychological counselor",
keywords="online health communities",
keywords="clients' choice",
abstract="Background: Although online health communities are acknowledged for their role in bridging the supply-demand gap in mental health services, the client decision-making process in these environments remains underexplored. Objective: This study aimed to explore the impact of different signals presented on psychological counselors' home pages on clients' choices. Methods: Adopting signaling theory as the framework, this study classified information into online and offline signals and developed a theoretical model to examine client choice behaviors. We collected data from 487 psychological counselors in a leading Chinese online mental health community during March, June, September, and December 2023. Based on these data, we constructed a 4-period balanced panel dataset. A fixed effects model was used to analyze which signals influence clients' choices of psychological counselors. Results: Regarding online signals, the service price ($\beta$=0.186, P<.001) and online reputation ($\beta$=0.489, P=.002) of psychological counselors positively influence clients' choices. Concerning offline signals, psychological counselors' practical experience ($\beta$=0.007, P<.001) is positively related to clients' choices. Moreover, the results indicate that the relationship between a counselor's prosocial behavior and clients' choices is not linear but rather exhibits an inverted U-shape. Conclusions: This study reveals that the varied information provided by psychological counselors has distinct impacts on clients' choices in online health communities. It broadens the application of signaling theory to online behaviors and emphasizes the importance of both online and offline signals. These insights offer strategic guidance for counselors and online platforms to better meet potential clients' needs by optimizing the information presented on psychological counselors' home pages. ",
doi="10.2196/58428",
url="https://www.jmir.org/2024/1/e58428"
}


@Article{info:doi/10.2196/56034,
author="Ahmed, Wasim
and Hardey, Mariann
and Winters, David Bradford
and Sarwal, Aarti",
title="Racial Biases Associated With Pulse Oximetry: Longitudinal Social Network Analysis of Social Media Advocacy Impact",
journal="J Med Internet Res",
year="2024",
month="Oct",
day="8",
volume="26",
pages="e56034",
keywords="social media",
keywords="X",
keywords="racial biases",
keywords="pulse oximetry",
keywords="advocacy",
keywords="impact",
keywords="awareness",
keywords="racial",
keywords="bias",
keywords="biases",
keywords="longitudinal study",
keywords="information",
keywords="dissemination",
keywords="disparity",
keywords="disparities",
keywords="accuracy",
keywords="social network analysis",
keywords="Academic Track application programming interface",
keywords="API",
abstract="Background: Pulse oximetry is a noninvasive method widely used in critical care and various clinical settings to monitor blood oxygen saturation. During the COVID-19 pandemic, its application for at-home oxygen saturation monitoring became prevalent. Further investigations found that pulse oximetry devices show decreased accuracy when used on individuals with darker skin tones. This study aimed to investigate the influence of X (previously known as Twitter) on the dissemination of information and the extent to which it raised health care sector awareness regarding racial disparities in pulse oximetry. Objective: This study aimed to explore the impact of social media, specifically X, on increasing awareness of racial disparities in the accuracy of pulse oximetry and to map this analysis against the evolution of published literature on this topic. Methods: We used social network analysis drawing upon Network Overview Discovery and Exploration for Excel Pro (NodeXL Pro; Social Media Research Foundation) to examine the impact of X conversations concerning pulse oximetry devices. Searches were conducted using the Twitter Academic Track application programming interface (as it was known then). These searches were performed each year (January to December) from 2012 to 2022 to cover 11 years with up to 52,052 users, generating 188,051 posts. We identified the nature of influencers in this field and monitored the temporal dissemination of information about social events and regulatory changes. Furthermore, our social media analysis was mapped against the evolution of published literature on this topic, which we located using PubMed. Results: Conversations on X increased health care awareness of racial bias in pulse oximetry. They also facilitated the rapid dissemination of information, attaining a substantial audience within a compressed time frame, which may have impacted regulatory action announced concerning the investigation of racial biases in pulse oximetry. This increased awareness led to a surge in scientific research on the subject, highlighting a growing recognition of the necessity to understand and address these disparities in medical technology and its usage. Conclusions: Social media platforms such as X enabled researchers, health experts, patients, and the public to rapidly share information, increasing awareness of potential racial bias. These platforms also helped connect individuals interested in these topics and facilitated discussions that spurred further research. Our research provides a basis for understanding the role of X and other social media platforms in spreading health-related information about potential biases in medical devices such as pulse oximeters. ",
doi="10.2196/56034",
url="https://www.jmir.org/2024/1/e56034"
}


@Article{info:doi/10.2196/55511,
author="Turjo, Das Manoshi
and Mundada, Suchit Khushboo
and Haque, Jabeen Nuzhat
and Ahmed, Nova",
title="Predicting the Transition From Depression to Suicidal Ideation Using Facebook Data Among Indian-Bangladeshi Individuals: Protocol for a Cohort Study",
journal="JMIR Res Protoc",
year="2024",
month="Oct",
day="7",
volume="13",
pages="e55511",
keywords="human-computer interaction",
keywords="depression",
keywords="suicidal ideation",
keywords="mental health",
keywords="India",
keywords="Bangladesh",
keywords="Facebook",
keywords="major depressive disorder",
keywords="MDD",
keywords="9-item Patient Health Questionnaire",
keywords="PHQ-9",
keywords="natural language processing",
keywords="NLP",
keywords="machine learning",
keywords="ML",
abstract="Background: Suicide stands as a global public health concern with a pronounced impact, especially in low- and middle-income countries, where it remains largely unnoticed as a significant health concern, leading to delays in diagnosis and intervention. South Asia, in particular, has seen limited development in this area of research, and applying existing models from other regions is challenging due to cost constraints and the region's distinct linguistics and behavior. Social media analysis, notably on platforms such as Facebook (Meta Platforms Inc), offers the potential for detecting major depressive disorder and aiding individuals at risk of suicidal ideation. Objective: This study primarily focuses on India and Bangladesh, both South Asian countries. It aims to construct a predictive model for suicidal ideation by incorporating unique, unexplored features along with masked content from both public and private Facebook profiles. Moreover, the research aims to fill the existing research gap by addressing the distinct challenges posed by South Asia's unique behavioral patterns, socioeconomic conditions, and linguistic nuances. Ultimately, this research strives to enhance suicide prevention efforts in the region by offering a cost-effective solution. Methods: This quantitative research study will gather data through a web-based platform. Initially, participants will be asked a few demographic questions and to complete the 9-item Patient Health Questionnaire assessment. Eligible participants who provide consent will receive an email requesting them to upload a ZIP file of their Facebook data. The study will begin by determining whether Facebook is the primary application for the participants based on their active hours and Facebook use duration. Subsequently, the predictive model will incorporate a wide range of previously unexplored variables, including anonymous postings, and textual analysis features, such as captions, biographic information, group membership, preferred pages, interactions with advertisement content, and search history. The model will also analyze the use of emojis and the types of games participants engage with on Facebook. Results: The study obtained approval from the scientific review committee on October 2, 2023, and subsequently received institutional review committee ethical clearance on December 8, 2023. Our system is anticipated to automatically detect posts related to depression by analyzing the text and use pattern of the individual with the best accuracy possible. Ultimately, our research aims to have practical utility in identifying individuals who may be at risk of depression or in need of mental health support. Conclusions: This initiative aims to enhance engagement in suicidal ideation medical care in South Asia to improve health outcomes. It is set to be the first study to consider predicting participants' primary social application use before analyzing their content to forecast behavior and mental states. The study holds the potential to revolutionize strategies and offer insights for scalable, accessible interventions while maintaining quality through comprehensive Facebook feature analysis. International Registered Report Identifier (IRRID): DERR1-10.2196/55511 ",
doi="10.2196/55511",
url="https://www.researchprotocols.org/2024/1/e55511",
url="http://www.ncbi.nlm.nih.gov/pubmed/39374059"
}


@Article{info:doi/10.2196/58201,
author="Le, Nicolette
and McMann, Tiana
and Yang, Luning
and Li, Zhuoran
and Cuomo, E. Raphael
and Mackey, K. Tim",
title="Detection and Characterization of Online Substance Use Discussions Among Gamers: Qualitative Retrospective Analysis of Reddit r/StopGaming Data",
journal="JMIR Infodemiology",
year="2024",
month="Oct",
day="2",
volume="4",
pages="e58201",
keywords="internet gaming disorder",
keywords="gaming disorder",
keywords="substance use",
keywords="alcohol use",
keywords="nicotine use",
keywords="stimulants",
keywords="gaming",
keywords="internet gaming",
keywords="video games",
keywords="addiction",
keywords="addiction medicine",
keywords="digital mental health",
keywords="reddit",
abstract="Background: Video games have rapidly become mainstream in recent decades, with over half of the US population involved in some form of digital gaming. However, concerns regarding the potential harms of excessive, disordered gaming have also risen. Internet gaming disorder (IGD) has been proposed as a tentative psychiatric disorder that requires further study by the American Psychological Association (APA) and is recognized as a behavioral addiction by the World Health Organization. Substance use among gamers has also become a concern, with caffeinated or energy drinks and prescription stimulants commonly used for performance enhancement. Objective: This study aimed to identify substance use patterns and health-related concerns among gamers among a population of Reddit users. Methods: We used the public streaming Reddit application programming interface to collect and analyze all posts from the popular subreddit, r/StopGaming. From this corpus of posts, we filtered the dataset for keywords associated with common substances that may be used to enhance gaming performance. We then applied an inductive coding approach to characterize substance use behaviors, gaming genres, and physical and mental health concerns. Potential disordered gaming behavior was also identified using the tentative IGD guidelines proposed by the APA. A chi-square test of independence was used to assess the association between gaming disorder and substance use characteristics, and multivariable logistic regression was used to analyze whether mental health discussion or the mention of any substance with sufficient sample size was significantly associated with IGD. Results: In total, 10,551 posts were collected from Reddit from June 2017 to December 2022. After filtering the dataset for substance-related keywords, 1057 were included for further analysis, of which 286 mentioned both gaming and the use of ?1 substances. Among the 286 posts that discussed both gaming and substance use, the most mentioned substances were alcohol (n=132), cannabis (n=104), and nicotine (n=48), while the most mentioned genres were role-playing games (n=120), shooters (n=90), and multiplayer online battle arenas (n=43). Self-reported behavior that aligned with the tentative guidelines for IGD was identified in 66.8\% (191/286) posts. More than half, 62.9\% (180/286) of the posts, discussed a health issue, with the majority (n=144) cited mental health concerns. Common mental health concerns discussed were depression and anxiety. There was a significant association between IGD and substance use (P<.001; chi-square test), and there were significantly increased odds of IGD among those who self-reported substance use (odds ratio 2.29, P<.001) and those who discussed mental health (odds ratio 1.64, P<.03). Conclusions: As gaming increasingly becomes highly prevalent among various age groups and demographics, a better understanding of the interplay and convergence among disordered gaming, substance use, and negative health impacts can inform the development of interventions to mitigate risks and promote healthier gaming habits. ",
doi="10.2196/58201",
url="https://infodemiology.jmir.org/2024/1/e58201"
}


@Article{info:doi/10.2196/57970,
author="Andreas, Marike
and Grundinger, Nadja
and Wolber, Nadine
and Szafran, Daria
and G{\"o}rig, Tatiana
and Mons, Ute
and Lohner, Valerie
and Vollst{\"a}dt-Klein, Sabine
and Schneider, Sven",
title="Understanding e-Cigarette Addictiveness: Triangulation of Focus Group and Netnographic Data",
journal="J Med Internet Res",
year="2024",
month="Oct",
day="1",
volume="26",
pages="e57970",
keywords="e-cigarettes",
keywords="online forums",
keywords="netnographic analysis",
keywords="addictive",
keywords="addiction",
keywords="smoking cessation",
keywords="smoker",
keywords="user",
keywords="focus group",
keywords="nicotine",
keywords="public health",
keywords="prevalence",
keywords="smoking behavior",
abstract="Background: Numerous studies have shown that e-cigarettes are addictive. For example, we previously showed that users of e-cigarette online forums discuss experiences of addiction in a netnographic analysis. However, it is unclear what makes e-cigarettes addictive apart from nicotine. In a focus group analysis, we recently identified 3 unique features of e-cigarettes that users linked to experiences of addiction: the pleasant taste, unobtrusiveness, and unlimited usability of e-cigarettes. Objective: This study aimed to validate the previously identified features of e-cigarette addictive potential by triangulating data from the netnographic analysis and focus group discussions. Methods: Drawing on a netnographic analysis of 3 popular, German-language e-cigarette forums, we studied whether experiences of addiction were linked to specific e-cigarette features. We included 451 threads in the analysis that had been coded for addictive experiences in a previous study by our team. First, we conducted a deductive analysis with preregistered codes to determine whether the features of pleasant taste, unobtrusiveness, and unlimited usability were mentioned in relation to the addictive potential of e-cigarettes in the online forums. Second, an inductive approach was chosen to identify further possible addictive features of e-cigarettes. Results: Our deductive analysis confirmed that the features highlighted in our previous focus group study (pleasant taste, unobtrusiveness, and unlimited usability) were also frequently discussed in online forums in connection to addictive symptoms. In addition, our inductive analysis identified nicotine dosage as a significant feature linked to addiction. Users reported varying their nicotine doses for different reasons, leading to the identification of four distinct user types based on dosing patterns: (1) high doses for intermittent, (2) high doses for constant use, (3) low doses for constant use, and (4) switching between high and low doses depending on the situation. Conclusions: Our comprehensive analysis of online forum threads revealed that users' experiences of addiction are linked to 4 specific features unique to e-cigarettes: pleasant taste, unobtrusiveness, unlimited usability, and nicotine dosage. Recognizing these addictive features of e-cigarettes is crucial for designing cessation programs and informing public health policies to reduce the addictiveness of e-cigarettes. ",
doi="10.2196/57970",
url="https://www.jmir.org/2024/1/e57970"
}


@Article{info:doi/10.2196/58919,
author="Lin, Shuo-Yu
and Tulabandu, Kiran Sahithi
and Koch, Randy J.
and Hayes, Rashelle
and Barnes, Andrew
and Purohit, Hemant
and Chen, Songqing
and Han, Bo
and Xue, Hong",
title="Public Response to Federal Electronic Cigarette Regulations Analyzed Using Social Media Data Through Natural Language Processing: Topic Modeling Study",
journal="J Med Internet Res",
year="2024",
month="Oct",
day="1",
volume="26",
pages="e58919",
keywords="social media analysis",
keywords="data mining",
keywords="natural language processing",
keywords="topic modeling",
keywords="sentiment analysis",
keywords="e-cigarette regulation",
keywords="vaping",
keywords="Twitter analysis",
keywords="public health related policy",
keywords="marketing denial orders",
abstract="Background: e-Cigarette (electronic cigarette) use has been a public health issue in the United States. On June 23, 2022, the US Food and Drug Administration (FDA) issued marketing denial orders (MDOs) to Juul Labs Inc for all their products currently marketed in the United States. However, one day later, on June 24, 2022, a federal appeals court granted a temporary reprieve to Juul Labs that allowed it to keep its e-cigarettes on the market. As the conversation around Juul continues to evolve, it is crucial to gain insights into the sentiments and opinions expressed by individuals on social media. Objective: This study aims to conduct a comprehensive analysis of tweets before and after the ban on Juul, aiming to shed light on public perceptions and sentiments surrounding this contentious topic and to better understand the life cycle of public health--related policy on social media. Methods: Natural language processing (NLP) techniques were used, including state-of-the-art BERTopic topic modeling and sentiment analysis. A total of 6023 tweets and 22,288 replies or retweets were collected from Twitter (rebranded as X in 2023) between June 2022 and October 2022. The encoded topics were used in time-trend analysis to depict the boom-and-bust cycle. Content analyses of retweets were also performed to better understand public perceptions and sentiments about this contentious topic. Results: The attention surrounding the FDA's ban on Juul lasted no longer than a week on Twitter. Not only the news (ie, tweets with a YouTube link that directs to the news site) related to the announcement itself, but the surrounding discussions (eg, potential consequences of this ban or block and concerns toward kids or youth health) diminished shortly after June 23, 2022, the date when the ban was officially announced. Although a short rebound was observed on July 4, 2022, which was contributed by the suspension on the following day, discussions dried out in 2 days. Out of the top 50 most retweeted tweets, we observed that, except for neutral (23/45, 51\%) sentiment that broadcasted the announcement, posters responded more negatively (19/45, 42\%) to the FDA's ban. Conclusions: We observed a short life cycle for this news announcement, with a preponderance of negative sentiment toward the FDA's ban on Juul. Policy makers could use tactics such as issuing ongoing updates and reminders about the ban, highlighting its impact on public health, and actively engaging with influential social media users who can help maintain the conversation. ",
doi="10.2196/58919",
url="https://www.jmir.org/2024/1/e58919",
url="http://www.ncbi.nlm.nih.gov/pubmed/39352739"
}


@Article{info:doi/10.2196/58241,
author="Liu, Yuhan
and Fang, Anna
and Moriarty, Glen
and Firman, Cristopher
and Kraut, E. Robert
and Zhu, Haiyi",
title="Exploring Trade-Offs for Online Mental Health Matching: Agent-Based Modeling Study",
journal="JMIR Form Res",
year="2024",
month="Oct",
day="1",
volume="8",
pages="e58241",
keywords="agent-based modeling",
keywords="mental health",
keywords="algorithmic matching",
keywords="social computing",
keywords="online communities",
abstract="Background: Online mental health communities (OMHCs) are an effective and accessible channel to give and receive social support for individuals with mental and emotional issues. However, a key challenge on these platforms is finding suitable partners to interact with given that mechanisms to match users are currently underdeveloped or highly naive. Objective: In this study, we collaborated with one of the world's largest OMHCs; our contribution is to show the application of agent-based modeling for the design of online community matching algorithms. We developed an agent-based simulation framework and showcased how it can uncover trade-offs in different matching algorithms between people seeking support and volunteer counselors. Methods: We used a comprehensive data set spanning January 2020 to April 2022 to create a simulation framework based on agent-based modeling that replicates the current matching mechanisms of our research site. After validating the accuracy of this simulated replication, we used this simulation framework as a ``sandbox'' to test different matching algorithms based on the deferred acceptance algorithm. We compared trade-offs among these different matching algorithms based on various metrics of interest, such as chat ratings and matching success rates. Results: Our study suggests that various tensions emerge through different algorithmic choices for these communities. For example, our simulation uncovered that increased waiting time for support seekers was an inherent consequence on these sites when intelligent matching was used to find more suitable matches. Our simulation also verified some intuitive effects, such as that the greatest number of support seeker--counselor matches occurred using a ``first come, first served'' protocol, whereas relatively fewer matches occurred using a ``last come, first served'' protocol. We also discuss practical findings regarding matching for vulnerable versus overall populations. Results by demographic group revealed disparities---underaged and gender minority groups had lower average chat ratings and higher blocking rates on the site when compared to their majority counterparts, indicating the potential benefits of algorithmically matching them. We found that some protocols, such as a ``filter''-based approach that matched vulnerable support seekers only with a counselor of their same demographic, led to improvements for these groups but resulted in lower satisfaction (--12\%) among the overall population. However, this trade-off between minority and majority groups was not observed when using ``topic'' as a matching criterion. Topic-based matching actually outperformed the filter-based protocol among underaged people and led to significant improvements over the status quo among all minority and majority groups---specifically, a 6\% average chat rating improvement and a decrease in blocking incidents from 5.86\% to 4.26\%. Conclusions: Agent-based modeling can reveal significant design considerations in the OMHC context, including trade-offs in various outcome metrics and the potential benefits of algorithmic matching for marginalized communities. ",
doi="10.2196/58241",
url="https://formative.jmir.org/2024/1/e58241"
}


@Article{info:doi/10.2196/64196,
author="Kawaguchi, Kenjiro
and Nakagomi, Atsushi
and Ide, Kazushige
and Kondo, Katsunori",
title="Effects of a Mobile App to Promote Social Participation on Older Adults: Randomized Controlled Trial",
journal="J Med Internet Res",
year="2024",
month="Sep",
day="30",
volume="26",
pages="e64196",
keywords="gerontology",
keywords="geriatrics",
keywords="older adults",
keywords="elderly",
keywords="older people",
keywords="community dwelling older adult",
keywords="aging",
keywords="social participation",
keywords="walking",
keywords="mHealth",
keywords="apps",
keywords="smartphone",
keywords="digital health",
keywords="digital technology",
keywords="digital interventions",
keywords="physical activity",
keywords="exercise",
abstract="Background: Social participation is crucial for healthy aging, improving physical and mental health, cognitive function, and quality of life among older adults. However, social participation tends to decline with age due to factors like loss of social networks and health issues. Mobile health apps show promise in promoting healthy behaviors among older adults, but their effectiveness in increasing social participation remains understudied. Objective: This randomized controlled trial aimed to evaluate the efficacy of a mobile app called Encouragement of Social Participation (ESP, ``Shakai Sanka no Susume;'' Hitachi) in promoting social participation and physical activity among community-dwelling older adults. Methods: The study recruited 181 community-dwelling adults aged 60 years or older from 2 municipalities in Japan and through a web-based research panel. Participants were randomly assigned to either the intervention group (n=87), which used the ESP app for 12 weeks, or the control group (n=94), which used only Google Fit. The ESP app incorporated features such as self-monitoring of social participation, personalized feedback, gamification elements, and educational content. Primary outcomes were changes in social participation frequency over the previous 2 months and changes in step counts, measured at baseline and week 12. Secondary outcomes included changes in specific types of social activities and subjective well-being. Data were analyzed using analysis of covariance and linear mixed-effects models. Results: The intervention group showed a significantly greater increase in social participation frequency compared with the control group (adjusted difference 3.03; 95\% CI 0.17-5.90; P=.04). Specifically, the intervention group demonstrated higher frequencies of participation in hobbies (adjusted difference: 0.82; 95\% CI 0.01-1.63) and cultural clubs (adjusted difference 0.65; 95\% CI 0.07-1.23) compared with the control group. However, there were no significant differences in weekly step counts between the groups. Subgroup analyses suggested potentially larger effects among participants who were older than 70 years, female, had lower educational attainment, and were recruited from community settings, although only females and the lower educational attainment subgroups demonstrated 95\% CIs that did not encompass zero. Conclusions: The ESP mobile app effectively promoted social participation among community-dwelling older adults, particularly in hobbies and cultural club activities. However, it did not significantly impact physical activity levels as measured by step counts. These findings suggest that mobile apps can be valuable tools for encouraging social engagement in older populations, potentially contributing to healthy aging. Future research should focus on optimizing app features to maintain long-term engagement and exploring strategies to enhance physical activity alongside social participation. Trial Registration: University Medical Information Network Clinical Trial Registry UMIN000049045; https://center6.umin.ac.jp/cgi-open-bin/ctr\_e/ctr\_view.cgi?recptno=R000055781 ",
doi="10.2196/64196",
url="https://www.jmir.org/2024/1/e64196",
url="http://www.ncbi.nlm.nih.gov/pubmed/39348180"
}


@Article{info:doi/10.2196/60678,
author="Haupt, Robert Michael
and Yang, Luning
and Purnat, Tina
and Mackey, Tim",
title="Evaluating the Influence of Role-Playing Prompts on ChatGPT's Misinformation Detection Accuracy: Quantitative Study",
journal="JMIR Infodemiology",
year="2024",
month="Sep",
day="26",
volume="4",
pages="e60678",
keywords="large language models",
keywords="ChatGPT",
keywords="artificial intelligence",
keywords="AI",
keywords="experiment",
keywords="prompt engineering",
keywords="role-playing",
keywords="social identity",
keywords="misinformation detection",
keywords="COVID-19",
abstract="Background: During the COVID-19 pandemic, the rapid spread of misinformation on social media created significant public health challenges. Large language models (LLMs), pretrained on extensive textual data, have shown potential in detecting misinformation, but their performance can be influenced by factors such as prompt engineering (ie, modifying LLM requests to assess changes in output). One form of prompt engineering is role-playing, where, upon request, OpenAI's ChatGPT imitates specific social roles or identities. This research examines how ChatGPT's accuracy in detecting COVID-19--related misinformation is affected when it is assigned social identities in the request prompt. Understanding how LLMs respond to different identity cues can inform messaging campaigns, ensuring effective use in public health communications. Objective: This study investigates the impact of role-playing prompts on ChatGPT's accuracy in detecting misinformation. This study also assesses differences in performance when misinformation is explicitly stated versus implied, based on contextual knowledge, and examines the reasoning given by ChatGPT for classification decisions. Methods: Overall, 36 real-world tweets about COVID-19 collected in September 2021 were categorized into misinformation, sentiment (opinions aligned vs unaligned with public health guidelines), corrections, and neutral reporting. ChatGPT was tested with prompts incorporating different combinations of multiple social identities (ie, political beliefs, education levels, locality, religiosity, and personality traits), resulting in 51,840 runs. Two control conditions were used to compare results: prompts with no identities and those including only political identity. Results: The findings reveal that including social identities in prompts reduces average detection accuracy, with a notable drop from 68.1\% (SD 41.2\%; no identities) to 29.3\% (SD 31.6\%; all identities included). Prompts with only political identity resulted in the lowest accuracy (19.2\%, SD 29.2\%). ChatGPT was also able to distinguish between sentiments expressing opinions not aligned with public health guidelines from misinformation making declarative statements. There were no consistent differences in performance between explicit and implicit misinformation requiring contextual knowledge. While the findings show that the inclusion of identities decreased detection accuracy, it remains uncertain whether ChatGPT adopts views aligned with social identities: when assigned a conservative identity, ChatGPT identified misinformation with nearly the same accuracy as it did when assigned a liberal identity. While political identity was mentioned most frequently in ChatGPT's explanations for its classification decisions, the rationales for classifications were inconsistent across study conditions, and contradictory explanations were provided in some instances. Conclusions: These results indicate that ChatGPT's ability to classify misinformation is negatively impacted when role-playing social identities, highlighting the complexity of integrating human biases and perspectives in LLMs. This points to the need for human oversight in the use of LLMs for misinformation detection. Further research is needed to understand how LLMs weigh social identities in prompt-based tasks and explore their application in different cultural contexts. ",
doi="10.2196/60678",
url="https://infodemiology.jmir.org/2024/1/e60678"
}


@Article{info:doi/10.2196/48695,
author="Bennett, Verity
and Spasi{\'c}, Irena
and Filimonov, Maxim
and Muralidaran, Vigneshwaran
and Kemp, Mary Alison
and Allen, Stuart
and Watkins, John William",
title="Assessing the Feasibility of Using Parents' Social Media Conversations to Inform Burn First Aid Interventions: Mixed Methods Study",
journal="JMIR Form Res",
year="2024",
month="Sep",
day="26",
volume="8",
pages="e48695",
keywords="social media",
keywords="burn first aid",
keywords="health interventions",
keywords="parents",
keywords="burns",
abstract="Background: Burns are common childhood injuries, which can lead to serious physical and psychological outcomes. Appropriate first aid is essential in managing the pain and severity of these injuries; hence, parents who need timely access to such information often seek it from the web. In particular, social media allow them to reach other parents, hence these conversations may provide insight to aid the design and evaluation of burn first aid interventions for parents. Objective: This study aims to determine the feasibility of finding, accessing, and analyzing parent burn first aid conversations on social media to inform intervention research. Methods: The initial choice of the relevant social media was made based on the results of a parent focus group and survey. We considered Facebook (Meta Platforms, Inc), Mumsnet (Mumsnet Limited), Netmums (Aufeminin Group), Twitter (subsequently rebranded as ``X''; X Corp), Reddit (Reddit, Inc), and YouTube (Google LLC). To locate the relevant data on these platforms, we collated a taxonomy of search terms and designed a search strategy. A combination of natural language processing and manual inspection was used to filter out irrelevant data. The remaining data were analyzed manually to determine the length of conversations, the number of participants, the purpose of the initial post (eg, asking for or offering advice), burn types, and distribution of relevant keywords. Results: Facebook parenting groups were not accessed due to privacy, and public influencer pages yielded scant data. No relevant data were found on Reddit. Data were collected from Mumsnet, Netmums, YouTube, and Twitter. The amount of available data varied across these platforms and through time. Sunburn was identified as a topic across all 4 platforms. Conversations on the parenting forums Mumsnet and Netmums were started predominantly to seek advice (112/116, 96.6\% and 25/25, 100\%, respectively). Conversely, YouTube and Twitter were used mainly to provide advice (362/328, 94.8\% and 126/197, 64\%, respectively). Contact burns and sunburn were the most frequent burn types discussed on Mumsnet (30/94, 32\% and 23/94, 25\%, respectively) and Netmums (2/25, 8\% and 14/26, 56\%, respectively). Conclusions: This study provides a suite of bespoke search strategies, tailored to a range of social media platforms, for the extraction and analysis of burn first aid conversation data. Our methodology provides a template for other topics not readily accessible via a specific search term or hashtag. YouTube and Twitter show potential utility in measuring advice offered before and after interventions and extending the reach of messaging. Mumsnet and Netmums present the best opportunity for informing burn first aid intervention design via an in-depth qualitative investigation into parents' knowledge, attitudes, and behaviors. ",
doi="10.2196/48695",
url="https://formative.jmir.org/2024/1/e48695"
}


@Article{info:doi/10.2196/53899,
author="Schneller-Najm, M. Liane
and Xie, Zidian
and Chen, Jiarui
and Lee, Sarah
and Xu, Emily
and Li, Dongmei",
title="Public Perception of the Tobacco 21 Amendment on Twitter in the United States: Observational Study",
journal="JMIR Infodemiology",
year="2024",
month="Sep",
day="25",
volume="4",
pages="e53899",
keywords="tobacco policy",
keywords="tobacco regulation",
keywords="social media",
keywords="tobacco use",
keywords="tobacco",
keywords="health belief",
keywords="sentiment analysis",
keywords="smoking",
keywords="cigarettes",
keywords="social media analysis",
keywords="vaping",
keywords="e-cigarettes",
keywords="health behavior",
keywords="public opinion",
abstract="Background: Following the signing of the Tobacco 21 Amendment (T21) in December 2019 to raise the minimum legal age for the sale of tobacco products from 18 to 21 years in the United States, there is a need to monitor public responses and potential unintended consequences. Social media platforms, such as Twitter (subsequently rebranded as X), can provide rich data on public perceptions. Objective: This study contributes to the literature using Twitter data to assess the knowledge and beliefs of T21. Methods: Twitter data were collected from November 2019 to February 2021 using the Twitter streaming application programming interface with keywords related to vaping or e-cigarettes, such as ``vape,'' ``ecig,'' etc. The temporal trend of the T21 discussion on Twitter was examined using the mean number of daily T21-related tweets. Inductive methods were used to manually code the tweets into different sentiment groups (positive, neutral, and negative) based on the attitude expressed toward the policy by 3 coders with high interrater reliability. Topics discussed were examined within each sentiment group through theme analyses. Results: Among the collected 3197 tweets, 2169 tweets were related to T21, of which 444 tweets (20.5\%) showed a positive attitude, 736 (33.9\%) showed a negative attitude, and 989 (45.6\%) showed a neutral attitude. The temporal trend showed a clear peak in the number of tweets around January 2020, following the enactment of this legislation. For positive tweets, the most frequent topics were ``avoidance of further regulation'' (120/444, 27\%), ``Enforce T21'' (110/444, 24.8\%), and ``health benefits'' (81/444, 18.2\%). For negative tweets, the most frequent topics were ``general disagreement or frustration'' (207/736, 28.1\%) and ``will still use tobacco'' (188/736, 25.5\%). Neutral tweets were primarily ``public service announcements (PSA) or news posts'' (782/989, 79.1\%). Conclusions: Overall, we find that one-third of tweets displayed a negative attitude toward T21 during the study period. Many were frustrated with T21 and reported that underage consumers could still obtain products. Social media data provide a timely opportunity to monitor public perceptions and responses to regulatory actions. Continued monitoring can inform enforcement efforts and potential unintended consequences of T21. ",
doi="10.2196/53899",
url="https://infodemiology.jmir.org/2024/1/e53899"
}


@Article{info:doi/10.2196/53171,
author="Wu, Dezhi
and Shead, Hannah
and Ren, Yang
and Raynor, Phyllis
and Tao, Youyou
and Villanueva, Harvey
and Hung, Peiyin
and Li, Xiaoming
and Brookshire, G. Robert
and Eichelberger, Kacey
and Guille, Constance
and Litwin, H. Alain
and Olatosi, Bankole",
title="Uncovering the Complexity of Perinatal Polysubstance Use Disclosure Patterns on X: Mixed Methods Study",
journal="J Med Internet Res",
year="2024",
month="Sep",
day="20",
volume="26",
pages="e53171",
keywords="polysubstance use",
keywords="prenatal care",
keywords="perinatal care",
keywords="pregnant care",
keywords="social media",
keywords="Twitter",
keywords="sentiment analysis",
abstract="Background: According to the Morbidity and Mortality Weekly Report, polysubstance use among pregnant women is prevalent, with 38.2\% of those who consume alcohol also engaging in the use of one or more additional substances. However, the underlying mechanisms, contexts, and experiences of polysubstance use are unclear. Organic information is abundant on social media such as X (formerly Twitter). Traditional quantitative and qualitative methods, as well as natural language processing techniques, can be jointly used to derive insights into public opinions, sentiments, and clinical and public health policy implications. Objective: Based on perinatal polysubstance use (PPU) data that we extracted on X from May 1, 2019, to October 31, 2021, we proposed two primary research questions: (1) What is the overall trend and sentiment of PPU discussions on X? (2) Are there any distinct patterns in the discussion trends of PPU-related tweets? If so, what are the implications for perinatal care and associated public health policies? Methods: We used X's application programming interface to extract >6 million raw tweets worldwide containing ?2 prenatal health- and substance-related keywords provided by our clinical team. After removing all non--English-language tweets, non-US tweets, and US tweets without disclosed geolocations, we obtained 4848 PPU-related US tweets. We then evaluated them using a mixed methods approach. The quantitative analysis applied frequency, trend analysis, and several natural language processing techniques such as sentiment analysis to derive statistics to preview the corpus. To further understand semantics and clinical insights among these tweets, we conducted an in-depth thematic content analysis with a random sample of 500 PPU-related tweets with a satisfying $\kappa$ score of 0.7748 for intercoder reliability. Results: Our quantitative analysis indicates the overall trends, bigram and trigram patterns, and negative sentiments were more dominant in PPU tweets (2490/4848, 51.36\%) than in the non-PPU sample (1323/4848, 27.29\%). Paired polysubstance use (4134/4848, 85.27\%) was the most common, with the combination alcohol and drugs identified as the most mentioned. From the qualitative analysis, we identified 3 main themes: nonsubstance, single substance, and polysubstance, and 4 subthemes to contextualize the rationale of underlying PPU behaviors: lifestyle, perceptions of others' drug use, legal implications, and public health. Conclusions: This study identified underexplored, emerging, and important topics related to perinatal PPU, with significant stigmas and legal ramifications discussed on X. Overall, public sentiments on PPU were mixed, encompassing negative (2490/4848, 51.36\%), positive (1884/4848, 38.86\%), and neutral (474/4848, 9.78\%) sentiments. The leading substances in PPU were alcohol and drugs, and the normalization of PPU discussed on X is becoming more prevalent. Thus, this study provides valuable insights to further understand the complexity of PPU and its implications for public health practitioners and policy makers to provide proper access and support to individuals with PPU. ",
doi="10.2196/53171",
url="https://www.jmir.org/2024/1/e53171"
}


@Article{info:doi/10.2196/54025,
author="Vargas Meza, Xanat
and Oikawa, Masanori",
title="Japanese Perception of Brain Death and Implications for New Medical Technologies: Quantitative and Qualitative Social Media Analysis",
journal="JMIR Form Res",
year="2024",
month="Sep",
day="18",
volume="8",
pages="e54025",
keywords="brain death",
keywords="Japan",
keywords="social media",
keywords="multidimensional analysis",
keywords="Twitter",
keywords="YouTube",
abstract="Background: Brain death has been used to decide whether to keep sustained care and treatment. It can facilitate tissue, organ, and body donation for several purposes, such as transplantation and medical education and research. In Japan, brain death has strict diagnostic criteria and family consent is crucial, but it has been a challenging concept for the public since its introduction, including knowledge and communication issues. Objective: We analyzed data across YouTube and Twitter in Japan to uncover actors and assess the quality of brain death communication, providing recommendations to communicate new medical technologies. Methods: Using the keyword ``??'' (brain death), we collected recent data from YouTube and Twitter, classifying the data into 5 dimensions: time, individuality (type of users), place, activity, and relations (hyperlinks). We employed a scale to evaluate brain death information quality. We divided YouTube videos into 3 groups and assessed their differences through statistical analysis. We also provided a text-based analysis of brain death--related narratives. Results: Most videos (20/61, 33\%) were uploaded in 2019, while 10,892 tweets peaked between July 3 and 9, 2023, and June 12 and 18, 2023. Videos about brain death were mostly uploaded by citizens (18/61, 27\%), followed by media (13/61, 20\%) and unknown actors (10/61, 15\%). On the other hand, most identified users in a random sample of 100 tweets were citizens (73/100, 73\%), and the top 10 retweeted and liked tweets were also mostly authored by citizens (75/100, 75\%). No specific information on location was uncovered. Information videos contained guides for accreditation of the National Nursing Exam and religious points of view, while misinformation videos mostly contained promotions by spirituality actors and webtoon artists. Some tweets involved heart transplantation and patient narratives. Most hyperlinks pointed to YouTube and Twitter. Conclusions: Brain death has become a common topic in everyday life, with some actors disseminating high-quality information, others disseminating no medical information, and others disseminating misinformation. Recommendations include partnering with interested actors, discussing medical information in detail, and teaching people to recognize pseudoscience. ",
doi="10.2196/54025",
url="https://formative.jmir.org/2024/1/e54025"
}


@Article{info:doi/10.2196/48257,
author="Alasmari, Ashwag
and Zhou, Lina",
title="Quality Measurement of Consumer Health Questions: Content and Language Perspectives",
journal="J Med Internet Res",
year="2024",
month="Sep",
day="12",
volume="26",
pages="e48257",
keywords="question quality",
keywords="quality measurement",
keywords="health questions",
keywords="",
keywords="information needs",
keywords="information behavior",
keywords="information sharing",
keywords="consumer",
keywords="health information",
keywords="health information consumers",
keywords="quality",
abstract="Background: Health information consumers increasingly rely on question-and-answer (Q\&A) communities to address their health concerns. However, the quality of questions posted significantly impacts the likelihood and relevance of received answers. Objective: This study aims to improve our understanding of the quality of health questions within web-based Q\&A communities. Methods: We develop a novel framework for defining and measuring question quality within web-based health communities, incorporating content- and language-based variables. This framework leverages k-means clustering and establishes automated metrics to assess overall question quality. To validate our framework, we analyze questions related to kidney disease from expert-curated and community-based Q\&A platforms. Expert evaluations confirm the validity of our quality construct, while regression analysis helps identify key variables. Results: High-quality questions were more likely to include demographic and medical information than lower-quality questions (P<.001). In contrast, asking questions at the various stages of disease development was less likely to reflect high-quality questions (P<.001). Low-quality questions were generally shorter with lengthier sentences than high-quality questions (P<.01). Conclusions: Our findings empower consumers to formulate more effective health information questions, ultimately leading to better engagement and more valuable insights within web-based Q\&A communities. Furthermore, our findings provide valuable insights for platform developers and moderators seeking to enhance the quality of user interactions and foster a more trustworthy and informative environment for health information exchange. ",
doi="10.2196/48257",
url="https://www.jmir.org/2024/1/e48257"
}


@Article{info:doi/10.2196/58371,
author="Ariana, Hanifa
and Almuhtadi, Ikmal
and Natania, Jacey Nikita
and Handayani, Wuri Putu
and Bressan, St{\'e}phane
and Larasati, Dwi Pramitha",
title="Influence of TikTok on Body Satisfaction Among Generation Z in Indonesia: Mixed Methods Approach",
journal="JMIR Hum Factors",
year="2024",
month="Sep",
day="6",
volume="11",
pages="e58371",
keywords="body satisfaction",
keywords="social media",
keywords="TikTok",
keywords="Indonesia",
keywords="cyber-bullying",
keywords="cyberbullying",
keywords="cyberbully",
keywords="cyber-harassment",
keywords="bullying",
keywords="harassment",
keywords="body shaming",
keywords="objectify",
keywords="objectifying",
keywords="social media use",
keywords="social media usage",
keywords="socials",
keywords="social network",
keywords="social networks",
keywords="social networking",
keywords="Tik Tok",
keywords="GenZ",
keywords="Gen-Z",
keywords="youth",
keywords="adolescent",
keywords="adolescents",
keywords="teen",
keywords="teens",
keywords="teenager",
keywords="teenagers",
keywords="young-adult",
keywords="young-adults",
abstract="Background: As social media platforms gain popularity, their usage is increasingly associated with cyberbullying and body shaming, causing devastating effects. Objective: This study aims to investigate the impact of social media on Generation Z users' body image satisfaction. More specifically, it examines the impact of TikTok on body image satisfaction among TikTok users aged between 17 years and 26 years in Indonesia. Methods: The methodology used mixed-method approaches. Quantitative data were obtained from 507 responses to a questionnaire and analyzed using covariance-based structural equation modeling. Qualitative data were obtained from the interviews of 32 respondents and analyzed through content analysis. Results: This study reveals that upward appearance comparison is influenced by video-based activity and appearance motivation. Conversely, thin-ideal internalization is influenced by appearance motivation and social media literacy. Upward appearance comparisons and thin-ideal internalization comparisons detrimentally impact users' body image satisfaction. Conclusions: The results of this study are expected to provide valuable insights for social media providers, regulators, and educators in their endeavors to establish a positive and healthy social media environment for users. ",
doi="10.2196/58371",
url="https://humanfactors.jmir.org/2024/1/e58371"
}


@Article{info:doi/10.2196/46531,
author="Zahroh, Islamiah Rana
and Cheong, Marc
and Hazfiarini, Alya
and Vazquez Corona, Martha
and Ekawati, Murriya Fitriana
and Emilia, Ova
and Homer, SE Caroline
and Betr{\'a}n, Pilar Ana
and Bohren, A. Meghan",
title="The Portrayal of Cesarean Section on Instagram: Mixed Methods Social Media Analysis",
journal="JMIR Form Res",
year="2024",
month="Sep",
day="6",
volume="8",
pages="e46531",
keywords="cesarean section",
keywords="social media analysis",
keywords="maternal health",
keywords="childbirth",
keywords="mode of birth",
keywords="instagram",
abstract="Background: Cesarean section (CS) rates in Indonesia are rapidly increasing for both sociocultural and medical reasons. However, there is limited understanding of the role that social media plays in influencing preferences regarding mode of birth (vaginal or CS). Social media provides a platform for users to seek and exchange information, including information on the mode of birth, which may help unpack social influences on health behavior. Objective: This study aims to explore how CS is portrayed on Instagram in Indonesia. Methods: We downloaded public Instagram posts from Indonesia containing CS hashtags and extracted their attributes (image, caption, hashtags, and objects and texts within images). Posts were divided into 2 periods---before COVID-19 and during COVID-19---to examine changes in CS portrayal during the pandemic. We used a mixed methods approach to analysis using text mining, descriptive statistics, and qualitative content analysis. Results: A total of 9978 posts were analyzed quantitatively, and 720 (7.22\%) posts were sampled and analyzed qualitatively. The use of text (527/5913, 8.91\% vs 242/4065, 5.95\%; P<.001) and advertisement materials (411/5913, 6.95\% vs 83/4065, 2.04\%; P<.001) increased during the COVID-19 pandemic compared to before the pandemic, indicating growth of information sharing on CS over time. Posts with CS hashtags primarily promoted herbal medicine for faster recovery and services for choosing auspicious childbirth dates, encouraging elective CS. Some private health facilities offered discounts on CS for special events such as Mother's Day and promoted techniques such as enhanced recovery after CS for comfortable, painless birth, and faster recovery after CS. Hashtags related to comfortable or painless birth (2358/5913, 39.88\% vs 278/4065, 6.84\%; P<.001), enhanced recovery after CS (124/5913, 2.1\% vs 0\%; P<.001), feng shui services (110/5913, 1.86\% vs 56/4065, 1.38\%; P=.03), names of health care providers (2974/5913, 50.3\% vs 304/4065, 7.48\%; P<.001), and names of hospitals (1460/5913, 24.69\% vs 917/4065, 22.56\%; P=.007) were more prominent during compared to before the pandemic. Conclusions: This study highlights the necessity of enforcing advertisement regulations regarding birth-related medical services in the commercial and private sectors. Enhanced health promotion efforts are crucial to ensure that women receive accurate, balanced, and appropriate information about birth options. Continuous and proactive health information dissemination from government organizations is essential to counteract biases favoring CS over vaginal birth. ",
doi="10.2196/46531",
url="https://formative.jmir.org/2024/1/e46531"
}


@Article{info:doi/10.2196/45858,
author="Necaise, Aaron
and Amon, Jean Mary",
title="Peer Support for Chronic Pain in Online Health Communities: Quantitative Study on the Dynamics of Social Interactions in a Chronic Pain Forum",
journal="J Med Internet Res",
year="2024",
month="Sep",
day="5",
volume="26",
pages="e45858",
keywords="social media",
keywords="chronic pain",
keywords="peer support",
keywords="sentiment analysis",
keywords="wavelet analysis",
keywords="nonlinear dynamics",
keywords="growth curve modeling",
keywords="online health communities",
keywords="affective synchrony",
abstract="Background: Peer support for chronic pain is increasingly taking place on social media via social networking communities. Several theories on the development and maintenance of chronic pain highlight how rumination, catastrophizing, and negative social interactions can contribute to poor health outcomes. However, little is known regarding the role web-based health discussions play in the development of negative versus positive health attitudes relevant to chronic pain. Objective: This study aims to investigate how participation in online peer-to-peer support communities influenced pain expressions by examining how the sentiment of user language evolved in response to peer interactions. Methods: We collected the comment histories of 199 randomly sampled Reddit (Reddit, Inc) users who were active in a popular peer-to-peer chronic pain support community over 10 years. A total of 2 separate natural language processing methods were compared to calculate the sentiment of user comments on the forum (N=73,876). We then modeled the trajectories of users' language sentiment using mixed-effects growth curve modeling and measured the degree to which users affectively synchronized with their peers using bivariate wavelet analysis. Results: In comparison to a shuffled baseline, we found evidence that users entrained their language sentiment to match the language of community members they interacted with (t198=4.02; P<.001; Cohen d=0.40). This synchrony was most apparent in low-frequency sentiment changes unfolding over hundreds of interactions as opposed to reactionary changes occurring from comment to comment (F2,198=17.70; P<.001). We also observed a significant trend in sentiment across all users ($\beta$=--.02; P=.003), with users increasingly using more negative language as they continued to interact with the community. Notably, there was a significant interaction between affective synchrony and community tenure ($\beta$=.02; P=.02), such that greater affective synchrony was associated with negative sentiment trajectories among short-term users and positive sentiment trajectories among long-term users. Conclusions: Our results are consistent with the social communication model of pain, which describes how social interactions can influence the expression of pain symptoms. The difference in long-term versus short-term affective synchrony observed between community members suggests a process of emotional coregulation and social learning. Participating in health discussions on Reddit appears to be associated with both negative and positive changes in sentiment depending on how individual users interacted with their peers. Thus, in addition to characterizing the sentiment dynamics existing within online chronic pain communities, our work provides insight into the potential benefits and drawbacks of relying on support communities organized on social media platforms. ",
doi="10.2196/45858",
url="https://www.jmir.org/2024/1/e45858",
url="http://www.ncbi.nlm.nih.gov/pubmed/39235845"
}


@Article{info:doi/10.2196/58259,
author="Zhang, Zhenwen
and Zhu, Jianghong
and Guo, Zhihua
and Zhang, Yu
and Li, Zepeng
and Hu, Bin",
title="Natural Language Processing for Depression Prediction on Sina Weibo: Method Study and Analysis",
journal="JMIR Ment Health",
year="2024",
month="Sep",
day="4",
volume="11",
pages="e58259",
keywords="depression",
keywords="social media",
keywords="natural language processing",
keywords="deep learning",
keywords="mental health",
keywords="statistical analysis",
keywords="linguistic analysis",
keywords="Sina Weibo",
keywords="risk prediction",
keywords="mood analysis",
abstract="Background: Depression represents a pressing global public health concern, impacting the physical and mental well-being of hundreds of millions worldwide. Notwithstanding advances in clinical practice, an alarming number of individuals at risk for depression continue to face significant barriers to timely diagnosis and effective treatment, thereby exacerbating a burgeoning social health crisis. Objective: This study seeks to develop a novel online depression risk detection method using natural language processing technology to identify individuals at risk of depression on the Chinese social media platform Sina Weibo. Methods: First, we collected approximately 527,333 posts publicly shared over 1 year from 1600 individuals with depression and 1600 individuals without depression on the Sina Weibo platform. We then developed a hierarchical transformer network for learning user-level semantic representations, which consists of 3 primary components: a word-level encoder, a post-level encoder, and a semantic aggregation encoder. The word-level encoder learns semantic embeddings from individual posts, while the post-level encoder explores features in user post sequences. The semantic aggregation encoder aggregates post sequence semantics to generate a user-level semantic representation that can be classified as depressed or nondepressed. Next, a classifier is employed to predict the risk of depression. Finally, we conducted statistical and linguistic analyses of the post content from individuals with and without depression using the Chinese Linguistic Inquiry and Word Count. Results: We divided the original data set into training, validation, and test sets. The training set consisted of 1000 individuals with depression and 1000 individuals without depression. Similarly, each validation and test set comprised 600 users, with 300 individuals from both cohorts (depression and nondepression). Our method achieved an accuracy of 84.62\%, precision of 84.43\%, recall of 84.50\%, and F1-score of 84.32\% on the test set without employing sampling techniques. However, by applying our proposed retrieval-based sampling strategy, we observed significant improvements in performance: an accuracy of 95.46\%, precision of 95.30\%, recall of 95.70\%, and F1-score of 95.43\%. These outstanding results clearly demonstrate the effectiveness and superiority of our proposed depression risk detection model and retrieval-based sampling technique. This breakthrough provides new insights for large-scale depression detection through social media. Through language behavior analysis, we discovered that individuals with depression are more likely to use negation words (the value of ``swear'' is 0.001253). This may indicate the presence of negative emotions, rejection, doubt, disagreement, or aversion in individuals with depression. Additionally, our analysis revealed that individuals with depression tend to use negative emotional vocabulary in their expressions (``NegEmo'': 0.022306; ``Anx'': 0.003829; ``Anger'': 0.004327; ``Sad'': 0.005740), which may reflect their internal negative emotions and psychological state. This frequent use of negative vocabulary could be a way for individuals with depression to express negative feelings toward life, themselves, or their surrounding environment. Conclusions: The research results indicate the feasibility and effectiveness of using deep learning methods to detect the risk of depression. These findings provide insights into the potential for large-scale, automated, and noninvasive prediction of depression among online social media users. ",
doi="10.2196/58259",
url="https://mental.jmir.org/2024/1/e58259"
}


@Article{info:doi/10.2196/51513,
author="Gong, Xun
and Chen, Meijuan
and Ning, Lihong
and Zeng, Lingzhong
and Dong, Bo",
title="The Quality of Short Videos as a Source of Coronary Heart Disease Information on TikTok: Cross-Sectional Study",
journal="JMIR Form Res",
year="2024",
month="Sep",
day="3",
volume="8",
pages="e51513",
keywords="coronary heart disease",
keywords="content quality",
keywords="social media",
keywords="short-video platform",
keywords="TikTok",
abstract="Background: Coronary heart disease (CHD) is a leading cause of death worldwide and imposes a significant economic burden. TikTok has risen as a favored platform within the social media sphere for disseminating CHD-related information and stands as a pivotal resource for patients seeking knowledge about CHD. However, the quality of such content on TikTok remains largely unexplored. Objective: This study aims to assess the quality of information conveyed in TikTok CHD-related videos. Methods: A comprehensive cross-sectional study was undertaken on TikTok videos related to CHD. The sources of the videos were identified and analyzed. The comprehensiveness of content was assessed through 6 questions addressing the definition, signs and symptoms, risk factors, evaluation, management, and outcomes. The quality of the videos was assessed using 3 standardized evaluative instruments: DISCERN, the Journal of the American Medical Association (JAMA) benchmarks, and the Global Quality Scale (GQS). Furthermore, correlative analyses between video quality and characteristics of the uploaders and the videos themselves were conducted. Results: The search yielded 145 CHD-related videos from TikTok, predominantly uploaded by health professionals (n=128, 88.3\%), followed by news agencies (n=6, 4.1\%), nonprofit organizations (n=10, 6.9\%), and for-profit organizations (n=1, 0.7\%). Content comprehensiveness achieved a median score of 3 (IQR 2-4). Median values for the DISCERN, JAMA, and GQS evaluations across all videos stood at 27 (IQR 24-32), 2 (IQR 2-2), and 2 (IQR 2-3), respectively. Videos from health professionals and nonprofit organizations attained significantly superior JAMA scores in comparison to those of news agencies (P<.001 and P=.02, respectively), whereas GQS scores for videos from health professionals were also notably higher than those from news agencies (P=.048). Within health professionals, cardiologists demonstrated discernibly enhanced performance over noncardiologists in both DISCERN and GQS assessments (P=.02). Correlative analyses unveiled positive correlations between video quality and uploader metrics, encompassing the positive correlations between the number of followers; total likes; average likes per video; and established quality indices such as DISCERN, JAMA, or GQS scores. Similar investigations relating to video attributes showed correlations between user engagement factors---likes, comments, collections, shares---and the aforementioned quality indicators. In contrast, a negative correlation emerged between the number of days since upload and quality indices, while a longer video duration corresponded positively with higher DISCERN and GQS scores. Conclusions: The quality of the videos was generally poor, with significant disparities based on source category. The content comprehensiveness coverage proved insufficient, casting doubts on the reliability and quality of the information relayed through these videos. Among health professionals, video contributions from cardiologists exhibited superior quality compared to noncardiologists. As TikTok's role in health information dissemination expands, ensuring accurate and reliable content is crucial to better meet patients' needs for CHD information that conventional health education fails to fulfill. ",
doi="10.2196/51513",
url="https://formative.jmir.org/2024/1/e51513"
}


@Article{info:doi/10.2196/52120,
author="Victoria-Castro, Maria Angela
and Arora, Tanima
and Simonov, Michael
and Biswas, Aditya
and Alausa, Jameel
and Subair, Labeebah
and Gerber, Brett
and Nguyen, Andrew
and Hsiao, Allen
and Hintz, Richard
and Yamamoto, Yu
and Soufer, Robert
and Desir, Gary
and Wilson, Perry Francis
and Villanueva, Merceditas",
title="Promoting Collaborative Scholarship During the COVID-19 Pandemic Through an Innovative COVID-19 Data Explorer and Repository at Yale School of Medicine: Development and Usability Study",
journal="JMIR Form Res",
year="2024",
month="Sep",
day="3",
volume="8",
pages="e52120",
keywords="COVID-19",
keywords="database",
keywords="data access",
keywords="interdepartmental communication",
keywords="collaborative scholarship",
keywords="clinical data",
keywords="repository",
keywords="researchers",
keywords="large-scale database",
keywords="innovation",
abstract="Background: The COVID-19 pandemic sparked a surge of research publications spanning epidemiology, basic science, and clinical science. Thanks to the digital revolution, large data sets are now accessible, which also enables real-time epidemic tracking. However, despite this, academic faculty and their trainees have been struggling to access comprehensive clinical data. To tackle this issue, we have devised a clinical data repository that streamlines research processes and promotes interdisciplinary collaboration. Objective: This study aimed to present an easily accessible up-to-date database that promotes access to local COVID-19 clinical data, thereby increasing efficiency, streamlining, and democratizing the research enterprise. By providing a robust database, a broad range of researchers (faculty and trainees) and clinicians from different areas of medicine are encouraged to explore and collaborate on novel clinically relevant research questions. Methods: A research platform, called the Yale Department of Medicine COVID-19 Explorer and Repository (DOM-CovX), was constructed to house cleaned, highly granular, deidentified, and continually updated data from over 18,000 patients hospitalized with COVID-19 from January 2020 to January 2023, across the Yale New Haven Health System. Data across several key domains were extracted including demographics, past medical history, laboratory values during hospitalization, vital signs, medications, imaging, procedures, and outcomes. Given the time-varying nature of several data domains, summary statistics were constructed to limit the computational size of the database and provide a reasonable data file that the broader research community could use for basic statistical analyses. The initiative also included a front-end user interface, the DOM-CovX Explorer, for simple data visualization of aggregate data. The detailed clinical data sets were made available for researchers after a review board process. Results: As of January 2023, the DOM-CovX Explorer has received 38 requests from different groups of scientists at Yale and the repository has expanded research capability to a diverse group of stakeholders including clinical and research-based faculty and trainees within 15 different surgical and nonsurgical specialties. A dedicated DOM-CovX team guides access and use of the database, which has enhanced interdepartmental collaborations, resulting in the publication of 16 peer-reviewed papers, 2 projects available in preprint servers, and 8 presentations in scientific conferences. Currently, the DOM-CovX Explorer continues to expand and improve its interface. The repository includes up to 3997 variables across 7 different clinical domains, with continued growth in response to researchers' requests and data availability. Conclusions: The DOM-CovX Data Explorer and Repository is a user-friendly tool for analyzing data and accessing a consistently updated, standardized, and large-scale database. Its innovative approach fosters collaboration, diversity of scholarly pursuits, and expands medical education. In addition, it can be applied to other diseases beyond COVID-19. ",
doi="10.2196/52120",
url="https://formative.jmir.org/2024/1/e52120"
}


@Article{info:doi/10.2196/54450,
author="Conley, C. Claire
and Rodriguez, D. Jennifer
and McIntyre, McKenzie
and Niell, L. Bethany
and O'Neill, C. Suzanne
and Vadaparampil, T. Susan",
title="Strategies for Identifying and Recruiting Women at High Risk for Breast Cancer for Research Outside of Clinical Settings: Observational Study",
journal="J Med Internet Res",
year="2024",
month="Sep",
day="2",
volume="26",
pages="e54450",
keywords="breast cancer",
keywords="high-risk populations",
keywords="risk management",
keywords="recruitment",
keywords="woman",
keywords="women",
keywords="high risk",
keywords="observational study",
keywords="cross-sectional",
keywords="Facebook",
keywords="Twitter",
keywords="flyer",
keywords="flyers",
keywords="community events",
keywords="community event",
keywords="genetic mutation",
abstract="Background: Research is needed to understand and address barriers to risk management for women at high (?20\% lifetime) risk for breast cancer, but recruiting this population for research studies is challenging. Objective: This paper compares a variety of recruitment strategies used for a cross-sectional, observational study of high-risk women. Methods: Eligible participants were assigned female at birth, aged 25-85 years, English-speaking, living in the United States, and at high risk for breast cancer as defined by the American College of Radiology. Individuals were excluded if they had a personal history of breast cancer, prior bilateral mastectomy, medical contraindications for magnetic resonance imaging, or were not up-to-date on screening mammography per American College of Radiology guidelines. Participants were recruited from August 2020 to January 2021 using the following mechanisms: targeted Facebook advertisements, Twitter posts, ResearchMatch (a web-based research recruitment database), community partner promotions, paper flyers, and community outreach events. Interested individuals were directed to a secure website with eligibility screening questions. Participants self-reported method of recruitment during the eligibility screening. For each recruitment strategy, we calculated the rate of eligible respondents and completed surveys, costs per eligible participant, and participant demographics. Results: We received 1566 unique responses to the eligibility screener. Participants most often reported recruitment via Facebook advertisements (724/1566, 46\%) and ResearchMatch (646/1566, 41\%). Community partner promotions resulted in the highest proportion of eligible respondents (24/46, 52\%), while ResearchMatch had the lowest proportion of eligible respondents (73/646, 11\%). Word of mouth was the most cost-effective recruitment strategy (US \$4.66 per completed survey response) and paper flyers were the least cost-effective (US \$1448.13 per completed survey response). The demographic characteristics of eligible respondents varied by recruitment strategy: Twitter posts and community outreach events resulted in the highest proportion of Hispanic or Latina women (1/4, 25\% and 2/6, 33\%, respectively), and community partner promotions resulted in the highest proportion of non-Hispanic Black women (4/24, 17\%). Conclusions: Although recruitment strategies varied in their yield of study participants, results overall support the feasibility of identifying and recruiting women at high risk for breast cancer outside of clinical settings. Researchers must balance the associated costs and participant yield of various recruitment strategies in planning future studies focused on high-risk women. ",
doi="10.2196/54450",
url="https://www.jmir.org/2024/1/e54450",
url="http://www.ncbi.nlm.nih.gov/pubmed/39222344"
}


@Article{info:doi/10.2196/48389,
author="Haddad, Firas
and Abou Shahla, William
and Saade, Dana",
title="Investigating Topical Steroid Withdrawal Videos on TikTok: Cross-Sectional Analysis of the Top 100 Videos",
journal="JMIR Form Res",
year="2024",
month="Aug",
day="29",
volume="8",
pages="e48389",
keywords="steroid withdrawal",
keywords="medical dermatology",
keywords="drug response",
keywords="social media",
keywords="videos",
keywords="TikTok",
keywords="steroids",
keywords="content analysis",
keywords="information quality",
keywords="skin",
keywords="topical",
keywords="dermatology",
keywords="misinformation",
abstract="Background:  Social media platforms like TikTok are a very popular source of information, especially for skin diseases. Topical steroid withdrawal (TSW) is a condition that is yet to be fully defined and understood. This did not stop the hashtag \#topicalsteroidwithdrawal from amassing more than 600 million views on TikTok. It is of utmost importance to assess the quality and content of TikTok videos on TSW to prevent the spread of misinformation. Objective: This study aims to assess the quality and content of the top 100 videos dedicated to the topic of TSW on TikTok. Methods: This observational study assesses the content and quality of the top 100 videos about TSW on TikTok. A total of 3 independent scoring systems: DISCERN, Journal of the American Medical Association, and Global Quality Scale were used to assess the video quality. The content of the videos was coded by 2 reviewers and analyzed for recurrent themes and topics. Results: This study found that only 10.0\% (n=10) of the videos clearly defined what TSW is. Videos were predominantly posted by White, middle-aged, and female creators. Neither cause nor mechanism of the disease were described in the videos. The symptoms suggested itching, peeling, and dryness which resembled the symptoms of atopic dermatitis. The videos fail to mention important information regarding the use of steroids such as the reason it was initially prescribed, the name of the drug, concentration, mechanism of usage, and method of discontinuation. Management techniques varied from hydration methods approved for treatment of atopic dermatitis to treatment options without scientific evidence. Overall, the videos had immense reach with over 200 million views, 45 million likes, 90,000 comments, and 100,000 shares. Video quality was poor with an average DISCERN score of 1.63 (SD 0.56)/5. Video length, total view count, and views/day were all associated with increased quality, indicating that patients were interacting more with higher quality videos. However, videos were created exclusively by personal accounts, highlighting the absence of dermatologists on the platform to discuss this topic. Conclusions: The videos posted on TikTok are of low quality and lack pertinent information. The content is varied and not consistent. Health care professionals, including dermatologists and residents in the field, need to be more active on the topic, to spread proper information and prevent an increase in steroid phobia. Health care professionals are encouraged to ride the wave and produce high-quality videos discussing what is known about TSW to avoid the spread of misinformation. ",
doi="10.2196/48389",
url="https://formative.jmir.org/2024/1/e48389"
}


@Article{info:doi/10.2196/59641,
author="Deiner, S. Michael
and Honcharov, Vlad
and Li, Jiawei
and Mackey, K. Tim
and Porco, C. Travis
and Sarkar, Urmimala",
title="Large Language Models Can Enable Inductive Thematic Analysis of a Social Media Corpus in a Single Prompt: Human Validation Study",
journal="JMIR Infodemiology",
year="2024",
month="Aug",
day="29",
volume="4",
pages="e59641",
keywords="generative large language model",
keywords="generative pretrained transformer",
keywords="GPT",
keywords="Claude",
keywords="Twitter",
keywords="X formerly known as Twitter",
keywords="social media",
keywords="inductive content analysis",
keywords="COVID-19",
keywords="vaccine hesitancy",
keywords="infodemiology",
abstract="Background: Manually analyzing public health--related content from social media provides valuable insights into the beliefs, attitudes, and behaviors of individuals, shedding light on trends and patterns that can inform public understanding, policy decisions, targeted interventions, and communication strategies. Unfortunately, the time and effort needed from well-trained human subject matter experts makes extensive manual social media listening unfeasible. Generative large language models (LLMs) can potentially summarize and interpret large amounts of text, but it is unclear to what extent LLMs can glean subtle health-related meanings in large sets of social media posts and reasonably report health-related themes. Objective: We aimed to assess the feasibility of using LLMs for topic model selection or inductive thematic analysis of large contents of social media posts by attempting to answer the following question: Can LLMs conduct topic model selection and inductive thematic analysis as effectively as humans did in a prior manual study, or at least reasonably, as judged by subject matter experts? Methods: We asked the same research question and used the same set of social media content for both the LLM selection of relevant topics and the LLM analysis of themes as was conducted manually in a published study about vaccine rhetoric. We used the results from that study as background for this LLM experiment by comparing the results from the prior manual human analyses with the analyses from 3 LLMs: GPT4-32K, Claude-instant-100K, and Claude-2-100K. We also assessed if multiple LLMs had equivalent ability and assessed the consistency of repeated analysis from each LLM. Results: The LLMs generally gave high rankings to the topics chosen previously by humans as most relevant. We reject a null hypothesis (P<.001, overall comparison) and conclude that these LLMs are more likely to include the human-rated top 5 content areas in their top rankings than would occur by chance. Regarding theme identification, LLMs identified several themes similar to those identified by humans, with very low hallucination rates. Variability occurred between LLMs and between test runs of an individual LLM. Despite not consistently matching the human-generated themes, subject matter experts found themes generated by the LLMs were still reasonable and relevant. Conclusions: LLMs can effectively and efficiently process large social media--based health-related data sets. LLMs can extract themes from such data that human subject matter experts deem reasonable. However, we were unable to show that the LLMs we tested can replicate the depth of analysis from human subject matter experts by consistently extracting the same themes from the same data. There is vast potential, once better validated, for automated LLM-based real-time social listening for common and rare health conditions, informing public health understanding of the public's interests and concerns and determining the public's ideas to address them. ",
doi="10.2196/59641",
url="https://infodemiology.jmir.org/2024/1/e59641"
}


@Article{info:doi/10.2196/58121,
author="Sharma, Pravesh
and Tranby, Brianna
and Kamath, Celia
and Brockman, A. Tabetha
and Lenhart, Ned
and Quade, Brian
and Abuan, Nate
and Halom, Martin
and Staples, Jamie
and Young, Colleen
and Brewer, LaPrincess
and Patten, Christi",
title="Beta Test of a Christian Faith-Based Facebook Intervention for Smoking Cessation in Rural Communities (FaithCore): Development and Usability Study",
journal="JMIR Form Res",
year="2024",
month="Aug",
day="26",
volume="8",
pages="e58121",
keywords="social media",
keywords="Facebook",
keywords="rural",
keywords="smoking",
keywords="cessation",
keywords="quitline",
keywords="community-based participatory research",
keywords="CBPR",
keywords="FaithCore",
keywords="mobile phone",
abstract="Background: Individuals living in rural communities experience substantial geographic and infrastructure barriers to attaining health equity in accessing tobacco use cessation treatment. Social media and other digital platforms offer promising avenues to improve access and overcome engagement challenges in tobacco cessation efforts. Research has also shown a positive correlation between faith-based involvement and a lower likelihood of smoking, which can be used to engage rural communities in these interventions. Objective: This study aimed to develop and beta test a social intervention prototype using a Facebook (Meta Platforms, Inc) group specifically designed for rural smokers seeking evidence-based smoking cessation resources. Methods: We designed a culturally aligned and faith-aligned Facebook group intervention, FaithCore, tailored to engage rural people who smoke in smoking cessation resources. Both intervention content and engagement strategies were guided by community-based participatory research principles. Given the intervention's focus on end users, that is, rural people who smoked, we conducted a beta test to assess any technical or usability issues of this intervention before any future trials for large-scale implementation. Results: No critical beta test technical and usability issues were noted. Besides, the FaithCore intervention was helpful, easy to understand, and achieved its intended goals. Notably, 90\% (9/10) of the participants reported that they tried quitting smoking, while 90\% (9/10) reported using or seeking cessation resources discussed within the group. Conclusions: This study shows that social media platform with culturally aligned and faith-aligned content and engagement strategies delivered by trained moderators are promising for smoking cessation interventions in rural communities. Our future step is to conduct a large pilot trial to evaluate the intervention's effectiveness on smoking cessation outcomes. ",
doi="10.2196/58121",
url="https://formative.jmir.org/2024/1/e58121"
}


@Article{info:doi/10.2196/54034,
author="Willem, Theresa
and Zimmermann, M. Bettina
and Matthes, Nina
and Rost, Michael
and Buyx, Alena",
title="Acceptance of Social Media Recruitment for Clinical Studies Among Patients With Hepatitis B: Mixed Methods Study",
journal="J Med Internet Res",
year="2024",
month="Aug",
day="26",
volume="26",
pages="e54034",
keywords="Facebook",
keywords="Twitter",
keywords="social media",
keywords="clinical trial",
keywords="enrollment",
keywords="health technology acceptance",
keywords="ethics",
keywords="infectious diseases",
keywords="privacy",
keywords="data protection",
keywords="stigma",
keywords="discrimination",
abstract="Background: Social media platforms are increasingly used to recruit patients for clinical studies. Yet, patients' attitudes regarding social media recruitment are underexplored. Objective: This mixed methods study aims to assess predictors of the acceptance of social media recruitment among patients with hepatitis B, a patient population that is considered particularly vulnerable in this context. Methods: Using a mixed methods approach, the hypotheses for our survey were developed based on a qualitative interview study with 6 patients with hepatitis B and 30 multidisciplinary experts. Thematic analysis was applied to qualitative interview analysis. For the cross-sectional survey, we additionally recruited 195 patients with hepatitis B from 3 clinical centers in Germany. Adult patients capable of judgment with a hepatitis B diagnosis who understood German and visited 1 of the 3 study centers during the data collection period were eligible to participate. Data analysis was conducted using SPSS (version 28; IBM Corp), including descriptive statistics and regression analysis. Results: On the basis of the qualitative interview analysis, we hypothesized that 6 factors were associated with acceptance of social media recruitment: using social media in the context of hepatitis B (hypothesis 1), digital literacy (hypothesis 2), interest in clinical studies (hypothesis 3), trust in nonmedical (hypothesis 4a) and medical (hypothesis 4b) information sources, perceiving the hepatitis B diagnosis as a secret (hypothesis 5a), attitudes toward data privacy in the social media context (hypothesis 5b), and perceived stigma (hypothesis 6). Regression analysis revealed that the higher the social media use for hepatitis B (hypothesis 1), the higher the interest in clinical studies (hypothesis 3), the more trust in nonmedical information sources (hypothesis 4a), and the less secrecy around a hepatitis B diagnosis (hypothesis 5a), the higher the acceptance of social media as a recruitment tool for clinical hepatitis B studies. Conclusions: This mixed methods study provides the first quantitative insights into social media acceptance for clinical study recruitment among patients with hepatitis B. The study was limited to patients with hepatitis B in Germany but sets out to be a reference point for future studies assessing the attitudes toward and acceptance of social media recruitment for clinical studies. Such empirical inquiries can facilitate the work of researchers designing clinical studies as well as ethics review boards in balancing the risks and benefits of social media recruitment in a context-specific manner. ",
doi="10.2196/54034",
url="https://www.jmir.org/2024/1/e54034"
}


@Article{info:doi/10.2196/57885,
author="Rao, K. Varun
and Valdez, Danny
and Muralidharan, Rasika
and Agley, Jon
and Eddens, S. Kate
and Dendukuri, Aravind
and Panth, Vandana
and Parker, A. Maria",
title="Digital Epidemiology of Prescription Drug References on X (Formerly Twitter): Neural Network Topic Modeling and Sentiment Analysis",
journal="J Med Internet Res",
year="2024",
month="Aug",
day="23",
volume="26",
pages="e57885",
keywords="digital epidemiology",
keywords="BERTtopic",
keywords="Valence Aware Dictionary and Sentiment Reasoner",
keywords="VADER",
keywords="sentiment analysis",
keywords="social media",
keywords="prescription drugs",
keywords="prescription",
keywords="prescriptions",
keywords="drug",
keywords="drugs",
keywords="drug use",
keywords="platform X",
keywords="Twitter",
keywords="tweet",
keywords="tweets",
keywords="latent Dirichlet allocation",
keywords="machine-driven",
keywords="natural language processing",
keywords="NLP",
keywords="brand name",
keywords="logistic regression",
keywords="machine learning",
keywords="health informatics",
abstract="Background: Data from the social media platform X (formerly Twitter) can provide insights into the types of language that are used when discussing drug use. In past research using latent Dirichlet allocation (LDA), we found that tweets containing ``street names'' of prescription drugs were difficult to classify due to the similarity to other colloquialisms and lack of clarity over how the terms were used. Conversely, ``brand name'' references were more amenable to machine-driven categorization. Objective: This study sought to use next-generation techniques (beyond LDA) from natural language processing to reprocess X data and automatically cluster groups of tweets into topics to differentiate between street- and brand-name data sets. We also aimed to analyze the differences in emotional valence between the 2 data sets to study the relationship between engagement on social media and sentiment. Methods: We used the Twitter application programming interface to collect tweets that contained the street and brand name of a prescription drug within the tweet. Using BERTopic in combination with Uniform Manifold Approximation and Projection and k-means, we generated topics for the street-name corpus (n=170,618) and brand-name corpus (n=245,145). Valence Aware Dictionary and Sentiment Reasoner (VADER) scores were used to classify whether tweets within the topics had positive, negative, or neutral sentiments. Two different logistic regression classifiers were used to predict the sentiment label within each corpus. The first model used a tweet's engagement metrics and topic ID to predict the label, while the second model used those features in addition to the top 5000 tweets with the largest term-frequency--inverse document frequency score. Results: Using BERTopic, we identified 40 topics for the street-name data set and 5 topics for the brand-name data set, which we generalized into 8 and 5 topics of discussion, respectively. Four of the general themes of discussion in the brand-name corpus referenced drug use, while 2 themes of discussion in the street-name corpus referenced drug use. From the VADER scores, we found that both corpora were inclined toward positive sentiment. Adding the vectorized tweet text increased the accuracy of our models by around 40\% compared with the models that did not incorporate the tweet text in both corpora. Conclusions: BERTopic was able to classify tweets well. As with LDA, the discussion using brand names was more similar between tweets than the discussion using street names. VADER scores could only be logically applied to the brand-name corpus because of the high prevalence of non--drug-related topics in the street-name data. Brand-name tweets either discussed drugs positively or negatively, with few posts having a neutral emotionality. From our machine learning models, engagement alone was not enough to predict the sentiment label; the added context from the tweets was needed to understand the emotionality of a tweet. ",
doi="10.2196/57885",
url="https://www.jmir.org/2024/1/e57885",
url="http://www.ncbi.nlm.nih.gov/pubmed/39178036"
}


@Article{info:doi/10.2196/38786,
author="Kbaier, Dhouha
and Kane, Annemarie
and McJury, Mark
and Kenny, Ian",
title="Prevalence of Health Misinformation on Social Media---Challenges and Mitigation Before, During, and Beyond the COVID-19 Pandemic: Scoping Literature Review",
journal="J Med Internet Res",
year="2024",
month="Aug",
day="19",
volume="26",
pages="e38786",
keywords="health misinformation",
keywords="online health communities",
keywords="vaccine hesitancy",
keywords="social media",
keywords="health professionals",
keywords="public health",
keywords="COVID-19",
keywords="intervention",
keywords="antivaxxers",
abstract="Background: This scoping review accompanies our research study ``The Experience of Health Professionals With Misinformation and Its Impact on Their Job Practice: Qualitative Interview Study.'' It surveys online health misinformation and is intended to provide an understanding of the communication context in which health professionals must operate. Objective: Our objective was to illustrate the impact of social media in introducing additional sources of misinformation that impact health practitioners' ability to communicate effectively with their patients. In addition, we considered how the level of knowledge of practitioners mitigated the effect of misinformation and additional stress factors associated with dealing with outbreaks, such as the COVID-19 pandemic, that affect communication with patients. Methods: This study used a 5-step scoping review methodology following Arksey and O'Malley's methodology to map relevant literature published in English between January 2012 and March 2024, focusing on health misinformation on social media platforms. We defined health misinformation as a false or misleading health-related claim that is not based on valid evidence or scientific knowledge. Electronic searches were performed on PubMed, Scopus, Web of Science, and Google Scholar. We included studies on the extent and impact of health misinformation in social media, mitigation strategies, and health practitioners' experiences of confronting health misinformation. Our independent reviewers identified relevant articles for data extraction. Results: Our review synthesized findings from 70 sources on online health misinformation. It revealed a consensus regarding the significant problem of health misinformation disseminated on social network platforms. While users seek trustworthy sources of health information, they often lack adequate health and digital literacies, which is exacerbated by social and economic inequalities. Cultural contexts influence the reception of such misinformation, and health practitioners may be vulnerable, too. The effectiveness of online mitigation strategies like user correction and automatic detection are complicated by malicious actors and politicization. The role of health practitioners in this context is a challenging one. Although they are still best placed to combat health misinformation, this review identified stressors that create barriers to their abilities to do this well. Investment in health information management at local and global levels could enhance their capacity for effective communication with patients. Conclusions: This scoping review underscores the significance of addressing online health misinformation, particularly in the postpandemic era. It highlights the necessity for a collaborative global interdisciplinary effort to ensure equitable access to accurate health information, thereby empowering health practitioners to effectively combat the impact of online health misinformation. Academic research will need to be disseminated into the public domain in a way that is accessible to the public. Without equipping populations with health and digital literacies, the prevalence of online health misinformation will continue to pose a threat to global public health efforts. ",
doi="10.2196/38786",
url="https://www.jmir.org/2024/1/e38786"
}


@Article{info:doi/10.2196/50353,
author="Ma, Ning
and Yu, Guang
and Jin, Xin",
title="Investigation of Public Acceptance of Misinformation Correction in Social Media Based on Sentiment Attributions: Infodemiology Study Using Aspect-Based Sentiment Analysis",
journal="J Med Internet Res",
year="2024",
month="Aug",
day="16",
volume="26",
pages="e50353",
keywords="misinformation correction",
keywords="sentiment attribution",
keywords="public acceptance",
keywords="public sentiments",
keywords="aspect-based sentiment analysis",
keywords="pretraining model",
abstract="Background: The proliferation of misinformation on social media is a significant concern due to its frequent occurrence and subsequent adverse social consequences. Effective interventions for and corrections of misinformation have become a focal point of scholarly inquiry. However, exploration of the underlying causes that affect the public acceptance of misinformation correction is still important and not yet sufficient. Objective: This study aims to identify the critical attributions that influence public acceptance of misinformation correction by using attribution analysis of aspects of public sentiment, as well as investigate the differences and similarities in public sentiment attributions in different types of misinformation correction. Methods: A theoretical framework was developed for analysis based on attribution theory, and public sentiment attributions were divided into 6 aspects and 11 dimensions. The correction posts for the 31 screened misinformation events comprised 33,422 Weibo posts, and the corresponding Weibo comments amounted to 370,218. A pretraining model was used to assess public acceptance of misinformation correction from these comments, and the aspect-based sentiment analysis method was used to identify the attributions of public sentiment response. Ultimately, this study revealed the causality between public sentiment attributions and public acceptance of misinformation correction through logistic regression analysis. Results: The findings were as follows: First, public sentiments attributed to external attribution had a greater impact on public acceptance than those attributed to internal attribution. The public associated different aspects with correction depending on the type of misinformation. The accuracy of the correction and the entity responsible for carrying it out had a significant impact on public acceptance of misinformation correction. Second, negative sentiments toward the media significantly increased, and public trust in the media significantly decreased. The collapse of media credibility had a detrimental effect on the actual effectiveness of misinformation correction. Third, there was a significant difference in public attitudes toward the official government and local governments. Public negative sentiments toward local governments were more pronounced. Conclusions: Our findings imply that public acceptance of misinformation correction requires flexible communication tailored to public sentiment attribution. The media need to rebuild their image and regain public trust. Moreover, the government plays a central role in public acceptance of misinformation correction. Some local governments need to repair trust with the public. Overall, this study offered insights into practical experience and a theoretical foundation for controlling various types of misinformation based on attribution analysis of public sentiment. ",
doi="10.2196/50353",
url="https://www.jmir.org/2024/1/e50353"
}


@Article{info:doi/10.2196/51325,
author="Denis-Robichaud, Jos{\'e}
and Rees, E. Erin
and Daley, Patrick
and Zarowsky, Christina
and Diouf, Assane
and Nasri, R. Bouchra
and de Montigny, Simon
and Carabin, H{\'e}l{\`e}ne",
title="Linking Opinions Shared on Social Media About COVID-19 Public Health Measures to Adherence: Repeated Cross-Sectional Surveys of Twitter Use in Canada",
journal="J Med Internet Res",
year="2024",
month="Aug",
day="13",
volume="26",
pages="e51325",
keywords="adherence to mask wearing",
keywords="adherence to vaccination",
keywords="social media",
keywords="sociodemographic characteristics",
keywords="Twitter",
keywords="COVID-19",
keywords="survey data",
abstract="Background: The effectiveness of public health measures (PHMs) depends on population adherence. Social media were suggested as a tool to assess adherence, but representativeness and accuracy issues have been raised. Objective: The objectives of this repeated cross-sectional study were to compare self-reported PHM adherence and sociodemographic characteristics between people who used Twitter (subsequently rebranded X) and people who did not use Twitter. Methods: Repeated Canada-wide web-based surveys were conducted every 14 days from September 2020 to March 2022. Weighted proportions were calculated for descriptive variables. Using Bayesian logistic regression models, we investigated associations between Twitter use, as well as opinions in tweets, and self-reported adherence with mask wearing and vaccination. Results: Data from 40,230 respondents were analyzed. As self-reported, Twitter was used by 20.6\% (95\% CI 20.1\%-21.2\%) of Canadians, of whom 29.9\% (95\% CI 28.6\%-31.3\%) tweeted about COVID-19. The sociodemographic characteristics differed across categories of Twitter use and opinions. Overall, 11\% (95\% CI 10.6\%-11.3\%) of Canadians reported poor adherence to mask-wearing, and 10.8\% (95\% CI 10.4\%-11.2\%) to vaccination. Twitter users who tweeted about COVID-19 reported poorer adherence to mask wearing than nonusers, which was modified by the age of the respondents and their geographical region (odds ratio [OR] 0.79, 95\% Bayesian credibility interval [BCI] 0.18-1.69 to OR 4.83, 95\% BCI 3.13-6.86). The odds of poor adherence to vaccination of Twitter users who tweeted about COVID-19 were greater than those of nonusers (OR 1.76, 95\% BCI 1.48-2.07). English- and French-speaking Twitter users who tweeted critically of PHMs were more likely (OR 4.07, 95\% BCI 3.38-4.80 and OR 7.31, 95\% BCI 4.26-11.03, respectively) to report poor adherence to mask wearing than non--Twitter users, and those who tweeted in support were less likely (OR 0.47, 95\% BCI 0.31-0.64 and OR 0.96, 95\% BCI 0.18-2.33, respectively) to report poor adherence to mask wearing than non--Twitter users. The OR of poor adherence to vaccination for those tweeting critically about PHMs and for those tweeting in support of PHMs were 4.10 (95\% BCI 3.40-4.85) and 0.20 (95\% BCI 0.10-0.32), respectively, compared to non--Twitter users. Conclusions: Opinions shared on Twitter can be useful to public health authorities, as they are associated with adherence to PHMs. However, the sociodemographics of social media users do not represent the general population, calling for caution when using tweets to assess general population-level behaviors. ",
doi="10.2196/51325",
url="https://www.jmir.org/2024/1/e51325",
url="http://www.ncbi.nlm.nih.gov/pubmed/39137009"
}


@Article{info:doi/10.2196/51317,
author="Postma, J. Doerine
and Heijkoop, A. Magali L.
and De Smet, M. Peter A. G.
and Notenboom, Kim
and Leufkens, M. Hubert G.
and Mantel-Teeuwisse, K. Aukje",
title="Identifying Medicine Shortages With the Twitter Social Network: Retrospective Observational Study",
journal="J Med Internet Res",
year="2024",
month="Aug",
day="6",
volume="26",
pages="e51317",
keywords="medicine shortages",
keywords="signal detection",
keywords="social media",
keywords="Twitter social network",
keywords="drug shortage",
keywords="Twitter",
abstract="Background: Early identification is critical for mitigating the impact of medicine shortages on patients. The internet, specifically social media, is an emerging source of health data. Objective: This study aimed to explore whether a routine analysis of data from the Twitter social network can detect signals of a medicine shortage and serve as an early warning system and, if so, for which medicines or patient groups. Methods: Medicine shortages between January 31 and December 1, 2019, were collected from the Dutch pharmacists' society's national catalog Royal Dutch Pharmacists Association (KNMP) Farmanco. Posts on these shortages were collected by searching for the name, the active pharmaceutical ingredient, or the first word of the brand name of the medicines in shortage. Posts were then selected based on relevant keywords that potentially indicated a shortage and the percentage of shortages with at least 1 post was calculated. The first posts per shortage were analyzed for their timing (median number of days, including the IQR) versus the national catalog, also stratified by disease and medicine characteristics. The content of the first post per shortage was analyzed descriptively for its reporting stakeholder and the nature of the post. Results: Of the 341 medicine shortages, 102 (29.9\%) were mentioned on Twitter. Of these 102 shortages, 18 (5.3\% of the total) were mentioned prior to or simultaneous to publication by KNMP Farmanco. Only 4 (1.2\%) of these were mentioned on Twitter more than 14 days before. On average, posts were published with a median delay of 37 (IQR 7-81) days to publication by KNMP Farmanco. Shortages mentioned on Twitter affected a greater number of patients and lasted longer than those that were not mentioned. We could not conclusively relate either the presence or absence on Twitter to a disease area or route of administration of the medicine in shortage. The first posts on the 102 shortages were mainly published by patients (n=51, 50.0\%) and health care professionals (n=46, 45.1\%). We identified 8 categories of nature of content. Sharing personal experience (n=44, 43.1\%) was the most common category. Conclusions: The Twitter social network is not a suitable early warning system for medicine shortages. Twitter primarily echoes already-known information rather than spreads new information. However, Twitter or potentially any other social media platform provides the opportunity for future qualitative research in the increasingly important field of medicine shortages that investigates how a larger population of patients is affected by shortages. ",
doi="10.2196/51317",
url="https://www.jmir.org/2024/1/e51317"
}


@Article{info:doi/10.2196/52058,
author="Cho, HyunYi
and Li, Wenbo
and Lopez, Rachel",
title="A Multidimensional Approach for Evaluating Reality in Social Media: Mixed Methods Study",
journal="J Med Internet Res",
year="2024",
month="Aug",
day="6",
volume="26",
pages="e52058",
keywords="fake",
keywords="fact",
keywords="misinformation",
keywords="reality",
keywords="social media",
keywords="scale",
keywords="measure",
keywords="instrument",
keywords="user-centric",
keywords="tailoring",
keywords="digital media literacy",
abstract="Background: Misinformation is a threat to public health. The effective countering of misinformation may require moving beyond the binary classification of fake versus fact to capture the range of schemas that users employ to evaluate social media content. A more comprehensive understanding of user evaluation schemas is necessary. Objective: The goal of this research was to advance the current understanding of user evaluations of social media information and to develop and validate a measurement instrument for assessing social media realism. Methods: This research involved a sequence of 2 studies. First, we used qualitative focus groups (n=48). Second, building on the first study, we surveyed a national sample of social media users (n=442). The focus group data were analyzed using the constant comparison approach. The survey data were analyzed using confirmatory factor analyses and ordinary least squares regression. Results: The findings showed that social media reality evaluation involves 5 dimensions: falsity, naturality, authenticity, resonance, and social assurance. These dimensions were differentially mapped onto patterns of social media use. Authenticity was strongly associated with the existing global measure of social media realism (P<.001). Naturality, or the willingness to accept artificiality and engineered aspects of social media representations, was linked to hedonic enjoyment (P<.001). Resonance predicted reflective thinking (P<.001), while social assurance was strongly related to addictive use (P<.001). Falsity, the general belief that much of what is on social media is not real, showed a positive association with both frequency (P<.001) and engagement with (P=.003) social media. These results provide preliminary validity data for a social media reality measure that encompasses multiple evaluation schemas for social media content. Conclusions: The identification of divergent schemas expands the current focus beyond fake versus fact, while the goals, contexts, and outcomes of social media use associated with these schemas can guide future digital media literacy efforts. Specifically, the social media reality measure can be used to develop tailored digital media literacy interventions for addressing diverse public health issues. ",
doi="10.2196/52058",
url="https://www.jmir.org/2024/1/e52058",
url="http://www.ncbi.nlm.nih.gov/pubmed/39106092"
}


@Article{info:doi/10.2196/50871,
author="Pascual-Ferr{\'a}, Paola
and Alperstein, Neil
and Burleson, Julia
and Jamison, M. Amelia
and Bhaktaram, Ananya
and Rath, Sidharth
and Ganjoo, Rohini
and Mohanty, Satyanarayan
and Barnett, J. Daniel
and Rimal, N. Rajiv",
title="Assessing Message Deployment During Public Health Emergencies Through Social Media: Empirical Test of Optimizing Content for Effective Dissemination",
journal="J Med Internet Res",
year="2024",
month="Jul",
day="26",
volume="26",
pages="e50871",
keywords="message testing",
keywords="web-based communication",
keywords="user engagement",
keywords="vaccine communication",
keywords="methodology",
keywords="Meta",
keywords="Facebook",
keywords="advertising",
keywords="infodemic",
keywords="communication",
keywords="infodemiology",
keywords="social media advertising tool",
keywords="social media",
keywords="audience",
keywords="engagement",
keywords="rapid message testing at scale",
keywords="mobile phone",
abstract="Background: During an infodemic, timely, reliable, and accessible information is crucial to combat the proliferation of health misinformation. While message testing can provide vital information to make data-informed decisions, traditional methods tend to be time- and resource-intensive. Recognizing this need, we developed the rapid message testing at scale (RMTS) approach to allow communicators to repurpose existing social media advertising tools and understand the full spectrum of audience engagement. Objective: We had two main objectives: (1) to demonstrate the use of the RMTS approach for message testing, especially when resources and time are limited, and (2) to propose and test the efficacy of an outcome variable that measures engagement along a continuum of viewing experience. Methods: We developed 12 versions of a single video created for a vaccine confidence project in India. We manipulated video length, aspect ratio, and use of subtitles. The videos were tested across 4 demographic groups (women or men, younger or older). We assessed user engagement along a continuum of viewing experience: obtaining attention, sustaining attention, conveying the message, and inspiring action. These were measured by the percentage of video watched and clicks on the call-to-action link. Results: The video advertisements were placed on Facebook for over 4 consecutive days at the cost of US \$450 and garnered a total of 3.34 million impressions. Overall, we found that the best-performing video was the shorter version in portrait aspect ratio and without subtitles. There was a significant but small association between the length of the video and users' level of engagement at key points along the continuum of viewing experience (N=1,032,888; $\chi$24=48,261.97; P<.001; V=.22). We found that for the longer video, those with subtitles held viewers longer after 25\% video watch time than those without subtitles (n=15,597; $\chi$21=7.33; P=.007; V=.02). While we found some significant associations between the aspect ratio, the use of subtitles, and the number of users watching the video and clicking on the call-to-action link, the effect size for those were extremely small. Conclusions: This test served as a proof of concept for the RMTS approach. We obtained rapid feedback on formal message attributes from a very large sample. The results of this test reinforce the need for platform-specific tailoring of communications. While our data showed a general preference for a short video in portrait orientation and without subtitles among our target audiences on Facebook, that may not necessarily be the case in other social media platforms such as YouTube or TikTok, where users go primarily to watch videos. RMTS testing highlights nuances that communication professionals can address instead of being limited to a ``one size fits all'' approach. ",
doi="10.2196/50871",
url="https://www.jmir.org/2024/1/e50871",
url="http://www.ncbi.nlm.nih.gov/pubmed/38861266"
}


@Article{info:doi/10.2196/52366,
author="Hong, Hang
and Shi, Xiaojun
and Liu, Yuhui
and Feng, Wei
and Fang, Ting
and Tang, Chunlan
and Xu, Guozhang",
title="HIV Incidence and Transactional Sex Among Men Who Have Sex With Men in Ningbo, China: Prospective Cohort Study Using a WeChat-Based Platform",
journal="JMIR Public Health Surveill",
year="2024",
month="Jul",
day="23",
volume="10",
pages="e52366",
keywords="HIV/AIDS",
keywords="incidence",
keywords="men who have sex with men",
keywords="MSM",
keywords="transactional sex",
keywords="WeChat",
keywords="HIV",
keywords="STI",
keywords="STD",
keywords="sexual",
keywords="behavior",
keywords="behavioral",
keywords="risk",
keywords="risky",
keywords="risks",
keywords="China",
keywords="Chinese",
keywords="testing",
keywords="mHealth",
keywords="mobile health",
keywords="app",
keywords="apps",
keywords="applications",
keywords="text message",
keywords="text messages",
keywords="messaging",
keywords="social media",
keywords="regression",
keywords="sexually transmitted infection",
keywords="sexually transmitted disease",
abstract="Background: Sexual transmission among men who have sex with men (MSM) has become the major HIV transmission route. However, limited research has been conducted to investigate the association between transactional sex (TS) and HIV incidence in China. Objective: This study aims to investigate HIV incidence and distinguish sociodemographic and sexual behavioral risk factors associated with HIV incidence among MSM who engage in TS (MSM-TS) in China. Methods: We conducted a prospective cohort study using a WeChat-based platform to evaluate HIV incidence among Chinese MSM, including MSM-TS in Ningbo, recruited from July 2019 until June 2022. At each visit, participants completed a questionnaire and scheduled an appointment for HIV counseling and testing on the WeChat-based platform before undergoing offline HIV tests. HIV incidence density was calculated as the number of HIV seroconversions divided by person-years (PYs) of follow-up, and univariate and multivariate Cox proportional hazards regression was conducted to identify factors associated with HIV incidence. Results: A total of 932 participants contributed 630.9 PYs of follow-up, and 25 HIV seroconversions were observed during the study period, resulting in an estimated HIV incidence of 4.0 (95\% CI 2.7-5.8) per 100 PYs. The HIV incidence among MSM-TS was 18.4 (95\% CI 8.7-34.7) per 100 PYs, which was significantly higher than the incidence of 3.2 (95\% CI 2.1-5.0) per 100 PYs among MSM who do not engage in TS. After adjusting for sociodemographic characteristics, factors associated with HIV acquisition were MSM-TS (adjusted hazard ratio [aHR] 3.93, 95\% CI 1.29-11.93), having unprotected sex with men (aHR 10.35, 95\% CI 2.25-47.69), and having multiple male sex partners (aHR 3.43, 95\% CI 1.22-9.64) in the past 6 months. Conclusions: This study found a high incidence of HIV among MSM-TS in Ningbo, China. The risk factors associated with HIV incidence include TS, having unprotected sex with men, and having multiple male sex partners. These findings emphasize the need for developing targeted interventions and providing comprehensive medical care, HIV testing, and preexposure prophylaxis for MSM, particularly those who engage in TS. ",
doi="10.2196/52366",
url="https://publichealth.jmir.org/2024/1/e52366"
}


@Article{info:doi/10.2196/55797,
author="Vargas Meza, Xanat
and Oikawa, Masanori",
title="Japanese Perception of Organ Donation and Implications for New Medical Technologies: Quantitative and Qualitative Social Media Analyses",
journal="JMIR Form Res",
year="2024",
month="Jul",
day="19",
volume="8",
pages="e55797",
keywords="Japan",
keywords="organ donation",
keywords="social media",
keywords="multidimensional analysis",
keywords="Twitter/X",
keywords="YouTube",
abstract="Background: The Rapid Autopsy Program (RAP) is a valuable procedure for studying human biology and diseases such as cancer. However, implementing the RAP in Japan necessitates a thorough understanding of concepts such as good death and the integration of sociocultural aspects. By revising perceptions of organ donation on social media, we bring attention to the challenges associated with implementing new medical research procedures such as the RAP. Objective: This study aims to examine YouTube and Twitter/X to identify stakeholders, evaluate the quality of organ donation communication, and analyze sociocultural aspects associated with organ donation. Based on our findings, we propose recommendations for the implementation of new medical research procedures. Methods: Using the term ``????'' (organ donation), we collected data from YouTube and Twitter/X, categorizing them into 5 dimensions: time, individuality, place, activity, and relationships. We utilized a scale to evaluate the quality of organ donation information and categorized YouTube videos into 3 groups to analyze their differences using statistical methods. Additionally, we conducted a text-based analysis to explore narratives associated with organ donation. Results: Most YouTube videos were uploaded in 2021 (189/638, 29.6\%) and 2022 (165/638, 25.9\%), while tweets about organ donation peaked between 2019 and 2022. Citizens (184/770, 23.9\%), media (170/770, 22.0\%), and unknown actors (121/770, 15.7\%) were the primary uploaders of videos on organ donation. In a sample of average retweeted and liked tweets, citizens accounted for the majority of identified users (64/91, 70\%, and 65/95, 68\%, respectively). Regarding Japanese regions, there were numerous information videos about organ donation in Hokkaido (F2.46,147.74=--5.28, P=.005) and Kyushu and Okinawa (F2.46,147.74=--5.28, P=.005). On Twitter/X, Japan and China were the most frequently mentioned countries in relation to organ donation discussions. Information videos often focused on themes such as borrowed life and calls to register as donors, whereas videos categorized as no information and misinformation frequently included accusations of organ trafficking, often propagated by Chinese-American media. Tweets primarily centered around statements of donation intention and discussions about family consent. The majority of video hyperlinks directed users to YouTube and Twitter/X platforms, while Twitter/X hyperlinks predominantly led to news reports from Japanese media outlets. Conclusions: There is significant potential to implement new medical research procedures such as the RAP in Japan. Recommendations include conceptualizing research data as borrowed data, implementing horizontally diversified management of donation programs, and addressing issues related to science misinformation and popular culture trends. ",
doi="10.2196/55797",
url="https://formative.jmir.org/2024/1/e55797",
url="http://www.ncbi.nlm.nih.gov/pubmed/39028549"
}


@Article{info:doi/10.2196/59794,
author="Jaiswal, Aditi
and Shah, Aekta
and Harjadi, Christopher
and Windgassen, Erik
and Washington, Peter",
title="Ethics of the Use of Social Media as Training Data for AI Models Used for Digital Phenotyping",
journal="JMIR Form Res",
year="2024",
month="Jul",
day="17",
volume="8",
pages="e59794",
keywords="social media analytics",
keywords="machine learning",
keywords="ethics",
keywords="research ethics",
keywords="consent",
keywords="scientific integrity",
doi="10.2196/59794",
url="https://formative.jmir.org/2024/1/e59794"
}


@Article{info:doi/10.2196/59349,
author="Jaiswal, Aditi
and Shah, Aekta
and Harjadi, Christopher
and Windgassen, Erik
and Washington, Peter",
title="Addendum: Using \#ActuallyAutistic on Twitter for Precision Diagnosis of Autism Spectrum Disorder: Machine Learning Study",
journal="JMIR Form Res",
year="2024",
month="Jul",
day="17",
volume="8",
pages="e59349",
doi="10.2196/59349",
url="https://formative.jmir.org/2024/1/e59349"
}


@Article{info:doi/10.2196/59546,
author="Cho, Hyeongchan
and Kim, Kyu-Min
and Kim, Jee-Young
and Youn, Bo-Young",
title="Twitter Discussions on \#digitaldementia: Content and Sentiment Analysis",
journal="J Med Internet Res",
year="2024",
month="Jul",
day="16",
volume="26",
pages="e59546",
keywords="digital dementia",
keywords="dementia",
keywords="public health",
keywords="Twitter",
keywords="social media",
keywords="mobile phone",
abstract="Background: Digital dementia is a term that describes a possible decline in cognitive abilities, especially memory, attributed to the excessive use of digital technology such as smartphones, computers, and tablets. This concept has gained popularity in public discourse and media lately. With the increasing use of social media platforms such as Twitter (subsequently rebranded as X), discussions about digital dementia have become more widespread, which offer a rich source of information to understand public perceptions, concerns, and sentiments regarding this phenomenon. Objective: The aim of this research was to delve into a comprehensive content and sentiment analysis of Twitter discussions regarding digital dementia using the hashtag \#digitaldementia. Methods: Retrospectively, publicly available English-language tweets with hashtag combinations related to the topic of digital dementia were extracted from Twitter. The tweets were collected over a period of 15 years, from January 1, 2008, to December 31, 2022. Content analysis was used to identify major themes within the tweets, and sentiment analysis was conducted to understand the positive and negative emotions associated with these themes in order to gain a better understanding of the issues surrounding digital dementia. A one-way ANOVA was performed to gather detailed statistical insights regarding the selected tweets from influencers within each theme. Results: This study was conducted on 26,290 tweets over 15 years by 5123 Twitter users, mostly female users in the United States. The influencers had followers ranging from 20,000 to 1,195,000 and an average of 214,878 subscribers. The study identified four themes regarding digital dementia after analyzing tweet content: (1) cognitive decline, (2) digital dependency, (3) technology overload, and (4) coping strategies. Categorized according to Glaser and Strauss's classifications, most tweets (14,492/26,290, 55.12\%) fell under the categories of wretched (purely negative) or bad (mostly negative). However, only a small proportion of tweets (3122/26,290, 11.86\%) were classified as great (purely positive) or swell sentiment (mostly positive). The ANOVA results showed significant differences in mean sentiment scores among the themes (F3,3581=29.03; P<.001). The mean sentiment score was --0.1072 (SD 0.4276). Conclusions: Various negative tweets have raised concerns about the link between excessive use of digital devices and cognitive decline, often known as digital dementia. Of particular concern is the rapid increase in digital device use. However, some positive tweets have suggested coping strategies. Engaging in digital detox activities, such as increasing physical exercise and participating in yoga and meditation, could potentially help prevent cognitive decline. ",
doi="10.2196/59546",
url="https://www.jmir.org/2024/1/e59546",
url="http://www.ncbi.nlm.nih.gov/pubmed/39012679"
}


@Article{info:doi/10.2196/51506,
author="Storman, Dawid
and Jemio?o, Pawe?
and Sawiec, Zuzanna
and Swierz, Jan Mateusz
and Antonowicz, Ewa
and Bala, M. Malgorzata
and Prokop-Dorner, Anna",
title="Needs Expressed in Peer-to-Peer Web-Based Interactions Among People With Depression and Anxiety Disorders Hospitalized in a Mental Health Facility: Mixed Methods Study",
journal="J Med Internet Res",
year="2024",
month="Jul",
day="12",
volume="26",
pages="e51506",
keywords="anxiety disorders",
keywords="depression",
keywords="peer-to-peer web-based interactions",
keywords="needs",
keywords="psychiatric hospitalization",
abstract="Background: Hospitalization in psychiatric wards is a necessary step for many individuals experiencing severe mental health issues. However, being hospitalized can also be a stressful and unsettling experience. It is crucial to understand and address the various needs of hospitalized individuals with psychiatric disorders to promote their overall well-being and support their recovery. Objective: Our objectives were to identify and describe individual needs related to mental hospitals through peer-to-peer interactions on Polish web-based forums among individuals with depression and anxiety disorders and to assess whether these needs were addressed by peers. Methods: We conducted a search of web-based forums focused on depression and anxiety and selected samples of 160 and 176 posts, respectively, until we reached saturation. A mixed methods analysis that included an in-depth content analysis, the Pearson $\chi$2 test, and $\phi$ coefficient was used to evaluate the posts. Results: The most frequently identified needs were the same for depression and anxiety forums and involved informational (105/160, 65.6\% and 169/393, 43\%, respectively), social life (17/160, 10.6\% and 90/393, 22.9\%, respectively), and emotional (9/160, 5.6\% and 66/393, 16.8\%, respectively) needs. The results show that there is no difference in the expression of needs between the analyzed forums. The needs were directly (42/47, 89\% vs 98/110, 89.1\% of times for depression and anxiety, respectively) and not fully (27/47, 57\% vs 86/110, 78.2\% of times for depression and anxiety, respectively) addressed by forum users. In quantitative analysis, we found that depression-related forums had more posts about the need for informational support and rectification, the expression of anger, and seeking professional support. By contrast, anxiety-related forums had more posts about the need for emotional support; social life; and information concerning medications, hope, and motivation. The most common co-occurrence of expressed needs was between sharing own experience and the need for professional support, with a strong positive association. The qualitative analysis showed that users join web-based communities to discuss their fears and questions about psychiatric hospitals. The posts revealed 4 mental and emotional representations of psychiatric hospitals: the hospital as an unknown place, the ambivalence of presumptions and needs, the negative representation of psychiatric hospitals, and the people associated with psychiatric hospitals. The tone of the posts was mostly negative, with discussions revolving around negative stereotypes; traumatic experiences; and beliefs that increased anxiety, shock, and fright and deterred users from hospitalization. Conclusions: Our study demonstrates that web-based forums can provide a platform for individuals with depression and anxiety disorders to express a wide range of needs. Most needs were addressed by peers but not sufficiently. Mental health professionals can benefit from these findings by gaining insights into the unique needs and concerns of their patients, thus allowing for more effective treatment and support. ",
doi="10.2196/51506",
url="https://www.jmir.org/2024/1/e51506"
}


@Article{info:doi/10.2196/56881,
author="Stimpson, P. Jim
and Park, Sungchul
and Wilson, A. Fernando
and Ortega, N. Alexander",
title="Variations in Unmet Health Care Needs by Perceptions of Social Media Health Mis- and Disinformation, Frequency of Social Media Use, Medical Trust, and Medical Care Discrimination: Cross-Sectional Study",
journal="JMIR Public Health Surveill",
year="2024",
month="Jul",
day="11",
volume="10",
pages="e56881",
keywords="United States",
keywords="cross-sectional study",
keywords="trust",
keywords="consumer health information",
keywords="misinformation",
keywords="disinformation",
keywords="perceived discrimination",
keywords="social media",
keywords="unmet need",
keywords="unmet needs",
keywords="health care",
keywords="discrimination",
keywords="racism",
keywords="adult",
keywords="adults",
keywords="medical care",
keywords="frequency",
keywords="multivariable regression",
keywords="user",
keywords="users",
keywords="cross-sectional",
keywords="survey",
keywords="surveys",
keywords="questionnaire",
keywords="questionnaires",
keywords="HINTS",
keywords="Health Information National Trends Survey",
abstract="Background: Unmet need for health care is defined as choosing to postpone or completely avoid necessary medical treatment despite having a need for it, which can worsen current conditions or contribute to new health problems. The emerging infodemic can be a barrier that prevents people from accessing quality health information, contributing to lower levels of seeking medical care when needed. Objective: We evaluated the association between perceptions of health mis- and disinformation on social media and unmet need for health care. In addition, we evaluated mechanisms for this relationship, including frequency of social media use, medical trust, and medical care discrimination. Methods: Data from 3964 active adult social media users responding to the 2022 Health Information National Trends Survey 6 (HINTS 6), a nationally representative survey, were analyzed. The outcome was unmet need for medical care, defined as delaying or not getting the necessary medical care. The predictor variables were perception of social media health mis- and disinformation, frequency of social media use, level of trust in the health care system, and perceived racial and ethnic discrimination when receiving health care. Results: Multivariable logistic regression models indicated that perception of substantial social media health mis- and disinformation (odds ratio [OR] 1.40, 95\% CI 1.07?1.82), daily use of social media (OR 1.34, 95\% CI 1.01?1.79), low medical trust (OR 1.46, 95\% CI 1.06?2.01), and perceived discrimination (OR 2.24, 95\% CI 1.44?3.50) were significantly associated with a higher likelihood of unmet need for medical care. Unmet need among adults who did not use social media daily and who did not perceive substantial mis- and disinformation (24\%; 95\% CI 19\%?30\%) was lower compared to daily social media users who perceived substantial mis- and disinformation (38\%; 95\% CI 32\%?43\%). Adults who perceived substantial mis- and disinformation and had low trust in health care had the highest probability of reporting unmet need (43\%; 95\% CI 38\%?49\%) compared to the other three groups. Adults who perceived substantial mis- and disinformation and experienced medical care discrimination had a statistically significant higher probability of reporting unmet need (51\%; 95\% CI 40\%?62\%) compared to adults who did not experience medical care discrimination and did not perceive substantial mis- and disinformation (29\%; 95\% CI 26\%?32\%). Conclusions: Unmet need for medical care was higher among individuals who perceived a substantial degree of social media mis- and disinformation, especially among those who used social media daily, did not trust the health care system, and experienced racial or ethnic discrimination when receiving health care. To counter the negative effects of social media mis- and disinformation on unmet need for health care, public health messaging must focus on daily social media users as well as improving trust and reducing structural racism in the health care system. ",
doi="10.2196/56881",
url="https://publichealth.jmir.org/2024/1/e56881"
}


@Article{info:doi/10.2196/51327,
author="Liu, Pinxin
and Lou, Xubin
and Xie, Zidian
and Shang, Ce
and Li, Dongmei",
title="Public Perceptions and Discussions of the US Food and Drug Administration's JUUL Ban Policy on Twitter: Observational Study",
journal="JMIR Form Res",
year="2024",
month="Jul",
day="11",
volume="8",
pages="e51327",
keywords="e-cigarettes",
keywords="JUUL",
keywords="Twitter",
keywords="deep learning",
keywords="FDA",
keywords="Food and Drug Administration",
keywords="vape",
keywords="vaping",
keywords="smoking",
keywords="social media",
keywords="regulation",
abstract="Background: On June 23, 2022, the US Food and Drug Administration announced a JUUL ban policy, to ban all vaping and electronic cigarette products sold by Juul Labs. Objective: This study aims to understand public perceptions and discussions of this policy using Twitter (subsequently rebranded as X) data. Methods: Using the Twitter streaming application programming interface, 17,007 tweets potentially related to the JUUL ban policy were collected between June 22, 2022, and July 25, 2022. Based on 2600 hand-coded tweets, a deep learning model (RoBERTa) was trained to classify all tweets into propolicy, antipolicy, neutral, and irrelevant categories. A deep learning model (M3 model) was used to estimate basic demographics (such as age and gender) of Twitter users. Furthermore, major topics were identified using latent Dirichlet allocation modeling. A logistic regression model was used to examine the association of different Twitter users with their attitudes toward the policy. Results: Among 10,480 tweets related to the JUUL ban policy, there were similar proportions of propolicy and antipolicy tweets (n=2777, 26.5\% vs n=2666, 25.44\%). Major propolicy topics included ``JUUL causes youth addition,'' ``market surge of JUUL,'' and ``health effects of JUUL.'' In contrast, major antipolicy topics included ``cigarette should be banned instead of JUUL,'' ``against the irrational policy,'' and ``emotional catharsis.'' Twitter users older than 29 years were more likely to be propolicy (have a positive attitude toward the JUUL ban policy) than those younger than 29 years. Conclusions: Our study showed that the public showed different responses to the JUUL ban policy, which varies depending on the demographic characteristics of Twitter users. Our findings could provide valuable information to the Food and Drug Administration for future electronic cigarette and other tobacco product regulations. ",
doi="10.2196/51327",
url="https://formative.jmir.org/2024/1/e51327",
url="http://www.ncbi.nlm.nih.gov/pubmed/38990633"
}


@Article{info:doi/10.2196/49422,
author="Wei, Lu
and Huang, Qing",
title="Retrospecting Digital Media Use, Negative Emotions, and Trust Gaps During the COVID-19 Pandemic in China: Cross-Sectional Web-Based Survey",
journal="J Med Internet Res",
year="2024",
month="Jul",
day="10",
volume="26",
pages="e49422",
keywords="digital media use",
keywords="negative emotions",
keywords="family members--strangers trust gap",
keywords="family members--acquaintances trust gap",
keywords="mediation effect",
keywords="COVID-19",
abstract="Background: Retrospecting the trust gaps and their dynamics during the pandemic is crucial for understanding the root causes of postpandemic challenges and offers valuable insights into preparing for future public health emergencies. The COVID-19 pandemic eroded people's trust in strangers and acquaintances, while their trust in family members remained relatively stable. This resulted in 2 trust gaps, namely, the family members--strangers trust gap and the family members--acquaintances trust gap. Widening trust gaps impede social integration and undermine the effective management of public health crises. However, little is known about how digital media use shaped trust gaps during a pandemic. Objective: This study aims to investigate the relationships between digital media use, negative emotions, the family members--strangers trust gap, and the family members--acquaintances trust gap during the COVID-19 pandemic in China. We test the mediating role of negative emotions between digital media use and 2 trust gaps and compare the indirect effect of digital media use on 2 trust gaps through negative emotions. Methods: A cross-sectional web-based survey was conducted in China between January 31, 2020, and February 9, 2020. A total of 1568 adults participated in the survey. Questions related to digital media use, negative emotions, trust in family members, trust in acquaintances, and trust in strangers during the pandemic were asked. Regression analyses were performed to test the associations between the examined variables. We used a 95\% bootstrap CI approach to estimate the mediation effects. Results: Digital media use was positively associated with negative emotions (B=0.17, SE 0.03; P<.001), which in turn were positively associated with the family members--strangers trust gap (B=0.15, SE 0.03; P<.001). Likewise, digital media use was positively associated with negative emotions (B=0.17, SE 0.03; P<.001), while negative emotions were positively associated with the family members--acquaintances trust gap (B=0.08, SE 0.03; P=.01). Moreover, the indirect effect of digital media use on the family members--strangers trust gap (B=0.03, SE 0.01; 95\% CI 0.01-0.04) was stronger than that on the family members--acquaintances trust gap (B=0.01, SE 0.01; 95\% CI 0.003-0.027). Conclusions: The results demonstrate that negative emotions resulting from the frequent use of digital media are a key factor that accounts for the widening trust gaps. Considering the increasing reliance on digital media, the findings indicate that the appropriate use of digital media can prevent the overamplification of negative emotions and curb the enlargement of trust gaps. This may help restore social trust and prepare for future public health crises in the postpandemic era. ",
doi="10.2196/49422",
url="https://www.jmir.org/2024/1/e49422"
}


@Article{info:doi/10.2196/51520,
author="Teano, L. Anthony
and Scott, Ashley
and Gipson, Cassandra
and Albert, Marilyn
and Pettigrew, Corinne",
title="Social Media Programs for Outreach and Recruitment Supporting Aging and Alzheimer Disease and Related Dementias Research: Longitudinal Descriptive Study",
journal="JMIR Aging",
year="2024",
month="Jul",
day="9",
volume="7",
pages="e51520",
keywords="education",
keywords="social media",
keywords="outreach",
keywords="recruitment",
keywords="Alzheimer's disease",
keywords="Alzheimer disease",
abstract="Background: Social media may be a useful method for research centers to deliver health messages, increase their visibility in the local community, and recruit study participants. Sharing examples of social media--based community outreach and educational programs, and evaluating their outcomes in this setting, is important for understanding whether these efforts have a measurable impact. Objective: The aim of this study is to describe one center's social media activities for community education on topics related to aging, memory loss, and Alzheimer disease and related dementias, and provide metrics related to recruitment into clinical research studies. Methods: Several social media platforms were used, including Facebook, X (formerly Twitter), and YouTube. Objective assessments quantified monthly, based on each platform's native dashboard, included the number of followers, number of posts, post reach and engagement, post impressions, and video views. The number of participants volunteering for research during this period was additionally tracked using a secure database. Educational material posted to social media most frequently included content developed by center staff, content from partner organizations, and news articles or resources featuring center researchers. Multiple educational programs were developed, including social media series, web-based talks, Twitter chats, and webinars. In more recent years, Facebook content was occasionally boosted to increase visibility in the local geographical region. Results: Up to 4 years of page metrics demonstrated continuing growth in reaching social media audiences, as indicated by increases over time in the numbers of likes or followers on Facebook and X/Twitter and views of YouTube videos (growth trajectories). While Facebook reach and X/Twitter impression rates were reasonable, Facebook engagement rates were more modest. Months that included boosted Facebook posts resulted in a greater change in page followers and page likes, and higher reach and engagement rates (all P?.002). Recruitment of participants into center-affiliated research studies increased during this time frame, particularly in response to boosted Facebook posts. Conclusions: These data demonstrate that social media activities can provide meaningful community educational opportunities focused on Alzheimer disease and related dementias and have a measurable impact on the recruitment of participants into research studies. Additionally, this study highlights the importance of tracking outreach program outcomes for evaluating return on investment. ",
doi="10.2196/51520",
url="https://aging.jmir.org/2024/1/e51520"
}


@Article{info:doi/10.2196/54407,
author="Pretorius, Kelly",
title="A Simple and Systematic Approach to Qualitative Data Extraction From Social Media for Novice Health Care Researchers: Tutorial",
journal="JMIR Form Res",
year="2024",
month="Jul",
day="9",
volume="8",
pages="e54407",
keywords="social media analysis",
keywords="data extraction",
keywords="health care research",
keywords="extraction tutorial",
keywords="Facebook extraction",
keywords="Facebook analysis",
keywords="safe sleep",
keywords="sudden unexpected infant death",
keywords="social media",
keywords="analysis",
keywords="systematic approach",
keywords="qualitative data",
keywords="Facebook",
keywords="health-related",
keywords="maternal perspective",
keywords="maternal perspectives",
keywords="sudden infant death syndrome",
keywords="mother",
keywords="mothers",
keywords="women",
keywords="United States",
keywords="SIDS",
keywords="SUID",
keywords="post",
keywords="posts",
doi="10.2196/54407",
url="https://formative.jmir.org/2024/1/e54407",
url="http://www.ncbi.nlm.nih.gov/pubmed/38980712"
}


@Article{info:doi/10.2196/52503,
author="Neely, Stephen
and Witkowski, Kaila",
title="Social Media Authentication and Users' Assessments of Health Information: Random Assignment Survey Experiment",
journal="JMIR Form Res",
year="2024",
month="Jul",
day="9",
volume="8",
pages="e52503",
keywords="social media",
keywords="verification markers",
keywords="vaccine efficacy",
keywords="health communication",
keywords="trust",
abstract="Background: In an effort to signal the authenticity of user accounts, social networking sites (SNSs) such as Facebook and X, formerly known as Twitter, use visual heuristics (blue checkmarks) to signify whether accounts are verified. While these verification badges are generally well recognized (and often coveted) by SNS users, relatively little is known about how they affect users' perceptions of accuracy or their likelihood of engaging with web-based information. This is particularly true in the case of information posted by medical experts and health care professionals. Objective: This study aims to use an experimental survey design to assess the effect of these verification badges on SNS users' assessments of information accuracy as well as their proclivity to recirculate health information or follow verified medical experts in their social network. Methods: A survey experiment using random assignment was conducted on a representative sample of 534 adult SNS users in Florida, United States. A total of 2 separate experimental scenarios exposed users to vaccine-related posts from verified medical experts on X. In each case, the original post contained a platform-issued verification badge (treatment group), which was subsequently edited out of the image as an experimental control. For each scenario, respondents were randomly assigned to either the treatment or control group, and responses to 3 follow-up questions were assessed through a series of chi-square analyses and 2 logit regression models. Responses were fielded using a stratified quota sampling approach to ensure representativeness of the state's population based on age, sex, race, ethnicity, and political affiliation. Results: Users' assessments of information accuracy were not significantly impacted by the presence or absence of verification badges, and users exposed to the experimental treatment (verification badge) were not any more likely to repost the message or follow the author. While verification badges did not influence users' assessments or subsequent behaviors, reliance on social media for health-related information and political affiliation were substantial predictors of accuracy assessments in both experimental scenarios. In scenario 1, which included a post addressing COVID-19 vaccine efficacy, users who relied on social media ``a great deal'' for health information were 2 times more likely to assess the post as accurate (odds ratio 2.033, 95\% CI 1.129-3.661; P=.01). In scenario 2, which included a post about measles vaccines, registered Republicans were nearly 6 times less likely to assess the post as accurate (odds ratio 0.171, 95\% CI 0.097-0.299; P<.001). Conclusions: For health professionals and medical experts wishing to leverage social networks to combat misinformation and spread reliable health-related content, account verification appears to offer little by way of added value. On the basis of prior research, other heuristics and communication strategies are likely to yield better results. ",
doi="10.2196/52503",
url="https://formative.jmir.org/2024/1/e52503",
url="http://www.ncbi.nlm.nih.gov/pubmed/38980714"
}


@Article{info:doi/10.2196/55680,
author="Campbell, Laura
and Quicke, Jonathan
and Stevenson, Kay
and Paskins, Zoe
and Dziedzic, Krysia
and Swaithes, Laura",
title="Using Twitter (X) to Mobilize Knowledge for First Contact Physiotherapists: Qualitative Study",
journal="J Med Internet Res",
year="2024",
month="Jul",
day="8",
volume="26",
pages="e55680",
keywords="Twitter",
keywords="X",
keywords="social media",
keywords="first contact physiotherapy",
keywords="musculoskeletal",
keywords="knowledge mobilisation",
keywords="primary care",
keywords="mindlines",
keywords="qualitative",
keywords="physiotherapy",
keywords="implementation",
abstract="Background: Twitter (now X) is a digital social network commonly used by health care professionals. Little is known about whether it helps health care professionals to share, mobilize, and cocreate knowledge or reduce the time between research knowledge being created and used in clinical practice (the evidence-to-practice gap). Musculoskeletal first contact physiotherapists (FCPs) are primary care specialists who diagnose and treat people with musculoskeletal conditions without needing to see their general practitioner (family physician) first. They often work as a sole FCP in practice; hence, they are an ideal health care professional group with whom to explore knowledge mobilization using Twitter. Objective: We aimed to explore how Twitter is and can be used to mobilize knowledge, including research findings, to inform FCPs' clinical practice. Methods: Semistructured interviews of FCPs with experience of working in English primary care were conducted. FCPs were purposively sampled based on employment arrangements and Twitter use. Recruitment was accomplished via known FCP networks and Twitter, supplemented by snowball sampling. Interviews were conducted digitally and used a topic guide exploring FCP's perceptions and experiences of accessing knowledge, via Twitter, for clinical practice. Data were analyzed thematically and informed by the knowledge mobilization mindlines model. Public contributors were involved throughout. Results: In total, 19 FCPs consented to the interview (Twitter users, n=14 and female, n=9). Three themes were identified: (1) How Twitter meets the needs of FCPs, (2) Twitter and a journey of knowledge to support clinical practice, and (3) factors impeding knowledge sharing on Twitter. FCPs described needs relating to isolated working practices, time demands, and role uncertainty. Twitter provided rapid access to succinct knowledge, the opportunity to network, and peer reassurance regarding clinical cases, evidence, and policy. FCPs took a journey of knowledge exchange on Twitter, including scrolling for knowledge, filtering for credibility and adapting knowledge for in-service training and clinical practice. Participants engaged best with images and infographics. FCPs described misinformation, bias, echo chambers, unprofessionalism, hostility, privacy concerns and blurred personal boundaries as factors impeding knowledge sharing on Twitter. Consequently, many did not feel confident enough to actively participate on Twitter. Conclusions: This study explores how Twitter is and can be used to mobilize knowledge to inform FCP clinical practice. Twitter can meet the knowledge needs of FCPs through rapid access to succinct knowledge, networking opportunities, and professional reassurance. The journey of knowledge exchange from Twitter to clinical practice can be explained by considering the mindlines model, which describes how FCPs exchange knowledge in digital and offline contexts. Findings demonstrate that Twitter can be a useful adjunct to FCP practice, although several factors impede knowledge sharing on the platform. We recommend social media training and enhanced governance guidance from professional bodies to support the use of Twitter for knowledge mobilization. ",
doi="10.2196/55680",
url="https://www.jmir.org/2024/1/e55680",
url="http://www.ncbi.nlm.nih.gov/pubmed/38742615"
}


@Article{info:doi/10.2196/53233,
author="Turuba, Roxanne
and Cormier, Willow
and Zimmerman, Rae
and Ow, Nikki
and Zenone, Marco
and Quintana, Yuri
and Jenkins, Emily
and Ben-David, Shelly
and Raimundo, Alicia
and Marcon, R. Alessandro
and Mathias, Steve
and Henderson, Jo
and Barbic, Skye",
title="Exploring How Youth Use TikTok for Mental Health Information in British Columbia: Semistructured Interview Study With Youth",
journal="JMIR Infodemiology",
year="2024",
month="Jul",
day="5",
volume="4",
pages="e53233",
keywords="youth",
keywords="adolescents",
keywords="young adults",
keywords="mental health",
keywords="TikTok",
keywords="social media",
keywords="qualitative research",
abstract="Background: TikTok (ByteDance) experienced a surge in popularity during the COVID-19 pandemic as a way for people to interact with others, share experiences and thoughts related to the pandemic, and cope with ongoing mental health challenges. However, few studies have explored how youth use TikTok to learn about mental health. Objective: This study aims to understand how youth used TikTok during the COVID-19 pandemic to learn about mental health and mental health support. Methods: Semistructured interviews were conducted with 21 youths (aged 12-24 years) living in British Columbia, Canada, who had accessed TikTok for mental health information during the COVID-19 pandemic. Interviews were audio-recorded, transcribed verbatim, coded, and analyzed using an inductive, data-driven approach. Results: A total of 3 overarching themes were identified describing youth's experiences. The first theme centered on how TikTok gave youth easy access to mental health information and support, which was particularly helpful during the COVID-19 pandemic to curb the effects of social isolation and the additional challenges of accessing mental health services. The second theme described how the platform provided youth with connection, as it gave youth a safe space to talk about mental health and allowed them to feel seen by others going through similar experiences. This helped normalize and destigmatize conversations about mental health and brought awareness to various mental health conditions. Finally, the last theme focused on how this information led to action, such as trying different coping strategies, discussing mental health with peers and family, accessing mental health services, and advocating for themselves during medical appointments. Across the 3 themes, youth expressed having to be mindful of bias and misinformation, highlighting the barriers to identifying and reporting misinformation and providing individualized advice on the platform. Conclusions: Findings suggest that TikTok can be a useful tool to increase mental health awareness, reduce stigma, and encourage youth to learn and address their mental health challenges while providing a source of peer connection and support. Simultaneously, TikTok can adversely impact mental health through repetitive exposure to mentally distressing content and misleading diagnosis and treatment information. Regulations against harmful content are needed to mitigate these risks and make TikTok safer for youth. Efforts should also be made to increase media and health literacy among youth so that they can better assess the information they consume online. ",
doi="10.2196/53233",
url="https://infodemiology.jmir.org/2024/1/e53233",
url="http://www.ncbi.nlm.nih.gov/pubmed/38967966"
}


@Article{info:doi/10.2196/50240,
author="Sobolewski, Jessica
and Rothschild, Allie
and Freeman, Andrew",
title="The Impact of Incentives on Data Collection for Online Surveys: Social Media Recruitment Study",
journal="JMIR Form Res",
year="2024",
month="Jul",
day="4",
volume="8",
pages="e50240",
keywords="social media",
keywords="online survey recruitment",
keywords="incentive",
keywords="experiment",
keywords="online surveys",
keywords="Facebook",
keywords="Instagram",
keywords="data collection",
keywords="users",
keywords="cost",
keywords="social media recruitment",
keywords="survey",
abstract="Background: The use of targeted advertisements on social media platforms (eg, Facebook and Instagram) has become increasingly popular for recruiting participants for online survey research. Many of these surveys offer monetary incentives for survey completion in the form of gift cards; however, little is known about whether the incentive amount impacts the cost, speed, and quality of data collection. Objective: This experiment addresses this gap in the literature by examining how different incentives in paid advertising campaigns on Instagram for completing a 10-minute online survey influence the response rate, recruitment advertising cost, data quality, and length of data collection. Methods: This experiment tested three incentive conditions using three Instagram campaigns that were each allocated a US \$1400 budget to spend over a maximum of 4 days; ads targeted users aged 15-24 years in three nonadjacent designated market areas of similar size to avoid overlapping audiences. Four ad creatives were designed for each campaign; all ads featured the same images and text, but the incentive amount varied: no incentive, US \$5 gift card, and US \$15 gift card. All ads had a clickable link that directed users to an eligibility screener and a 10-minute online survey, if eligible. Each campaign ran for either the full allotted time (4 days) or until there were 150 total survey completes, prior to data quality checks for fraud. Results: The US \$15 incentive condition resulted in the quickest and cheapest data collection, requiring 17 hours and ad spending of US \$338.64 to achieve 142 survey completes. The US \$5 condition took more than twice as long (39 hours) and cost US \$864.33 in ad spending to achieve 148 survey completes. The no-incentive condition ran for 60 hours, spending nearly the full budget (US \$1398.23), and achieved only 24 survey completes. The US \$15 and US \$5 incentive conditions had similar levels of fraudulent respondents, whereas the no-incentive condition had no fraudulent respondents. The completion rate for the US \$15 and US \$5 incentive conditions were 93.4\% (155/166) and 89.8\% (149/166), respectively, while the completion rate for the no-incentive condition was 43.6\% (24/55). Conclusions: Overall, we found that a higher incentive resulted in quicker data collection, less money spent on ads, and higher response rates, despite some fraudulent cases that had to be dropped from the sample. However, when considering the total incentive amounts in addition to the ad spending, a US \$5 incentive appeared to be the most cost-effective data collection option. Other costs associated with running a campaign for a longer period should also be considered. A longer experiment is warranted to determine whether fraud varies over time across conditions. ",
doi="10.2196/50240",
url="https://formative.jmir.org/2024/1/e50240"
}


@Article{info:doi/10.2196/51397,
author="Duggan, M. Nicole
and Jin, Mike
and Duran Mendicuti, Alejandra Maria
and Hallisey, Stephen
and Bernier, Denie
and Selame, A. Lauren
and Asgari-Targhi, Ameneh
and Fischetti, E. Chanel
and Lucassen, Ruben
and Samir, E. Anthony
and Duhaime, Erik
and Kapur, Tina
and Goldsmith, J. Andrew",
title="Gamified Crowdsourcing as a Novel Approach to Lung Ultrasound Data Set Labeling: Prospective Analysis",
journal="J Med Internet Res",
year="2024",
month="Jul",
day="4",
volume="26",
pages="e51397",
keywords="crowdsource",
keywords="crowdsourced",
keywords="crowdsourcing",
keywords="machine learning",
keywords="artificial intelligence",
keywords="point-of-care ultrasound",
keywords="POCUS",
keywords="lung ultrasound",
keywords="B-lines",
keywords="gamification",
keywords="gamify",
keywords="gamified",
keywords="label",
keywords="labels",
keywords="labeling",
keywords="classification",
keywords="lung",
keywords="pulmonary",
keywords="respiratory",
keywords="ultrasound",
keywords="imaging",
keywords="medical image",
keywords="diagnostic",
keywords="diagnose",
keywords="diagnosis",
keywords="data science",
abstract="Background: Machine learning (ML) models can yield faster and more accurate medical diagnoses; however, developing ML models is limited by a lack of high-quality labeled training data. Crowdsourced labeling is a potential solution but can be constrained by concerns about label quality. Objective: This study aims to examine whether a gamified crowdsourcing platform with continuous performance assessment, user feedback, and performance-based incentives could produce expert-quality labels on medical imaging data. Methods: In this diagnostic comparison study, 2384 lung ultrasound clips were retrospectively collected from 203 emergency department patients. A total of 6 lung ultrasound experts classified 393 of these clips as having no B-lines, one or more discrete B-lines, or confluent B-lines to create 2 sets of reference standard data sets (195 training clips and 198 test clips). Sets were respectively used to (1) train users on a gamified crowdsourcing platform and (2) compare the concordance of the resulting crowd labels to the concordance of individual experts to reference standards. Crowd opinions were sourced from DiagnosUs (Centaur Labs) iOS app users over 8 days, filtered based on past performance, aggregated using majority rule, and analyzed for label concordance compared with a hold-out test set of expert-labeled clips. The primary outcome was comparing the labeling concordance of collated crowd opinions to trained experts in classifying B-lines on lung ultrasound clips. Results: Our clinical data set included patients with a mean age of 60.0 (SD 19.0) years; 105 (51.7\%) patients were female and 114 (56.1\%) patients were White. Over the 195 training clips, the expert-consensus label distribution was 114 (58\%) no B-lines, 56 (29\%) discrete B-lines, and 25 (13\%) confluent B-lines. Over the 198 test clips, expert-consensus label distribution was 138 (70\%) no B-lines, 36 (18\%) discrete B-lines, and 24 (12\%) confluent B-lines. In total, 99,238 opinions were collected from 426 unique users. On a test set of 198 clips, the mean labeling concordance of individual experts relative to the reference standard was 85.0\% (SE 2.0), compared with 87.9\% crowdsourced label concordance (P=.15). When individual experts' opinions were compared with reference standard labels created by majority vote excluding their own opinion, crowd concordance was higher than the mean concordance of individual experts to reference standards (87.4\% vs 80.8\%, SE 1.6 for expert concordance; P<.001). Clips with discrete B-lines had the most disagreement from both the crowd consensus and individual experts with the expert consensus. Using randomly sampled subsets of crowd opinions, 7 quality-filtered opinions were sufficient to achieve near the maximum crowd concordance. Conclusions: Crowdsourced labels for B-line classification on lung ultrasound clips via a gamified approach achieved expert-level accuracy. This suggests a strategic role for gamified crowdsourcing in efficiently generating labeled image data sets for training ML systems. ",
doi="10.2196/51397",
url="https://www.jmir.org/2024/1/e51397"
}


@Article{info:doi/10.2196/55424,
author="Hughes, S. Allyson
and Beach, Sarah
and Vasistha, Spruhaa
and Heydarian, Nazanin
and Morera, Osvaldo",
title="Development and Validation of a Measure for Seeking Health Information in the Diabetes Online Community: Mixed Methods Study",
journal="JMIR Diabetes",
year="2024",
month="Jul",
day="4",
volume="9",
pages="e55424",
keywords="online health information",
keywords="health information seeking",
keywords="digital health",
keywords="digital technology",
keywords="digital intervention",
keywords="social support",
keywords="social media",
keywords="diabetes distress",
keywords="diabetes",
keywords="type 2 diabetes",
keywords="type 1 diabetes",
keywords="scale development",
keywords="chronic disease",
keywords="telehealth",
abstract="Background: Individuals with chronic diseases often search for health information online. The Diabetes Online Community (DOC) is an active community with members who exchange health information; however, few studies have examined health information brokering in the DOC. Objective: The aim of this study was to develop and validate the Attitudes Toward Seeking Health Information Online (ATSHIO) scale in a sample of adults with type 1 diabetes (T1D). Methods: People with T1D were recruited through the DOC, specifically Facebook and Twitter. They were provided with a Qualtrics link to complete the survey. This was a mixed methods study that used thematic analysis along with existing theory and formative research to design the quantitative ATSHIO scale. Results: A total of 166 people with T1D participated in this study. Confirmatory factor analyses determined a 2-factor scale (Trusting and Evaluating Online Health Information in the DOC and Engaging With Online Health Information in the DOC) with good convergent validity and discriminant validity. Correlations were found between social support, online health information--seeking, diabetes distress, and disease management. Conclusions: The ATSHIO scale can be used to investigate how people with diabetes are using the internet for obtaining health information, which is especially relevant in the age of telehealth and Health 2.0. ",
doi="10.2196/55424",
url="https://diabetes.jmir.org/2024/1/e55424",
url="http://www.ncbi.nlm.nih.gov/pubmed/38963699"
}


@Article{info:doi/10.2196/59198,
author="Paquin, Vincent
and Ackerman, A. Robert
and Depp, A. Colin
and Moore, C. Raeanne
and Harvey, D. Philip
and Pinkham, E. Amy",
title="Media Use and Its Associations With Paranoia in Schizophrenia and Bipolar Disorder: Ecological Momentary Assessment",
journal="JMIR Ment Health",
year="2024",
month="Jul",
day="3",
volume="11",
pages="e59198",
keywords="paranoia",
keywords="social media",
keywords="digital media",
keywords="technology",
keywords="psychosis",
keywords="schizophrenia",
keywords="schizoaffective",
keywords="bipolar disorder",
keywords="ecological momentary assessment",
keywords="spectrum",
keywords="sociodemographic",
keywords="linear mixed model",
keywords="media use",
keywords="mental health",
keywords="digital intervention",
keywords="adult",
keywords="adults",
keywords="medical center",
keywords="mental health clinic",
keywords="psychiatry",
keywords="psychiatrist",
abstract="Background: Paranoia is a spectrum of fear-related experiences that spans diagnostic categories and is influenced by social and cognitive factors. The extent to which social media and other types of media use are associated with paranoia remains unclear. Objective: We aimed to examine associations between media use and paranoia at the within- and between-person levels. Methods: Participants were 409 individuals diagnosed with schizophrenia spectrum or bipolar disorder. Measures included sociodemographic and clinical characteristics at baseline, followed by ecological momentary assessments (EMAs) collected 3 times daily over 30 days. EMA evaluated paranoia and 5 types of media use: social media, television, music, reading or writing, and other internet or computer use. Generalized linear mixed models were used to examine paranoia as a function of each type of media use and vice versa at the within- and between-person levels. Results: Of the 409 participants, the following subgroups reported at least 1 instance of media use: 261 (63.8\%) for using social media, 385 (94.1\%) for watching TV, 292 (71.4\%) for listening to music, 191 (46.7\%) for reading or writing, and 280 (68.5\%) for other internet or computer use. Gender, ethnoracial groups, educational attainment, and diagnosis of schizophrenia versus bipolar disorder were differentially associated with the likelihood of media use. There was a within-person association between social media use and paranoia: using social media was associated with a subsequent decrease of 5.5\% (fold-change 0.945, 95\% CI 0.904-0.987) in paranoia. The reverse association, from paranoia to subsequent changes in social media use, was not statistically significant. Other types of media use were not significantly associated with paranoia. Conclusions: This study shows that social media use was associated with a modest decrease in paranoia, perhaps reflecting the clinical benefits of social connection. However, structural disadvantage and individual factors may hamper the accessibility of media activities, and the mental health correlates of media use may further vary as a function of contents and contexts of use. ",
doi="10.2196/59198",
url="https://mental.jmir.org/2024/1/e59198"
}


@Article{info:doi/10.2196/49879,
author="Foriest, C. Jasmine
and Mittal, Shravika
and Kim, Eugenia
and Carmichael, Andrea
and Lennon, Natalie
and Sumner, A. Steven
and De Choudhury, Munmun",
title="News Media Framing of Suicide Circumstances and Gender: Mixed Methods Analysis",
journal="JMIR Ment Health",
year="2024",
month="Jul",
day="3",
volume="11",
pages="e49879",
keywords="suicide",
keywords="framing",
keywords="disparities",
keywords="reporting guidelines",
keywords="gender",
keywords="stigma",
keywords="glorification",
keywords="glorify",
keywords="glorifying",
keywords="suicidal",
keywords="self harm",
keywords="suicides",
keywords="stigmatizing",
keywords="stigmatization",
keywords="reporting",
keywords="news",
keywords="journalist",
keywords="journalists",
keywords="journalism",
keywords="machine learning",
keywords="NLP",
keywords="natural language processing",
keywords="LLM",
keywords="LLMs",
keywords="language model",
keywords="language models",
keywords="linguistic",
keywords="linguistics",
keywords="reporter",
keywords="reporters",
keywords="digital mental health",
keywords="mHealth",
keywords="media",
abstract="Background: Suicide is a leading cause of death worldwide. Journalistic reporting guidelines were created to curb the impact of unsafe reporting; however, how suicide is framed in news reports may differ by important characteristics such as the circumstances and the decedent's gender. Objective: This study aimed to examine the degree to which news media reports of suicides are framed using stigmatized or glorified language and differences in such framing by gender and circumstance of suicide. Methods: We analyzed 200 news articles regarding suicides and applied the validated Stigma of Suicide Scale to identify stigmatized and glorified language. We assessed linguistic similarity with 2 widely used metrics, cosine similarity and mutual information scores, using a machine learning--based large language model. Results: News reports of male suicides were framed more similarly to stigmatizing (P<.001) and glorifying (P=.005) language than reports of female suicides. Considering the circumstances of suicide, mutual information scores indicated that differences in the use of stigmatizing or glorifying language by gender were most pronounced for articles attributing legal (0.155), relationship (0.268), or mental health problems (0.251) as the cause. Conclusions: Linguistic differences, by gender, in stigmatizing or glorifying language when reporting suicide may exacerbate suicide disparities. ",
doi="10.2196/49879",
url="https://mental.jmir.org/2024/1/e49879"
}


@Article{info:doi/10.2196/53334,
author="Faccio, Elena
and Reggiani, Margherita
and Rocelli, Michele
and Cipolletta, Sabrina",
title="Issues Related to the Use of Visual Social Networks and Perceived Usefulness of Social Media Literacy During the Recovery Phase: Qualitative Research Among Girls With Eating Disorders",
journal="J Med Internet Res",
year="2024",
month="Jul",
day="2",
volume="26",
pages="e53334",
keywords="visual social networks",
keywords="body image",
keywords="eating disorders",
keywords="risks",
keywords="potentials",
keywords="social networks",
keywords="social network",
keywords="social media",
keywords="literacy",
keywords="food intake",
keywords="appetite disorders",
keywords="appetite disorder",
keywords="eating disorder",
keywords="patient safety",
keywords="patient-centered approach",
keywords="recovery",
keywords="body comparison",
keywords="users",
keywords="semistructured interviews",
keywords="semistructured interview",
keywords="girls",
keywords="adolescent",
keywords="adolescents",
keywords="content analysis",
keywords="online",
abstract="Background: The patient-centered approach is essential for quality health care and patient safety. Understanding the service user's perspective on the factors maintaining the health problem is crucial for successful treatment, especially for patients who do not recognize their condition as clinically relevant or concerning. Despite the association between intensive use of visual social media and body dissatisfaction and eating disorders, little is known about the meanings users assign to posting or searching for edited photos and the strategies they use to protect themselves from digital risks. Objective: This study aims to examine how young women recovering from eating disorders in Northern Italy perceive the health risks and potential benefits associated with visual social networks (ie, Instagram and Snapchat). The literature has found these platforms to be detrimental to online body comparisons. It also explores the perceived usefulness, willingness, and personal interest in coconstructing social media literacy programs with girls recovering from eating disorders. Methods: A total of 30 semistructured interviews were conducted with adolescent girls aged 14-17 years at the end of their treatment for eating disorders. The following areas of research were addressed: (1) the meanings associated with the use of Instagram and Snapchat; (2) the investment in the photographic dimension and feedback; (3) the impact of visual social networks on body experiences; (4) the potential and risks perceived in their use; (5) the importance of supporting girls undergoing treatment for eating disorders in using social networks; and (6) the usefulness and willingness to co-design social network literacy programs. Content analysis was applied. Results: A total of 7 main contents emerged: active or passive role in using social networks, the impact of online interactions on body image, investment in the photographic dimension, effects on self-representation, perceived risks, self-protective strategies, and potential benefits. The findings highlight a strong awareness of the processes that trigger body comparisons in the virtual context, creating insecurity and worsening the relationship with oneself. The self-protective behaviors identified are the development of critical thinking, the avoidance of sensitive content, increased control over social networking site use, and a certain skepticism toward developing antagonistic ideologies. All these topics were considered fundamental. Conclusions: The findings provide important insights for health professionals working with youth in preparing media literacy programs. These programs aim to reduce potential risks and amplify the positive effects of online resources. They underscore the importance of addressing this issue during hospitalization to develop skills and critical thinking aimed at changing small habits that perpetuate the problem in everyday life. The inherent limitations in current service practices, which may not adequately address individual needs or impact posttreatment life, must also be considered. ",
doi="10.2196/53334",
url="https://www.jmir.org/2024/1/e53334"
}


@Article{info:doi/10.2196/55747,
author="Sweeney, Colm
and Ennis, Edel
and Mulvenna, D. Maurice
and Bond, Raymond
and O'Neill, Siobhan",
title="Insights Derived From Text-Based Digital Media, in Relation to Mental Health and Suicide Prevention, Using Data Analysis and Machine Learning: Systematic Review",
journal="JMIR Ment Health",
year="2024",
month="Jun",
day="27",
volume="11",
pages="e55747",
keywords="mental health",
keywords="machine learning",
keywords="text analysis",
keywords="digital intervention",
abstract="Background: Text-based digital media platforms have revolutionized communication and information sharing, providing valuable access to knowledge and understanding in the fields of mental health and suicide prevention. Objective: This systematic review aimed to determine how machine learning and data analysis can be applied to text-based digital media data to understand mental health and aid suicide prevention. Methods: A systematic review of research papers from the following major electronic databases was conducted: Web of Science, MEDLINE, Embase (via MEDLINE), and PsycINFO (via MEDLINE). The database search was supplemented by a hand search using Google Scholar. Results: Overall, 19 studies were included, with five major themes as to how data analysis and machine learning techniques could be applied: (1) as predictors of personal mental health, (2) to understand how personal mental health and suicidal behavior are communicated, (3) to detect mental disorders and suicidal risk, (4) to identify help seeking for mental health difficulties, and (5) to determine the efficacy of interventions to support mental well-being. Conclusions: Our findings show that data analysis and machine learning can be used to gain valuable insights, such as the following: web-based conversations relating to depression vary among different ethnic groups, teenagers engage in a web-based conversation about suicide more often than adults, and people seeking support in web-based mental health communities feel better after receiving online support. Digital tools and mental health apps are being used successfully to manage mental health, particularly through the COVID-19 epidemic, during which analysis has revealed that there was increased anxiety and depression, and web-based communities played a part in reducing isolation during the pandemic. Predictive analytics were also shown to have potential, and virtual reality shows promising results in the delivery of preventive or curative care. Future research efforts could center on optimizing algorithms to enhance the potential of text-based digital media analysis in mental health and suicide prevention. In addressing depression, a crucial step involves identifying the factors that contribute to happiness and using machine learning to forecast these sources of happiness. This could extend to understanding how various activities result in improved happiness across different socioeconomic groups. Using insights gathered from such data analysis and machine learning, there is an opportunity to craft digital interventions, such as chatbots, designed to provide support and address mental health challenges and suicide prevention. ",
doi="10.2196/55747",
url="https://mental.jmir.org/2024/1/e55747",
url="http://www.ncbi.nlm.nih.gov/pubmed/38935419"
}


@Article{info:doi/10.2196/50453,
author="Szeto, D. Mindy
and Hook Sobotka, Michelle
and Woolhiser, Emily
and Parmar, Pritika
and Wu, Jieying
and Alhanshali, Lina
and Dellavalle, P. Robert",
title="PatientsLikeMe and Online Patient Support Communities in Dermatology",
journal="JMIR Dermatol",
year="2024",
month="Jun",
day="26",
volume="7",
pages="e50453",
keywords="PatientsLikeMe",
keywords="PLM",
keywords="online support communities",
keywords="social media",
keywords="forums",
keywords="discussion boards",
keywords="internet",
keywords="misinformation",
keywords="community engagement",
keywords="representation",
keywords="demographics",
keywords="lived experience",
keywords="atopic dermatitis",
keywords="prevalence",
doi="10.2196/50453",
url="https://derma.jmir.org/2024/1/e50453"
}


@Article{info:doi/10.2196/52316,
author="Das Swain, Vedant
and Ye, Jingjing
and Ramesh, Karthik Siva
and Mondal, Abhirup
and Abowd, D. Gregory
and De Choudhury, Munmun",
title="Leveraging Social Media to Predict COVID-19--Induced Disruptions to Mental Well-Being Among University Students: Modeling Study",
journal="JMIR Form Res",
year="2024",
month="Jun",
day="25",
volume="8",
pages="e52316",
keywords="social media",
keywords="mental health",
keywords="linguistic markers",
keywords="digital phenotyping",
keywords="COVID-19",
keywords="disaster well-being",
keywords="well-being",
keywords="machine learning",
keywords="temporal trends",
keywords="disruption",
abstract="Background: Large-scale crisis events such as COVID-19 often have secondary impacts on individuals' mental well-being. University students are particularly vulnerable to such impacts. Traditional survey-based methods to identify those in need of support do not scale over large populations and they do not provide timely insights. We pursue an alternative approach through social media data and machine learning. Our models aim to complement surveys and provide early, precise, and objective predictions of students disrupted by COVID-19. Objective: This study aims to demonstrate the feasibility of language on private social media as an indicator of crisis-induced disruption to mental well-being. Methods: We modeled 4124 Facebook posts provided by 43 undergraduate students, spanning over 2 years. We extracted temporal trends in the psycholinguistic attributes of their posts and comments. These trends were used as features to predict how COVID-19 disrupted their mental well-being. Results: The social media--enabled model had an F1-score of 0.79, which was a 39\% improvement over a model trained on the self-reported mental state of the participant. The features we used showed promise in predicting other mental states such as anxiety, depression, social, isolation, and suicidal behavior (F1-scores varied between 0.85 and 0.93). We also found that selecting the windows of time 7 months after the COVID-19--induced lockdown presented better results, therefore, paving the way for data minimization. Conclusions: We predicted COVID-19--induced disruptions to mental well-being by developing a machine learning model that leveraged language on private social media. The language in these posts described psycholinguistic trends in students' online behavior. These longitudinal trends helped predict mental well-being disruption better than models trained on correlated mental health questionnaires. Our work inspires further research into the potential applications of early, precise, and automatic warnings for individuals concerned about their mental health in times of crisis. ",
doi="10.2196/52316",
url="https://formative.jmir.org/2024/1/e52316",
url="http://www.ncbi.nlm.nih.gov/pubmed/38916951"
}


@Article{info:doi/10.2196/57164,
author="Huang, Liang-Chin
and Eiden, L. Amanda
and He, Long
and Annan, Augustine
and Wang, Siwei
and Wang, Jingqi
and Manion, J. Frank
and Wang, Xiaoyan
and Du, Jingcheng
and Yao, Lixia",
title="Natural Language Processing--Powered Real-Time Monitoring Solution for Vaccine Sentiments and Hesitancy on Social Media: System Development and Validation",
journal="JMIR Med Inform",
year="2024",
month="Jun",
day="21",
volume="12",
pages="e57164",
keywords="vaccine sentiment",
keywords="vaccine hesitancy",
keywords="natural language processing",
keywords="NLP",
keywords="social media",
keywords="social media platforms",
keywords="real-time tracking",
keywords="vaccine",
keywords="vaccines",
keywords="sentiment",
keywords="sentiments",
keywords="vaccination",
keywords="vaccinations",
keywords="hesitancy",
keywords="attitude",
keywords="attitudes",
keywords="opinion",
keywords="perception",
keywords="perceptions",
keywords="perspective",
keywords="perspectives",
keywords="machine learning",
keywords="uptake",
keywords="willing",
keywords="willingness",
keywords="classification",
abstract="Background: Vaccines serve as a crucial public health tool, although vaccine hesitancy continues to pose a significant threat to full vaccine uptake and, consequently, community health. Understanding and tracking vaccine hesitancy is essential for effective public health interventions; however, traditional survey methods present various limitations. Objective: This study aimed to create a real-time, natural language processing (NLP)--based tool to assess vaccine sentiment and hesitancy across 3 prominent social media platforms. Methods: We mined and curated discussions in English from Twitter (subsequently rebranded as X), Reddit, and YouTube social media platforms posted between January 1, 2011, and October 31, 2021, concerning human papillomavirus; measles, mumps, and rubella; and unspecified vaccines. We tested multiple NLP algorithms to classify vaccine sentiment into positive, neutral, or negative and to classify vaccine hesitancy using the World Health Organization's (WHO) 3Cs (confidence, complacency, and convenience) hesitancy model, conceptualizing an online dashboard to illustrate and contextualize trends. Results: We compiled over 86 million discussions. Our top-performing NLP models displayed accuracies ranging from 0.51 to 0.78 for sentiment classification and from 0.69 to 0.91 for hesitancy classification. Explorative analysis on our platform highlighted variations in online activity about vaccine sentiment and hesitancy, suggesting unique patterns for different vaccines. Conclusions: Our innovative system performs real-time analysis of sentiment and hesitancy on 3 vaccine topics across major social networks, providing crucial trend insights to assist campaigns aimed at enhancing vaccine uptake and public health. ",
doi="10.2196/57164",
url="https://medinform.jmir.org/2024/1/e57164",
url="http://www.ncbi.nlm.nih.gov/pubmed/38904984"
}


@Article{info:doi/10.2196/49077,
author="Terada, Marina
and Okuhara, Tsuyoshi
and Yokota, Rie
and Kiuchi, Takahiro
and Murakami, Kentaro",
title="Nutrients and Foods Recommended for Blood Pressure Control on Twitter in Japan: Content Analysis",
journal="J Med Internet Res",
year="2024",
month="Jun",
day="20",
volume="26",
pages="e49077",
keywords="Twitter",
keywords="food",
keywords="nutrition",
keywords="misinformation",
keywords="salt",
keywords="content analysis",
keywords="hypertension",
keywords="blood pressure",
keywords="sodium",
keywords="salt reduction",
abstract="Background: Management and prevention of hypertension are important public health issues. Healthy dietary habits are one of the modifiable factors. As Twitter (subsequently rebranded X) is a digital platform that can influence public eating behavior, there is a knowledge gap regarding the information about foods and nutrients recommended for blood pressure control and who disseminates them on Twitter. Objective: This study aimed to investigate the nature of the information people are exposed to on Twitter regarding nutrients and foods for blood pressure control. Methods: A total of 147,898 Japanese tweets were extracted from January 1, 2022, to December 31, 2022. The final sample of 2347 tweets with at least 1 retweet was manually coded into categories of food groups, nutrients, user characteristics, and themes. The number and percentage of tweets, retweets, and themes in each category were calculated. Results: Of the 2347 tweets, 80\% (n=1877) of tweets mentioned foods, which were categorized into 17 different food groups. Seasonings and spices, including salt, were most frequently mentioned (1356/1877, 72.2\%). This was followed by vegetable and fruit groups. The 15 kinds of nutrients were mentioned in 1566 tweets, with sodium being the largest proportion at 83.1\% (n=1301), followed by potassium at 8.4\% (n=132). There was misinformation regarding salt intake for hypertension, accounting for 40.8\% (n=531) of tweets referring to salt, including recommendations for salt intake to lower blood pressure. In total, 75\% (n=21) of tweets from ``doctors'' mentioned salt reduction is effective for hypertension control, while 31.1\% (n=74) of tweets from ``health, losing weight, and beauty-related users,'' 25.9\% (n=429) of tweets from ``general public,'' and 23.5\% (n=4) tweets from ``dietitian or registered dietitian'' denied salt reduction for hypertension. The antisalt reduction tweets accounted for 31.5\% (n=106) of the most disseminated tweets related to nutrients and foods for blood pressure control. Conclusions: The large number of tweets in this study indicates a high interest in nutrients and foods for blood pressure control. Misinformation asserting antisalt reduction was posted primarily by the general public and self-proclaimed health experts. The number of tweets from nutritionists, registered dietitians, and doctors who were expected to correct misinformation and promote salt reduction was relatively low, and their messages were not always positive toward salt reduction. There is a need for communication strategies to combat misinformation, promote correct information on salt reduction, and train health care professionals to effectively communicate evidence-based information on this topic. ",
doi="10.2196/49077",
url="https://www.jmir.org/2024/1/e49077"
}


@Article{info:doi/10.2196/58056,
author="Frennesson, Felicia Nessie
and Barnett, Julie
and Merouani, Youssouf
and Attwood, Angela
and Zuccolo, Luisa
and McQuire, Cheryl",
title="Analyzing Questions About Alcohol in Pregnancy Using Web-Based Forum Topics: Qualitative Content Analysis",
journal="JMIR Infodemiology",
year="2024",
month="Jun",
day="20",
volume="4",
pages="e58056",
keywords="social media",
keywords="web-based forum",
keywords="alcohol",
keywords="pregnancy",
keywords="prenatal health",
keywords="prenatal alcohol exposure",
abstract="Background: Prenatal alcohol exposure represents a substantial public health concern as it may lead to detrimental outcomes, including pregnancy complications and fetal alcohol spectrum disorder. Although UK national guidance recommends abstaining from alcohol if pregnant or planning a pregnancy, evidence suggests that confusion remains on this topic among members of the public, and little is known about what questions people have about consumption of alcohol in pregnancy outside of health care settings. Objective: This study aims to assess what questions and topics are raised on alcohol in pregnancy on a web-based UK-based parenting forum and how these correspond to official public health guidelines with respect to 2 critical events: the implementation of the revised UK Chief Medical Officers' (CMO) low-risk drinking guidelines (2016) and the first COVID-19 pandemic lockdown (2020). Methods: All thread starts mentioning alcohol in the ``Pregnancy'' forum were collected from Mumsnet for the period 2002 to 2022 and analyzed using qualitative content analysis. Descriptive statistics were used to characterize the number and proportion of thread starts for each topic over the whole study period and for the periods corresponding to the change in CMO guidance and the COVID-19 pandemic. Results: A total of 395 thread starts were analyzed, and key topics included ``Asking for advice on whether it is safe to consume alcohol'' or on ``safe limits'' and concerns about having consumed alcohol before being aware of a pregnancy. In addition, the Mumsnet thread starts included discussions and information seeking on ``Research, guidelines, and official information about alcohol in pregnancy.'' Topics discussed on Mumsnet regarding alcohol in pregnancy remained broadly similar between 2002 and 2022, although thread starts disclosing prenatal alcohol use were more common before the introduction of the revised CMO guidance than in later periods. Conclusions: Web-based discussions within a UK parenting forum indicated that users were often unclear on guidance and risks associated with prenatal alcohol use and that they used this platform to seek information and reassurance from peers. ",
doi="10.2196/58056",
url="https://infodemiology.jmir.org/2024/1/e58056",
url="http://www.ncbi.nlm.nih.gov/pubmed/38900536"
}


@Article{info:doi/10.2196/51094,
author="Raber, Margaret
and Allen, Haley
and Huang, Sophia
and Vazquez, Maria
and Warner, Echo
and Thompson, Debbe",
title="Mediterranean Diet Information on TikTok and Implications for Digital Health Promotion Research: Social Media Content Analysis",
journal="JMIR Form Res",
year="2024",
month="Jun",
day="19",
volume="8",
pages="e51094",
keywords="misinformation",
keywords="social media",
keywords="Mediterranean Diet",
keywords="content analysis",
keywords="health communication",
keywords="communication",
keywords="TikTok",
keywords="diet",
keywords="cardiometabolic disease",
keywords="cardiometabolic",
keywords="consumer",
keywords="eating",
keywords="quality",
keywords="mHealth",
keywords="mobile health",
keywords="digital health",
keywords="promotion research",
keywords="nutrition therapy",
keywords="healthy diet",
abstract="Background: The Mediterranean diet has been linked to reduced risk for several cardiometabolic diseases. The lack of a clear definition of the Mediterranean diet in the scientific literature and the documented proliferation of nutrition misinformation on the internet suggest the potential for confusion among consumers seeking web-based Mediterranean diet information. Objective: We conducted a social media content analysis of information about the Mediterranean diet on the influential social media platform, TikTok, to examine public discourse about the diet and identify potential areas of misinformation. We then analyzed these findings in the context of health promotion to identify potential challenges and opportunities for the use of TikTok in promoting the Mediterranean diet for healthy living. Methods: The first-appearing 202 TikTok posts that resulted from a search of the hashtag \#mediterraneandiet were downloaded and qualitatively examined. Post features and characteristics, poster information, and engagement metrics were extracted and synthesized across posts. Posts were categorized as those created by health professionals and those created by nonhealth professionals based on poster-reported credentials. In addition to descriptive statistics of the entire sample, we compared posts created by professionals and nonprofessionals for content using chi-square tests. Results: TikTok posts varied in content, but posts that were developed by health professionals versus nonprofessionals were more likely to offer a definition of the Mediterranean diet (16/106, 15.1\% vs 2/96, 2.1\%; P=.001), use scientific citations to support claims (26/106, 24.5\% vs 0/96, 0\%; P<.001), and discuss specific nutrients (33/106, 31.1\% vs 6/96, 6.3\%; P<.001) and diseases related to the diet (27/106, 25.5\% vs 5/96, 5.2\%; P<.001) compared to posts created by nonhealth professionals. Conclusions: Social media holds promise as a venue to promote the Mediterranean diet, but the variability in information found in this study highlights the need to create clear definitions about the diet and its components when developing Mediterranean diet interventions that use new media structures. ",
doi="10.2196/51094",
url="https://formative.jmir.org/2024/1/e51094"
}


@Article{info:doi/10.2196/59294,
author="Pickett, C. Andrew
and Valdez, Danny
and Sinclair, L. Kelsey
and Kochell, J. Wesley
and Fowler, Boone
and Werner, E. Nicole",
title="Social Media Discourse Related to Caregiving for Older Adults Living With Alzheimer Disease and Related Dementias: Computational and Qualitative Study",
journal="JMIR Aging",
year="2024",
month="Jun",
day="19",
volume="7",
pages="e59294",
keywords="caregiving",
keywords="dementia",
keywords="social support",
keywords="social media",
keywords="Reddit",
abstract="Background: In the United States, caregivers of people living with Alzheimer disease and Alzheimer disease--related dementias (AD/ADRD) provide >16 billion hours of unpaid care annually. These caregivers experience high levels of stress and burden related to the challenges associated with providing care. Social media is an emerging space for individuals to seek various forms of support. Objective: We aimed to explore the primary topics of conversation on the social media site Reddit related to AD/ADRD. We then aimed to explore these topics in depth, specifically examining elements of social support and behavioral symptomology discussed by users. Methods: We first generated an unsupervised topic model from 6563 posts made to 2 dementia-specific subreddit forums (r/Alzheimers and r/dementia). Then, we conducted a manual qualitative content analysis of a random subset of these data to further explore salient themes in the corpus. Results: The topic model with the highest overall coherence score (0.38) included 10 topics, including caregiver burden, anxiety, support-seeking, and AD/ADRD behavioral symptomology. Qualitative analyses provided added context, wherein users sought emotional and informational support for many aspects of the care experience, including assistance in making key care-related decisions. Users expressed challenging and complex emotions on Reddit, which may be taboo to express in person. Conclusions: Reddit users seek many different forms of support, including emotional and specific informational support, from others on the internet. Users expressed a variety of concerns, challenges, and behavioral symptoms to manage as part of the care experience. The unique (ie, anonymous and moderated) nature of the forum allowed for a safe space to express emotions free from documented caregiver stigma. Additional support structures are needed to assist caregivers of people living with AD/ADRD. ",
doi="10.2196/59294",
url="https://aging.jmir.org/2024/1/e59294",
url="http://www.ncbi.nlm.nih.gov/pubmed/38896462"
}


@Article{info:doi/10.2196/46176,
author="Karapetiantz, Pierre
and Audeh, Bissan
and Redjdal, Akram
and Tiffet, Th{\'e}ophile
and Bousquet, C{\'e}dric
and Jaulent, Marie-Christine",
title="Monitoring Adverse Drug Events in Web Forums: Evaluation of a Pipeline and Use Case Study",
journal="J Med Internet Res",
year="2024",
month="Jun",
day="18",
volume="26",
pages="e46176",
keywords="pharmacovigilance",
keywords="social media",
keywords="scraper",
keywords="natural language processing",
keywords="signal detection",
keywords="graphical user interface",
abstract="Background: To mitigate safety concerns, regulatory agencies must make informed decisions regarding drug usage and adverse drug events (ADEs). The primary pharmacovigilance data stem from spontaneous reports by health care professionals. However, underreporting poses a notable challenge within the current system. Explorations into alternative sources, including electronic patient records and social media, have been undertaken. Nevertheless, social media's potential remains largely untapped in real-world scenarios. Objective: The challenge faced by regulatory agencies in using social media is primarily attributed to the absence of suitable tools to support decision makers. An effective tool should enable access to information via a graphical user interface, presenting data in a user-friendly manner rather than in their raw form. This interface should offer various visualization options, empowering users to choose representations that best convey the data and facilitate informed decision-making. Thus, this study aims to assess the potential of integrating social media into pharmacovigilance and enhancing decision-making with this novel data source. To achieve this, our objective was to develop and assess a pipeline that processes data from the extraction of web forum posts to the generation of indicators and alerts within a visual and interactive environment. The goal was to create a user-friendly tool that enables regulatory authorities to make better-informed decisions effectively. Methods: To enhance pharmacovigilance efforts, we have devised a pipeline comprising 4 distinct modules, each independently editable, aimed at efficiently analyzing health-related French web forums. These modules were (1) web forums' posts extraction, (2) web forums' posts annotation, (3) statistics and signal detection algorithm, and (4) a graphical user interface (GUI). We showcase the efficacy of the GUI through an illustrative case study involving the introduction of the new formula of Levothyrox in France. This event led to a surge in reports to the French regulatory authority. Results: Between January 1, 2017, and February 28, 2021, a total of 2,081,296 posts were extracted from 23 French web forums. These posts contained 437,192 normalized drug-ADE couples, annotated with the Anatomical Therapeutic Chemical (ATC) Classification and Medical Dictionary for Regulatory Activities (MedDRA). The analysis of the Levothyrox new formula revealed a notable pattern. In August 2017, there was a sharp increase in posts related to this medication on social media platforms, which coincided with a substantial uptick in reports submitted by patients to the national regulatory authority during the same period. Conclusions: We demonstrated that conducting quantitative analysis using the GUI is straightforward and requires no coding. The results aligned with prior research and also offered potential insights into drug-related matters. Our hypothesis received partial confirmation because the final users were not involved in the evaluation process. Further studies, concentrating on ergonomics and the impact on professionals within regulatory agencies, are imperative for future research endeavors. We emphasized the versatility of our approach and the seamless interoperability between different modules over the performance of individual modules. Specifically, the annotation module was integrated early in the development process and could undergo substantial enhancement by leveraging contemporary techniques rooted in the Transformers architecture. Our pipeline holds potential applications in health surveillance by regulatory agencies or pharmaceutical companies, aiding in the identification of safety concerns. Moreover, it could be used by research teams for retrospective analysis of events. ",
doi="10.2196/46176",
url="https://www.jmir.org/2024/1/e46176",
url="http://www.ncbi.nlm.nih.gov/pubmed/38888956"
}


@Article{info:doi/10.2196/50698,
author="Stupnicki, Aleksander
and Suresh, Basil
and Jain, Saurabh",
title="Online Visibility and Scientific Relevance of Strabismus Research: Bibliometric Analysis",
journal="Interact J Med Res",
year="2024",
month="Jun",
day="12",
volume="13",
pages="e50698",
keywords="strabismus research",
keywords="squint",
keywords="social media",
keywords="scientific relevance",
keywords="altmetrics",
keywords="accuracy",
keywords="medical knowledge",
keywords="metric",
keywords="bibliometric analysis",
keywords="research",
keywords="strabismus",
keywords="online visibility",
keywords="platform",
keywords="evidence-based information",
keywords="accessibility",
abstract="Background: Quality and accuracy of online scientific data are crucial, given that the internet and social media serve nowadays as primary sources of medical knowledge. Objective: This study aims to analyze the relationship between scientific relevance and online visibility of strabismus research to answer the following questions: (1) Are the most popular strabismus papers scientifically relevant? (2) Are the most high-impact strabismus studies shared enough online? Methods: The Altmetric Attention Score (AAS) was used as a proxy for online visibility, whereas citations and the journal's impact factor (IF) served as a metric for scientific relevance. Using ``strabismus'' as a keyword, 100 papers with the highest AAS and 100 papers with the highest number of citations were identified. Statistical analyses, including the Spearman rank test, linear regression, and factor analysis, were performed to assess the relationship between AAS, citations, a journal's IF, and mentions across 18 individual Web 2.0 platforms. Results: A weak, positive, statistically significant correlation was observed between normalized AAS and normalized citations (P<.001; r=0.27) for papers with high visibility. Only Twitter mentions and Mendeley readers correlated significantly with normalized citations (P=.02 and P<.001, respectively) and IF (P=.04 and P=.009, respectively), with Twitter being the strongest significant predictor of citation numbers (r=0.53). For high-impact papers, no correlation was found between normalized citations and normalized AAS (P=.12) or the IF of the journal (P=.55). Conclusions: While clinical relevance influences online attention, most high-impact research related to strabismus is not sufficiently shared on the web. Therefore, researchers should make a greater effort to share high-impact papers related to strabismus on online media platforms to improve accessibility and quality of evidence-based knowledge for patients. ",
doi="10.2196/50698",
url="https://www.i-jmr.org/2024/1/e50698",
url="http://www.ncbi.nlm.nih.gov/pubmed/38865170"
}


@Article{info:doi/10.2196/48491,
author="Wang, Hanjing
and Li, Yupeng
and Ning, Xuan",
title="News Coverage of the COVID-19 Pandemic on Social Media and the Public's Negative Emotions: Computational Study",
journal="J Med Internet Res",
year="2024",
month="Jun",
day="6",
volume="26",
pages="e48491",
keywords="web news coverage",
keywords="emotions",
keywords="social media",
keywords="Facebook",
keywords="COVID-19",
abstract="Background: Social media has become an increasingly popular and critical tool for users to digest diverse information and express their perceptions and attitudes. While most studies endeavor to delineate the emotional responses of social media users, there is limited research exploring the factors associated with the emergence of emotions, particularly negative ones, during news consumption. Objective: We aim to first depict the web coverage by news organizations on social media and then explore the crucial elements of news coverage that trigger the public's negative emotions. Our findings can act as a reference for responsible parties and news organizations in times of crisis. Methods: We collected 23,705 Facebook posts with 1,019,317 comments from the public pages of representative news organizations in Hong Kong. We used text mining techniques, such as topic models and Bidirectional Encoder Representations from Transformers, to analyze news components and public reactions. Beyond descriptive analysis, we used regression models to shed light on how news coverage on social media is associated with the public's negative emotional responses. Results: Our results suggest that occurrences of issues regarding pandemic situations, antipandemic measures, and supportive actions are likely to reduce the public's negative emotions, while comments on the posts mentioning the central government and the Government of Hong Kong reveal more negativeness. Negative and neutral media tones can alleviate the rage and interact with the subjects and issues in the news to affect users' negative emotions. Post length is found to have a curvilinear relationship with users' negative emotions. Conclusions: This study sheds light on the impacts of various components of news coverage (issues, subjects, media tone, and length) on social media on the public's negative emotions (anger, fear, and sadness). Our comprehensive analysis provides a reference framework for efficient crisis communication for similar pandemics at present or in the future. This research, although first extending the analysis between the components of news coverage and negative user emotions to the scenario of social media, echoes previous studies drawn from traditional media and its derivatives, such as web newspapers. Although the era of COVID-19 pandemic gradually brings down the curtain, the commonality of this research and previous studies also contributes to establishing a clearer territory in the field of health crises. ",
doi="10.2196/48491",
url="https://www.jmir.org/2024/1/e48491",
url="http://www.ncbi.nlm.nih.gov/pubmed/38843521"
}


@Article{info:doi/10.2196/49450,
author="Li, Weicong
and Tang, Maggie Liyaning
and Montayre, Jed
and Harris, B. Celia
and West, Sancia
and Antoniou, Mark",
title="Investigating Health and Well-Being Challenges Faced by an Aging Workforce in the Construction and Nursing Industries: Computational Linguistic Analysis of Twitter Data",
journal="J Med Internet Res",
year="2024",
month="Jun",
day="5",
volume="26",
pages="e49450",
keywords="social media",
keywords="construction",
keywords="nursing",
keywords="aging",
keywords="health and well-being",
keywords="Twitter",
abstract="Background: Construction and nursing are critical industries. Although both careers involve physically and mentally demanding work, the risks to workers during the COVID-19 pandemic are not well understood. Nurses (both younger and older) are more likely to experience the ill effects of burnout and stress than construction workers, likely due to accelerated work demands and increased pressure on nurses during the COVID-19 pandemic. In this study, we analyzed a large social media data set using advanced natural language processing techniques to explore indicators of the mental status of workers across both industries before and during the COVID-19 pandemic. Objective: This social media analysis aims to fill a knowledge gap by comparing the tweets of younger and older construction workers and nurses to obtain insights into any potential risks to their mental health due to work health and safety issues. Methods: We analyzed 1,505,638 tweets published on Twitter (subsequently rebranded as X) by younger and older (aged <45 vs >45 years) construction workers and nurses. The study period spanned 54 months, from January 2018 to June 2022, which equates to approximately 27 months before and 27 months after the World Health Organization declared COVID-19 a global pandemic on March 11, 2020. The tweets were analyzed using big data analytics and computational linguistic analyses. Results: Text analyses revealed that nurses made greater use of hashtags and keywords (both monograms and bigrams) associated with burnout, health issues, and mental health compared to construction workers. The COVID-19 pandemic had a pronounced effect on nurses' tweets, and this was especially noticeable in younger nurses. Tweets about health and well-being contained more first-person singular pronouns and affect words, and health-related tweets contained more affect words. Sentiment analyses revealed that, overall, nurses had a higher proportion of positive sentiment in their tweets than construction workers. However, this changed markedly during the COVID-19 pandemic. Since early 2020, sentiment switched, and negative sentiment dominated the tweets of nurses. No such crossover was observed in the tweets of construction workers. Conclusions: The social media analysis revealed that younger nurses had language use patterns consistent with someone experiencing the ill effects of burnout and stress. Older construction workers had more negative sentiments than younger workers, who were more focused on communicating about social and recreational activities rather than work matters. More broadly, these findings demonstrate the utility of large data sets enabled by social media to understand the well-being of target populations, especially during times of rapid societal change. ",
doi="10.2196/49450",
url="https://www.jmir.org/2024/1/e49450",
url="http://www.ncbi.nlm.nih.gov/pubmed/38838308"
}


@Article{info:doi/10.2196/51418,
author="Roberts-Lewis, Sarah
and Baxter, Helen
and Mein, Gill
and Quirke-McFarlane, Sophia
and Leggat, J. Fiona
and Garner, Hannah
and Powell, Martha
and White, Sarah
and Bearne, Lindsay",
title="Examining the Effectiveness of Social Media for the Dissemination of Research Evidence for Health and Social Care Practitioners: Systematic Review and Meta-Analysis",
journal="J Med Internet Res",
year="2024",
month="Jun",
day="5",
volume="26",
pages="e51418",
keywords="social media",
keywords="dissemination",
keywords="health care",
keywords="social care",
keywords="research evidence",
keywords="practitioners",
keywords="effectiveness",
keywords="meta-analysis",
keywords="systematic review",
keywords="randomized controlled trial",
keywords="RCT",
abstract="Background: Social media use has potential to facilitate the rapid dissemination of research evidence to busy health and social care practitioners. Objective: This study aims to quantitatively synthesize evidence of the between- and within-group effectiveness of social media for dissemination of research evidence to health and social care practitioners. It also compared effectiveness between different social media platforms, formats, and strategies. Methods: We searched electronic databases for articles in English that were published between January 1, 2010, and January 10, 2023, and that evaluated social media interventions for disseminating research evidence to qualified, postregistration health and social care practitioners in measures of reach, engagement, direct dissemination, or impact. Screening, data extraction, and risk of bias assessments were carried out by at least 2 independent reviewers. Meta-analyses of standardized pooled effects were carried out for between- and within-group effectiveness of social media and comparisons between platforms, formats, and strategies. Certainty of evidence for outcomes was assessed using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) framework. Results: In total, 50 mixed-quality articles that were heterogeneous in design and outcome were included (n=9, 18\% were randomized controlled trials [RCTs]). Reach (measured in number of practitioners, impressions, or post views) was reported in 26 studies. Engagement (measured in likes or post interactions) was evaluated in 21 studies. Direct dissemination (measured in link clicks, article views, downloads, or altmetric attention score) was analyzed in 23 studies (8 RCTs). Impact (measured in citations or measures of thinking and practice) was reported in 13 studies. Included studies almost universally indicated effects in favor of social media interventions, although effect sizes varied. Cumulative evidence indicated moderate certainty of large and moderate between-group effects of social media interventions on direct dissemination (standardized mean difference [SMD] 0.88; P=.02) and impact (SMD 0.76; P<.001). After social media interventions, cumulative evidence showed moderate certainty of large within-group effects on reach (SMD 1.99; P<.001), engagement (SMD 3.74; P<.001), and direct dissemination (SMD 0.82; P=.004) and low certainty of a small within-group effect on impacting thinking or practice (SMD 0.45; P=.02). There was also evidence for the effectiveness of using multiple social media platforms (including Twitter, subsequently rebranded X; and Facebook), images (particularly infographics), and intensive social media strategies with frequent, daily posts and involving influential others. No included studies tested the dissemination of research evidence to social care practitioners. Conclusions: Social media was effective for disseminating research evidence to health care practitioners. More intense social media campaigns using specific platforms, formats, and strategies may be more effective than less intense interventions. Implications include recommendations for effective dissemination of research evidence to health care practitioners and further RCTs in this field, particularly investigating the dissemination of social care research. Trial Registration: PROSPERO International Prospective Register of Systematic Reviews CRD42022378793; https://www.crd.york.ac.uk/prospero/display\_record.php?RecordID=378793 International Registered Report Identifier (IRRID): RR2-10.2196/45684 ",
doi="10.2196/51418",
url="https://www.jmir.org/2024/1/e51418",
url="http://www.ncbi.nlm.nih.gov/pubmed/38838330"
}


@Article{info:doi/10.2196/56899,
author="Nickel, Brooke
and Heiss, Raffael
and Shih, Patti
and Gram, Grundtvig Emma
and Copp, Tessa
and Taba, Melody
and Moynihan, Ray
and Zadro, Joshua",
title="Social Media Promotion of Health Tests With Potential for Overdiagnosis or Overuse: Protocol for a Content Analysis",
journal="JMIR Res Protoc",
year="2024",
month="Jun",
day="4",
volume="13",
pages="e56899",
keywords="social media",
keywords="influencers",
keywords="tests",
keywords="overdiagnosis",
keywords="overuse",
keywords="evidence-based medicine",
keywords="promotion",
abstract="Background: In recent years, social media have emerged as important spaces for commercial marketing of health tests, which can be used for the screening and diagnosis of otherwise generally healthy people. However, little is known about how health tests are promoted on social media, whether the information provided is accurate and balanced, and if there is transparency around conflicts of interest. Objective: This study aims to understand and quantify how social media is being used to discuss or promote health tests with the potential for overdiagnosis or overuse to generally healthy people. Methods: Content analysis of social media posts on the anti-Mullerian hormone test, whole-body magnetic resonance imaging scan, multicancer early detection, testosterone test, and gut microbe test from influential international social media accounts on Instagram and TikTok. The 5 tests have been identified as having the following criteria: (1) there are evidence-based concerns about overdiagnosis or overuse, (2) there is evidence or concerns that the results of tests do not lead to improved health outcomes for generally healthy people and may cause harm or waste, and (3) the tests are being promoted on social media to generally healthy people. English language text-only posts, images, infographics, articles, recorded videos including reels, and audio-only posts are included. Posts from accounts with <1000 followers as well as stories, live videos, and non-English posts are excluded. Using keywords related to the test, the top posts were searched and screened until there were 100 eligible posts from each platform for each test (total of 1000 posts). Data from the caption, video, and on-screen text are being summarized and extracted into a Microsoft Excel (Microsoft Corporation) spreadsheet and included in the analysis. The analysis will take a combined inductive approach when generating key themes and a deductive approach using a prespecified framework. Quantitative data will be analyzed in Stata SE (version 18.0; Stata Corp). Results: Data on Instagram and TikTok have been searched and screened. Analysis has now commenced. The findings will be disseminated via publications in peer-reviewed international medical journals and will also be presented at national and international conferences in late 2024 and 2025. Conclusions: This study will contribute to the limited evidence base on the nature of the relationship between social media and the problems of overdiagnosis and overuse of health care services. This understanding is essential to develop strategies to mitigate potential harm and plan solutions, with the aim of helping to protect members of the public from being marketed low-value tests, becoming patients unnecessarily, and taking resources away from genuine needs within the health system. International Registered Report Identifier (IRRID): DERR1-10.2196/56899 ",
doi="10.2196/56899",
url="https://www.researchprotocols.org/2024/1/e56899",
url="http://www.ncbi.nlm.nih.gov/pubmed/38833693"
}


@Article{info:doi/10.2196/44443,
author="Weng, Huiqin Janice
and Hu, Yanyan
and Heaukulani, Creighton
and Tan, Clarence
and Chang, Kuiyu Julian
and Phang, Sheng Ye
and Rajendram, Priyanka
and Tan, Mooi Weng
and Loke, Chiong Wai
and Morris, T. Robert J.",
title="Mental Wellness Self-Care in Singapore With mindline.sg: A Tutorial on the Development of a Digital Mental Health Platform for Behavior Change",
journal="J Med Internet Res",
year="2024",
month="Jun",
day="4",
volume="26",
pages="e44443",
keywords="digital mental health",
keywords="artificial intelligence",
keywords="AI",
keywords="AI chatbot",
keywords="digital therapeutics",
keywords="mental health",
keywords="mental wellness",
keywords="mobile phone",
abstract="Background: Singapore, like the rest of Asia, faces persistent challenges to mental health promotion, including stigma around unwellness and seeking treatment and a lack of trained mental health personnel. The COVID-19 pandemic, which created a surge in mental health care needs and simultaneously accelerated the adoption of digital health solutions, revealed a new opportunity to quickly scale innovative solutions in the region. Objective: In June 2020, the Singaporean government launched mindline.sg, an anonymous digital mental health resource website that has grown to include >500 curated local mental health resources, a clinically validated self-assessment tool for depression and anxiety, an artificial intelligence (AI) chatbot from Wysa designed to deliver digital therapeutic exercises, and a tailored version of the website for working adults called mindline at work. The goal of the platform is to empower Singapore residents to take charge of their own mental health and to be able to offer basic support to those around them through the ease and convenience of a barrier-free digital solution. Methods: Website use is measured through click-level data analytics captured via Google Analytics and custom application programming interfaces, which in turn drive a customized analytics infrastructure based on the open-source platforms Titanium Database and Metabase. Unique, nonbounced (users that do not immediately navigate away from the site), engaged, and return users are reported. Results: In the 2 years following launch (July 1, 2020, through June 30, 2022), the website received >447,000 visitors (approximately 15\% of the target population of 3 million), 62.02\% (277,727/447,783) of whom explored the site or engaged with resources (referred to as nonbounced visitors); 10.54\% (29,271/277,727) of those nonbounced visitors returned. The most popular features on the platform were the dialogue-based therapeutic exercises delivered by the chatbot and the self-assessment tool, which were used by 25.54\% (67,626/264,758) and 11.69\% (32,469/277,727) of nonbounced visitors. On mindline at work, the rates of nonbounced visitors who engaged extensively (ie, spent ?40 seconds exploring resources) and who returned were 51.56\% (22,474/43,588) and 13.43\% (5,853/43,588) over a year, respectively, compared to 30.9\% (42,829/138,626) and 9.97\% (13,822/138,626), respectively, on the generic mindline.sg site in the same year. Conclusions: The site has achieved desired reach and has seen a strong growth rate in the number of visitors, which required substantial and sustained digital marketing campaigns and strategic outreach partnerships. The site was careful to preserve anonymity, limiting the detail of analytics. The good levels of overall adoption encourage us to believe that mild to moderate mental health conditions and the social factors that underly them are amenable to digital interventions. While mindline.sg was primarily used in Singapore, we believe that similar solutions with local customization are widely and globally applicable. ",
doi="10.2196/44443",
url="https://www.jmir.org/2024/1/e44443",
url="http://www.ncbi.nlm.nih.gov/pubmed/38833294"
}


@Article{info:doi/10.2196/51530,
author="Kumarasamy, Vithusa
and Goodfellow, Nicole
and Ferron, Mae Era
and Wright, L. Amy",
title="Evaluating the Problem of Fraudulent Participants in Health Care Research: Multimethod Pilot Study",
journal="JMIR Form Res",
year="2024",
month="Jun",
day="4",
volume="8",
pages="e51530",
keywords="fraudulent participants",
keywords="threats to data integrity",
keywords="online recruitment",
keywords="multimethod study",
keywords="health care research",
keywords="bots",
keywords="social media",
abstract="Background: The shift toward online recruitment methods, accelerated by the COVID-19 pandemic, has brought to the forefront the growing concern of encountering fraudulent participants in health care research. The increasing prevalence of this issue poses a serious threat to the reliability and integrity of research data and subsequent findings. Objective: This study aims to explore the experiences of health care researchers (HCRs) who have encountered fraudulent participants while using online recruitment methods and platforms. The primary objective was to gain insights into how researchers detect and mitigate fraudulent behavior in their work and provide prevention recommendations. Methods: A multimethod sequential design was used for this pilot study, comprising a quantitative arm involving a web-based survey followed by a qualitative arm featuring semistructured interviews. The qualitative description approach framed the qualitative arm of the study. Sample sizes for the quantitative and qualitative arms were based on pragmatic considerations that in part stemmed from encountering fraudulent participants in a concurrent study. Content analysis was used to analyze open-ended survey questions and interview data. Results: A total of 37 HCRs participated, with 35\% (13/37) of them engaging in qualitative interviews. Online platforms such as Facebook, email, Twitter (subsequently rebranded X), and newsletters were the most used methods for recruitment. A total of 84\% (31/37) of participants indicated that fraudulent participation occurred in studies that mentioned incentives in their recruitment communications, with 71\% (26/37) of HCRs offering physical or electronic gift cards as incentives. Researchers identified several indicators of suspicious behavior, including email surges, discrepancies in contact or personal information, geographical inconsistencies, and suspicious responses to survey questions. HCRs emphasized the need for a comprehensive screening protocol that extends beyond eligibility checks and is seamlessly integrated into the study protocol, grant applications, and research ethics board submissions. Conclusions: This study sheds light on the intricate and pervasive problem of fraudulent participation in health care research using online recruitment methods. The findings underscore the importance of vigilance and proactivity among HCRs in identifying, preventing, and addressing fraudulent behavior. To effectively tackle this challenge, researchers are encouraged to develop a comprehensive prevention strategy and establish a community of practice, facilitating real-time access to solutions and support and the promotion of ethical research practices. This collaborative approach will enable researchers to effectively address the issue of fraudulent participation, ensuring the conduct of high-quality and ethically sound research in the digital age. ",
doi="10.2196/51530",
url="https://formative.jmir.org/2024/1/e51530",
url="http://www.ncbi.nlm.nih.gov/pubmed/38833292"
}


@Article{info:doi/10.2196/56919,
author="Ma, Yanan
and Law, Kate
and Hassan, Lamiece
and Nenadic, Goran
and van der Veer, N. Sabine",
title="Experiences and Views of Young People and Health Care Professionals of Using Social Media to Self-Manage Type 1 Diabetes Mellitus: Thematic Synthesis of Qualitative Studies",
journal="JMIR Pediatr Parent",
year="2024",
month="May",
day="29",
volume="7",
pages="e56919",
keywords="adolescents",
keywords="health care professionals",
keywords="social media",
keywords="thematic synthesis",
keywords="type 1 diabetes",
keywords="type 1 diabetes mellitus",
keywords="T1DM",
keywords="young people",
abstract="Background: Social media have shown the potential to support type 1 diabetes self-management by providing informational, emotional, and peer-to-peer support. However, the perceptions of young people and health care professionals' (HCPs) toward the use of social media for type 1 diabetes self-management have not been systematically reviewed. Objective: The aim of this study is to explore and summarize the experiences and views of young people with type 1 diabetes and their HCPs on using social media for self-management across qualitative findings. Methods: We searched MEDLINE, Embase, PsycINFO, and CINAHL from 2012 to 2023 using Medical Subject Heading terms and text words related to type 1 diabetes and social media. We screened and selected the studies according to the inclusion and exclusion criteria. We quality appraised and characterized the included studies and conducted a thematic synthesis. Results: We included 11 studies in our synthesis. A total of 9 of them were qualitative and 2 were mixed methods studies. Ten focused on young people with type 1 diabetes and 1 on HCPs. All used content analysis and were of moderate to high quality. Thirteen descriptive themes were yielded by our thematic synthesis, contributing to five analytic themes: (1) differences in how young people interact with social media, (2) characteristics of social media platforms that influence their use and uptake for type 1 diabetes self-management, (3) social media as a source of information, (4) impact on young people's coping and emotional well-being, and (5) impact on support from and relationships with HCPs and services. Conclusions: The synthesis suggests that we should consider leveraging social media's peer support capabilities to augment the traditional services for young people with type 1 diabetes. However, the patients may have privacy concerns about HCPs' involvement in their online activities. This warrants an update of existing guidelines to help young people use social media safely for self-managing their diabetes. ",
doi="10.2196/56919",
url="https://pediatrics.jmir.org/2024/1/e56919",
url="http://www.ncbi.nlm.nih.gov/pubmed/38809591"
}


@Article{info:doi/10.2196/45561,
author="Sapre, Manali
and Elaiho, R. Cordelia
and Brar Prayaga, Rena
and Prayaga, Ram
and Constable, Jeremy
and Vangeepuram, Nita",
title="The Development of a Text Messaging Platform to Enhance a Youth Diabetes Prevention Program: Observational Process Study",
journal="JMIR Form Res",
year="2024",
month="May",
day="29",
volume="8",
pages="e45561",
keywords="community-based participatory research",
keywords="youth",
keywords="diabetes prevention",
keywords="peer education",
keywords="mobile health technology",
keywords="SMS text messaging",
keywords="mobile phone",
keywords="artificial intelligence",
keywords="AI",
abstract="Background: Approximately 1 in 5 adolescents in the United States has prediabetes, and racially and ethnically minoritized youths are disproportionately impacted. Unfortunately, there are few effective youth diabetes prevention programs, and in-person interventions are challenging because of barriers to access and engagement. Objective: We aimed to develop and assess the preliminary feasibility and acceptability of a youth-informed SMS text messaging platform to provide additional support and motivation to adolescents with prediabetes participating in a diabetes prevention workshop in East Harlem, New York City, New York, United States. We collaborated with our youth action board and a technology partner (mPulse Mobile) to develop and pilot-test the novel interactive platform. Methods: The technology subcommittee of our community action board (comprising youths and young adults) used the results from focus groups that we had previously conducted with youths from our community to develop 5 message types focused on healthy eating and active living: goal setting, behavior tracking, individually tailored guidance, motivational messages, and photo diary. We used an iterative process to develop and pilot the program with our internal study team, including youths from our community action board and mPulse Mobile developers. We then conducted a pilot of the 12-week SMS text messaging program with 13 youths with prediabetes. Results: Participants (aged 15-21 years; 10/13, 77\% female; 3/10, 23\% Black and 10/13, 77\% Hispanic or Latinx) received an average of 2 automated messages per day. The system correctly sent 84\% (2231/2656) of the messages at the time intended; the remaining 16\% (425/2656) of the messages were either sent at the incorrect time, or the system did not recognize a participant response to provide the appropriate reply. The level of engagement with the program ranged from 1 (little to no response) to 5 (highly responsive) based on how frequently participants responded to the interactive (2-way) messages. Highly responsive participants (6/13, 46\%) responded >75\% (1154/1538) of the time to interactive messages sent over 12 weeks, and 69\% (9/13) of the participants were still engaged with the program at week 12. During a focus group conducted after program completion, the participants remarked that the message frequency was appropriate, and those who had participated in our in-person workshops reflected that the messages were reminiscent of the workshop content. Participants rated goal setting, behavior tracking, and tailored messages most highly and informed planned adaptations to the platform. Participants described the program as: ``interactive, informative, enjoyable, very convenient, reliable, motivational, productive, and reflective.'' Conclusions: We partnered with youths in the initial content development and pilot testing of a novel SMS text messaging platform to support diabetes prevention. This study is unique in the triple partnership we formed among researchers, technology experts, and diverse youths to develop a mobile health platform to address diabetes-related disparities. ",
doi="10.2196/45561",
url="https://formative.jmir.org/2024/1/e45561",
url="http://www.ncbi.nlm.nih.gov/pubmed/38809599"
}


@Article{info:doi/10.2196/54023,
author="Hakariya, Hayase
and Yokoyama, Natsuki
and Lee, Jeonse
and Hakariya, Arisa
and Ikejiri, Tatsuki",
title="Illicit Trade of Prescription Medications Through X (Formerly Twitter) in Japan: Cross-Sectional Study",
journal="JMIR Form Res",
year="2024",
month="May",
day="28",
volume="8",
pages="e54023",
keywords="illegal trading",
keywords="pharmacovigilance",
keywords="social networking service",
keywords="SNS",
keywords="overdose",
keywords="social support",
keywords="antipsychotics",
keywords="Japan",
keywords="prescription medication",
keywords="cross-sectional study",
keywords="prescription drug",
keywords="social networking",
keywords="medication",
keywords="pharmaceutical",
keywords="pharmaceutical drugs",
keywords="Japanese",
keywords="psychiatric",
keywords="support",
abstract="Background: Nonmedical use of prescription drugs can cause overdose; this represents a serious public health crisis globally. In this digital era, social networking services serve as viable platforms for illegal acquisition of excessive amounts of medications, including prescription medications. In Japan, such illegal drug transactions have been conducted through popular flea market applications, social media, and auction websites, with most of the trades being over-the-counter (OTC) medications. Recently, an emerging unique black market, where individuals trade prescription medications---predominantly nervous system drugs---using a specific keyword (``Okusuri Mogu Mogu''), has emerged on X (formerly Twitter). Hence, these dynamic methods of illicit trading should routinely be monitored to encourage the appropriate use of medications. Objective: This study aimed to specify the characteristics of medications traded on X using the search term ``Okusuri Mogu Mogu'' and analyze individual behaviors associated with X posts, including the types of medications traded and hashtag usage. Methods: We conducted a cross-sectional study with publicly available posts on X between September 18 and October 1, 2022. Posts that included the term ``Okusuri Mogu Mogu'' during this period were scrutinized. Posts were categorized on the basis of their contents: buying, selling, self-administration, heads-up, and others. Among posts categorized as buying, selling, and self-administration, medication names were systematically enumerated and categorized using the Anatomical Therapeutic Chemical (ATC) classification. Additionally, hashtags in all the analyzed posts were counted and classified into 6 categories: medication name, mental disorder, self-harm, buying and selling, community formation, and others. Results: Out of 961 identified posts, 549 were included for analysis. Of these posts, 119 (21.7\%) referenced self-administration, and 237 (43.2\%; buying: n=67, 12.2\%; selling: n=170, 31.0\%) referenced transactions. Among these 237 posts, 1041 medication names were mentioned, exhibiting a >5-fold increase from the study in March 2021. Categorization based on the ATC classification predominantly revealed nervous system drugs, representing 82.1\% (n=855) of the mentioned medications, consistent with the previous survey. Of note, the diversity of medications has expanded to include medications that have not been approved by the Japanese government. Interestingly, OTC medications were frequently mentioned in self-administration posts (odds ratio 23.6, 95\% CI 6.93-80.15). Analysis of hashtags (n=866) revealed efforts to foster community connections among users. Conclusions: This study highlighted the escalating complexity of trading of illegal prescription medication facilitated by X posts. Regulatory measures to enhance public awareness should be considered to prevent illegal transactions, which may ultimately lead to misuse or abuse such as overdose. Along with such pharmacovigilance measures, social approaches that could direct individuals to appropriate medical or psychiatric resources would also be beneficial as our hashtag analysis shed light on the formation of a cohesive or closed community among users. ",
doi="10.2196/54023",
url="https://formative.jmir.org/2024/1/e54023",
url="http://www.ncbi.nlm.nih.gov/pubmed/38805262"
}


@Article{info:doi/10.2196/51991,
author="Sun, Yehao
and Prabhu, Prital
and Rahman, Ryan
and Li, Dongmei
and McIntosh, Scott
and Rahman, Irfan",
title="e-Cigarette Tobacco Flavors, Public Health, and Toxicity: Narrative Review",
journal="Online J Public Health Inform",
year="2024",
month="May",
day="27",
volume="16",
pages="e51991",
keywords="vaping",
keywords="e-cigarettes",
keywords="tobacco flavors",
keywords="toxicity",
keywords="regulation",
keywords="tobacco",
keywords="public health",
keywords="smoking",
keywords="menthol",
keywords="social media",
keywords="nicotine",
keywords="symptoms",
keywords="symptom",
keywords="risk",
keywords="risks",
keywords="toxicology",
keywords="health risk",
abstract="Background: Recently, the US Food and Drug Administration implemented enforcement priorities against all flavored, cartridge-based e-cigarettes other than menthol and tobacco flavors. This ban undermined the products' appeal to vapers, so e-cigarette manufacturers added flavorants of other attractive flavors into tobacco-flavored e-cigarettes and reestablished appeal. Objective: This review aims to analyze the impact of the addition of other flavorants in tobacco-flavored e-cigarettes on both human and public health issues and to propose further research as well as potential interventions. Methods: Searches for relevant literature published between 2018 and 2023 were performed. Cited articles about the toxicity of e-cigarette chemicals included those published before 2018, and governmental websites and documents were also included for crucial information. Results: Both the sales of e-cigarettes and posts on social media suggested that the manufacturers' strategy was successful. The reestablished appeal causes not only a public health issue but also threats to the health of individual vapers. Research has shown an increase in toxicity associated with the flavorants commonly used in flavored e-cigarettes, which are likely added to tobacco-flavored e-cigarettes based on tobacco-derived and synthetic tobacco-free nicotine, and these other flavors are associated with higher clinical symptoms not often induced solely by natural, traditional tobacco flavors. Conclusions: The additional health risks posed by the flavorants are pronounced even without considering the toxicological interactions of the different tobacco flavorants, and more research should be done to understand the health risks thoroughly and to take proper actions accordingly for the regulation of these emerging products. ",
doi="10.2196/51991",
url="https://ojphi.jmir.org/2024/1/e51991",
url="http://www.ncbi.nlm.nih.gov/pubmed/38801769"
}


@Article{info:doi/10.2196/53810,
author="Timpka, Toomas",
title="Time for Medicine and Public Health to Leave Platform X",
journal="JMIR Med Educ",
year="2024",
month="May",
day="24",
volume="10",
pages="e53810",
keywords="internet",
keywords="social media",
keywords="medical informatics",
keywords="knowledge translation",
keywords="digital technology",
keywords="clinical decision support",
keywords="health services research",
keywords="public health",
keywords="digital health",
keywords="perspective",
keywords="medicine",
doi="10.2196/53810",
url="https://mededu.jmir.org/2024/1/e53810"
}


@Article{info:doi/10.2196/51977,
author="Li, Xiancheng
and Gill, Aneet
and Panzarasa, Pietro
and Bestwick, Jonathan
and Schrag, Anette
and Noyce, Alastair
and De Simoni, Anna",
title="Web Application to Enable Online Social Interactions in a Parkinson Disease Risk Cohort: Feasibility Study and Social Network Analysis",
journal="JMIR Form Res",
year="2024",
month="May",
day="24",
volume="8",
pages="e51977",
keywords="pilot studies",
keywords="network analysis",
keywords="Parkinson disease",
keywords="risk factors",
keywords="risk",
keywords="risk cohort",
keywords="social interaction",
keywords="development",
keywords="neurodegenerative disease",
keywords="neurodegenerative",
keywords="United Kingdom",
keywords="feasibility",
keywords="design",
keywords="pilot",
keywords="engagement",
keywords="users",
keywords="online forum",
keywords="online network",
keywords="online",
keywords="regression analysis",
abstract="Background: There is evidence that social interaction has an inverse association with the development of neurodegenerative diseases. PREDICT-Parkinson Disease (PREDICT-PD) is an online UK cohort study that stratifies participants for risk of future Parkinson disease (PD). Objective: This study aims to explore the methodological approach and feasibility of assessing the digital social characteristics of people at risk of developing PD and their social capital within the PREDICT-PD platform, making hypotheses about the relationship between web-based social engagement and potential predictive risk indicators of PD. Methods: A web-based application was built to enable social interaction through the PREDICT-PD portal. Feedback from existing members of the cohort was sought and informed the design of the pilot. Dedicated staff used weekly engagement activities, consisting of PD-related research, facts, and queries, to stimulate discussion. Data were collected by the hosting platform. We examined the pattern of connections generated over time through the cumulative number of posts and replies and ego networks using social network analysis. We used network metrics to describe the bonding, bridging, and linking of social capital among participants on the platform. Relevant demographic data and Parkinson risk scores (expressed as an odd 1:x) were analyzed using descriptive statistics. Regression analysis was conducted to estimate the relationship between risk scores (after log transformation) and network measures. Results: Overall, 219 participants took part in a 4-month pilot forum embedded in the study website. In it, 200 people (n=80, 40\% male and n=113, 57\% female) connected in a large group, where most pairs of users could reach one another either directly or indirectly through other users. A total of 59\% (20/34) of discussions were spontaneously started by participants. Participation was asynchronous, with some individuals acting as ``brokers'' between groups of discussions. As more participants joined the forum and connected to one another through online posts, distinct groups of connected users started to emerge. This pilot showed that a forum application within the cohort web platform was feasible and acceptable and fostered digital social interaction. Matching participants' web-based social engagement with previously collected data at individual level in the PREDICT-PD study was feasible, showing potential for future analyses correlating online network characteristics with the risk of PD over time, as well as testing digital social engagement as an intervention to modify the risk of developing neurodegenerative diseases. Conclusions: The results from the pilot suggest that an online forum can serve as an intervention to enhance social connectedness and investigate whether patterns of online engagement can impact the risk of developing PD through long-term follow-up. This highlights the potential of leveraging online platforms to study the role of social capital in moderating PD risk and underscores the feasibility of such approaches in future research or interventions. ",
doi="10.2196/51977",
url="https://formative.jmir.org/2024/1/e51977",
url="http://www.ncbi.nlm.nih.gov/pubmed/38788211"
}


@Article{info:doi/10.2196/52185,
author="Lin, Chien-Chung
and Shen, Jian-Hong
and Chen, Shu-Fang
and Chen, Hung-Ming
and Huang, Hung-Meng",
title="Developing a Cost-Effective Surgical Scheduling System Applying Lean Thinking and Toyota's Methods for Surgery-Related Big Data for Improved Data Use in Hospitals: User-Centered Design Approach",
journal="JMIR Form Res",
year="2024",
month="May",
day="24",
volume="8",
pages="e52185",
keywords="algorithm",
keywords="process",
keywords="computational thinking",
keywords="continuous improvement",
keywords="customer needs",
keywords="lean principles",
keywords="problem solving",
keywords="Toyota Production System",
keywords="value stream map",
keywords="need",
keywords="needs",
keywords="operating room",
abstract="Background: Surgical scheduling is pivotal in managing daily surgical sequences, impacting patient experience and hospital resources significantly. With operating rooms costing approximately US \$36 per minute, efficient scheduling is vital. However, global practices in surgical scheduling vary, largely due to challenges in predicting individual surgeon times for diverse patient conditions. Inspired by the Toyota Production System's efficiency in addressing similar logistical challenges, we applied its principles as detailed in the book ``Lean Thinking'' by Womack and Jones, which identifies processes that do not meet customer needs as wasteful. This insight is critical in health care, where waste can compromise patient safety and medical quality. Objective: This study aims to use lean thinking and Toyota methods to develop a more efficient surgical scheduling system that better aligns with user needs without additional financial burdens. Methods: We implemented the 5 principles of the Toyota system: specifying value, identifying the value stream, enabling flow, establishing pull, and pursuing perfection. Value was defined in terms of meeting the customer's needs, which in this context involved developing a responsive and efficient scheduling system. Our approach included 2 subsystems: one handling presurgery patient data and another for intraoperative and postoperative data. We identified inefficiencies in the presurgery data subsystem and responded by creating a comprehensive value stream map of the surgical process. We developed 2 Excel (Microsoft Corporation) macros using Visual Basic for Applications. The first calculated average surgery times from intra- or postoperative historic data, while the second estimated surgery durations and generated concise, visually engaging scheduling reports from presurgery data. We assessed the effectiveness of the new system by comparing task completion times and user satisfaction between the old and new systems. Results: The implementation of the revised scheduling system significantly reduced the overall scheduling time from 301 seconds to 261 seconds (P=.02), with significant time reductions in the revised process from 99 seconds to 62 seconds (P<.001). Despite these improvements, approximately 21\% of nurses preferred the older system for its familiarity. The new system protects patient data privacy and streamlines schedule dissemination through a secure LINE group (LY Corp), ensuring seamless flow. The design of the system allows for real-time updates and has been effectively monitoring surgical durations daily for over 3 years. The ``pull'' principle was demonstrated when an unplanned software issue prompted immediate, user-led troubleshooting, enhancing system reliability. Continuous improvement efforts are ongoing, except for the preoperative patient confirmation step, which requires further enhancement to ensure optimal patient safety. Conclusions: Lean principles and Toyota's methods, combined with computer programming, can revitalize surgical scheduling processes. They offer effective solutions for surgical scheduling challenges and enable the creation of a novel surgical scheduling system without incurring additional costs. ",
doi="10.2196/52185",
url="https://formative.jmir.org/2024/1/e52185",
url="http://www.ncbi.nlm.nih.gov/pubmed/38787610"
}


@Article{info:doi/10.2196/53067,
author="Cornell, Samuel
and Peden, E. Amy",
title="Visual ``Scrollytelling'': Mapping Aquatic Selfie-Related Incidents in Australia",
journal="Interact J Med Res",
year="2024",
month="May",
day="23",
volume="13",
pages="e53067",
keywords="selfie",
keywords="map",
keywords="social media",
keywords="selfies",
keywords="scrollama",
keywords="JavaScript",
keywords="scrollytelling",
keywords="Mapbox",
keywords="incidence",
keywords="incidents",
keywords="incident",
keywords="fatality",
keywords="fatalities",
keywords="injury",
keywords="injuries",
keywords="retrieval",
keywords="prevalence",
keywords="image",
keywords="images",
keywords="photo",
keywords="photos",
keywords="photograph",
keywords="photographs",
keywords="Australia",
keywords="emergency",
keywords="visualization",
keywords="visualizations",
keywords="interactive",
keywords="location",
keywords="geography",
keywords="geographic",
keywords="geographical",
keywords="spatial",
keywords="artificial intelligence",
keywords="longitude",
keywords="latitude",
keywords="visual representation",
keywords="visual representations",
doi="10.2196/53067",
url="https://www.i-jmr.org/2024/1/e53067",
url="http://www.ncbi.nlm.nih.gov/pubmed/38781002"
}


@Article{info:doi/10.2196/54663,
author="Kirkpatrick, E. Ciera
and Lawrie, L. LaRissa",
title="TikTok as a Source of Health Information and Misinformation for Young Women in the United States: Survey Study",
journal="JMIR Infodemiology",
year="2024",
month="May",
day="21",
volume="4",
pages="e54663",
keywords="credibility perceptions",
keywords="health information",
keywords="health misinformation",
keywords="information seeking",
keywords="misinformation perceptions",
keywords="public health",
keywords="social media",
keywords="strategic communication",
keywords="third-person effect",
keywords="TikTok",
abstract="Background: TikTok is one of the most-used and fastest-growing social media platforms in the world, and recent reports indicate that it has become an increasingly popular source of news and information in the United States. These trends have important implications for public health because an abundance of health information exists on the platform. Women are among the largest group of TikTok users in the United States and may be especially affected by the dissemination of health information on TikTok. Prior research has shown that women are not only more likely to look for information on the internet but are also more likely to have their health-related behaviors and perceptions affected by their involvement with social media. Objective: We conducted a survey of young women in the United States to better understand their use of TikTok for health information as well as their perceptions of TikTok's health information and health communication sources. Methods: A web-based survey of US women aged 18 to 29 years (N=1172) was conducted in April-May 2023. The sample was recruited from a Qualtrics research panel and 2 public universities in the United States. Results: The results indicate that the majority of young women in the United States who have used TikTok have obtained health information from the platform either intentionally (672/1026, 65.5\%) or unintentionally (948/1026, 92.4\%). Age (959/1026, 93.47\%; r=0.30; P<.001), education (959/1026, 93.47\%; $\rho$=0.10; P=.001), and TikTok intensity (ie, participants' emotional connectedness to TikTok and TikTok's integration into their daily lives; 959/1026, 93.47\%; r=0.32; P<.001) were positively correlated with overall credibility perceptions of the health information. Nearly the entire sample reported that they think that misinformation is prevalent on TikTok to at least some extent (1007/1026, 98.15\%), but a third-person effect was found because the young women reported that they believe that other people are more susceptible to health misinformation on TikTok than they personally are (t1025=21.16; P<.001). Both health professionals and general users were common sources of health information on TikTok: 93.08\% (955/1026) of the participants indicated that they had obtained health information from a health professional, and 93.86\% (963/1026) indicated that they had obtained health information from a general user. The respondents showed greater preference for health information from health professionals (vs general users; t1025=23.75; P<.001); the respondents also reported obtaining health information from health professionals more often than from general users (t1025=8.13; P<.001), and they were more likely to act on health information from health professionals (vs general users; t1025=12.74; P<.001). Conclusions: The findings suggest that health professionals and health communication scholars need to proactively consider using TikTok as a platform for disseminating health information to young women because young women are obtaining health information from TikTok and prefer information from health professionals. ",
doi="10.2196/54663",
url="https://infodemiology.jmir.org/2024/1/e54663",
url="http://www.ncbi.nlm.nih.gov/pubmed/38772020"
}


@Article{info:doi/10.2196/53968,
author="Zhu, Jianfeng
and Jin, Ruoming
and Kenne, R. Deric
and Phan, NhatHai
and Ku, Wei-Shinn",
title="User Dynamics and Thematic Exploration in r/Depression During the COVID-19 Pandemic: Insights From Overlapping r/SuicideWatch Users",
journal="J Med Internet Res",
year="2024",
month="May",
day="20",
volume="26",
pages="e53968",
keywords="reddit",
keywords="natural language processing",
keywords="NLP",
keywords="suicidal ideation",
keywords="SI",
keywords="online communities",
keywords="depression symptoms",
keywords="COVID-19 pandemic",
keywords="bidirectional encoder representations from transformers",
keywords="BERT",
keywords="r/SuicideWatch",
keywords="r/Depression",
abstract="Background: In 2023, the United States experienced its highest- recorded number of suicides, exceeding 50,000 deaths. In the realm of psychiatric disorders, major depressive disorder stands out as the most common issue, affecting 15\% to 17\% of the population and carrying a notable suicide risk of approximately 15\%. However, not everyone with depression has suicidal thoughts. While ``suicidal depression'' is not a clinical diagnosis, it may be observed in daily life, emphasizing the need for awareness. Objective: This study aims to examine the dynamics, emotional tones, and topics discussed in posts within the r/Depression subreddit, with a specific focus on users who had also engaged in the r/SuicideWatch community. The objective was to use natural language processing techniques and models to better understand the complexities of depression among users with potential suicide ideation, with the goal of improving intervention and prevention strategies for suicide. Methods: Archived posts were extracted from the r/Depression and r/SuicideWatch Reddit communities in English spanning from 2019 to 2022, resulting in a final data set of over 150,000 posts contributed by approximately 25,000 unique overlapping users. A broad and comprehensive mix of methods was conducted on these posts, including trend and survival analysis, to explore the dynamic of users in the 2 subreddits. The BERT family of models extracted features from data for sentiment and thematic analysis. Results: On August 16, 2020, the post count in r/SuicideWatch surpassed that of r/Depression. The transition from r/Depression to r/SuicideWatch in 2020 was the shortest, lasting only 26 days. Sadness emerged as the most prevalent emotion among overlapping users in the r/Depression community. In addition, physical activity changes, negative self-view, and suicidal thoughts were identified as the most common depression symptoms, all showing strong positive correlations with the emotion tone of disappointment. Furthermore, the topic ``struggles with depression and motivation in school and work'' (12\%) emerged as the most discussed topic aside from suicidal thoughts, categorizing users based on their inclination toward suicide ideation. Conclusions: Our study underscores the effectiveness of using natural language processing techniques to explore language markers and patterns associated with mental health challenges in online communities like r/Depression and r/SuicideWatch. These insights offer novel perspectives distinct from previous research. In the future, there will be potential for further refinement and optimization of machine classifications using these techniques, which could lead to more effective intervention and prevention strategies. ",
doi="10.2196/53968",
url="https://www.jmir.org/2024/1/e53968",
url="http://www.ncbi.nlm.nih.gov/pubmed/38767953"
}


@Article{info:doi/10.2196/51496,
author="Zhang, Yujie
and Fu, Jiaqi
and Lai, Jie
and Deng, Shisi
and Guo, Zihan
and Zhong, Chuhan
and Tang, Jianyao
and Cao, Wenqiong
and Wu, Yanni",
title="Reporting of Ethical Considerations in Qualitative Research Utilizing Social Media Data on Public Health Care: Scoping Review",
journal="J Med Internet Res",
year="2024",
month="May",
day="17",
volume="26",
pages="e51496",
keywords="qualitative research",
keywords="informed consent",
keywords="ethics approval",
keywords="privacy",
keywords="internet community",
abstract="Background: The internet community has become a significant source for researchers to conduct qualitative studies analyzing users' views, attitudes, and experiences about public health. However, few studies have assessed the ethical issues in qualitative research using social media data. Objective: This study aims to review the reportage of ethical considerations in qualitative research utilizing social media data on public health care. Methods: We performed a scoping review of studies mining text from internet communities and published in peer-reviewed journals from 2010 to May 31, 2023. These studies, limited to the English language, were retrieved to evaluate the rates of reporting ethical approval, informed consent, and privacy issues. We searched 5 databases, that is, PubMed, Web of Science, CINAHL, Cochrane, and Embase. Gray literature was supplemented from Google Scholar and OpenGrey websites. Studies using qualitative methods mining text from the internet community focusing on health care topics were deemed eligible. Data extraction was performed using a standardized data extraction spreadsheet. Findings were reported using PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. Results: After 4674 titles, abstracts, and full texts were screened, 108 studies on mining text from the internet community were included. Nearly half of the studies were published in the United States, with more studies from 2019 to 2022. Only 59.3\% (64/108) of the studies sought ethical approval, 45.3\% (49/108) mentioned informed consent, and only 12.9\% (14/108) of the studies explicitly obtained informed consent. Approximately 86\% (12/14) of the studies that reported informed consent obtained digital informed consent from participants/administrators, while 14\% (2/14) did not describe the method used to obtain informed consent. Notably, 70.3\% (76/108) of the studies contained users' written content or posts: 68\% (52/76) contained verbatim quotes, while 32\% (24/76) paraphrased the quotes to prevent traceability. However, 16\% (4/24) of the studies that paraphrased the quotes did not report the paraphrasing methods. Moreover, 18.5\% (20/108) of the studies used aggregated data analysis to protect users' privacy. Furthermore, the rates of reporting ethical approval were different between different countries (P=.02) and between papers that contained users' written content (both direct and paraphrased quotes) and papers that did not contain users' written content (P<.001). Conclusions: Our scoping review demonstrates that the reporting of ethical considerations is widely neglected in qualitative research studies using social media data; such studies should be more cautious in citing user quotes to maintain user privacy. Further, our review reveals the need for detailed information on the precautions of obtaining informed consent and paraphrasing to reduce the potential bias. A national consensus of ethical considerations such as ethical approval, informed consent, and privacy issues is needed for qualitative research of health care using social media data of internet communities. ",
doi="10.2196/51496",
url="https://www.jmir.org/2024/1/e51496",
url="http://www.ncbi.nlm.nih.gov/pubmed/38758590"
}


@Article{info:doi/10.2196/51332,
author="Zhang, Zhouqing
and Liew, Kongmeng
and Kuijer, Roeline
and She, Jou Wan
and Yada, Shuntaro
and Wakamiya, Shoko
and Aramaki, Eiji",
title="Differing Content and Language Based on Poster-Patient Relationships on the Chinese Social Media Platform Weibo: Text Classification, Sentiment Analysis, and Topic Modeling of Posts on Breast Cancer",
journal="JMIR Cancer",
year="2024",
month="May",
day="9",
volume="10",
pages="e51332",
keywords="cancer",
keywords="social media",
keywords="text classification",
keywords="topic modeling",
keywords="sentiment analysis",
keywords="Weibo",
abstract="Background: Breast cancer affects the lives of not only those diagnosed but also the people around them. Many of those affected share their experiences on social media. However, these narratives may differ according to who the poster is and what their relationship with the patient is; a patient posting about their experiences may post different content from someone whose friends or family has breast cancer. Weibo is 1 of the most popular social media platforms in China, and breast cancer--related posts are frequently found there. Objective: With the goal of understanding the different experiences of those affected by breast cancer in China, we aimed to explore how content and language used in relevant posts differ according to who the poster is and what their relationship with the patient is and whether there are differences in emotional expression and topic content if the patient is the poster themselves or a friend, family member, relative, or acquaintance. Methods: We used Weibo as a resource to examine how posts differ according to the different poster-patient relationships. We collected a total of 10,322 relevant Weibo posts. Using a 2-step analysis method, we fine-tuned 2 Chinese Robustly Optimized Bidirectional Encoder Representations from Transformers (BERT) Pretraining Approach models on this data set with annotated poster-patient relationships. These models were lined in sequence, first a binary classifier (no\_patient or patient) and then a multiclass classifier (post\_user, family\_members, friends\_relatives, acquaintances, heard\_relation), to classify poster-patient relationships. Next, we used the Linguistic Inquiry and Word Count lexicon to conduct sentiment analysis from 5 emotion categories (positive and negative emotions, anger, sadness, and anxiety), followed by topic modeling (BERTopic). Results: Our binary model (F1-score=0.92) and multiclass model (F1-score=0.83) were largely able to classify poster-patient relationships accurately. Subsequent sentiment analysis showed significant differences in emotion categories across all poster-patient relationships. Notably, negative emotions and anger were higher for the ``no\_patient'' class, but sadness and anxiety were higher for the ``family\_members'' class. Focusing on the top 30 topics, we also noted that topics on fears and anger toward cancer were higher in the ``no\_patient'' class, but topics on cancer treatment were higher in the ``family\_members'' class. Conclusions: Chinese users post different types of content, depending on the poster- poster-patient relationships. If the patient is family, posts are sadder and more anxious but also contain more content on treatments. However, if no patient is detected, posts show higher levels of anger. We think that these may stem from rants from posters, which may help with emotion regulation and gathering social support. ",
doi="10.2196/51332",
url="https://cancer.jmir.org/2024/1/e51332",
url="http://www.ncbi.nlm.nih.gov/pubmed/38723250"
}


@Article{info:doi/10.2196/51698,
author="Xue, Jia
and Shier, L. Micheal
and Chen, Junxiang
and Wang, Yirun
and Zheng, Chengda
and Chen, Chen",
title="A Typology of Social Media Use by Human Service Nonprofits: Mixed Methods Study",
journal="J Med Internet Res",
year="2024",
month="May",
day="8",
volume="26",
pages="e51698",
keywords="human service nonprofits",
keywords="sexual assault support centers",
keywords="Canada",
keywords="typology",
keywords="theory",
keywords="Twitter",
keywords="machine learning",
keywords="social media",
keywords="tweet",
keywords="tweets",
keywords="nonprofit",
keywords="nonprofits",
keywords="crisis",
keywords="sexual assault",
keywords="sexual violence",
keywords="sexual abuse",
keywords="support center",
keywords="support centers",
keywords="communication",
keywords="communications",
keywords="organization",
keywords="organizations",
keywords="organizational",
keywords="sentiment analysis",
keywords="business",
keywords="marketing",
abstract="Background: Nonprofit organizations are increasingly using social media to improve their communication strategies with the broader population. However, within the domain of human service nonprofits, there is hesitancy to fully use social media tools, and there is limited scope among organizational personnel in applying their potential beyond self-promotion and service advertisement. There is a pressing need for greater conceptual clarity to support education and training on the varied reasons for using social media to increase organizational outcomes. Objective: This study leverages the potential of Twitter (subsequently rebranded as X [X Corp]) to examine the online communication content within a sample (n=133) of nonprofit sexual assault (SA) centers in Canada. To achieve this, we developed a typology using a qualitative and supervised machine learning model for the automatic classification of tweets posted by these centers. Methods: Using a mixed methods approach that combines machine learning and qualitative analysis, we manually coded 10,809 tweets from 133 SA centers in Canada, spanning the period from March 2009 to March 2023. These manually labeled tweets were used as the training data set for the supervised machine learning process, which allowed us to classify 286,551 organizational tweets. The classification model based on supervised machine learning yielded satisfactory results, prompting the use of unsupervised machine learning to classify the topics within each thematic category and identify latent topics. The qualitative thematic analysis, in combination with topic modeling, provided a contextual understanding of each theme. Sentiment analysis was conducted to reveal the emotions conveyed in the tweets. We conducted validation of the model with 2 independent data sets. Results: Manual annotation of 10,809 tweets identified seven thematic categories: (1) community engagement, (2) organization administration, (3) public awareness, (4) political advocacy, (5) support for others, (6) partnerships, and (7) appreciation. Organization administration was the most frequent segment, and political advocacy and partnerships were the smallest segments. The supervised machine learning model achieved an accuracy of 63.4\% in classifying tweets. The sentiment analysis revealed a prevalence of neutral sentiment across all categories. The emotion analysis indicated that fear was predominant, whereas joy was associated with the partnership and appreciation tweets. Topic modeling identified distinct themes within each category, providing valuable insights into the prevalent discussions surrounding SA and related issues. Conclusions: This research contributes an original theoretical model that sheds light on how human service nonprofits use social media to achieve their online organizational communication objectives across 7 thematic categories. The study advances our comprehension of social media use by nonprofits, presenting a comprehensive typology that captures the diverse communication objectives and contents of these organizations, which provide content to expand training and education for nonprofit leaders to connect and engage with the public, policy experts, other organizations, and potential service users. ",
doi="10.2196/51698",
url="https://www.jmir.org/2024/1/e51698",
url="http://www.ncbi.nlm.nih.gov/pubmed/38718390"
}


@Article{info:doi/10.2196/54433,
author="Yuan, Yunhao
and Kasson, Erin
and Taylor, Jordan
and Cavazos-Rehg, Patricia
and De Choudhury, Munmun
and Aledavood, Talayeh",
title="Examining the Gateway Hypothesis and Mapping Substance Use Pathways on Social Media: Machine Learning Approach",
journal="JMIR Form Res",
year="2024",
month="May",
day="7",
volume="8",
pages="e54433",
keywords="gateway hypothesis",
keywords="substance use",
keywords="social media",
keywords="deep learning",
keywords="natural language processing",
abstract="Background: Substance misuse presents significant global public health challenges. Understanding transitions between substance types and the timing of shifts to polysubstance use is vital to developing effective prevention and recovery strategies. The gateway hypothesis suggests that high-risk substance use is preceded by lower-risk substance use. However, the source of this correlation is hotly contested. While some claim that low-risk substance use causes subsequent, riskier substance use, most people using low-risk substances also do not escalate to higher-risk substances. Social media data hold the potential to shed light on the factors contributing to substance use transitions. Objective: By leveraging social media data, our study aimed to gain a better understanding of substance use pathways. By identifying and analyzing the transitions of individuals between different risk levels of substance use, our goal was to find specific linguistic cues in individuals' social media posts that could indicate escalating or de-escalating patterns in substance use. Methods: We conducted a large-scale analysis using data from Reddit, collected between 2015 and 2019, consisting of over 2.29 million posts and approximately 29.37 million comments by around 1.4 million users from subreddits. These data, derived from substance use subreddits, facilitated the creation of a risk transition data set reflecting the substance use behaviors of over 1.4 million users. We deployed deep learning and machine learning techniques to predict the escalation or de-escalation transitions in risk levels, based on initial transition phases documented in posts and comments. We conducted a linguistic analysis to analyze the language patterns associated with transitions in substance use, emphasizing the role of n-gram features in predicting future risk trajectories. Results: Our results showed promise in predicting the escalation or de-escalation transition in risk levels, based on the historical data of Reddit users created on initial transition phases among drug-related subreddits, with an accuracy of 78.48\% and an F1-score of 79.20\%. We highlighted the vital predictive features, such as specific substance names and tools indicative of future risk escalations. Our linguistic analysis showed that terms linked with harm reduction strategies were instrumental in signaling de-escalation, whereas descriptors of frequent substance use were characteristic of escalating transitions. Conclusions: This study sheds light on the complexities surrounding the gateway hypothesis of substance use through an examination of web-based behavior on Reddit. While certain findings validate the hypothesis, indicating a progression from lower-risk substances such as marijuana to higher-risk ones, a significant number of individuals did not show this transition. The research underscores the potential of using machine learning with social media analysis to predict substance use transitions. Our results point toward future directions for leveraging social media data in substance use research, underlining the importance of continued exploration before suggesting direct implications for interventions. ",
doi="10.2196/54433",
url="https://formative.jmir.org/2024/1/e54433",
url="http://www.ncbi.nlm.nih.gov/pubmed/38713904"
}


@Article{info:doi/10.2196/49262,
author="Larsen, Maria
and Holde, Eirin Gro
and Johnsen, Kolset Jan-Are",
title="Investigating Patient Satisfaction Through Web-Based Reviews of Norwegian Dentists: Quantitative Study Using the Meaning Extraction Method",
journal="J Particip Med",
year="2024",
month="May",
day="3",
volume="16",
pages="e49262",
keywords="internet use",
keywords="Linguistic Inquiry and Word Count",
keywords="LIWC",
keywords="patient satisfaction",
keywords="patient preference",
keywords="challenging encounters",
keywords="preventive dentistry",
keywords="population surveillance",
abstract="Background: Challenging encounters in health care professions, including in dentistry, are relatively common. Challenging encounters can be defined as stressful or emotional situations involving patients that could impact both treatment outcomes and patients' experiences. Through written web-based reviews, patients can share their experiences with health care providers, and these posts can be a useful source for investigating patient satisfaction and their experiences of challenging encounters. Objective: This study aims to identify dominant themes from patient-written, web-based reviews of dentists and investigate how these themes are related to patient satisfaction with dental treatment. Methods: The study data consisted of 11,764 reviews written by dental patients, which included 1- to 5-star ratings on overall satisfaction and free-text comments. The free-text comments were analyzed using Linguistic Inquiry and Word Count software, and the meaning extraction method was used to group words into thematic categories. These themes were used as variables in a multilevel logistic regression analysis to predict patient satisfaction. Results: Eight themes emerged from the analyses, of which 6 (75\%)---explanation (odds ratio [OR] 2.56, 95\% CI 2.16-3.04; P<.001), assurance (OR 3.61, 95\% CI 2.57-5.06; P<.001), performance assessment (OR 2.17, 95\% CI 1.84-2.55; P<.001), professional advice (OR 1.81, 95\% CI 1.55-2.13; P<.001), facilities (OR 1.78, 95\% CI 1.08-2.91; P=.02), and recommendation (OR 1.31, 95\% CI 1.12-1.53; P<.001)---increased the odds of high patient satisfaction. The remaining themes (2/8, 25\%)---consequences of treatment need (OR 0.24, 95\% CI 0.20-0.29; P<.001) and patient-centered care (OR 0.62, 95\% CI 0.52-0.74; P<.001)---reduced the odds of high patient satisfaction. Conclusions: The meaning extraction method is an interesting approach to explore patients' written accounts of encounters with dental health professionals. The experiences described by patients provide insight into key elements related to patient satisfaction that can be used in the education of dental health professionals and to improve the provision of dental health services. ",
doi="10.2196/49262",
url="https://jopm.jmir.org/2024/1/e49262",
url="http://www.ncbi.nlm.nih.gov/pubmed/38700933"
}


@Article{info:doi/10.2196/53646,
author="Glayzer, E. Jennifer
and Bray, C. Bethany
and Kobak, H. William
and Steffen, D. Alana
and Schlaeger, M. Judith",
title="Lack of Diversity in Research on Females with Ehlers-Danlos Syndromes: Recruitment Protocol for a Quantitative Online Survey",
journal="JMIR Res Protoc",
year="2024",
month="May",
day="2",
volume="13",
pages="e53646",
keywords="Ehlers-Danlos syndrome",
keywords="hypermobility",
keywords="social media",
keywords="recruitment",
keywords="Facebook",
keywords="hereditary disease",
keywords="connective tissue disorders",
keywords="racial",
keywords="ethnic",
keywords="diversity",
keywords="challenges",
keywords="strategies",
keywords="strategy",
keywords="online",
keywords="information seeking",
keywords="cross-sectional survey",
keywords="dyspareunia",
keywords="painful sex",
keywords="United States",
abstract="Background: Ehlers-Danlos syndromes (EDS) are a group of connective tissue disorders caused by fragile lax collagen. Current EDS research lacks racial and ethnic diversity. The lack of diversity may be associated with the complexities of conducting a large international study on an underdiagnosed condition and a lack of EDS health care providers who diagnose and conduct research outside of the United States and Europe. Social media may be the key to recruiting a large diverse EDS sample. However, studies that have used social media to recruit have not been able to recruit diverse samples. Objective: This study aims to discuss challenges, strategies, outcomes, and lessons learned from using social media to recruit a large sample of females with EDS. Methods: Recruitment on social media for a cross-sectional survey examining dyspareunia (painful sexual intercourse) in females was examined. Inclusion criteria were (1) older than 18 years of age, (2) assigned female at birth, and (3) diagnosed with EDS. Recruitment took place on Facebook and Twitter (now X), from June 1 to June 25, 2019. Results: A total of 1178 females with EDS were recruited from Facebook (n=1174) and X (n=4). On Facebook, participants were recruited via support groups. A total of 166 EDS support groups were identified, 104 permitted the principal investigator to join, 90 approved posting, and the survey was posted in 54 groups. Among them, 30 of the support groups posted in were globally focused and not tied to any specific country or region, 21 were for people in the United States, and 3 were for people outside of the United States. Recruitment materials were posted on X with the hashtag \#EDS. A total of 1599 people accessed the survey and 1178 people were eligible and consented. The average age of participants was 38.6 (SD 11.7) years. Participants were predominantly White (n=1063, 93\%) and non-Hispanic (n=1046, 92\%). Participants were recruited from 29 countries, with 900 (79\%) from the United States and 124 (11\%) from Great Britain. Conclusions: Our recruitment method was successful at recruiting a large sample. The sample was predominantly White and from North America and Europe. More research needs to be conducted on how to recruit a diverse sample. Areas to investigate may include connecting with more support groups from outside the United States and Europe, researching which platforms are popular in different countries, and translating study materials into different languages. A larger obstacle to recruiting diverse samples may be the lack of health care providers that diagnose EDS outside the United States and Europe, making the pool of potential participants small. There needs to be more health care providers that diagnose and treat EDS in countries that are predominantly made up of people of color as well as research that specifically focuses on these populations. International Registered Report Identifier (IRRID): RR1-10.2196/53646 ",
doi="10.2196/53646",
url="https://www.researchprotocols.org/2024/1/e53646",
url="http://www.ncbi.nlm.nih.gov/pubmed/38696252"
}


@Article{info:doi/10.2196/48519,
author="Lokala, Usha
and Phukan, Chetia Orchid
and Dastidar, Ghosh Triyasha
and Lamy, Francois
and Daniulaityte, Raminta
and Sheth, Amit",
title="Detecting Substance Use Disorder Using Social Media Data and the Dark Web: Time- and Knowledge-Aware Study",
journal="JMIRx Med",
year="2024",
month="May",
day="1",
volume="5",
pages="e48519",
keywords="opioid",
keywords="substance use",
keywords="substance use disorder",
keywords="social media",
keywords="US",
keywords="opioid crisis",
keywords="mental health",
keywords="substance misuse",
keywords="crypto",
keywords="dark web",
keywords="users",
keywords="user perception",
keywords="fentanyl",
keywords="synthetic opioids",
keywords="United States",
abstract="Background: Opioid and substance misuse has become a widespread problem in the United States, leading to the ``opioid crisis.'' The relationship between substance misuse and mental health has been extensively studied, with one possible relationship being that substance misuse causes poor mental health. However, the lack of evidence on the relationship has resulted in opioids being largely inaccessible through legal means. Objectives: This study aims to analyze social media posts related to substance use and opioids being sold through cryptomarket listings. The study aims to use state-of-the-art deep learning models to generate sentiment and emotion from social media posts to understand users' perceptions of social media. The study also aims to investigate questions such as which synthetic opioids people are optimistic, neutral, or negative about; what kind of drugs induced fear and sorrow; what kind of drugs people love or are thankful about; which drugs people think negatively about; and which opioids cause little to no sentimental reaction. Methods: The study used the drug abuse ontology and state-of-the-art deep learning models, including knowledge-aware Bidirectional Encoder Representations From Transformers--based models, to generate sentiment and emotion from social media posts related to substance use and opioids being sold through cryptomarket listings. The study crawled cryptomarket data and extracted posts for fentanyl, fentanyl analogs, and other novel synthetic opioids. The study performed topic analysis associated with the generated sentiments and emotions to understand which topics correlate with people's responses to various drugs. Additionally, the study analyzed time-aware neural models built on these features while considering historical sentiment and emotional activity of posts related to a drug. Results: The study found that the most effective model performed well (statistically significant, with a macro--F1-score of 82.12 and recall of 83.58) in identifying substance use disorder. The study also found that there were varying levels of sentiment and emotion associated with different synthetic opioids, with some drugs eliciting more positive or negative responses than others. The study identified topics that correlated with people's responses to various drugs, such as pain relief, addiction, and withdrawal symptoms. Conclusions: The study provides insight into users' perceptions of synthetic opioids based on sentiment and emotion expressed in social media posts. The study's findings can be used to inform interventions and policies aimed at reducing substance misuse and addressing the opioid crisis. The study demonstrates the potential of deep learning models for analyzing social media data to gain insights into public health issues. ",
doi="10.2196/48519",
url="https://xmed.jmir.org/2024/1/e48519"
}


@Article{info:doi/10.2196/49608,
author="Ng, Reuben
and Indran, Nicole
and Liu, Luyao",
title="Advocating for Older Adults in the Age of Social Media: Strategies to Achieve Peak Engagement on Twitter",
journal="JMIR Aging",
year="2024",
month="May",
day="1",
volume="7",
pages="e49608",
keywords="age advocacy",
keywords="social media engagement",
keywords="older adults",
keywords="ageism",
keywords="data science",
abstract="Background: Over the last decade, many organizations dedicated to serving the needs and interests of older adults have turned to social media platforms, such as Twitter, subsequently rebranded X, to improve the visibility of age-related issues. However, notwithstanding their growing digital presence and participation, minimal attention has been paid to the use of social media among these advocacy groups. To achieve policy change, advocacy organizations must first be able to engage and mobilize audiences. Objective: Our study aims to elucidate how different tweet features affect the time it takes for posts uploaded by age advocacy organizations to reach peak engagement. Methods: We collated 204,905 tweets from 53 age advocacy organizations posted over a 12-year period. The engagement score of each tweet was calculated by combining well-established metrics, namely likes, retweets, quote tweets, and replies. We ran Cox models with tweet features as predictors and time-to-peak engagement as the outcome. ``Peak engagement'' (event) refers to engagement scores above the 75th percentile, and ``time'' refers to months taken to reach peak engagement per tweet. Results: Approximately 1 in 2 tweets (n=103,068, 50.3\%) had either no hashtags or just 1 hashtag. Around two-thirds (n=131,220, 64\%) of the tweets included a URL. Visual information was highly underused, with most tweets not including GIFs (n=204,202, 99.7\%), videos (n=199,800, 97.5\%), or photos (n=143,844, 70.2\%). Roughly half (n=101,470, 49.5\%) of the tweets contained mentions and 9.3\% (n=19,009) of tweets were replies. Only 4.5\% (n=9285) of tweets were quote tweets. Most tweets were uploaded in the afternoon (n=86,004, 42\%) and on a weekday (n=180,499, 88.1\%). As hypothesized, features associated with peak engagement were the inclusion of visual elements like photos, which increased peak engagement by 3 times (P<.001), and the use of 3 or more hashtags (P<.001). Quote tweets increased engagement by 3 times (P<.001), as compared to regular tweets, controlling for account-level covariates. Tweets from organizations with a higher tweet volume were 40\% less likely to reach peak engagement (P<.001). Conclusions: Social media as a networked platform has the potential to reach users on a global scale and at an exponential speed. Having uncovered the features that are more likely to reach peak engagement on Twitter, our study serves as an invaluable resource for age advocacy organizations in their movement to create a more age-inclusive world. ",
doi="10.2196/49608",
url="https://aging.jmir.org/2024/1/e49608"
}


@Article{info:doi/10.2196/51127,
author="Gaysynsky, Anna
and Senft Everson, Nicole
and Heley, Kathryn
and Chou, Sylvia Wen-Ying",
title="Perceptions of Health Misinformation on Social Media: Cross-Sectional Survey Study",
journal="JMIR Infodemiology",
year="2024",
month="Apr",
day="30",
volume="4",
pages="e51127",
keywords="social media",
keywords="misinformation",
keywords="health communication",
keywords="health literacy",
keywords="patient-provider communication",
abstract="Background: Health misinformation on social media can negatively affect knowledge, attitudes, and behaviors, undermining clinical care and public health efforts. Therefore, it is vital to better understand the public's experience with health misinformation on social media. Objective: The goal of this analysis was to examine perceptions of the social media information environment and identify associations between health misinformation perceptions and health communication behaviors among US adults. Methods: Analyses used data from the 2022 Health Information National Trends Survey (N=6252). Weighted unadjusted proportions described respondents' perceptions of the amount of false or misleading health information on social media (``perceived misinformation amount'') and how difficult it is to discern true from false information on social media (``perceived discernment difficulty''). Weighted multivariable logistic regressions examined (1) associations of sociodemographic characteristics and subjective literacy measures with misinformation perceptions and (2) relationships between misinformation perceptions and health communication behaviors (ie, sharing personal or general health information on social media and using social media information in health decisions or in discussions with health care providers). Results: Over one-third of social media users (35.61\%) perceived high levels of health misinformation, and approximately two-thirds (66.56\%) reported high perceived discernment difficulty. Odds of perceiving high amounts of misinformation were lower among non-Hispanic Black/African American (adjusted odds ratio [aOR] 0.407, 95\% CI 0.282-0.587) and Hispanic (aOR 0.610, 95\% CI 0.449-0.831) individuals compared to White individuals. Those with lower subjective health literacy were less likely to report high perceived misinformation amount (aOR 0.602, 95\% CI 0.374-0.970), whereas those with lower subjective digital literacy were more likely to report high perceived misinformation amount (aOR 1.775, 95\% CI 1.400-2.251). Compared to White individuals, Hispanic individuals had lower odds of reporting high discernment difficulty (aOR 0.620, 95\% CI 0.462-0.831). Those with lower subjective digital literacy (aOR 1.873, 95\% CI 1.478-2.374) or numeracy (aOR 1.465, 95\% CI 1.047-2.049) were more likely to report high discernment difficulty. High perceived misinformation amount was associated with lower odds of sharing general health information on social media (aOR 0.742, 95\% CI 0.568-0.968), using social media information to make health decisions (aOR 0.273, 95\% CI 0.156-0.479), and using social media information in discussions with health care providers (aOR 0.460, 95\% CI 0.323-0.655). High perceived discernment difficulty was associated with higher odds of using social media information in health decisions (aOR 1.724, 95\% CI 1.208-2.460) and health care provider discussions (aOR 1.389, 95\% CI 1.035-1.864). Conclusions: Perceptions of high health misinformation prevalence and discernment difficulty are widespread among social media users, and each has unique associations with sociodemographic characteristics, literacy, and health communication behaviors. These insights can help inform future health communication interventions. ",
doi="10.2196/51127",
url="https://infodemiology.jmir.org/2024/1/e51127",
url="http://www.ncbi.nlm.nih.gov/pubmed/38687591"
}


@Article{info:doi/10.2196/48371,
author="Arena, Sandy
and Adams, Mackenzie
and Burns, Jade",
title="Exploring the Use of Customized Links to Improve Electronic Engagement With Sexual and Reproductive Health Care Among Young African American Male Individuals: Web-Based Survey Study",
journal="JMIR Form Res",
year="2024",
month="Apr",
day="24",
volume="8",
pages="e48371",
keywords="African American",
keywords="engagement",
keywords="men's health",
keywords="recruit",
keywords="recruitment",
keywords="reproductive health",
keywords="sexual behavior",
keywords="sexual health behavior",
keywords="sexual health",
keywords="sexual transmission",
keywords="sexually transmitted",
keywords="social media",
keywords="STIs",
keywords="young adult",
keywords="young adults",
abstract="Background: Research has shown that heterosexual African American male individuals aged 18-24 years have a higher prevalence of sexually transmitted infections (STIs) and are more likely to engage in risky sexual behavior. There is a critical need to promote sexual reproductive health (SRH) services among this population, especially in urban settings. Young African American male individuals use social media platforms to access health information, showcasing the potential of social media and web-based links as tools to leverage electronic engagement with this population to promote SRH care. Objective: This study aims to explore electronic engagement with young African American male individuals in discussions about SRH care. This paper focuses on the recruitment and social media marketing methods used to recruit young, heterosexual African American male individuals aged 18-24 years for the Stay Safe Project, a larger study that aims to promote SRH services among this population in Detroit, Michigan. We investigate the use of TinyURL, a URL shortener and customized tool, and culturally informed social media marketing strategies to promote electronic engagement within this population. Methods: Participants were recruited between December 2021 and February 2022 through various modes, including email listserves, Mailchimp, the UMHealthResearch website, X (formerly Twitter), Facebook, and Instagram. Images and vector graphics of African American male individuals were used to create social media advertisements that directed participants to click on a TinyURL that led to a recruitment survey for the study. Results: TinyURL metrics were used to monitor demographic and user data, analyzing the top countries, browsers, operating systems, and devices of individuals who engaged with the customized TinyURL links and the total human and unique clicks from various social media platforms. Mailchimp was the most successful platform for electronic engagement with human and unique clicks on the custom TinyURL link, followed by Instagram and Facebook. In contrast, X, traditional email, and research recruiting websites had the least engagement among our population. Success was determined based on the type of user and follower for each platform, whether gained in the community through sign-ups or promoted at peak user time and embedded and spotlighted on nontraditional media (eg, social media sites, blogs, and podcasts) for the user. Low engagement (eg, traditional email) from the target population, limited visibility, and fewer followers contributed to decreased engagement. Conclusions: This study provides insight into leveraging customized, shortened URLs, TinyURL metrics, and social media platforms to improve electronic engagement with young African American male individuals seeking information and resources about SRH care. The results of this study have been used to develop a pilot intervention for this population that will contribute to strategies for encouraging sexual well-being, clinic use, and appropriate linkage to SRH care services among young, heterosexual African American male individuals. ",
doi="10.2196/48371",
url="https://formative.jmir.org/2024/1/e48371",
url="http://www.ncbi.nlm.nih.gov/pubmed/38656772"
}


@Article{info:doi/10.2196/54610,
author="Pretorius, Kelly
and Kang, Sookja
and Choi, Eunju",
title="Photos Shared on Facebook in the Context of Safe Sleep Recommendations: Content Analysis of Images",
journal="JMIR Pediatr Parent",
year="2024",
month="Apr",
day="23",
volume="7",
pages="e54610",
keywords="SUID",
keywords="SIDS",
keywords="parenting",
keywords="safe sleep",
keywords="photo analysis",
keywords="pediatric",
keywords="pediatrics",
keywords="paediatric",
keywords="paediatrics",
keywords="infant",
keywords="infants",
keywords="infancy",
keywords="baby",
keywords="babies",
keywords="neonate",
keywords="neonates",
keywords="neonatal",
keywords="newborn",
keywords="newborns",
keywords="sleep",
keywords="safety",
keywords="death",
keywords="mortality",
keywords="social media",
keywords="picture",
keywords="pictures",
keywords="photo",
keywords="photos",
keywords="photographs",
keywords="image",
keywords="images",
keywords="Facebook",
keywords="mother",
keywords="mothers",
keywords="parent",
keywords="co-sleeping",
keywords="sudden infant death",
keywords="sudden unexpected infant death",
keywords="adherence",
keywords="parent education",
keywords="parents' education",
keywords="awareness",
abstract="Background: Sudden unexpected infant death (SUID) remains a leading cause of infant mortality; therefore, understanding parental practices of infant sleep at home is essential. Since social media analyses yield invaluable patient perspectives, understanding sleep practices in the context of safe sleep recommendations via a Facebook mothers' group is instrumental for policy makers, health care providers, and researchers. Objective: This study aimed to identify photos shared by mothers discussing SUID and safe sleep online and assess their consistency with infant sleep guidelines per the American Academy of Pediatrics (AAP). We hypothesized the photos would not be consistent with guidelines based on prior research and increasing rates of accidental suffocation and strangulation in bed. Methods: Data were extracted from a Facebook mothers' group in May 2019. After trialing various search terms, searching for the term ``SIDS'' on the selected Facebook group resulted in the most relevant discussions on SUID and safe sleep. The resulting data, including 20 posts and 912 comments among 512 mothers, were extracted and underwent qualitative descriptive content analysis. In completing the extraction and subsequent analysis, 24 shared personal photos were identified among the discussions. Of the photos, 14 pertained to the infant sleep environment. Photos of the infant sleep environment were then assessed for consistency with safe sleep guidelines per the AAP standards by 2 separate reviewers. Results: Of the shared photos relating to the infant sleep environment, 86\% (12/14) were not consistent with AAP safe sleep guidelines. Specific inconsistencies included prone sleeping, foreign objects in the sleeping environment, and use of infant sleeping devices. Use of infant monitoring devices was also identified. Conclusions: This study is unique because the photos originated from the home setting, were in the context of SUID and safe sleep, and were obtained without researcher interference. Despite study limitations, the commonality of prone sleeping, foreign objects, and the use of both infant sleep and monitoring devices (ie, overall inconsistency regarding AAP safe sleep guidelines) sets the stage for future investigation regarding parental barriers to practicing safe infant sleep and has implications for policy makers, clinicians, and researchers. ",
doi="10.2196/54610",
url="https://pediatrics.jmir.org/2024/1/e54610"
}


@Article{info:doi/10.2196/53373,
author="Haff, L. Priscilla
and Jacobson, Alli
and Taylor, M. Madison
and Schandua, P. Hayden
and Farris, P. David
and Doan, Q. Hung
and Nelson, C. Kelly",
title="The New Media Landscape and Its Effects on Skin Cancer Diagnostics, Prognostics, and Prevention: Scoping Review",
journal="JMIR Dermatol",
year="2024",
month="Apr",
day="8",
volume="7",
pages="e53373",
keywords="social media",
keywords="communication",
keywords="skin cancer",
keywords="melanoma",
keywords="misinformation",
keywords="scoping review",
abstract="Background: The wide availability of web-based sources, including social media (SM), has supported rapid, widespread dissemination of health information. This dissemination can be an asset during public health emergencies; however, it can also present challenges when the information is inaccurate or ill-informed. Of interest, many SM sources discuss cancer, specifically cutaneous melanoma and keratinocyte cancers (basal cell and squamous cell carcinoma). Objective: Through a comprehensive and scoping review of the literature, this study aims to gain an actionable perspective of the state of SM information regarding skin cancer diagnostics, prognostics, and prevention. Methods: We performed a scoping literature review to establish the relationship between SM and skin cancer. A literature search was conducted across MEDLINE, Embase, Cochrane Library, Web of Science, and Scopus from January 2000 to June 2023. The included studies discussed SM and its relationship to and effect on skin cancer. Results: Through the search, 1009 abstracts were initially identified, 188 received full-text review, and 112 met inclusion criteria. The included studies were divided into 7 groupings based on a publication's primary objective: misinformation (n=40, 36\%), prevention campaign (n=19, 17\%), engagement (n=16, 14\%), research (n=12, 11\%), education (n=11, 10\%), demographics (n=10, 9\%), and patient support (n=4, 3\%), which were the most common identified themes. Conclusions: Through this review, we gained a better understanding of the SM environment addressing skin cancer information, and we gained insight into the best practices by which SM could be used to positively influence the health care information ecosystem. ",
doi="10.2196/53373",
url="https://derma.jmir.org/2024/1/e53373",
url="http://www.ncbi.nlm.nih.gov/pubmed/38587890"
}


@Article{info:doi/10.2196/53375,
author="Zhang, M. Jueman
and Wang, Yi
and Mouton, Magali
and Zhang, Jixuan
and Shi, Molu",
title="Public Discourse, User Reactions, and Conspiracy Theories on the X Platform About HIV Vaccines: Data Mining and Content Analysis",
journal="J Med Internet Res",
year="2024",
month="Apr",
day="3",
volume="26",
pages="e53375",
keywords="HIV",
keywords="vaccine",
keywords="Twitter",
keywords="X platform",
keywords="infodemiology",
keywords="machine learning",
keywords="topic modeling",
keywords="sentiment",
keywords="conspiracy theory",
keywords="COVID-19",
abstract="Background: The initiation of clinical trials for messenger RNA (mRNA) HIV vaccines in early 2022 revived public discussion on HIV vaccines after 3 decades of unsuccessful research. These trials followed the success of mRNA technology in COVID-19 vaccines but unfolded amid intense vaccine debates during the COVID-19 pandemic. It is crucial to gain insights into public discourse and reactions about potential new vaccines, and social media platforms such as X (formerly known as Twitter) provide important channels. Objective: Drawing from infodemiology and infoveillance research, this study investigated the patterns of public discourse and message-level drivers of user reactions on X regarding HIV vaccines by analyzing posts using machine learning algorithms. We examined how users used different post types to contribute to topics and valence and how these topics and valence influenced like and repost counts. In addition, the study identified salient aspects of HIV vaccines related to COVID-19 and prominent anti--HIV vaccine conspiracy theories through manual coding. Methods: We collected 36,424 English-language original posts about HIV vaccines on the X platform from January 1, 2022, to December 31, 2022. We used topic modeling and sentiment analysis to uncover latent topics and valence, which were subsequently analyzed across post types in cross-tabulation analyses and integrated into linear regression models to predict user reactions, specifically likes and reposts. Furthermore, we manually coded the 1000 most engaged posts about HIV and COVID-19 to uncover salient aspects of HIV vaccines related to COVID-19 and the 1000 most engaged negative posts to identify prominent anti--HIV vaccine conspiracy theories. Results: Topic modeling revealed 3 topics: HIV and COVID-19, mRNA HIV vaccine trials, and HIV vaccine and immunity. HIV and COVID-19 underscored the connections between HIV vaccines and COVID-19 vaccines, as evidenced by subtopics about their reciprocal impact on development and various comparisons. The overall valence of the posts was marginally positive. Compared to self-composed posts initiating new conversations, there was a higher proportion of HIV and COVID-19--related and negative posts among quote posts and replies, which contribute to existing conversations. The topic of mRNA HIV vaccine trials, most evident in self-composed posts, increased repost counts. Positive valence increased like and repost counts. Prominent anti--HIV vaccine conspiracy theories often falsely linked HIV vaccines to concurrent COVID-19 and other HIV-related events. Conclusions: The results highlight COVID-19 as a significant context for public discourse and reactions regarding HIV vaccines from both positive and negative perspectives. The success of mRNA COVID-19 vaccines shed a positive light on HIV vaccines. However, COVID-19 also situated HIV vaccines in a negative context, as observed in some anti--HIV vaccine conspiracy theories misleadingly connecting HIV vaccines with COVID-19. These findings have implications for public health communication strategies concerning HIV vaccines. ",
doi="10.2196/53375",
url="https://www.jmir.org/2024/1/e53375",
url="http://www.ncbi.nlm.nih.gov/pubmed/38568723"
}


@Article{info:doi/10.2196/49699,
author="Kamba, Masaru
and She, Jou Wan
and Ferawati, Kiki
and Wakamiya, Shoko
and Aramaki, Eiji",
title="Exploring the Impact of the COVID-19 Pandemic on Twitter in Japan: Qualitative Analysis of Disrupted Plans and Consequences",
journal="JMIR Infodemiology",
year="2024",
month="Apr",
day="1",
volume="4",
pages="e49699",
keywords="COVID-19",
keywords="natural language processing",
keywords="NLP",
keywords="Twitter",
keywords="disrupted plans",
keywords="concerns",
abstract="Background: Despite being a pandemic, the impact of the spread of COVID-19 extends beyond public health, influencing areas such as the economy, education, work style, and social relationships. Research studies that document public opinions and estimate the long-term potential impact after the pandemic can be of value to the field. Objective: This study aims to uncover and track concerns in Japan throughout the COVID-19 pandemic by analyzing Japanese individuals' self-disclosure of disruptions to their life plans on social media. This approach offers alternative evidence for identifying concerns that may require further attention for individuals living in Japan. Methods: We extracted 300,778 tweets using the query phrase Corona-no-sei (``due to COVID-19,'' ``because of COVID-19,'' or ``considering COVID-19''), enabling us to identify the activities and life plans disrupted by the pandemic. The correlation between the number of tweets and COVID-19 cases was analyzed, along with an examination of frequently co-occurring words. Results: The top 20 nouns, verbs, and noun plus verb pairs co-occurring with Corona no-sei were extracted. The top 5 keywords were graduation ceremony, cancel, school, work, and event. The top 5 verbs were disappear, go, rest, can go, and end. Our findings indicate that education emerged as the top concern when the Japanese government announced the first state of emergency. We also observed a sudden surge in anxiety about material shortages such as toilet paper. As the pandemic persisted and more states of emergency were declared, we noticed a shift toward long-term concerns, including careers, social relationships, and education. Conclusions: Our study incorporated machine learning techniques for disease monitoring through the use of tweet data, allowing the identification of underlying concerns (eg, disrupted education and work conditions) throughout the 3 stages of Japanese government emergency announcements. The comparison with COVID-19 case numbers provides valuable insights into the short- and long-term societal impacts, emphasizing the importance of considering citizens' perspectives in policy-making and supporting those affected by the pandemic, particularly in the context of Japanese government decision-making. ",
doi="10.2196/49699",
url="https://infodemiology.jmir.org/2024/1/e49699",
url="http://www.ncbi.nlm.nih.gov/pubmed/38557446"
}


@Article{info:doi/10.2196/53666,
author="Zhou, Runtao
and Xie, Zidian
and Tang, Qihang
and Li, Dongmei",
title="Social Network Analysis of e-Cigarette--Related Social Media Influencers on Twitter/X: Observational Study",
journal="JMIR Form Res",
year="2024",
month="Apr",
day="1",
volume="8",
pages="e53666",
keywords="social network",
keywords="social media",
keywords="influencer",
keywords="electronic cigarettes",
keywords="e-cigarette",
keywords="vaping",
keywords="vape",
keywords="Twitter",
keywords="observational study",
keywords="aerosol",
keywords="consumer",
keywords="influencers",
keywords="social network analysis",
keywords="antivaping",
keywords="campaigns",
abstract="Background: An e-cigarette uses a battery to heat a liquid that generates an aerosol for consumers to inhale. e-Cigarette use (vaping) has been associated with respiratory disease, cardiovascular disease, and cognitive functions. Recently, vaping has become increasingly popular, especially among youth and young adults. Objective: The aim of this study was to understand the social networks of Twitter (now rebranded as X) influencers related to e-cigarettes through social network analysis. Methods: Through the Twitter streaming application programming interface, we identified 3,617,766 unique Twitter accounts posting e-cigarette--related tweets from May 3, 2021, to June 10, 2022. Among these, we identified 33 e-cigarette influencers. The followers of these influencers were grouped according to whether or not they post about e-cigarettes themselves; specifically, the former group was defined as having posted at least five e-cigarette--related tweets in the past year, whereas the latter group was defined as followers that had not posted any e-cigarette--related tweets in the past 3 years. We randomly sampled 100 user accounts among each group of e-cigarette influencer followers and created corresponding social networks for each e-cigarette influencer. We compared various network measures (eg, clustering coefficient) between the networks of the two follower groups. Results: Major topics from e-cigarette--related tweets posted by the 33 e-cigarette influencers included advocating against vaping policy (48.0\%), vaping as a method to quit smoking (28.0\%), and vaping product promotion (24.0\%). The follower networks of these 33 influencers showed more connections for those who also post about e-cigarettes than for followers who do not post about e-cigarettes, with significantly higher clustering coefficients for the former group (0.398 vs 0.098; P=.005). Further, networks of followers who post about e-cigarettes exhibited substantially more incoming and outgoing connections than those of followers who do not post about e-cigarettes, with significantly higher in-degree (0.273 vs 0.084; P=.02), closeness (0.452 vs 0.137; P=.04), betweenness (0.036 vs 0.008; P=.001), and out-of-degree (0.097 vs 0.014; P=.02) centrality values. The followers who post about e-cigarettes also had a significantly (P<.001) higher number of followers (n=322) than that of followers who do not post about e-cigarettes (n=201). The number of tweets in the networks of followers who post about e-cigarettes was significantly higher than that in the networks of followers who do not post about e-cigarettes (93 vs 43; P<.001). Two major topics discussed in the networks of followers who post about e-cigarettes included promoting e-cigarette products or vaping activity (55.7\%) and vaping being a help for smoking cessation and harm reduction (44.3\%). Conclusions: Followers of e-cigarette influencers who also post about e-cigarettes have more closely connected networks than those of followers who do not themselves post about e-cigarettes. These findings provide a potentially practical intervention approach for future antivaping campaigns. ",
doi="10.2196/53666",
url="https://formative.jmir.org/2024/1/e53666",
url="http://www.ncbi.nlm.nih.gov/pubmed/38557555"
}


@Article{info:doi/10.2196/49921,
author="Ahmed, Wasim
and Aiyenitaju, Opeoluwa
and Chadwick, Simon
and Hardey, Mariann
and Fenton, Alex",
title="The Influence of Joe Wicks on Physical Activity During the COVID-19 Pandemic: Thematic, Location, and Social Network Analysis of X Data",
journal="J Med Internet Res",
year="2024",
month="Mar",
day="29",
volume="26",
pages="e49921",
keywords="social media",
keywords="social network analysis",
keywords="COVID-19",
keywords="influencers",
keywords="public health",
keywords="social network",
keywords="physical activity",
keywords="promotion",
keywords="fitness",
keywords="exercise",
keywords="workout",
keywords="Twitter",
keywords="content creation",
keywords="communication",
abstract="Background: ?Social media (SM) was essential in promoting physical activity during the COVID-19 pandemic, especially among people confined to their homes. Joe Wicks, a fitness coach, became particularly popular on SM during this time, posting daily workouts that millions of people worldwide followed. Objective: ?This study aims to investigate the influence of Joe Wicks on SM and the impact of his content on physical activity levels among the public. Methods: ?We used NodeXL Pro (Social Media Research Foundation) to collect data from X (formerly Twitter) over 54 days (March 23, 2020, to May 15, 2020), corresponding to the strictest lockdowns in the United Kingdom. We collected 290,649 posts, which we analyzed using social network analysis, thematic analysis, time-series analysis, and location analysis. Results: ?We found that there was significant engagement with content generated by Wicks, including reposts, likes, and comments. The most common types of posts were those that contained images, videos, and text of young people (school-aged children) undertaking physical activity by watching content created by Joe Wicks and posts from schools encouraging pupils to engage with the content. Other shared posts included those that encouraged others to join the fitness classes run by Wicks and those that contained general commentary. We also found that Wicks' network of influence was extensive and complex. It contained numerous subcommunities and resembled a broadcast network shape. Other influencers added to engagement with Wicks via their networks. Our results show that influencers can create networks of influence that are exhibited in distinctive ways. Conclusions: Our study found that Joe Wicks was a highly influential figure on SM during the COVID-19 pandemic and that his content positively impacted physical activity levels among the public. Our findings suggest that influencers can play an important role in promoting public health and that government officials should consider working with influencers to communicate health messages and promote healthy behaviors. Our study has broader implications beyond the status of fitness influencers. Recognizing the critical role of individuals such as Joe Wicks in terms of health capital should be a critical area of inquiry for governments, public health authorities, and policy makers and mirrors the growing interest in health capital as part of embodied and digital experiences in everyday life. ",
doi="10.2196/49921",
url="https://www.jmir.org/2024/1/e49921",
url="http://www.ncbi.nlm.nih.gov/pubmed/38551627"
}


@Article{info:doi/10.2196/48130,
author="Chlabicz, Ma?gorzata
and Nabo?ny, Aleksandra
and Koszelew, Jolanta
and ?aguna, Wojciech
and Szpakowicz, Anna
and Sowa, Pawe?
and Budny, Wojciech
and Guziejko, Katarzyna
and R{\'o}g-Makal, Magdalena
and Pancewicz, S?awomir
and Kondrusik, Maciej
and Czupryna, Piotr
and Cudowska, Beata
and Lebensztejn, Dariusz
and Moniuszko-Malinowska, Anna
and Wierzbicki, Adam
and Kami?ski, A. Karol",
title="Medical Misinformation in Polish on the World Wide Web During the COVID-19 Pandemic Period: Infodemiology Study",
journal="J Med Internet Res",
year="2024",
month="Mar",
day="29",
volume="26",
pages="e48130",
keywords="infodemic",
keywords="fake news",
keywords="information credibility",
keywords="online health information",
keywords="evidence based medicine",
keywords="EBM",
keywords="false",
keywords="credibility",
keywords="credible",
keywords="health information",
keywords="online information",
keywords="information quality",
keywords="infoveillance",
keywords="infodemiology",
keywords="misinformation",
keywords="disinformation",
abstract="Background: Although researchers extensively study the rapid generation and spread of misinformation about the novel coronavirus during the pandemic, numerous other health-related topics are contaminating the internet with misinformation that have not received as much attention. Objective: This study aims to gauge the reach of the most popular medical content on the World Wide Web, extending beyond the confines of the pandemic. We conducted evaluations of subject matter and credibility for the years 2021 and 2022, following the principles of evidence-based medicine with assessments performed by experienced clinicians. Methods: We used 274 keywords to conduct web page searches through the BuzzSumo Enterprise Application. These keywords were chosen based on medical topics derived from surveys administered to medical practitioners. The search parameters were confined to 2 distinct date ranges: (1) January 1, 2021, to December 31, 2021; (2) January 1, 2022, to December 31, 2022. Our searches were specifically limited to web pages in the Polish language and filtered by the specified date ranges. The analysis encompassed 161 web pages retrieved in 2021 and 105 retrieved in 2022. Each web page underwent scrutiny by a seasoned doctor to assess its credibility, aligning with evidence-based medicine standards. Furthermore, we gathered data on social media engagements associated with the web pages, considering platforms such as Facebook, Pinterest, Reddit, and Twitter. Results: In 2022, the prevalence of unreliable information related to COVID-19 saw a noteworthy decline compared to 2021. Specifically, the percentage of noncredible web pages discussing COVID-19 and general vaccinations decreased from 57\% (43/76) to 24\% (6/25) and 42\% (10/25) to 30\% (3/10), respectively. However, during the same period, there was a considerable uptick in the dissemination of untrustworthy content on social media pertaining to other medical topics. The percentage of noncredible web pages covering cholesterol, statins, and cardiology rose from 11\% (3/28) to 26\% (9/35) and from 18\% (5/28) to 26\% (6/23), respectively. Conclusions: Efforts undertaken during the COVID-19 pandemic to curb the dissemination of misinformation seem to have yielded positive results. Nevertheless, our analysis suggests that these interventions need to be consistently implemented across both established and emerging medical subjects. It appears that as interest in the pandemic waned, other topics gained prominence, essentially ``filling the vacuum'' and necessitating ongoing measures to address misinformation across a broader spectrum of health-related subjects. ",
doi="10.2196/48130",
url="https://www.jmir.org/2024/1/e48130",
url="http://www.ncbi.nlm.nih.gov/pubmed/38551638"
}


@Article{info:doi/10.2196/51267,
author="Karadag, Serap Ayse
and Kandi, Basak
and Sanl?, Berna
and Ulusal, Hande
and Basusta, Hasan
and Sener, Seray
and Cal?ka, Sinem",
title="Social Media Use in Dermatology in Turkey: Challenges and Tips for Patient Health",
journal="JMIR Dermatol",
year="2024",
month="Mar",
day="28",
volume="7",
pages="e51267",
keywords="social media",
keywords="dermatology",
keywords="internet",
keywords="health promotion",
keywords="patient education",
keywords="Instagram",
keywords="YouTube",
keywords="online social networking",
keywords="social networking",
keywords="Turkey",
keywords="patient health",
keywords="skin",
keywords="skin disease",
keywords="skincare",
keywords="cosmetics",
keywords="digital communication",
keywords="misinformation",
doi="10.2196/51267",
url="https://derma.jmir.org/2024/1/e51267",
url="http://www.ncbi.nlm.nih.gov/pubmed/38546714"
}


@Article{info:doi/10.2196/51152,
author="Ullah, Nazifa
and Martin, Sam
and Poduval, Shoba",
title="A Snapshot of COVID-19 Vaccine Discourse Related to Ethnic Minority Communities in the United Kingdom Between January and April 2022: Mixed Methods Analysis",
journal="JMIR Form Res",
year="2024",
month="Mar",
day="26",
volume="8",
pages="e51152",
keywords="COVID-19",
keywords="ethnic minorities",
keywords="vaccine",
keywords="hesitancy",
keywords="social media",
keywords="discourse",
keywords="minority groups",
abstract="Background: Existing literature highlights the role of social media as a key source of information for the public during the COVID-19 pandemic and its influence on vaccination attempts. Yet there is little research exploring its role in the public discourse specifically among ethnic minority communities, who have the highest rates of vaccine hesitancy (delay or refusal of vaccination despite availability of services). Objective: This study aims to understand the discourse related to minority communities on social media platforms Twitter and YouTube. Methods: Social media data from the United Kingdom was extracted from Twitter and YouTube using the software Netlytics and YouTube Data Tools to provide a ``snapshot'' of the discourse between January and April 2022. A mixed method approach was used where qualitative data were contextualized into codes. Network analysis was applied to provide insight into the most frequent and weighted keywords and topics of conversations. Results: A total of 260 tweets and 156 comments from 4 YouTube videos were included in our analysis. Our data suggests that the most popular topics of conversation during the period sampled were related to communication strategies adopted during the booster vaccine rollout. These were noted to be divisive in nature and linked to wider conversations around racism and historical mistrust toward institutions. Conclusions: Our study suggests a shift in narrative from concerns about the COVID-19 vaccine itself, toward the strategies used in vaccination implementation, in particular the targeting of ethnic minority groups through vaccination campaigns. The implications for public health communication during crisis management in a pandemic context include acknowledging wider experiences of discrimination when addressing ethnic minority communities. ",
doi="10.2196/51152",
url="https://formative.jmir.org/2024/1/e51152",
url="http://www.ncbi.nlm.nih.gov/pubmed/38530334"
}


@Article{info:doi/10.2196/36441,
author="Freeman, Eric
and Patel, Darshilmukesh
and Odeniyi, Folasade
and Pasquinelli, Mary
and Jain, Shikha",
title="Where Do Oncology Patients Seek and Share Health Information? Survey Study",
journal="J Med Internet Res",
year="2024",
month="Mar",
day="25",
volume="26",
pages="e36441",
keywords="oncology",
keywords="social media",
keywords="patient-physician relationship",
keywords="patient-physician",
keywords="patient-provider",
keywords="cancer",
keywords="information sharing",
keywords="information seeking",
keywords="information behavior",
keywords="technology access",
keywords="digital divide",
doi="10.2196/36441",
url="https://www.jmir.org/2024/1/e36441",
url="http://www.ncbi.nlm.nih.gov/pubmed/38526546"
}


@Article{info:doi/10.2196/47826,
author="Molenaar, Annika
and Lukose, Dickson
and Brennan, Linda
and Jenkins, L. Eva
and McCaffrey, A. Tracy",
title="Using Natural Language Processing to Explore Social Media Opinions on Food Security: Sentiment Analysis and Topic Modeling Study",
journal="J Med Internet Res",
year="2024",
month="Mar",
day="21",
volume="26",
pages="e47826",
keywords="food security",
keywords="food insecurity",
keywords="public health",
keywords="sentiment analysis",
keywords="topic modeling",
keywords="natural language processing",
keywords="infodemiology",
abstract="Background: Social media has the potential to be of great value in understanding patterns in public health using large-scale analysis approaches (eg, data science and natural language processing [NLP]), 2 of which have been used in public health: sentiment analysis and topic modeling; however, their use in the area of food security and public health nutrition is limited. Objective: This study aims to explore the potential use of NLP tools to gather insights from real-world social media data on the public health issue of food security. Methods: A search strategy for obtaining tweets was developed using food security terms. Tweets were collected using the Twitter application programming interface from January 1, 2019, to December 31, 2021, filtered for Australia-based users only. Sentiment analysis of the tweets was performed using the Valence Aware Dictionary and Sentiment Reasoner. Topic modeling exploring the content of tweets was conducted using latent Dirichlet allocation with BigML (BigML, Inc). Sentiment, topic, and engagement (the sum of likes, retweets, quotations, and replies) were compared across years. Results: In total, 38,070 tweets were collected from 14,880 Twitter users. Overall, the sentiment when discussing food security was positive, although this varied across the 3 years. Positive sentiment remained higher during the COVID-19 lockdown periods in Australia. The topic model contained 10 topics (in order from highest to lowest probability in the data set): ``Global production,'' ``Food insecurity and health,'' ``Use of food banks,'' ``Giving to food banks,'' ``Family poverty,'' ``Food relief provision,'' ``Global food insecurity,'' ``Climate change,'' ``Australian food insecurity,'' and ``Human rights.'' The topic ``Giving to food banks,'' which focused on support and donation, had the highest proportion of positive sentiment, and ``Global food insecurity,'' which covered food insecurity prevalence worldwide, had the highest proportion of negative sentiment. When compared with news, there were some events, such as COVID-19 support payment introduction and bushfires across Australia, that were associated with high periods of positive or negative sentiment. Topics related to food insecurity prevalence, poverty, and food relief in Australia were not consistently more prominent during the COVID-19 pandemic than before the pandemic. Negative tweets received substantially higher engagement across 2019 and 2020. There was no clear relationship between topics that were more likely to be positive or negative and have higher or lower engagement, indicating that the identified topics are discrete issues. Conclusions: In this study, we demonstrated the potential use of sentiment analysis and topic modeling to explore evolution in conversations on food security using social media data. Future use of NLP in food security requires the context of and interpretation by public health experts and the use of broader data sets, with the potential to track dimensions or events related to food security to inform evidence-based decision-making in this area. ",
doi="10.2196/47826",
url="https://www.jmir.org/2024/1/e47826",
url="http://www.ncbi.nlm.nih.gov/pubmed/38512326"
}


@Article{info:doi/10.2196/51113,
author="Xian, Xuechang
and Neuwirth, J. Rostam
and Chang, Angela",
title="Government-Nongovernmental Organization (NGO) Collaboration in Macao's COVID-19 Vaccine Promotion: Social Media Case Study",
journal="JMIR Infodemiology",
year="2024",
month="Mar",
day="19",
volume="4",
pages="e51113",
keywords="COVID-19",
keywords="government",
keywords="vaccine",
keywords="automated content analysis",
keywords="Granger causality test",
keywords="network agenda setting",
keywords="QAP",
keywords="social media",
abstract="Background: The COVID-19 pandemic triggered unprecedented global vaccination efforts, with social media being a popular tool for vaccine promotion. Objective: This study probes into Macao's COVID-19 vaccine communication dynamics, with a focus on the multifaceted impacts of government agendas on social media. Methods: We scrutinized 22,986 vaccine-related Facebook posts from January 2020 to August 2022 in Macao. Using automated content analysis and advanced statistical methods, we unveiled intricate agenda dynamics between government and nongovernment entities. Results: ``Vaccine importance'' and ``COVID-19 risk'' were the most prominent topics co-occurring in the overall vaccine communication. The government tended to emphasize ``COVID-19 risk'' and ``vaccine effectiveness,'' while regular users prioritized vaccine safety and distribution, indicating a discrepancy in these agendas. Nonetheless, the government has limited impact on regular users in the aspects of vaccine importance, accessibility, affordability, and trust in experts. The agendas of government and nongovernment users intertwined, illustrating complex interactions. Conclusions: This study reveals the influence of government agendas on public discourse, impacting environmental awareness, public health education, and the social dynamics of inclusive communication during health crises. Inclusive strategies, accommodating public concerns, and involving diverse stakeholders are paramount for effective social media communication during health crises. ",
doi="10.2196/51113",
url="https://infodemiology.jmir.org/2024/1/e51113",
url="http://www.ncbi.nlm.nih.gov/pubmed/38502184"
}


@Article{info:doi/10.2196/47923,
author="O'Connor, Karen
and Golder, Su
and Weissenbacher, Davy
and Klein, Z. Ari
and Magge, Arjun
and Gonzalez-Hernandez, Graciela",
title="Methods and Annotated Data Sets Used to Predict the Gender and Age of Twitter Users: Scoping Review",
journal="J Med Internet Res",
year="2024",
month="Mar",
day="15",
volume="26",
pages="e47923",
keywords="social media",
keywords="demographics",
keywords="Twitter",
keywords="age",
keywords="gender",
keywords="prediction",
keywords="real-world data",
keywords="neural network",
keywords="machine learning",
keywords="gender prediction",
keywords="age prediction",
abstract="Background: Patient health data collected from a variety of nontraditional resources, commonly referred to as real-world data, can be a key information source for health and social science research. Social media platforms, such as Twitter (Twitter, Inc), offer vast amounts of real-world data. An important aspect of incorporating social media data in scientific research is identifying the demographic characteristics of the users who posted those data. Age and gender are considered key demographics for assessing the representativeness of the sample and enable researchers to study subgroups and disparities effectively. However, deciphering the age and gender of social media users poses challenges. Objective: This scoping review aims to summarize the existing literature on the prediction of the age and gender of Twitter users and provide an overview of the methods used. Methods: We searched 15 electronic databases and carried out reference checking to identify relevant studies that met our inclusion criteria: studies that predicted the age or gender of Twitter users using computational methods. The screening process was performed independently by 2 researchers to ensure the accuracy and reliability of the included studies. Results: Of the initial 684 studies retrieved, 74 (10.8\%) studies met our inclusion criteria. Among these 74 studies, 42 (57\%) focused on predicting gender, 8 (11\%) focused on predicting age, and 24 (32\%) predicted a combination of both age and gender. Gender prediction was predominantly approached as a binary classification task, with the reported performance of the methods ranging from 0.58 to 0.96 F1-score or 0.51 to 0.97 accuracy. Age prediction approaches varied in terms of classification groups, with a higher range of reported performance, ranging from 0.31 to 0.94 F1-score or 0.43 to 0.86 accuracy. The heterogeneous nature of the studies and the reporting of dissimilar performance metrics made it challenging to quantitatively synthesize results and draw definitive conclusions. Conclusions: Our review found that although automated methods for predicting the age and gender of Twitter users have evolved to incorporate techniques such as deep neural networks, a significant proportion of the attempts rely on traditional machine learning methods, suggesting that there is potential to improve the performance of these tasks by using more advanced methods. Gender prediction has generally achieved a higher reported performance than age prediction. However, the lack of standardized reporting of performance metrics or standard annotated corpora to evaluate the methods used hinders any meaningful comparison of the approaches. Potential biases stemming from the collection and labeling of data used in the studies was identified as a problem, emphasizing the need for careful consideration and mitigation of biases in future studies. This scoping review provides valuable insights into the methods used for predicting the age and gender of Twitter users, along with the challenges and considerations associated with these methods. ",
doi="10.2196/47923",
url="https://www.jmir.org/2024/1/e47923",
url="http://www.ncbi.nlm.nih.gov/pubmed/38488839"
}


@Article{info:doi/10.2196/49440,
author="Wright, A. William J.
and Howdle, Charlotte
and Coulson, S. Neil
and De Simoni, Anna",
title="Exploring the Types of Social Support Exchanged by Survivors of Pediatric Stroke and Their Families in an Online Peer Support Community: Qualitative Thematic Analysis",
journal="J Med Internet Res",
year="2024",
month="Mar",
day="15",
volume="26",
pages="e49440",
keywords="child",
keywords="internet-based intervention",
keywords="online health communities",
keywords="peer support",
keywords="qualitative analysis",
keywords="rehabilitation",
keywords="self-help group",
keywords="self-help",
keywords="social support",
keywords="stroke",
keywords="support groups",
keywords="thematic analysis",
abstract="Background: Pediatric stroke is relatively rare and underresearched, and there is little awareness of its occurrence in wider society. There is a paucity of literature on the effectiveness of interventions to improve rehabilitation and the services available to survivors. Access to online health communities through the internet may be a means of support for patients with pediatric stroke and their families during recovery; however, little research has been done in this area. Objective: This study aims to identify the types of social support provided by an online peer support group to survivors of pediatric stroke and their families. Methods: This was a qualitative thematic analysis of posts from a pediatric stroke population on a UK online stroke community active between 2004 and 2011. The population was split into 2 groups based on whether stroke survivors were aged ?18 years or aged >18 years at the time of posting. The posts were read by 2 authors who used the adapted Social Support Behavior Code to analyze the types of social support exchanged. Results: A total of 52 participants who experienced a pediatric stroke were identified, who posted a total of 425 messages to the community. About 41 survivors were aged ?18 years at the time of posting and were written about by others (31/35 were mothers), while 11 were aged >18 years and were writing about themselves. Survivors and their families joined together in discussion threads. Support was offered and received by all participants, regardless of age. Of all 425 posts, 193 (45.4\%) contained at least 1 instance of social support. All 5 types of social support were identified: informational, emotional, network, esteem support, and tangible aid. Informational and emotional support were most commonly exchanged. Emotional support was offered more often than informational support among participants aged ?18 years at the time of posting; this finding was reversed in the group aged >18 years. Network support and esteem support were less commonly exchanged. Notably, the access subcategory of network support was not exchanged with the community. Tangible aid was the least commonly offered type of support. The exchanged social support provided insight into rehabilitation interventions and the unmet needs of pediatric stroke survivors. Conclusions: We found evidence of engagement of childhood stroke survivors and their families in an online stroke community, with peer support being exchanged between both long- and short-term survivors of pediatric stroke. Engagement of long-term survivors of pediatric stroke through the online community was key, as they were able to offer informational support from lived experience. Further interventional research is needed to assess health and rehabilitation outcomes from engagement with online support groups. Research is also needed to ensure safe, nurturing online communities. ",
doi="10.2196/49440",
url="https://www.jmir.org/2024/1/e49440",
url="http://www.ncbi.nlm.nih.gov/pubmed/38488858"
}


@Article{info:doi/10.2196/51331,
author="Gonz{\'a}lez-Salinas, I. Anna
and Andrade, L. Elizabeth
and Abroms, C. Lorien
and G{\'o}mez, Kaitlyn
and Favetto, Carla
and G{\'o}mez, M. Valeria
and Collins, K. Karen",
title="Latino Parents' Reactions to and Engagement With a Facebook Group--Based COVID-19 Vaccine Promotion Intervention: Mixed Methods Pilot Study",
journal="JMIR Form Res",
year="2024",
month="Mar",
day="14",
volume="8",
pages="e51331",
keywords="COVID-19",
keywords="misinformation",
keywords="social media",
keywords="Latino parents",
keywords="Spanish",
keywords="vaccines",
keywords="digital intervention",
abstract="Background: Misinformation in Spanish on social media platforms has contributed to COVID-19 vaccine hesitancy among Latino parents. Brigada Digital de Salud was established to disseminate credible, science-based information about COVID-19 in Spanish on social media. Objective: This study aims to assess participants' reactions to and engagement with Brigada Digital content that sought to increase COVID-19 vaccine uptake among US Latino parents and their children. Methods: We conducted a 5-week intervention in a private, moderator-led Facebook (Meta Platforms, Inc) group with Spanish-speaking Latino parents of children aged ?18 years (N=55). The intervention participants received 3 to 4 daily Brigada Digital posts and were encouraged to discuss the covered topics through comments and polls. To assess participants' exposure, reactions, and engagement, we used participants' responses to a web-based survey administered at 2 time points (baseline and after 5 weeks) and Facebook analytics to calculate the average number of participant views, reactions, and comments. Descriptive statistics were assessed for quantitative survey items, qualitative responses were thematically analyzed, and quotes were selected to illustrate the themes. Results: Overall, 101 posts were published. Most participants reported visiting the group 1 to 3 times (22/55, 40\%) or 4 to 6 (18/55, 33\%) times per week and viewing 1 to 2 (23/55, 42\%) or 3 to 4 (16/55, 29\%) posts per day. Facebook analytics validated this exposure, with 36 views per participant on average. The participants reacted positively to the intervention. Most participants found the content informative and trustworthy (49/55, 89\%), easy to understand, and presented in an interesting manner. The participants thought that the moderators were well informed (51/55, 93\%) and helpful (50/55, 91\%) and praised them for being empathic and responsive. The participants viewed the group environment as welcoming and group members as friendly (45/55, 82\%) and supportive (19/55, 35\%). The 3 most useful topics for participants were the safety and efficacy of adult COVID-19 vaccines (29/55, 53\%), understanding child risk levels (29/55, 53\%), and the science behind COVID-19 (24/55, 44\%). The preferred formats were educational posts that could be read (38/55, 69\%) and videos, including expert (28/55, 51\%) and instructional (26/55, 47\%) interviews. Regarding engagement, most participants self-reported reacting to posts 1 to 2 (16/55, 29\%) or 3 to 4 (15/55, 27\%) times per week and commenting on posts 1 to 2 (16/55, 29\%) or <1 (20/55, 36\%) time per week. This engagement level was validated by analytics, with 10.6 reactions and 3 comments per participant, on average, during the 5 weeks. Participants recommended more opportunities for engagement, such as interacting with the moderators in real time. Conclusions: With adequate intervention exposure and engagement and overall positive participant reactions, the findings highlight the promise of this digital approach for COVID-19 vaccine--related health promotion. ",
doi="10.2196/51331",
url="https://formative.jmir.org/2024/1/e51331",
url="http://www.ncbi.nlm.nih.gov/pubmed/38483457"
}


@Article{info:doi/10.2196/50431,
author="Carboni, Alexa
and Martini, Olnita
and Kirk, Jessica
and Marroquin, A. Nathaniel
and Ricci, Corinne
and Cheng, Melissa
and Szeto, D. Mindy
and Pulsipher, J. Kayd
and Dellavalle, P. Robert",
title="Does Male Skin Care Content on Instagram Neglect Skin Cancer Prevention?",
journal="JMIR Dermatol",
year="2024",
month="Mar",
day="13",
volume="7",
pages="e50431",
keywords="men",
keywords="male",
keywords="male skin care",
keywords="male skincare",
keywords="sunscreen",
keywords="sun protection",
keywords="photoprotection",
keywords="anti-aging",
keywords="skin cancer prevention",
keywords="Instagram",
keywords="social media",
keywords="marketing",
keywords="advertising",
keywords="dermatology",
keywords="dermatologist",
keywords="skin",
keywords="man",
keywords="oncology",
keywords="oncologist",
doi="10.2196/50431",
url="https://derma.jmir.org/2024/1/e50431",
url="http://www.ncbi.nlm.nih.gov/pubmed/38477962"
}


@Article{info:doi/10.2196/50741,
author="Evans, Douglas William
and Bingenheimer, Jeffrey
and Cantrell, Jennifer
and Kreslake, Jennifer
and Tulsiani, Shreya
and Ichimiya, Megumi
and D'Esterre, P. Alexander
and Gerard, Raquel
and Martin, Madeline
and Hair, C. Elizabeth",
title="Effects of a Social Media Intervention on Vaping Intentions: Randomized Dose-Response Experiment",
journal="J Med Internet Res",
year="2024",
month="Mar",
day="12",
volume="26",
pages="e50741",
keywords="randomized controlled trial",
keywords="e-cigarettes",
keywords="vaping",
keywords="nicotine",
keywords="tobacco control",
keywords="social media",
keywords="dose-response effects",
abstract="Background: e-Cigarette use, especially by young adults, is at unacceptably high levels and represents a public health risk factor. Digital media are increasingly being used to deliver antivaping campaigns, but little is known about their effectiveness or the dose-response effects of content delivery. Objective: The objectives of this study were to evaluate (1) the effectiveness of a 60-day antivaping social media intervention in changing vaping use intentions and beliefs related to the stimulus content and (2) the dose-response effects of varying levels of exposure to the intervention on vaping outcomes, including anti-industry beliefs, vaping intentions, and other attitudes and beliefs related to vaping. Methods: Participants were adults aged 18 to 24 years in the United States. They were recruited into the study through Facebook (Meta Platforms) and Instagram (Meta Platforms), completed a baseline survey, and then randomized to 1 of the 5 conditions: 0 (control), 4, 8, 16, and 32 exposures over a 15-day period between each survey wave. Follow-up data were collected 30 and 60 days after randomization. We conducted stratified analyses of the full sample and in subsamples defined by the baseline vaping status (never, former, and current). Stimulus was delivered through Facebook and Instagram in four 15-second social media videos focused on anti-industry beliefs about vaping. The main outcome measures reported in this study were self-reported exposure to social media intervention content, attitudes and beliefs about vaping, and vaping intentions. We estimated a series of multivariate linear regressions in Stata 17 (StataCorp). To capture the dose-response effect, we assigned each study arm a numerical value corresponding to the number of advertisements (exposures) delivered to participants in each arm and used this number as our focal independent variable. In each model, the predictor was the treatment arm to which each participant was assigned. Results: The baseline sample consisted of 1491 participants, and the final analysis sample consisted of 57.28\% (854/1491) of the participants retained at the 60-day follow-up. We compared the retained participants with those lost to follow-up and found no statistically significant differences across demographic variables. We found a significant effect of the social media treatment on vaping intentions ($\beta$=?0.138, 95\% CI ?0.266 to ?0.010; P=.04) and anti-industry beliefs ($\beta$=?0.122, 95\% CI 0.008-0.237; P=.04) targeted by the intervention content among current vapers but not among the full sample or other strata. We found no significant effects of self-reported exposure to the stimulus. Conclusions: Social media interventions are a promising approach to preventing vaping among young adults. More research is needed on how to optimize the dosage of such interventions and the extent to which long-term exposure may affect vaping use over time. Trial Registration: ClinicalTrials.gov NCT04867668; https://clinicaltrials.gov/study/NCT04867668 ",
doi="10.2196/50741",
url="https://www.jmir.org/2024/1/e50741",
url="http://www.ncbi.nlm.nih.gov/pubmed/38470468"
}


@Article{info:doi/10.2196/54107,
author="Jia, Chenjin
and Li, Pengcheng",
title="Generation Z's Health Information Avoidance Behavior: Insights From Focus Group Discussions",
journal="J Med Internet Res",
year="2024",
month="Mar",
day="8",
volume="26",
pages="e54107",
keywords="information avoidance",
keywords="health information",
keywords="Generation Z",
keywords="information overload",
keywords="planned risk information avoidance model",
abstract="Background: Younger generations actively use social media to access health information. However, research shows that they also avoid obtaining health information online at times when confronted with uncertainty. Objective: This study aims to examine the phenomenon of health information avoidance among Generation Z, a representative cohort of active web users in this era. Methods: Drawing on the planned risk information avoidance model, we adopted a qualitative approach to explore the factors related to information avoidance within the context of health and risk communication. The researchers recruited 38 participants aged 16 to 25 years for the focus group discussion sessions. Results: In this study, we sought to perform a deductive qualitative analysis of the focus group interview content with open, focused, and theoretical coding. Our findings support several key components of the planned risk information avoidance model while highlighting the underlying influence of cognition on emotions. Specifically, socioculturally, group identity and social norms among peers lead some to avoid health information. Cognitively, mixed levels of risk perception, conflicting values, information overload, and low credibility of information sources elicited their information avoidance behaviors. Affectively, negative emotions such as anxiety, frustration, and the desire to stay positive contributed to avoidance. Conclusions: This study has implications for understanding young users' information avoidance behaviors in both academia and practice. ",
doi="10.2196/54107",
url="https://www.jmir.org/2024/1/e54107",
url="http://www.ncbi.nlm.nih.gov/pubmed/38457223"
}


@Article{info:doi/10.2196/54000,
author="Boatman, Dannell
and Starkey, Abby
and Acciavatti, Lori
and Jarrett, Zachary
and Allen, Amy
and Kennedy-Rea, Stephenie",
title="Using Social Listening for Digital Public Health Surveillance of Human Papillomavirus Vaccine Misinformation Online: Exploratory Study",
journal="JMIR Infodemiology",
year="2024",
month="Mar",
day="8",
volume="4",
pages="e54000",
keywords="human papillomavirus",
keywords="HPV",
keywords="vaccine",
keywords="vaccines",
keywords="vaccination",
keywords="vaccinations",
keywords="sexually transmitted infection",
keywords="STI",
keywords="sexually transmitted disease",
keywords="STD",
keywords="sexual transmission",
keywords="sexually transmitted",
keywords="social media",
keywords="social listening",
keywords="cancer",
keywords="surveillance",
keywords="health communication",
keywords="misinformation",
keywords="artificial intelligence",
keywords="AI",
keywords="infodemiology",
keywords="infoveillance",
keywords="oncology",
doi="10.2196/54000",
url="https://infodemiology.jmir.org/2024/1/e54000",
url="http://www.ncbi.nlm.nih.gov/pubmed/38457224"
}


@Article{info:doi/10.2196/48026,
author="Kong, Weitao
and Li, Yuanyuan
and Luo, Aijing
and Xie, Wenzhao",
title="Status and Influencing Factors of Social Media Addiction in Chinese Workers: Cross-Sectional Survey Study",
journal="J Med Internet Res",
year="2024",
month="Mar",
day="6",
volume="26",
pages="e48026",
keywords="social media addiction",
keywords="job burnout",
keywords="mindfulness",
keywords="mobile phone",
keywords="technology addiction",
keywords="cross-sectional survey",
abstract="Background: Social media addiction (SMA) caused by excessive dependence on social media is becoming a global problem. At present, most of the SMA studies recruit college students as research participants, with very few studies involving workers and other age groups, especially in China. Objective: This study aims to investigate the current status of SMA among Chinese workers and analyze its influencing factors. Methods: From November 1, 2022, to January 30, 2023, we conducted an anonymous web-based questionnaire survey in mainland China, and a total of 5176 participants completed the questionnaire. The questionnaire included the Social Networking Service Addiction Scale, Maslach Burnout Inventory--General Survey scale, Mindful Attention Awareness Scale, as well as questionnaires regarding participants' social media use habits and demographic information. Results: Through strict screening, 3468 valid questionnaires were included in this study. The main findings of this study revealed the following: the average SMA score of workers was higher (mean 53.19, SD 12.04), and some of them (393/3468, 11.33\%) relied heavily on social media; there were statistically significant differences in SMA scores among workers in different industries (F14,3453=3.98; P<.001); single workers (t3106=8.6; P<.001) and workers in a relationship (t2749=5.67; P<.001) had higher SMA scores than married workers, but some married workers (214/3468, 6.17\%) were highly dependent on social media; the level of SMA among female workers was higher than that of male workers (t3466=3.65; P<.001), and the SMA score of workers negatively correlated with age (r=?0.22; P<.001) and positively correlated with education level (r=0.12; P<.001); the frequency of using social media for entertainment during work (r=0.33; P<.001) and the frequency of staying up late using social media (r=0.14; P<.001) were positively correlated with the level of SMA in workers; and the level of SMA in workers was significantly positively correlated with their level of burnout (r=0.35; P<.001), whereas it was significantly negatively correlated with their level of mindfulness (r=?0.55; P<.001). Conclusions: The results of this study suggest that SMA among Chinese workers is relatively serious and that the SMA problem among workers requires more attention from society and academia. In particular, female workers, young workers, unmarried workers, highly educated workers, workers with bad social media habits, workers with high levels of job burnout, and workers with low levels of mindfulness were highly dependent on social media. In addition, occupation is an important influencing factor in SMA. Thus, the government should strengthen the supervision of social media companies. Medical institutions should provide health education on SMA and offer intervention programs for those addicted to social media. Workers should cultivate healthy habits while using social media. ",
doi="10.2196/48026",
url="https://www.jmir.org/2024/1/e48026",
url="http://www.ncbi.nlm.nih.gov/pubmed/38446542"
}


@Article{info:doi/10.2196/54052,
author="Groshon, Laurie
and Waring, E. Molly
and Blashill, J. Aaron
and Dean, Kristen
and Bankwalla, Sanaya
and Palmer, Lindsay
and Pagoto, Sherry",
title="A Content Analysis of Indoor Tanning Twitter Chatter During COVID-19 Shutdowns: Cross-Sectional Qualitative Study",
journal="JMIR Dermatol",
year="2024",
month="Mar",
day="4",
volume="7",
pages="e54052",
keywords="attitude",
keywords="attitudes",
keywords="content analysis",
keywords="dermatology",
keywords="opinion",
keywords="perception",
keywords="perceptions",
keywords="perspective",
keywords="perspectives",
keywords="sentiment",
keywords="skin",
keywords="social media",
keywords="sun",
keywords="tan",
keywords="tanner",
keywords="tanners",
keywords="tanning",
keywords="tweet",
keywords="tweets",
keywords="Twitter",
abstract="Background: Indoor tanning is a preventable risk factor for skin cancer. Statewide shutdowns during the COVID-19 pandemic resulted in temporary closures of tanning businesses. Little is known about how tanners reacted to losing access to tanning businesses. Objective: This study aimed to analyze Twitter (subsequently rebranded as X) chatter about indoor tanning during the statewide pandemic shutdowns. Methods: We collected tweets from March 15 to April 30, 2020, and performed a directed content analysis of a random sample of 20\% (1165/5811) of tweets from each week. The 2 coders independently rated themes ($\kappa$=0.67-1.0; 94\%-100\% agreement). Results: About half (589/1165, 50.6\%) of tweets were by people unlikely to indoor tan, and most of these mocked tanners or the act of tanning (562/589, 94.9\%). A total of 34\% (402/1165) of tweets were posted by users likely to indoor tan, and most of these (260/402, 64.7\%) mentioned missing tanning beds, often citing appearance- or mood-related reasons or withdrawal. Some tweets by tanners expressed a desire to purchase or use home tanning beds (90/402, 22\%), while only 3.9\% (16/402) mentioned tanning alternatives (eg, self-tanner). Very few tweets (29/1165, 2.5\%) were public health messages about the dangers of indoor tanning. Conclusions: Findings revealed that during statewide shutdowns, half of the tweets about indoor tanning were mocking tanning bed users and the tanned look, while about one-third were indoor tanners reacting to their inability to access tanning beds. Future work is needed to understand emerging trends in tanning post pandemic. ",
doi="10.2196/54052",
url="https://derma.jmir.org/2024/1/e54052",
url="http://www.ncbi.nlm.nih.gov/pubmed/38437006"
}


@Article{info:doi/10.2196/49139,
author="Deiner, S. Michael
and Deiner, A. Natalie
and Hristidis, Vagelis
and McLeod, D. Stephen
and Doan, Thuy
and Lietman, M. Thomas
and Porco, C. Travis",
title="Use of Large Language Models to Assess the Likelihood of Epidemics From the Content of Tweets: Infodemiology Study",
journal="J Med Internet Res",
year="2024",
month="Mar",
day="1",
volume="26",
pages="e49139",
keywords="conjunctivitis",
keywords="microblog",
keywords="social media",
keywords="generative large language model",
keywords="Generative Pre-trained Transformers",
keywords="GPT-3.5",
keywords="GPT-4",
keywords="epidemic detection",
keywords="Twitter",
keywords="X formerly known as Twitter",
keywords="infectious eye disease",
abstract="Background: Previous work suggests that Google searches could be useful in identifying conjunctivitis epidemics. Content-based assessment of social media content may provide additional value in serving as early indicators of conjunctivitis and other systemic infectious diseases. Objective: We investigated whether large language models, specifically GPT-3.5 and GPT-4 (OpenAI), can provide probabilistic assessments of whether social media posts about conjunctivitis could indicate a regional outbreak. Methods: A total of 12,194 conjunctivitis-related tweets were obtained using a targeted Boolean search in multiple languages from India, Guam (United States), Martinique (France), the Philippines, American Samoa (United States), Fiji, Costa Rica, Haiti, and the Bahamas, covering the time frame from January 1, 2012, to March 13, 2023. By providing these tweets via prompts to GPT-3.5 and GPT-4, we obtained probabilistic assessments that were validated by 2 human raters. We then calculated Pearson correlations of these time series with tweet volume and the occurrence of known outbreaks in these 9 locations, with time series bootstrap used to compute CIs. Results: Probabilistic assessments derived from GPT-3.5 showed correlations of 0.60 (95\% CI 0.47-0.70) and 0.53 (95\% CI 0.40-0.65) with the 2 human raters, with higher results for GPT-4. The weekly averages of GPT-3.5 probabilities showed substantial correlations with weekly tweet volume for 44\% (4/9) of the countries, with correlations ranging from 0.10 (95\% CI 0.0-0.29) to 0.53 (95\% CI 0.39-0.89), with larger correlations for GPT-4. More modest correlations were found for correlation with known epidemics, with substantial correlation only in American Samoa (0.40, 95\% CI 0.16-0.81). Conclusions: These findings suggest that GPT prompting can efficiently assess the content of social media posts and indicate possible disease outbreaks to a degree of accuracy comparable to that of humans. Furthermore, we found that automated content analysis of tweets is related to tweet volume for conjunctivitis-related posts in some locations and to the occurrence of actual epidemics. Future work may improve the sensitivity and specificity of these methods for disease outbreak detection. ",
doi="10.2196/49139",
url="https://www.jmir.org/2024/1/e49139",
url="http://www.ncbi.nlm.nih.gov/pubmed/38427404"
}


@Article{info:doi/10.2196/47984,
author="Weisblum, Margaret
and Trussell, Emma
and Schwinn, Traci
and Pacheco, R. Andrea
and Nurkin, Paige",
title="Screening and Retaining Adolescents Recruited Through Social Media: Secondary Analysis from a Longitudinal Clinical Trial",
journal="JMIR Pediatr Parent",
year="2024",
month="Feb",
day="28",
volume="7",
pages="e47984",
keywords="adolescents",
keywords="attrition prevention",
keywords="Instagram",
keywords="LGBQ",
keywords="online recruitment",
keywords="retention",
keywords="screening",
keywords="sexual minority",
keywords="social media",
keywords="youth",
abstract="Background: Social media has become a popular method to recruit participants, particularly for studies with hard-to-reach populations. These studies still face challenges in data quality and, for longitudinal studies, sample retention. However, in addition to aiding in recruitment, social media platforms can help researchers with participant verification and tracking procedures during the study. There is limited previous research describing how longitudinal studies can use social media to screen and retain participants. Objective: This paper describes strategies implemented to screen and retain a nationwide sample of sexual minority youth who were recruited through social media platforms for a longitudinal study testing a drug abuse prevention program. Methods: Our screening strategies for participants included collecting necessary demographic information (name, phone, email, and social media accounts), verifying this information using publicly available web-based records, and sending confirmation emails to ensure working email addresses and correct dates of birth. Retention strategies included communications designed to develop positive participant relationships, incentives for survey completion, regular updating of participant contact information, targeting hard-to-reach participants, and using social media as an alternative means of contacting participants. Results: During enrollment, although the only demographic data required were a phone number and an email address, 87.58\% (1065/1216) of participants provided their Instagram as an alternative means of contact. This form of alternative communication remains the most preferred with 87.40\% (1047/1198) of participants continuing to provide an Instagram username as of January 2023, about 3 years after recruitment began. In comparison, other alternative means of contact (eg, Facebook and alternative email) were provided by only 6.43\% (77/1198) to 56.18\% (673/1198) of participants. Direct messaging on Instagram was used to successfully confirm participant identity, remind participants to take annual follow-up surveys, and update lost participant contact information. Screening and retention strategies used in the study have helped achieve 96.30\% (1171/1216) to 96.79\% (1177/1216) sample retention across 3 waves of data collection. Conclusions: Though social media can be a helpful tool to recruit participants, attrition and participant authenticity difficulties may be associated with this method. Screening and retention strategies can be implemented to improve retention. Internet searches are effective for screening youth to ensure they meet eligibility requirements. Additionally, social media---Instagram in this study---can help to track and locate participants who do not respond to traditional contact methods. Trial Registration: ClinicalTrials.gov NCT03954535; https://clinicaltrials.gov/study/NCT03954535 ",
doi="10.2196/47984",
url="https://pediatrics.jmir.org/2024/1/e47984",
url="http://www.ncbi.nlm.nih.gov/pubmed/38416559"
}


@Article{info:doi/10.2196/47817,
author="Agha, Sohail
and Nsofor, Ifeanyi
and Bernard, Drew
and Francis, Sarah
and Rao, Nandan",
title="Behavioral Insights from Vaccine Adoption in Nigeria: Cross-Sectional Survey Findings",
journal="Interact J Med Res",
year="2024",
month="Feb",
day="26",
volume="13",
pages="e47817",
keywords="behavioral insights",
keywords="COVID-19",
keywords="Nigeria",
keywords="surveys",
keywords="vaccination",
abstract="Background: To generate behavioral insights for the development of effective vaccination interventions, we need approaches that combine rapid and inexpensive survey data collection with instruments based on easy-to-use behavior models. This study demonstrates how an inexpensive digital survey helped identify the drivers of COVID-19 vaccination in Nigeria. Objective: This study aims to illustrate how behavioral insights can be generated through inexpensive digital surveys. Methods: We designed and conducted a cross-sectional survey with multistage sampling. Data were collected from Nigerians (aged ?18 years) from 120 strata based on age, sex, state, and urban or rural location. Respondents were recruited via advertisements on Meta platforms (Facebook and Instagram) using the Virtual Lab open-source tool. We used a Meta Messenger chatbot for data collection; participants were compensated with 400 naira (US \$0.87 cents). Data collection took 2 weeks. In total, 957 respondents completed the survey, at an advertising cost of US \$1.55 per respondent. An 18-item instrument measuring core motivators, ability barriers, sociodemographic characteristics, and respondents' vaccination status was pretested before data collection. We ran separate logistic regression models to examine the relationships between vaccine uptake and core motivators, ability barriers, and sociodemographic variables. A final model that predicted vaccine uptake included all 3 sets of variables. Results: About 56\% (n=540) of respondents reported that they had received at least 1 COVID-19 vaccination. Three core motivators were positively associated with vaccine uptake: the belief that the COVID-19 vaccine promised a better life (adjusted odds ratio [aOR] 3.51, 95\% CI 2.23-5.52), the belief that the vaccine would allow respondents to do more things they enjoyed (aOR 1.97, 95\% CI 1.33-2.93), and respondents' perception that their friends and family members accepted their decision to get vaccinated (aOR 1.62, 95\% CI 1.06-2.48). Two ability barriers were negatively associated with vaccine uptake: cost- or income-related concerns lowered the odds of being vaccinated (aOR 0.35, 95\% CI 0.24-0.50) and the lack of availability of vaccines at places respondents routinely visited also lowered their odds of being vaccinated (aOR 0.29, 95\% CI 0.21-0.40). After adjusting for other variables, the perceived fear of getting COVID-19 and the hardship associated with the disease were no longer associated with vaccine uptake. Conclusions: These findings suggest that hope is more important for Nigerians than fear when it comes to vaccine adoption, enjoying life is more important than worrying about getting the disease, and approval from friends and family is more powerful than their disapproval. These findings suggest that emphasizing the benefits of leading a fuller life after being vaccinated is more likely to succeed than increasing Nigerians' fear of COVID-19. This study identifies a very different set of factors associated with COVID-19 vaccine adoption than previous Nigerian studies. ",
doi="10.2196/47817",
url="https://www.i-jmr.org/2024/1/e47817",
url="http://www.ncbi.nlm.nih.gov/pubmed/38407956"
}


@Article{info:doi/10.2196/48860,
author="Davidson, Anne Cara
and Booth, Richard
and Jackson, Teresa Kimberley
and Mantler, Tara",
title="Toxic Relationships Described by People With Breast Cancer on Reddit: Topic Modeling Study",
journal="JMIR Cancer",
year="2024",
month="Feb",
day="23",
volume="10",
pages="e48860",
keywords="breast cancer",
keywords="intimate partner violence",
keywords="meaning extraction method",
keywords="Reddit",
keywords="sentiment analysis",
keywords="social media",
keywords="social support",
keywords="toxic relationships",
keywords="topic modelling",
abstract="Background: Social support is essential to promoting optimal health outcomes for women with breast cancer. However, an estimated 12\% of women with breast cancer simultaneously experience intimate partner violence (IPV; physical, psychological, or sexual abuse by an intimate partner). Women who experience IPV during breast cancer may lack traditional social support, and thus seek out alternative sources of support. Online community forums, such as Reddit, can provide accessible social connections within breast cancer--specific communities. However, it is largely unknown how women with breast cancer use Reddit to describe and seek support for experiences of IPV. Objective: This study aims to explore how patients with breast cancer describe toxic relationships with their partners and immediate family members on Reddit. Methods: This exploratory, cross-sectional, topic-modeling study analyzed textual data from 96 users in the r/breastcancer subreddit in February 2023. The meaning extraction method, inclusive of principal component analysis, was used to identify underlying components. Components were subjected to sentiment analysis and summative content analysis with emergent categorical development to articulate themes. Results: Seven themes emerged related to toxic relationships: (1) contextualizing storytelling with lymph nodes, (2) toxic behavior and venting emotions, (3) abandonment and abuse following diagnosis, (4) toxic relationships and social-related fears, (5) inner strength and navigating breast cancer over time, (6) assessing social relationships and interactions, and (7) community advice and support. Toxic relationships were commonly characterized by isolation, abandonment, and emotional abuse, which had profound emotional consequences for patients. Reddit facilitated anonymous venting about toxic relationships that helped patients cope with intense feelings and stress. Exchanging advice and support about navigating toxic relationships during breast cancer were core functions of the r/breastcancer community. Conclusions: Findings emphasized the value of Reddit as a source of social support for patients with breast cancer experiencing toxic relationships. Clinicians who understand that many patients with breast cancer experience toxic relationships and considerable psychological sequelae are better prepared to support their patients' holistic well-being. Further investigation of Reddit as a possible resource for advice, information, and support has the potential to help inform clinical practice and subsequently, patient health outcomes. ",
doi="10.2196/48860",
url="https://cancer.jmir.org/2024/1/e48860",
url="http://www.ncbi.nlm.nih.gov/pubmed/38393769"
}


@Article{info:doi/10.2196/44726,
author="ElSherief, Mai
and Sumner, Steven
and Krishnasamy, Vikram
and Jones, Christopher
and Law, Royal
and Kacha-Ochana, Akadia
and Schieber, Lyna
and De Choudhury, Munmun",
title="Identification of Myths and Misinformation About Treatment for Opioid Use Disorder on Social Media: Infodemiology Study",
journal="JMIR Form Res",
year="2024",
month="Feb",
day="23",
volume="8",
pages="e44726",
keywords="addiction treatment",
keywords="machine learning",
keywords="misinformation",
keywords="natural language processing",
keywords="opioid use disorder",
keywords="social media",
keywords="substance use",
abstract="Background: Health misinformation and myths about treatment for opioid use disorder (OUD) are present on social media and contribute to challenges in preventing drug overdose deaths. However, no systematic, quantitative methodology exists to identify what types of misinformation are being shared and discussed. Objective: We developed a multistage analytic pipeline to assess social media posts from Twitter (subsequently rebranded as X), YouTube, Reddit, and Drugs-Forum for the presence of health misinformation about treatment for OUD. Methods: Our approach first used document embeddings to identify potential new statements of misinformation from known myths. These statements were grouped into themes using hierarchical agglomerative clustering, and public health experts then reviewed the results for misinformation. Results: We collected a total of 19,953,599 posts discussing opioid-related content across the aforementioned platforms. Our multistage analytic pipeline identified 7 main clusters or discussion themes. Among a high-yield data set of posts (n=303) for further public health expert review, these included discussion about potential treatments for OUD (90/303, 29.8\%), the nature of addiction (68/303, 22.5\%), pharmacologic properties of substances (52/303, 16.9\%), injection drug use (36/303, 11.9\%), pain and opioids (28/303, 9.3\%), physical dependence of medications (22/303, 7.2\%), and tramadol use (7/303, 2.3\%). A public health expert review of the content within each cluster identified the presence of misinformation and myths beyond those used as seed myths to initialize the algorithm. Conclusions: Identifying and addressing misinformation through appropriate communication strategies could be an increasingly important component of preventing overdose deaths. To further this goal, we developed and tested an approach to aid in the identification of myths and misinformation about OUD from large-scale social media content. ",
doi="10.2196/44726",
url="https://formative.jmir.org/2024/1/e44726",
url="http://www.ncbi.nlm.nih.gov/pubmed/38393772"
}


@Article{info:doi/10.2196/48324,
author="Gu, Dongxiao
and Wang, Qin
and Chai, Yidong
and Yang, Xuejie
and Zhao, Wang
and Li, Min
and Zolotarev, Oleg
and Xu, Zhengfei
and Zhang, Gongrang",
title="Identifying the Risk Factors of Allergic Rhinitis Based on Zhihu Comment Data Using a Topic-Enhanced Word-Embedding Model: Mixed Method Study and Cluster Analysis",
journal="J Med Internet Res",
year="2024",
month="Feb",
day="22",
volume="26",
pages="e48324",
keywords="social media platforms",
keywords="disease risk factor identification",
keywords="chronic disease management",
keywords="topic-enhanced word embedding",
keywords="text mining",
abstract="Background: Allergic rhinitis (AR) is a chronic disease, and several risk factors predispose individuals to the condition in their daily lives, including exposure to allergens and inhalation irritants. Analyzing the potential risk factors that can trigger AR can provide reference material for individuals to use to reduce its occurrence in their daily lives. Nowadays, social media is a part of daily life, with an increasing number of people using at least 1 platform regularly. Social media enables users to share experiences among large groups of people who share the same interests and experience the same afflictions. Notably, these channels promote the ability to share health information. Objective: This study aims to construct an intelligent method (TopicS-ClusterREV) for identifying the risk factors of AR based on these social media comments. The main questions were as follows: How many comments contained AR risk factor information? How many categories can these risk factors be summarized into? How do these risk factors trigger AR? Methods: This study crawled all the data from May 2012 to May 2022 under the topic of allergic rhinitis on Zhihu, obtaining a total of 9628 posts and 33,747 comments. We improved the Skip-gram model to train topic-enhanced word vector representations (TopicS) and then vectorized annotated text items for training the risk factor classifier. Furthermore, cluster analysis enabled a closer look into the opinions expressed in the category, namely gaining insight into how risk factors trigger AR. Results: Our classifier identified more comments containing risk factors than the other classification models, with an accuracy rate of 96.1\% and a recall rate of 96.3\%. In general, we clustered texts containing risk factors into 28 categories, with season, region, and mites being the most common risk factors. We gained insight into the risk factors expressed in each category; for example, seasonal changes and increased temperature differences between day and night can disrupt the body's immune system and lead to the development of allergies. Conclusions: Our approach can handle the amount of data and extract risk factors effectively. Moreover, the summary of risk factors can serve as a reference for individuals to reduce AR in their daily lives. The experimental data also provide a potential pathway that triggers AR. This finding can guide the development of management plans and interventions for AR. ",
doi="10.2196/48324",
url="https://www.jmir.org/2024/1/e48324",
url="http://www.ncbi.nlm.nih.gov/pubmed/38386404"
}


@Article{info:doi/10.2196/50392,
author="Buller, B. David
and Sussman, L. Andrew
and Thomson, A. Cynthia
and Kepka, Deanna
and Taren, Douglas
and Henry, L. Kimberly
and Warner, L. Echo
and Walkosz, J. Barbara
and Woodall, Gill W.
and Nuss, Kayla
and Blair, K. Cindy
and Guest, D. Dolores
and Borrayo, A. Evelinn
and Gordon, S. Judith
and Hatcher, Jennifer
and Wetter, W. David
and Kinsey, Alishia
and Jones, F. Christopher
and Yung, K. Angela
and Christini, Kaila
and Berteletti, Julia
and Torres, A. John
and Barraza Perez, Yessenya Emilia
and Small, Annelise",
title="\#4Corners4Health Social Media Cancer Prevention Campaign for Emerging Adults: Protocol for a Randomized Stepped-Wedge Trial",
journal="JMIR Res Protoc",
year="2024",
month="Feb",
day="22",
volume="13",
pages="e50392",
keywords="cancer prevention",
keywords="young adults",
keywords="rural",
keywords="social media",
keywords="physical activity",
keywords="diet",
keywords="alcohol",
keywords="tobacco control",
keywords="sunburn",
keywords="human papillomavirus",
keywords="HPV vaccination",
abstract="Background: Many emerging adults (EAs) are prone to making unhealthy choices, which increase their risk of premature cancer morbidity and mortality. In the era of social media, rigorous research on interventions to promote health behaviors for cancer risk reduction among EAs delivered over social media is limited. Cancer prevention information and recommendations may reach EAs more effectively over social media than in settings such as health care, schools, and workplaces, particularly for EAs residing in rural areas. Objective: This pragmatic randomized trial aims to evaluate a multirisk factor intervention using a social media campaign designed with community advisers aimed at decreasing cancer risk factors among EAs. The trial will target EAs from diverse backgrounds living in rural counties in the Four Corners states of Arizona, Colorado, New Mexico, and Utah. Methods: We will recruit a sample of EAs (n=1000) aged 18 to 26 years residing in rural counties (Rural-Urban Continuum Codes 4 to 9) in the Four Corners states from the Qualtrics' research panel and enroll them in a randomized stepped-wedge, quasi-experimental design. The inclusion criteria include English proficiency and regular social media engagement. A social media intervention will promote guideline-related goals for increased physical activity, healthy eating, and human papillomavirus vaccination and reduced nicotine product use, alcohol intake, and solar UV radiation exposure. Campaign posts will cover digital and media literacy skills, responses to misinformation, communication with family and friends, and referral to community resources. The intervention will be delivered over 12 months in Facebook private groups and will be guided by advisory groups of community stakeholders and EAs and focus groups with EAs. The EAs will complete assessments at baseline and at 12, 26, 39, 52, and 104 weeks after randomization. Assessments will measure 6 cancer risk behaviors, theoretical mediators, and participants' engagement with the social media campaign. Results: The trial is in its start-up phase. It is being led by a steering committee. Team members are working in 3 subcommittees to optimize community engagement, the social media intervention, and the measures to be used. The Stakeholder Organization Advisory Board and Emerging Adult Advisory Board were formed and provided initial input on the priority of cancer risk factors to target, social media use by EAs, and community resources available. A framework for the social media campaign with topics, format, and theoretical mediators has been created, along with protocols for campaign management. Conclusions: Social media can be used as a platform to counter misinformation and improve reliable health information to promote health behaviors that reduce cancer risks among EAs. Because of the popularity of web-based information sources among EAs, an innovative, multirisk factor intervention using a social media campaign has the potential to reduce their cancer risk behaviors. Trial Registration: ClinicalTrials.gov NCT05618158; https://classic.clinicaltrials.gov/ct2/show/NCT05618158 International Registered Report Identifier (IRRID): PRR1-10.2196/50392 ",
doi="10.2196/50392",
url="https://www.researchprotocols.org/2024/1/e50392",
url="http://www.ncbi.nlm.nih.gov/pubmed/38386396"
}


@Article{info:doi/10.2196/54414,
author="Berg, Valeska
and Arabiat, Diana
and Morelius, Evalotte
and Kervin, Lisa
and Zgambo, Maggie
and Robinson, Suzanne
and Jenkins, Mark
and Whitehead, Lisa",
title="Young Children and the Creation of a Digital Identity on Social Networking Sites: Scoping Review",
journal="JMIR Pediatr Parent",
year="2024",
month="Feb",
day="21",
volume="7",
pages="e54414",
keywords="digital identity",
keywords="children",
keywords="social networking sites",
keywords="sharenting",
keywords="scoping review",
keywords="perspectives",
abstract="Background: There is limited understanding of the concept of the digital identity of young children created through engagement on social networking sites. Objective: The objective of this scoping review was to identify key characteristics of the concept of digital identity for children from conception to the age of 8 years on social networking sites. Methods: This scoping review was conducted using the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. The key databases searched were EBSCO, Web of Science, ProQuest ERIC, and Scopus. Gray literature sources (National Grey Literature Collection, ProQuest Dissertations and Theses, and Google Scholar) were also searched to identify unpublished studies. Articles were selected if they were published in English and reported data on the digital identity of children in relation to social networking sites. Results: The key terms used in the literature were sharenting, followed by digital footprints and children's identities. Our study revealed 2 approaches to the creation of digital identity: social digital identity and performative digital identity. The articles in this review most commonly used the term sharenting to describe the behavior parents engage in to create digital identities for children on social networking sites. Motivations to post information about children differed among parents; however, the most common reasons were to share with friends and family and create digital archives of childhood photos, termed social digital identity. The second motivation was categorized as performative digital identity. The risk of digital kidnapping and identity theft associated with the creation of digital identities also influenced parents' behaviors. Conclusions: The creation of a digital identity for children is an emerging concept. Our review develops a deeper understanding of sharenting behaviors that can be used to better support parents and their children in creating a digital identity with children and awareness of the potential future impact. We recommend that future studies explore the perspectives of children as key stakeholders in the creation of their digital identity. ",
doi="10.2196/54414",
url="https://pediatrics.jmir.org/2024/1/e54414",
url="http://www.ncbi.nlm.nih.gov/pubmed/38381499"
}


@Article{info:doi/10.2196/48557,
author="Zou, Huijing
and Chair, Ying Sek
and Feng, Bilong
and Liu, Qian
and Liu, Jia Yu
and Cheng, Xin Yu
and Luo, Dan
and Wang, Qin Xiao
and Chen, Wei
and Huang, Leiqing
and Xianyu, Yunyan
and Yang, Xiang Bing",
title="A Social Media--Based Mindfulness Psycho-Behavioral Intervention (MCARE) for Patients With Acute Coronary Syndrome: Randomized Controlled Trial",
journal="J Med Internet Res",
year="2024",
month="Feb",
day="20",
volume="26",
pages="e48557",
keywords="acute coronary syndrome",
keywords="psychological distress",
keywords="depression",
keywords="anxiety",
keywords="mindfulness",
keywords="mindfulness-based intervention",
keywords="quality of life",
keywords="risk factors",
keywords="cardiac rehabilitation",
keywords="social media",
abstract="Background: Psychological distress is common among patients with acute coronary syndrome (ACS) and has considerable adverse impacts on disease progression and health outcomes. Mindfulness-based intervention is a promising complementary approach to address patients' psychological needs and promote holistic well-being. Objective: This study aims to examine the effects of a social media--based mindfulness psycho-behavioral intervention (MCARE) on psychological distress, psychological stress, health-related quality of life (HRQoL), and cardiovascular risk factors among patients with ACS. Methods: This study was a 2-arm, parallel-group randomized controlled trial. We recruited 178 patients (mean age 58.7, SD 8.9 years; 122/178, 68.5\% male) with ACS at 2 tertiary hospitals in Jinan, China. Participants were randomly assigned to the MCARE group (n=89) or control group (n=89). The 6-week intervention consisted of 1 face-to-face session (phase I) and 5 weekly WeChat (Tencent Holdings Ltd)--delivered sessions (phase II) on mindfulness training and health education and lifestyle modification. The primary outcomes were depression and anxiety. Secondary outcomes included psychological stress, HRQoL, and cardiovascular risk factors (ie, smoking status, physical activity, dietary behavior, BMI, blood pressure, blood lipids, and blood glucose). Outcomes were measured at baseline (T0), immediately after the intervention (T1), and 12 weeks after the commencement of the intervention (T2). Results: The MCARE group showed significantly greater reductions in depression (T1: $\beta$=--2.016, 95\% CI --2.584 to --1.449, Cohen d=--1.28, P<.001; T2: $\beta$=--2.089, 95\% CI --2.777 to --1.402, Cohen d=--1.12, P<.001) and anxiety (T1: $\beta$=--1.024, 95\% CI --1.551 to --0.497, Cohen d=--0.83, P<.001; T2: $\beta$=--0.932, 95\% CI --1.519 to --0.346, Cohen d=--0.70, P=.002). Significantly greater improvements were also observed in psychological stress ($\beta$=--1.186, 95\% CI --1.678 to --0.694, Cohen d=--1.41, P<.001), physical HRQoL ($\beta$=0.088, 95\% CI 0.008-0.167, Cohen d=0.72, P=.03), emotional HRQoL ($\beta$=0.294, 95\% CI 0.169-0.419, Cohen d=0.81, P<.001), and general HRQoL ($\beta$=0.147, 95\% CI 0.070-0.224, Cohen d=1.07) at T1, as well as dietary behavior ($\beta$=0.069, 95\% CI 0.003-0.136, Cohen d=0.75, P=.04), physical activity level ($\beta$=177.542, 95\% CI --39.073 to 316.011, Cohen d=0.51, P=.01), and systolic blood pressure ($\beta$=--3.326, 95\% CI --5.928 to --0.725, Cohen d=--1.32, P=.01) at T2. The overall completion rate of the intervention (completing ?5 sessions) was 76\% (68/89). Positive responses to the questions of the acceptability questionnaire ranged from 93\% (76/82) to 100\% (82/82). Conclusions: The MCARE program generated favorable effects on psychological distress, psychological stress, HRQoL, and several aspects of cardiovascular risk factors in patients with ACS. This study provides clues for guiding clinical practice in the recognition and management of psychological distress and integrating the intervention into routine rehabilitation practice. Trial Registration: Chinese Clinical Trial Registry ChiCTR2000033526; https://www.chictr.org.cn/showprojEN.html?proj=54693 ",
doi="10.2196/48557",
url="https://www.jmir.org/2024/1/e48557",
url="http://www.ncbi.nlm.nih.gov/pubmed/38376899"
}


@Article{info:doi/10.2196/47245,
author="Sloesen, Brigitte
and O'Brien, Paul
and Verma, Himanshu
and Asaithambi, Sathyaraj
and Parashar, Nikita
and Mothe, Kumar Raj
and Shaikh, Javed
and Syntosi, Annie",
title="Patient Experiences and Insights on Chronic Ocular Pain: Social Media Listening Study",
journal="JMIR Form Res",
year="2024",
month="Feb",
day="15",
volume="8",
pages="e47245",
keywords="chronic ocular surface pain, patients' experiences",
keywords="quality of life",
keywords="social media",
keywords="Twitter",
keywords="unmet needs",
keywords="ocular pain",
keywords="ophthalmology",
keywords="ocular",
keywords="listening",
keywords="experience",
keywords="experiences",
keywords="tweet",
keywords="eye pain",
keywords="eye condition",
keywords="social media platforms",
keywords="social media use",
keywords="patient experience",
keywords="chronic pain",
keywords="pain",
keywords="internet",
keywords="eye",
keywords="retina",
keywords="online health",
keywords="digital health",
keywords="web",
keywords="vision",
keywords="optical",
abstract="Background: Ocular pain has multifactorial etiologies that affect activities of daily life, psychological well-being, and health-related quality of life (QoL). Chronic ocular surface pain (COSP) is a persistent eye pain symptom lasting for a period longer than 3 months. Objective: The objective of this social media listening study was to better understand COSP and related symptoms and identify its perceived causes, comorbidities, and impact on QoL from social media posts. Methods: A search from February 2020 to February 2021 was performed on social media platforms (Twitter, Facebook, blogs, and forums) for English-language content posted on the web. Social media platforms that did not provide public access to information or posts were excluded. Social media posts from Australia, Canada, the United Kingdom, and the United States were retrieved using the Social Studio platform---a web-based aggregator tool. Results: Of the 25,590 posts identified initially, 464 posts about COSP were considered relevant; the majority of conversations (98.3\%, n=456) were posted by adults (aged >18 years). Work status was mentioned in 52 conversations. Patients' or caregivers' discussions across social media platforms were centered around the symptoms (61.9\%, n=287) and causes (58\%, n=269) of ocular pain. Patients mentioned having symptoms associated with COSP, including headache or head pressure, dry or gritty eyes, light sensitivity, etc. Patients posted that their COSP impacts day-to-day activities such as reading, driving, sleeping, and their social, mental, and functional well-being. Conclusions: Insights from this study reported patients' experiences, concerns, and the adverse impact on overall QoL. COSP imposes a significant burden on patients, which spans multiple aspects of daily life. ",
doi="10.2196/47245",
url="https://formative.jmir.org/2024/1/e47245",
url="http://www.ncbi.nlm.nih.gov/pubmed/38358786"
}


@Article{info:doi/10.2196/47408,
author="Valdez, Danny
and Mena-Mel{\'e}ndez, Lucrecia
and Crawford, L. Brandon
and Jozkowski, N. Kristen",
title="Analyzing Reddit Forums Specific to Abortion That Yield Diverse Dialogues Pertaining to Medical Information Seeking and Personal Worldviews: Data Mining and Natural Language Processing Comparative Study",
journal="J Med Internet Res",
year="2024",
month="Feb",
day="14",
volume="26",
pages="e47408",
keywords="abortion",
keywords="social media",
keywords="Reddit",
keywords="natural language processing",
keywords="NLP",
keywords="neural networks",
abstract="Background: Attitudes toward abortion have historically been characterized via dichotomized labels, yet research suggests that these labels do not appropriately encapsulate beliefs on abortion. Rather, contexts, circumstances, and lived experiences often shape views on abortion into more nuanced and complex perspectives. Qualitative data have also been shown to underpin belief systems regarding abortion. Social media, as a form of qualitative data, could reveal how attitudes toward abortion are communicated publicly in web-based spaces. Furthermore, in some cases, social media can also be leveraged to seek health information. Objective: This study applies natural language processing and social media mining to analyze Reddit (Reddit, Inc) forums specific to abortion, including r/Abortion (the largest subreddit about abortion) and r/AbortionDebate (a subreddit designed to discuss and debate worldviews on abortion). Our analytical pipeline intends to identify potential themes within the data and the affect from each post. Methods: We applied a neural network--based topic modeling pipeline (BERTopic) to uncover themes in the r/Abortion (n=2151) and r/AbortionDebate (n=2815) subreddits. After deriving the optimal number of topics per subreddit using an iterative coherence score calculation, we performed a sentiment analysis using the Valence Aware Dictionary and Sentiment Reasoner to assess positive, neutral, and negative affect and an emotion analysis using the Text2Emotion lexicon to identify potential emotionality per post. Differences in affect and emotion by subreddit were compared. Results: The iterative coherence score calculation revealed 10 topics for both r/Abortion (coherence=0.42) and r/AbortionDebate (coherence=0.35). Topics in the r/Abortion subreddit primarily centered on information sharing or offering a source of social support; in contrast, topics in the r/AbortionDebate subreddit centered on contextualizing shifting or evolving views on abortion across various ethical, moral, and legal domains. The average compound Valence Aware Dictionary and Sentiment Reasoner scores for the r/Abortion and r/AbortionDebate subreddits were 0.01 (SD 0.44) and ?0.06 (SD 0.41), respectively. Emotionality scores were consistent across the r/Abortion and r/AbortionDebate subreddits; however, r/Abortion had a marginally higher average fear score of 0.36 (SD 0.39). Conclusions: Our findings suggest that people posting on abortion forums on Reddit are willing to share their beliefs, which manifested in diverse ways, such as sharing abortion stories including how their worldview changed, which critiques the value of dichotomized abortion identity labels, and information seeking. Notably, the style of discourse varied significantly by subreddit. r/Abortion was principally leveraged as an information and outreach source; r/AbortionDebate largely centered on debating across various legal, ethical, and moral abortion domains. Collectively, our findings suggest that abortion remains an opaque yet politically charged issue for people and that social media can be leveraged to understand views and circumstances surrounding abortion. ",
doi="10.2196/47408",
url="https://www.jmir.org/2024/1/e47408",
url="http://www.ncbi.nlm.nih.gov/pubmed/38354044"
}


@Article{info:doi/10.2196/52660,
author="Jaiswal, Aditi
and Washington, Peter",
title="Using \#ActuallyAutistic on Twitter for Precision Diagnosis of Autism Spectrum Disorder: Machine Learning Study",
journal="JMIR Form Res",
year="2024",
month="Feb",
day="14",
volume="8",
pages="e52660",
keywords="autism",
keywords="autism spectrum disorder",
keywords="machine learning",
keywords="natural language processing",
keywords="public health",
keywords="sentiment analysis",
keywords="social media analysis",
keywords="Twitter",
abstract="Background: The increasing use of social media platforms has given rise to an unprecedented surge in user-generated content, with millions of individuals publicly sharing their thoughts, experiences, and health-related information. Social media can serve as a useful means to study and understand public health. Twitter (subsequently rebranded as ``X'') is one such social media platform that has proven to be a valuable source of rich information for both the general public and health officials. We conducted the first study applying Twitter data mining to autism screening. Objective: We aimed to study the feasibility of autism screening from Twitter data and discuss the ethical implications of such models. Methods: We developed a machine learning model to attempt to distinguish individuals with autism from their neurotypical peers based on the textual patterns from their public communications on Twitter. We collected 6,515,470 tweets from users' self-identification with autism using ``\#ActuallyAutistic'' and a separate control group. To construct the data set, we targeted English-language tweets using the search query ``\#ActuallyAutistic'' posted from January 1, 2014 to December 31, 2022. We encrypted all user IDs and stripped the tweets of identifiable information such as the associated email address prior to analysis. From these tweets, we identified unique users who used keywords such as ``autism'' OR ``autistic'' OR ``neurodiverse'' in their profile description and collected all the tweets from their timelines. To build the control group data set, we formulated a search query excluding the hashtag ``\#ActuallyAutistic'' and collected 1000 tweets per day during the same time period. We trained a word2vec model and an attention-based, bidirectional long short-term memory model to validate the performance of per-tweet and per-profile classification models. We deleted the data set and the models after our analysis. Results: Our tweet classifier reached a 73\% accuracy, a 0.728 area under the receiver operating characteristic curve score, and an 0.71 F1-score using word2vec representations fed into a logistic regression model, while the user profile classifier achieved an 0.78 area under the receiver operating characteristic curve score and an F1-score of 0.805 using an attention-based, bidirectional long short-term memory model. Conclusions: We have shown that it is feasible to train machine learning models using social media data to predict use of the \#ActuallyAutistic hashtag, an imperfect proxy for self-reported autism. While analyzing textual differences in naturalistic text has the potential to help clinicians screen for autism, there remain ethical questions that must be addressed for such research to move forward and to translate into the real world. While machine learning has the potential to improve behavioral research, there are still a plethora of ethical issues in digital phenotyping studies using social media with respect to user consent of marginalized populations. Achieving this requires a more inclusive approach during the model development process that involves the autistic community directly in the ideation and consent processes. ",
doi="10.2196/52660",
url="https://formative.jmir.org/2024/1/e52660",
url="http://www.ncbi.nlm.nih.gov/pubmed/38354045"
}


@Article{info:doi/10.2196/53025,
author="Castillo, R. Louise I.
and Tran, Vivian
and Brachaniec, Mary
and Chambers, T. Christine
and Chessie, Kelly
and Couros, Alec
and LeRuyet, Andre
and LeRuyet, Charmayne
and Thorpe, Lilian
and Williams, Jaime
and Wheelwright, Sara
and Hadjistavropoulos, Thomas",
title="The \#SeePainMoreClearly Phase II Pain in Dementia Social Media Campaign: Implementation and Evaluation Study",
journal="JMIR Aging",
year="2024",
month="Feb",
day="8",
volume="7",
pages="e53025",
keywords="knowledge translation",
keywords="Twitter",
keywords="older adults",
keywords="Facebook",
keywords="knowledge mobilization",
abstract="Background: Social media platforms have been effective in raising awareness of the underassessment and undertreatment of pain in dementia. Objective: After a successful pilot campaign, we aimed to scale our pain-in-dementia knowledge mobilization pilot initiative (ie, \#SeePainMoreClearly) to several social media platforms with the aid of a digital media partner. The goal of the initiative was to increase awareness of the challenges in the assessment and management of pain among people with dementia. A variety of metrics were implemented to evaluate the effort. Through this work, we endeavored to highlight key differences between our pilot initiative (which was a grassroots initiative), focusing largely on Twitter and YouTube, and the current science-media partnership. We also aimed to generate recommendations suitable for other social media campaigns related to health or aging. Methods: Evidence-based information about pain in dementia was summarized into engaging content (eg, videos) tailored to the needs of various knowledge users (eg, health professionals, families, and policy makers). We disseminated information using Facebook (Meta Platforms), Twitter (X Corp), YouTube (Alphabet Inc), Instagram (Meta Platforms), and LinkedIn (LinkedIn Corp) and measured the success of the initiative over a 12-month period (2020 to 2021). The evaluation methods focused on web analytics and questionnaires related to social media content. Knowledge users' web responses about the initiative and semistructured interviews were analyzed using thematic analysis. Results: During the course of the campaign, >700 posts were shared across all platforms. Web analytics showed that we drew >60,000 users from 82 countries to our resource website. Of the social media platforms used, Facebook was the most effective in reaching knowledge users (ie, over 1,300,000 users). Questionnaire responses from users were favorable; interview responses indicated that the information shared throughout the initiative increased awareness of the problem of pain in dementia and influenced respondent behavior. Conclusions: In this investigation, we demonstrated success in directing knowledge users to a resource website with practical information that health professionals could use in patient care along with pain assessment and management information for caregivers and people living with dementia. The evaluation metrics suggested no considerable differences between our pilot campaign and broader initiative when accounting for the length of time of each initiative. The limitations of large-scale health campaigns were noted, and recommendations were outlined for other researchers aiming to leverage social media as a knowledge mobilization tool. ",
doi="10.2196/53025",
url="https://aging.jmir.org/2024/1/e53025",
url="http://www.ncbi.nlm.nih.gov/pubmed/38329793"
}


@Article{info:doi/10.2196/50561,
author="Ni, Chen-xu
and Fei, Yi-bo
and Wu, Ran
and Cao, Wen-xiang
and Liu, Wenhao
and Huang, Fang
and Shen, Fu-ming
and Li, Dong-jie",
title="Tumor Immunotherapy--Related Information on Internet-Based Videos Commonly Used by the Chinese Population: Content Quality Analysis",
journal="JMIR Form Res",
year="2024",
month="Feb",
day="7",
volume="8",
pages="e50561",
keywords="immunotherapy",
keywords="internet videos",
keywords="quality",
keywords="misinformation",
keywords="health informatics",
keywords="Chinese",
abstract="Background: Tumor immunotherapy is an innovative treatment today, but there are limited data on the quality of immunotherapy information on social networks. Dissemination of misinformation through the internet is a major social issue. Objective: Our objective was to characterize the quality of information and presence of misinformation about tumor immunotherapy on internet-based videos commonly used by the Chinese population. Methods: Using the keyword ``tumor immunotherapy'' in Chinese, we searched TikTok, Tencent, iQIYI, and BiliBili on March 5, 2022. We reviewed the 118 screened videos using the Patient Education Materials Assessment Tool---a validated instrument to collect consumer health information. DISCERN quality criteria and the JAMA (Journal of the American Medical Association) Benchmark Criteria were used for assessing the quality and reliability of the health information. The videos' content was also evaluated. Results: The 118 videos about tumor immunotherapy were mostly uploaded by channels dedicated to lectures, health-related animations, and interviews; their median length was 5 minutes, and 79\% of them were published in and after 2018. The median understandability and actionability of the videos were 71\% and 71\%, respectively. However, the quality of information was moderate to poor on the validated DISCERN and JAMA assessments. Only 12 videos contained misinformation (score of >1 out of 5). Videos with a doctor (lectures and interviews) not only were significantly less likely to contain misinformation but also had better quality and a greater forwarding number. Moreover, the results showed that more than half of the videos contain little or no content on the risk factors and management of tumor immunotherapy. Overall, over half of the videos had some or more information on the definition, symptoms, evaluation, and outcomes of tumor immunotherapy. Conclusions: Although the quality of immunotherapy information on internet-based videos commonly used by Chinese people is moderate, these videos have less misinformation and better content. Caution must be exercised when using these videos as a source of tumor immunotherapy--related information. ",
doi="10.2196/50561",
url="https://formative.jmir.org/2024/1/e50561",
url="http://www.ncbi.nlm.nih.gov/pubmed/38324352"
}


@Article{info:doi/10.2196/37881,
author="Ueda, Ryuichiro
and Han, Feng
and Zhang, Hongjian
and Aoki, Tomohiro
and Ogasawara, Katsuhiko",
title="Verification in the Early Stages of the COVID-19 Pandemic: Sentiment Analysis of Japanese Twitter Users",
journal="JMIR Infodemiology",
year="2024",
month="Feb",
day="6",
volume="4",
pages="e37881",
keywords="COVID-19",
keywords="sentiment analysis",
keywords="Twitter",
keywords="infodemiology",
keywords="NLP",
keywords="Natural Language Processing",
abstract="Background: The COVID-19 pandemic prompted global behavioral restrictions, impacting public mental health. Sentiment analysis, a tool for assessing individual and public emotions from text data, gained importance amid the pandemic. This study focuses on Japan's early public health interventions during COVID-19, utilizing sentiment analysis in infodemiology to gauge public sentiment on social media regarding these interventions. Objective: This study aims to investigate shifts in public emotions and sentiments before and after the first state of emergency was declared in Japan. By analyzing both user-generated tweets and retweets, we aim to discern patterns in emotional responses during this critical period. Methods: We conducted a day-by-day analysis of Twitter (now known as X) data using 4,894,009 tweets containing the keywords ``corona,'' ``COVID-19,'' and ``new pneumonia'' from March 23 to April 21, 2020, approximately 2 weeks before and after the first declaration of a state of emergency in Japan. We also processed tweet data into vectors for each word, employing the Fuzzy-C-Means (FCM) method, a type of cluster analysis, for the words in the sentiment dictionary. We set up 7 sentiment clusters (negative: anger, sadness, surprise, disgust; neutral: anxiety; positive: trust and joy) and conducted sentiment analysis of the tweet groups and retweet groups. Results: The analysis revealed a mix of positive and negative sentiments, with ``joy'' significantly increasing in the retweet group after the state of emergency declaration. Negative emotions, such as ``worry'' and ``disgust,'' were prevalent in both tweet and retweet groups. Furthermore, the retweet group had a tendency to share more negative content compared to the tweet group. Conclusions: This study conducted sentiment analysis of Japanese tweets and retweets to explore public sentiments during the early stages of COVID-19 in Japan, spanning 2 weeks before and after the first state of emergency declaration. The analysis revealed a mix of positive (joy) and negative (anxiety, disgust) emotions. Notably, joy increased in the retweet group after the emergency declaration, but this group also tended to share more negative content than the tweet group. This study suggests that the state of emergency heightened positive sentiments due to expectations for infection prevention measures, yet negative information also gained traction. The findings propose the potential for further exploration through network analysis. ",
doi="10.2196/37881",
url="https://infodemiology.jmir.org/2024/1/e37881",
url="http://www.ncbi.nlm.nih.gov/pubmed/38127840"
}


@Article{info:doi/10.2196/48538,
author="Stoffel, T. Sandro
and Law, Hui Jing
and Kerrison, Robert
and Brewer, R. Hannah
and Flanagan, M. James
and Hirst, Yasemin",
title="Testing Behavioral Messages to Increase Recruitment to Health Research When Embedded Within Social Media Campaigns on Twitter: Web-Based Experimental Study",
journal="JMIR Form Res",
year="2024",
month="Feb",
day="5",
volume="8",
pages="e48538",
keywords="advertise",
keywords="advertisement",
keywords="advertisements",
keywords="advertising",
keywords="behavior change",
keywords="behavioral",
keywords="behaviour change",
keywords="behavioural",
keywords="campaign",
keywords="campaigns",
keywords="experimental design",
keywords="message",
keywords="messages",
keywords="messaging",
keywords="recruit",
keywords="recruiting",
keywords="recruitment",
keywords="social media",
keywords="social norms",
keywords="Twitter",
abstract="Background: Social media is rapidly becoming the primary source to disseminate invitations to the public to consider taking part in research studies. There is, however, little information on how the contents of the advertisement can be communicated to facilitate engagement and subsequently promote intentions to participate in research. Objective: This paper describes an experimental study that tested different behavioral messages for recruiting study participants for a real-life observational case-control study. Methods: We included 1060 women in a web-based experiment and randomized them to 1 of 3 experimental conditions: standard advertisement (n=360), patient endorsement advertisement (n=345), and social norms advertisement (n=355). After seeing 1 of the 3 advertisements, participants were asked to state (1) their intention to take part in the advertised case-control study, (2) the ease of understanding the message and study aims, and (3) their willingness to be redirected to the website of the case-control study after completing the survey. Individuals were further asked to suggest ways to improve the messages. Intentions were compared between groups using ordinal logistic regression, reported in percentages, adjusted odds ratio (aOR), and 95\% CIs. Results: Those who were in the patient endorsement and social norms--based advertisement groups had significantly lower intentions to take part in the advertised study compared with those in the standard advertisement group (aOR 0.73, 95\% CI 0.55-0.97; P=.03 and aOR 0.69, 95\% CI 0.52-0.92; P=.009, respectively). The patient endorsement advertisement was perceived to be more difficult to understand (aOR 0.65, 95\% CI 0.48-0.87; P=.004) and to communicate the study aims less clearly (aOR 0.72, 95\% CI 0.55-0.95; P=.01). While the patient endorsement advertisement had no impact on intention to visit the main study website, the social norms advertisement decreased willingness compared with the standard advertisement group (157/355, 44.2\% vs 191/360, 53.1\%; aOR 0.74, 95\% CI 0.54-0.99; P=.02). The majority of participants (395/609, 64.8\%) stated that the messages did not require changes, but some preferred clearer (75/609, 12.3\%) and shorter (59/609, 9.7\%) messages. Conclusions: The results of this study indicate that adding normative behavioral messages to simulated tweets decreased participant intention to take part in our web-based case-control study, as this made the tweet harder to understand. This suggests that simple messages should be used for participant recruitment through Twitter (subsequently rebranded X). ",
doi="10.2196/48538",
url="https://formative.jmir.org/2024/1/e48538",
url="http://www.ncbi.nlm.nih.gov/pubmed/38315543"
}


@Article{info:doi/10.2196/52768,
author="Spies, Erica
and Andreu, Thomas
and Hartung, Matthias
and Park, Josephine
and Kamudoni, Paul",
title="Exploring the Perspectives of Patients Living With Lupus: Retrospective Social Listening Study",
journal="JMIR Form Res",
year="2024",
month="Feb",
day="2",
volume="8",
pages="e52768",
keywords="systemic lupus erythematosus",
keywords="SLE",
keywords="cutaneous lupus erythematosus",
keywords="CLE",
keywords="quality of life",
keywords="health-related quality of life",
keywords="HRQoL",
keywords="social media listening",
keywords="lupus",
keywords="rare",
keywords="cutaneous",
keywords="social media",
keywords="infodemiology",
keywords="infoveillance",
keywords="social listening",
keywords="natural language processing",
keywords="machine learning",
keywords="experience",
keywords="experiences",
keywords="tagged",
keywords="tagging",
keywords="visualization",
keywords="visualizations",
keywords="knowledge graph",
keywords="chronic",
keywords="autoimmune",
keywords="inflammation",
keywords="inflammatory",
keywords="skin",
keywords="dermatology",
keywords="dermatological",
keywords="forum",
keywords="forums",
keywords="blog",
keywords="blogs",
abstract="Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory disease affecting various organs with a wide range of clinical manifestations. Cutaneous lupus erythematosus (CLE) can manifest as a feature of SLE or an independent skin ailment. Health-related quality of life (HRQoL) is frequently compromised in individuals living with lupus. Understanding patients' perspectives when living with a disease is crucial for effectively meeting their unmet needs. Social listening is a promising new method that can provide insights into the experiences of patients living with their disease (lupus) and leverage these insights to inform drug development strategies for addressing their unmet needs. Objective: The objective of this study is to explore the experience of patients living with SLE and CLE, including their disease and treatment experiences, HRQoL, and unmet needs, as discussed in web-based social media platforms such as blogs and forums. Methods: A retrospective exploratory social listening study was conducted across 13 publicly available English-language social media platforms from October 2019 to January 2022. Data were processed using natural language processing and knowledge graph tagging technology to clean, format, anonymize, and annotate them algorithmically before feeding them to Pharos, a Semalytix proprietary data visualization and analysis platform, for further analysis. Pharos was used to generate descriptive data statistics, providing insights into the magnitude of individual patient experience variables, their differences in the magnitude of variables, and the associations between algorithmically tagged variables. Results: A total of 45,554 posts from 3834 individuals who were algorithmically identified as patients with lupus were included in this study. Among them, 1925 (authoring 5636 posts) and 106 (authoring 243 posts) patients were identified as having SLE and CLE, respectively. Patients frequently mentioned various symptoms in relation to SLE and CLE including pain, fatigue, and rashes; pain and fatigue were identified as the main drivers of HRQoL impairment. The most affected aspects of HRQoL included ``mobility,'' ``cognitive capabilities,'' ``recreation and leisure,'' and ``sleep and rest.'' Existing pharmacological interventions poorly managed the most burdensome symptoms of lupus. Conversely, nonpharmacological treatments, such as exercise and meditation, were frequently associated with HRQoL improvement. Conclusions: Patients with lupus reported a complex interplay of symptoms and HRQoL aspects that negatively influenced one another. This study demonstrates that social listening is an effective method to gather insights into patients' experiences, preferences, and unmet needs, which can be considered during the drug development process to develop effective therapies and improve disease management. ",
doi="10.2196/52768",
url="https://formative.jmir.org/2024/1/e52768",
url="http://www.ncbi.nlm.nih.gov/pubmed/38306157"
}


@Article{info:doi/10.2196/50388,
author="Heaton, Dan
and Nichele, Elena
and Clos, J{\'e}r{\'e}mie
and Fischer, E. Joel",
title="Perceptions of the Agency and Responsibility of the NHS COVID-19 App on Twitter: Critical Discourse Analysis",
journal="J Med Internet Res",
year="2024",
month="Feb",
day="1",
volume="26",
pages="e50388",
keywords="COVID-19",
keywords="information system",
keywords="automated decisions",
keywords="agency metaphor",
keywords="corpus linguistics",
keywords="decision-making algorithm",
keywords="transitivity",
abstract="Background: Since September 2020, the National Health Service (NHS) COVID-19 contact-tracing app has been used to mitigate the spread of COVID-19 in the United Kingdom. Since its launch, this app has been a part of the discussion regarding the perceived social agency of decision-making algorithms. On the social media website Twitter, a plethora of views about the app have been found but only analyzed for sentiment and topic trajectories thus far, leaving the perceived social agency of the app underexplored. Objective: We aimed to examine the discussion of social agency in social media public discourse regarding algorithm-operated decisions, particularly when the artificial intelligence agency responsible for specific information systems is not openly disclosed in an example such as the COVID-19 contact-tracing app. To do this, we analyzed the presentation of the NHS COVID-19 App on Twitter, focusing on the portrayal of social agency and the impact of its deployment on society. We also aimed to discover what the presentation of social agents communicates about the perceived responsibility of the app. Methods: Using corpus linguistics and critical discourse analysis, underpinned by social actor representation, we used the link between grammatical and social agency and analyzed a corpus of 118,316 tweets from September 2020 to July 2021 to see whether the app was portrayed as a social actor. Results: We found that active presentations of the app---seen mainly through personalization and agency metaphor---dominated the discourse. The app was presented as a social actor in 96\% of the cases considered and grew in proportion to passive presentations over time. These active presentations showed the app to be a social actor in 5 main ways: informing, instructing, providing permission, disrupting, and functioning. We found a small number of occasions on which the app was presented passively through backgrounding and exclusion. Conclusions: Twitter users presented the NHS COVID-19 App as an active social actor with a clear sense of social agency. The study also revealed that Twitter users perceived the app as responsible for their welfare, particularly when it provided instructions or permission, and this perception remained consistent throughout the discourse, particularly during significant events. Overall, this study contributes to understanding how social agency is discussed in social media discourse related to algorithmic-operated decisions This research offers valuable insights into public perceptions of decision-making digital contact-tracing health care technologies and their perceptions on the web, which, even in a postpandemic world, may shed light on how the public might respond to forthcoming interventions. ",
doi="10.2196/50388",
url="https://www.jmir.org/2024/1/e50388",
url="http://www.ncbi.nlm.nih.gov/pubmed/38300688"
}


@Article{info:doi/10.2196/47508,
author="Guo, Feipeng
and Liu, Zixiang
and Lu, Qibei
and Ji, Shaobo
and Zhang, Chen",
title="Public Opinion About COVID-19 on a Microblog Platform in China: Topic Modeling and Multidimensional Sentiment Analysis of Social Media",
journal="J Med Internet Res",
year="2024",
month="Jan",
day="31",
volume="26",
pages="e47508",
keywords="COVID-19",
keywords="social media public opinion",
keywords="microblog",
keywords="sentiment analysis",
keywords="topic modeling",
abstract="Background: The COVID-19 pandemic raised wide concern from all walks of life globally. Social media platforms became an important channel for information dissemination and an effective medium for public sentiment transmission during the COVID-19 pandemic. Objective: Mining and analyzing social media text information can not only reflect the changes in public sentiment characteristics during the COVID-19 pandemic but also help the government understand the trends in public opinion and reasonably control public opinion. Methods: First, this study collected microblog comments related to the COVID-19 pandemic as a data set. Second, sentiment analysis was carried out based on the topic modeling method combining latent Dirichlet allocation (LDA) and Bidirectional Encoder Representations from Transformers (BERT). Finally, a machine learning logistic regression (ML-LR) model combined with a sparse matrix was proposed to explore the evolutionary trend in public opinion on social media and verify the high accuracy of the model. Results: The experimental results show that, in different stages, the characteristics of public emotion are different, and the overall trend is from negative to positive. Conclusions: The proposed method can effectively reflect the characteristics of the different times and space of public opinion. The results provide theoretical support and practical reference in response to public health and safety events. ",
doi="10.2196/47508",
url="https://www.jmir.org/2024/1/e47508",
url="http://www.ncbi.nlm.nih.gov/pubmed/38294856"
}


@Article{info:doi/10.2196/48599,
author="Moens, Maarten
and Van Doorslaer, Leen
and Billot, Maxime
and Eeckman, Edgard
and Roulaud, Manuel
and Rigoard, Philippe
and Fobelets, Maaike
and Goudman, Lisa",
title="Examining the Type, Quality, and Content of Web-Based Information for People With Chronic Pain Interested in Spinal Cord Stimulation: Social Listening Study",
journal="J Med Internet Res",
year="2024",
month="Jan",
day="30",
volume="26",
pages="e48599",
keywords="online information",
keywords="social listening",
keywords="neuromodulation",
keywords="patient care",
keywords="chronic pain",
keywords="web-based data",
abstract="Background: The increased availability of web-based medical information has encouraged patients with chronic pain to seek health care information from multiple sources, such as consultation with health care providers combined with web-based information. The type and quality of information that is available on the web is very heterogeneous, in terms of content, reliability, and trustworthiness. To date, no studies have evaluated what information is available about neuromodulation on the web for patients with chronic pain. Objective: This study aims to explore the type, quality, and content of web-based information regarding spinal cord stimulation (SCS) for chronic pain that is freely available and targeted at health care consumers. Methods: The social listening tool Awario was used to search Facebook (Meta Platforms, Inc), Twitter (Twitter, Inc), YouTube (Google LLC), Instagram (Meta Platforms, Inc), blogs, and the web for suitable hits with ``pain'' and ``neuromodulation'' as keywords. Quality appraisal of the extracted information was performed using the DISCERN instrument. A thematic analysis through inductive coding was conducted. Results: The initial search identified 2174 entries, of which 630 (28.98\%) entries were eventually withheld, which could be categorized as web pages, including news and blogs (114/630, 18.1\%); Reddit (Reddit, Inc) posts (32/630, 5.1\%); Vimeo (Vimeo, Inc) hits (38/630, 6\%); or YouTube (Google LLC) hits (446/630, 70.8\%). Most posts originated in the United States (519/630, 82.4\%). Regarding the content of information, 66.2\% (383/579) of the entries discussed (fully discussed or partially discussed) how SCS works. In total, 55.6\% (322/579) of the entries did not elaborate on the fact that there may be >1 potential treatment choice and 47.7\% (276/579) did not discuss the influence of SCS on the overall quality of life. The inductive coding revealed 4 main themes. The first theme of pain and the burden of pain (1274/8886, 14.34\% coding references) explained about pain, pain management, individual impact of pain, and patient experiences. The second theme included neuromodulation as a treatment approach (3258/8886, 36.66\% coding references), incorporating the background on neuromodulation, patient-centered care, SCS therapy, and risks. Third, several device-related aspects (1722/8886, 19.38\% coding references) were presented. As a final theme, patient benefits and testimonials of treatment with SCS (2632/8886, 29.62\% coding references) were revealed with subthemes regarding patient benefits, eligibility, and testimonials and expectations. Conclusions: Health care consumers have access to web-based information about SCS, where details about the surgical procedures, the type of material, working mechanisms, risks, patient expectations, testimonials, and the potential benefits of this therapy are discussed. The reliability, trustworthiness, and correctness of web-based sources should be carefully considered before automatically relying on the content. ",
doi="10.2196/48599",
url="https://www.jmir.org/2024/1/e48599",
url="http://www.ncbi.nlm.nih.gov/pubmed/38289645"
}


@Article{info:doi/10.2196/54439,
author="Ramjee, Serena
and Hasan, Zeeshaan-ul",
title="Strengthening TikTok Content Analysis in Academia Using Follower Count and Engagement",
journal="JMIR Dermatol",
year="2024",
month="Jan",
day="30",
volume="7",
pages="e54439",
keywords="social media",
keywords="skin of color",
keywords="skin of colour",
keywords="representation",
keywords="TikTok",
keywords="atopic dermatitis",
keywords="dermatology",
keywords="dermatologist",
doi="10.2196/54439",
url="https://derma.jmir.org/2024/1/e54439",
url="http://www.ncbi.nlm.nih.gov/pubmed/38289654"
}


@Article{info:doi/10.2196/49756,
author="Yin, Shuhua
and Chen, Shi
and Ge, Yaorong",
title="Dynamic Associations Between Centers for Disease Control and Prevention Social Media Contents and Epidemic Measures During COVID-19: Infoveillance Study",
journal="JMIR Infodemiology",
year="2024",
month="Jan",
day="23",
volume="4",
pages="e49756",
keywords="infoveillance",
keywords="social media",
keywords="COVID-19",
keywords="US Centers for Disease Control and Prevention",
keywords="CDC",
keywords="topic modeling",
keywords="multivariate time series analysis",
abstract="Background: Health agencies have been widely adopting social media to disseminate important information, educate the public on emerging health issues, and understand public opinions. The Centers for Disease Control and Prevention (CDC) widely used social media platforms during the COVID-19 pandemic to communicate with the public and mitigate the disease in the United States. It is crucial to understand the relationships between the CDC's social media communications and the actual epidemic metrics to improve public health agencies' communication strategies during health emergencies. Objective: This study aimed to identify key topics in tweets posted by the CDC during the pandemic, investigate the temporal dynamics between these key topics and the actual COVID-19 epidemic measures, and make recommendations for the CDC's digital health communication strategies for future health emergencies. Methods: Two types of data were collected: (1) a total of 17,524 COVID-19--related English tweets posted by the CDC between December 7, 2019, and January 15, 2022, and (2) COVID-19 epidemic measures in the United States from the public GitHub repository of Johns Hopkins University from January 2020 to July 2022. Latent Dirichlet allocation topic modeling was applied to identify key topics from all COVID-19--related tweets posted by the CDC, and the final topics were determined by domain experts. Various multivariate time series analysis techniques were applied between each of the identified key topics and actual COVID-19 epidemic measures to quantify the dynamic associations between these 2 types of time series data. Results: Four major topics from the CDC's COVID-19 tweets were identified: (1) information on the prevention of health outcomes of COVID-19; (2) pediatric intervention and family safety; (3) updates of the epidemic situation of COVID-19; and (4) research and community engagement to curb COVID-19. Multivariate analyses showed that there were significant variabilities of progression between the CDC's topics and the actual COVID-19 epidemic measures. Some CDC topics showed substantial associations with the COVID-19 measures over different time spans throughout the pandemic, expressing similar temporal dynamics between these 2 types of time series data. Conclusions: Our study is the first to comprehensively investigate the dynamic associations between topics discussed by the CDC on Twitter and the COVID-19 epidemic measures in the United States. We identified 4 major topic themes via topic modeling and explored how each of these topics was associated with each major epidemic measure by performing various multivariate time series analyses. We recommend that it is critical for public health agencies, such as the CDC, to update and disseminate timely and accurate information to the public and align major topics with key epidemic measures over time. We suggest that social media can help public health agencies to inform the public on health emergencies and to mitigate them effectively. ",
doi="10.2196/49756",
url="https://infodemiology.jmir.org/2024/1/e49756",
url="http://www.ncbi.nlm.nih.gov/pubmed/38261367"
}


@Article{info:doi/10.2196/45168,
author="Brassel, Sophie
and Brunner, Melissa
and Campbell, Andrew
and Power, Emma
and Togher, Leanne",
title="Exploring Discussions About Virtual Reality on Twitter to Inform Brain Injury Rehabilitation: Content and Network Analysis",
journal="J Med Internet Res",
year="2024",
month="Jan",
day="19",
volume="26",
pages="e45168",
keywords="virtual reality",
keywords="Twitter",
keywords="brain injury",
keywords="rehabilitation",
keywords="cognitive communication",
keywords="social networks",
keywords="social media",
keywords="brain injury rehabilitation",
keywords="engagement",
keywords="development",
keywords="clinical practice",
keywords="injury",
keywords="users",
abstract="Background: Virtual reality (VR) use in brain injury rehabilitation is emerging. Recommendations for VR development in this field encourage end user engagement to determine the benefits and challenges of VR use; however, existing literature on this topic is limited. Data from social networking sites such as Twitter may further inform development and clinical practice related to the use of VR in brain injury rehabilitation. Objective: This study collected and analyzed VR-related tweets to (1) explore the VR tweeting community to determine topics of conversation and network connections, (2) understand user opinions and experiences of VR, and (3) identify tweets related to VR use in health care and brain injury rehabilitation. Methods: Publicly available tweets containing the hashtags \#virtualreality and \#VR were collected up to twice weekly during a 6-week period from July 2020 to August 2020 using NCapture (QSR International). The included tweets were analyzed using mixed methods. All tweets were coded using inductive content analysis. Relevant tweets (ie, coded as ``VR in health care'' or ``talking about VR'') were further analyzed using Dann's content coding. The biographies of users who sent relevant tweets were examined descriptively. Tweet data networks were visualized using Gephi computational analysis. Results: A total of 260,715 tweets were collected, and 70,051 (26.87\%) were analyzed following eligibility screening. The sample comprised 33.68\% (23,596/70,051) original tweets and 66.32\% (46,455/70,051) retweets. Content analysis generated 10 main categories of original tweets related to VR (ie, advertising and promotion, VR content, talking about VR, VR news, general technology, VR industry, VR live streams, VR in health care, VR events, and VR community). Approximately 4.48\% (1056/23,596) of original tweets were related to VR use in health care, whereas 0.19\% (45/23,596) referred to VR in brain injury rehabilitation. In total, 14.86\% (3506/23,596) of original tweets featured commentary on user opinions and experiences of VR applications, equipment, and software. The VR tweeting community comprised a large network of 26,001 unique Twitter users. Users that posted tweets related to ``VR in health care'' (2124/26,001, 8.17\%) did not form an interconnected VR network, whereas many users ``talking about VR'' (3752/26,001, 14.43\%) were connected within a central network. Conclusions: This study provides valuable data on community-based experiences and opinions related to VR. Tweets showcased various VR applications, including in health care, and identified important user-based considerations that can be used to inform VR use in brain injury rehabilitation (eg, technical design, accessibility, and VR sickness). Limited discussions and small user networks related to VR in brain injury rehabilitation reflect the paucity of literature on this topic and the potential underuse of this technology. These findings emphasize that further research is required to understand the specific needs and perspectives of people with brain injuries and clinicians regarding VR use in rehabilitation. ",
doi="10.2196/45168",
url="https://www.jmir.org/2024/1/e45168",
url="http://www.ncbi.nlm.nih.gov/pubmed/38241072"
}


@Article{info:doi/10.2196/44923,
author="Alwuqaysi, Bdour
and Abdul-Rahman, Alfie
and Borgo, Rita",
title="The Impact of Social Media Use on Mental Health and Family Functioning Within Web-Based Communities in Saudi Arabia: Ethnographic Correlational Study",
journal="JMIR Form Res",
year="2024",
month="Jan",
day="16",
volume="8",
pages="e44923",
keywords="social media use",
keywords="mental health",
keywords="family functioning",
abstract="Background: In recent years, increasing numbers of parents, activists, and decision-makers have raised concerns about the potential adverse effects of social media use on both mental health and family functioning. Although some studies have indicated associations between social media use and negative mental health outcomes, others have found no evidence of mental health harm. Objective: This correlation study investigated the interplay between social media use, mental health, and family functioning. Analyzing data from 314 users, this study explores diverse mental health outcomes. The study places particular emphasis on the Saudi Arabian sample, providing valuable insights into the cultural context and shedding light on the specific dynamics of social media's impact on mental well-being and family dynamics in this demographic context. Methods: We collected data through a subsection of an anonymous web-based survey titled ``The Effect of COVID-19 on Social Media Usage, Mental Health, and Family Functioning.'' The survey was distributed through diverse web-based platforms in Saudi Arabia, emphasizing the Saudi sample. The participants indicated their social media accounts and estimated their daily use. Mental health was assessed using the General Health Questionnaire and family functioning was evaluated using the Family Assessment Device Questionnaire. In addition, 6 mental health conditions (anxiety, self-esteem, depression, body dysmorphia, social media addiction, and eating disorders) were self-reported by participants. Results: The study demonstrates a pattern of frequent social media use, with a significant portion dedicating 3-5 hours daily for web-based activities, and most of the sample accessed platforms multiple times a day. Despite concerns about social media addiction and perceived unhealthiness, participants cited staying connected with friends and family as their primary motivation for social media use. WhatsApp was perceived as the most positively impactful, whereas TikTok was considered the most negative for our Saudi sample. YouTube, Instagram, and Snapchat users reported poorer mental health compared with nonusers of these platforms. Mental health effects encompassed anxiety and addiction, with age and gender emerging as significant factors. Associations between social media use and family functioning were evident, with higher social media quartiles correlating with a greater likelihood of mental health and unhealthy family functioning. Logistic regression identified age and gender as factors linked to affected mental health, particularly noting that female participants aged 25-34 years were found to be more susceptible to affected mental health. In addition, multivariable analysis identified age and social media use quartiles as factors associated with poor family functioning. Conclusions: This study examined how social media affects mental health and family functioning in Saudi Arabia. These findings underscore the need for culturally tailored interventions to address these challenges, considering diverse demographic needs. Recognizing these nuances can guide the development of interventions to promote digital well-being, acknowledging the importance of familial connections in Saudi society. ",
doi="10.2196/44923",
url="https://formative.jmir.org/2024/1/e44923",
url="http://www.ncbi.nlm.nih.gov/pubmed/38227352"
}


@Article{info:doi/10.2196/49749,
author="Garg, Ashvita
and Nyitray, G. Alan
and Roberts, R. James
and Shungu, Nicholas
and Ruggiero, J. Kenneth
and Chandler, Jessica
and Damgacioglu, Haluk
and Zhu, Yenan
and Brownstein, C. Naomi
and Sterba, R. Katherine
and Deshmukh, A. Ashish
and Sonawane, Kalyani",
title="Consumption of Health-Related Videos and Human Papillomavirus Awareness: Cross-Sectional Analyses of a US National Survey and YouTube From the Urban-Rural Context",
journal="J Med Internet Res",
year="2024",
month="Jan",
day="15",
volume="26",
pages="e49749",
keywords="awareness",
keywords="health awareness",
keywords="health information",
keywords="health videos",
keywords="HINTS",
keywords="HPV vaccine",
keywords="HPV",
keywords="information behavior",
keywords="information behaviors",
keywords="information seeking",
keywords="online information",
keywords="reproductive health",
keywords="rural",
keywords="sexual health",
keywords="sexually transmitted",
keywords="social media",
keywords="STD",
keywords="STI",
keywords="urban",
keywords="video",
keywords="videos",
keywords="YouTube",
abstract="Background: Nearly 70\% of Americans use the internet as their first source of information for health-related questions. Contemporary data on the consumption of web-based videos containing health information among American adults by urbanity or rurality is currently unavailable, and its link with health topic awareness, particularly for human papillomavirus (HPV), is not known. Objective: We aim to describe trends and patterns in the consumption of health-related videos on social media from an urban-rural context, examine the association between exposure to health-related videos on social media and awareness of health topics (ie, HPV and HPV vaccine), and understand public interest in HPV-related video content through search terms and engagement analytics. Methods: We conducted a cross-sectional analysis of the US Health Information National Trends Survey 6, a nationally representative survey that collects data from civilian, noninstitutionalized adults aged 18 years or older residing in the United States. Bivariable analyses were used to estimate the prevalence of consumption of health-related videos on social media among US adults overall and by urbanity or rurality. Multivariable logistic regression models were used to examine the association between the consumption of health-related videos and HPV awareness among urban and rural adults. To provide additional context on the public's interest in HPV-specific video content, we examined search volumes (quantitative) and related query searches (qualitative) for the terms ``HPV'' and ``HPV vaccine'' on YouTube. Results: In 2022, 59.6\% of US adults (152.3 million) consumed health-related videos on social media, an increase of nearly 100\% from 2017 to 2022. Prevalence increased among adults living in both urban (from 31.4\% in 2017 to 59.8\% in 2022; P<.001) and rural (from 22.4\% in 2017 to 58\% in 2022; P<.001) regions. Within the urban and rural groups, consumption of health-related videos on social media was most prevalent among adults aged between 18 and 40 years and college graduates or higher-educated adults. Among both urban and rural groups, adults who consumed health-related videos had a significantly higher probability of being aware of HPV and the HPV vaccine compared with those who did not watch health videos on the internet. The term ``HPV'' was more frequently searched on YouTube compared with ``HPV vaccine.'' Individuals were most commonly searching for videos that covered content about the HPV vaccine, HPV in males, and side effects of the HPV vaccine. Conclusions: The consumption of health-related videos on social media in the United States increased dramatically between 2017 and 2022. The rise was prominent among both urban and rural adults. Watching a health-related video on social media was associated with a greater probability of being aware of HPV and the HPV vaccine. Additional research on designing and developing social media strategies is needed to increase public awareness of health topics. ",
doi="10.2196/49749",
url="https://www.jmir.org/2024/1/e49749",
url="http://www.ncbi.nlm.nih.gov/pubmed/38224476"
}


@Article{info:doi/10.2196/46693,
author="Pearce, Emily
and Raj, Hannah
and Emezienna, Ngozika
and Gilkey, B. Melissa
and Lazard, J. Allison
and Ribisl, M. Kurt
and Savage, A. Sharon
and Han, KJ Paul",
title="The Use of Social Media to Express and Manage Medical Uncertainty in Dyskeratosis Congenita: Content Analysis",
journal="JMIR Infodemiology",
year="2024",
month="Jan",
day="15",
volume="4",
pages="e46693",
keywords="social media",
keywords="medical uncertainty",
keywords="telomere biology disorder",
keywords="dyskeratosis congenita",
keywords="social support",
abstract="Background: Social media has the potential to provide social support for rare disease communities; however, little is known about the use of social media for the expression of medical uncertainty, a common feature of rare diseases. Objective: This study aims to evaluate the expression of medical uncertainty on social media in the context of dyskeratosis congenita, a rare cancer-prone inherited bone marrow failure and telomere biology disorder (TBD). Methods: We performed a content analysis of uncertainty-related posts on Facebook and Twitter managed by Team Telomere, a patient advocacy group for this rare disease. We assessed the frequency of uncertainty-related posts, uncertainty sources, issues, and management and associations between uncertainty and social support. Results: Across all TBD social media platforms, 45.98\% (1269/2760) of posts were uncertainty related. Uncertainty-related posts authored by Team Telomere on Twitter focused on scientific (306/434, 70.5\%) or personal (230/434, 53\%) issues and reflected uncertainty arising from probability, ambiguity, or complexity. Uncertainty-related posts in conversations among patients and caregivers in the Facebook community group focused on scientific (429/511, 84\%), personal (157/511, 30.7\%), and practical (114/511, 22.3\%) issues, many of which were related to prognostic unknowns. Both platforms suggested uncertainty management strategies that focused on information sharing and community building. Posts reflecting response-focused uncertainty management strategies (eg, emotional regulation) were more frequent on Twitter compared with the Facebook community group ($\chi$21=3.9; P=.05), whereas posts reflecting uncertainty-focused management strategies (eg, ordering information) were more frequent in the Facebook community group compared with Twitter ($\chi$21=55.1; P<.001). In the Facebook community group, only 36\% (184/511) of members created posts during the study period, and those who created posts did so with a low frequency (median 3, IQR 1-7 posts). Analysis of post creator characteristics suggested that most users of TBD social media are White, female, and parents of patients with dyskeratosis congenita. Conclusions: Although uncertainty is a pervasive and multifactorial issue in TBDs, our findings suggest that the discussion of medical uncertainty on TBD social media is largely limited to brief exchanges about scientific, personal, or practical issues rather than ongoing supportive conversation. The nature of uncertainty-related conversations also varied by user group: patients and caregivers used social media primarily to discuss scientific uncertainties (eg, regarding prognosis), form social connections, or exchange advice on accessing and organizing medical care, whereas Team Telomere used social media to express scientific and personal issues of uncertainty and to address the emotional impact of uncertainty. The higher involvement of female parents on TBD social media suggests a potentially greater burden of uncertainty management among mothers compared with other groups. Further research is needed to understand the dynamics of social media engagement to manage medical uncertainty in the TBD community. ",
doi="10.2196/46693",
url="https://infodemiology.jmir.org/2024/1/e46693",
url="http://www.ncbi.nlm.nih.gov/pubmed/38224480"
}


@Article{info:doi/10.2196/50512,
author="Yang, Ting
and Wu, Yihan
and Han, Nuo
and Liu, Tianli",
title="Chinese Women's Concept of Childbirth Based on the Social Media Topic ``What Does Childbirth Mean to a Woman'': Content and Thematic Analysis",
journal="JMIR Pediatr Parent",
year="2024",
month="Jan",
day="5",
volume="7",
pages="e50512",
keywords="childbirth willingness",
keywords="social media",
keywords="risk perception",
keywords="childbirth cost",
keywords="childbirth benefit",
abstract="Background: In recent years, women's fertility desire has attracted increasing attention in China. Objective: This study aims to detect attitudes toward giving birth among young female users on Douban, a very popular Chinese social media platform. Methods: A total of 2634 valid posts from 2489 users discussing the topic ``What does childbirth mean to a woman'' on Douban were crawled and retained for analysis. We utilized content and thematic analysis methods to capture users' concepts of childbirth. Results: The findings reveal that a significant majority of users conveyed generally neutral (1060/2634, 40.24\%) or negative (1051/2634, 39.90\%) attitudes toward childbirth, while only about one-fifth of users expressed positive (523/2634, 19.86\%) sentiments. Notably, posts with negative attitudes garnered more replies and likes, and the proportion of posts expressing negativity exhibited fluctuations over time. Health risk (339/2634, 12.87\%) emerged as the most frequently cited aspect of childbirth cost, with subjective happiness and the fulfillment of mental needs identified as primary benefits. Surprisingly, only a minimal number of posts (10/2634, 0.38\%) touched upon the traditional objective benefits of raising children for old-age care. Thematic analysis results suggest that discussions about fertility on social media platforms might contribute to an exaggerated perception of health risks among women. Additionally, a lack of knowledge about childbirth was observed, partially attributable to longstanding neglect and avoidance of communication on these matters, likely influenced by traditional cultural biases. Moreover, there is a prevailing assumption that women should naturally sacrifice themselves for childbirth and childcare, influenced by the idealization of the female figure. Consequently, women may harbor hesitations about having a baby, fearing the potential loss of their own identity in the process. Conclusions: The results indicate a shift in the perception of childbirth among modern Chinese women over time, influenced by their increasing social status and the pursuit of self-realization. Implementing strategies such as public education on the health risks associated with pregnancy and delivery, safeguarding women's rights, and creating a supportive environment for mothers may enhance women's willingness to undergo childbirth. International Registered Report Identifier (IRRID): RR2-10.2196/preprints.50468 ",
doi="10.2196/50512",
url="https://pediatrics.jmir.org/2024/1/e50512",
url="http://www.ncbi.nlm.nih.gov/pubmed/38180784"
}


@Article{info:doi/10.2196/46085,
author="Subramanyam, Chaitra
and Becker, Alyssa
and Rizzo, Julianne
and Afzal, Najiba
and Nong, Yvonne
and Sivamani, Raja",
title="Visibility of Board-Certified Dermatologists on TikTok",
journal="JMIR Dermatol",
year="2024",
month="Jan",
day="5",
volume="7",
pages="e46085",
keywords="board",
keywords="certification",
keywords="board certification",
keywords="health",
keywords="media",
keywords="public",
keywords="social",
keywords="TikTok",
keywords="social media",
keywords="health information",
keywords="misinformation",
keywords="diagnosis",
keywords="users",
keywords="medical training",
keywords="training",
keywords="media content",
keywords="skin",
keywords="derma",
keywords="derm",
keywords="dermatologist",
keywords="dermatology",
keywords="epidermis",
keywords="dermatitis",
keywords="cellulitis",
keywords="skin doctor",
keywords="hair",
keywords="nail",
doi="10.2196/46085",
url="https://derma.jmir.org/2024/1/e46085",
url="http://www.ncbi.nlm.nih.gov/pubmed/38180786"
}


@Article{info:doi/10.2196/51839,
author="Oldham, Melissa
and Dinu, Larisa
and Loebenberg, Gemma
and Field, Matt
and Hickman, Matthew
and Michie, Susan
and Brown, Jamie
and Garnett, Claire",
title="Methodological Insights on Recruitment and Retention From a Remote Randomized Controlled Trial Examining the Effectiveness of an Alcohol Reduction App: Descriptive Analysis Study",
journal="JMIR Form Res",
year="2024",
month="Jan",
day="5",
volume="8",
pages="e51839",
keywords="alcohol reduction",
keywords="alcohol",
keywords="digital care",
keywords="digital intervention",
keywords="ethnic minority",
keywords="methods",
keywords="mHealth",
keywords="randomised controlled trial",
keywords="recruitment",
keywords="retention",
keywords="social media",
abstract="Background: Randomized controlled trials (RCTs) with no in-person contact (ie, remote) between researchers and participants offer savings in terms of cost and time but present unique challenges. Objective: The goal of this study is to examine the differences between different forms of remote recruitment (eg, National Health Service [NHS] website, social media, and radio advertising) in the proportion of participants recruited, demographic diversity, follow-up rates, and cost. We also examine the cost per participant of sequential methods of follow-up (emails, phone calls, postal surveys, and postcards). Finally, our experience with broader issues around study advertising and participant deception is discussed. Methods: We conducted a descriptive analysis of 5602 increasing-and-higher-risk drinkers (Alcohol Use Disorders Identification Test score ?8), taking part in a 2-arm, parallel group, remote RCT with a 1:1 allocation, comparing the intervention (Drink Less app) with usual digital care (NHS alcohol advice web page). Participants were recruited between July 2020 and March 2022 and compensated with gift vouchers of up to {\textsterling}36 (a currency exchange rate of {\textsterling}1=US \$1.26988 is applicable) for completing follow-up surveys, with 4 stages of follow-up: email reminders, phone calls, postal survey, and postcard. Results: The three main recruitment methods were advertisements on (1) social media (2483/5602, 44.32\%), (2) the NHS website (1961/5602, 35.01\%), and (3) radio and newspapers (745/5602, 13.3\%), with the remaining methods of recruitment accounting 7.37\% (413/5602) of the sample. The overall recruitment cost per participant varied from {\textsterling}0 to {\textsterling}11.01. Costs were greater when recruiting participants who were men ({\textsterling}0-{\textsterling}28.85), from an ethnic minority group ({\textsterling}0-{\textsterling}303.81), and more disadvantaged ({\textsterling}0-{\textsterling}49.12). Targeted approaches were useful for recruiting more men but less useful in achieving diversity in ethnicity and socioeconomic status. Follow-up at 6 months was 79.58\% (4458/5602). Of those who responded, 92.4\% (4119/4458) responded by email. Each additional stage of follow-up resulted in an additional 2-3 percentage points of the overall sample being followed up, although phone calls, postal surveys, and postcards were more resource intensive than email reminders. Conclusions: For remote RCTs, researchers could benefit from using a range of recruitment methods and cost-targeted approaches to achieve demographic diversity. Automated emails with substantial financial incentives for prompt completion can achieve good follow-up rates, and sequential, offline follow-up options, such as phone calls and postal surveys, can further increase follow-up rates but are comparatively expensive. We also make broader recommendations focused on striking the right balance when designing remote RCTs. Careful planning, ongoing maintenance, and dynamic decision-making are required throughout a trial to balance the competing demands of participation among those eligible, deceptive participation among those who are not eligible, and ensuring no postrandomization bias is introduced by data-checking protocols. ",
doi="10.2196/51839",
url="https://formative.jmir.org/2024/1/e51839",
url="http://www.ncbi.nlm.nih.gov/pubmed/38180802"
}


@Article{info:doi/10.2196/49469,
author="Smith, Patrice Brandi
and Hoots, Brooke
and DePadilla, Lara
and Roehler, R. Douglas
and Holland, M. Kristin
and Bowen, A. Daniel
and Sumner, A. Steven",
title="Using Transformer-Based Topic Modeling to Examine Discussions of Delta-8 Tetrahydrocannabinol: Content Analysis",
journal="J Med Internet Res",
year="2023",
month="Dec",
day="21",
volume="25",
pages="e49469",
keywords="social media",
keywords="natural language processing",
keywords="public health surveillance",
keywords="machine learning",
keywords="topic modeling",
keywords="delta-8 tetrahydrocannabinol",
keywords="cannabis",
keywords="marijuana",
abstract="Background: Delta-8 tetrahydrocannabinol (THC) is a psychoactive cannabinoid found in small amounts naturally in the cannabis plant; it can also be synthetically produced in larger quantities from hemp-derived cannabidiol. Most states permit the sale of hemp and hemp-derived cannabidiol products; thus, hemp-derived delta-8 THC products have become widely available in many state hemp marketplaces, even where delta-9 THC, the most prominently occurring THC isomer in cannabis, is not currently legal. Health concerns related to the processing of delta-8 THC products and their psychoactive effects remain understudied. Objective: The goal of this study is to implement a novel topic modeling approach based on transformers, a state-of-the-art natural language processing architecture, to identify and describe emerging trends and topics of discussion about delta-8 THC from social media discourse, including potential symptoms and adverse health outcomes experienced by people using delta-8 THC products. Methods: Posts from January 2008 to December 2021 discussing delta-8 THC were isolated from cannabis-related drug forums on Reddit (Reddit Inc), a social media platform that hosts the largest web-based drug forums worldwide. Unsupervised topic modeling with state-of-the-art transformer-based models was used to cluster posts into topics and assign labels describing the kinds of issues being discussed with respect to delta-8 THC. Results were then validated by human subject matter experts. Results: There were 41,191 delta-8 THC posts identified and 81 topics isolated, the most prevalent being (1) discussion of specific brands or products, (2) comparison of delta-8 THC to other hemp-derived cannabinoids, and (3) safety warnings. About 5\% (n=1220) of posts from the resulting topics included content discussing health-related symptoms such as anxiety, sleep disturbance, and breathing problems. Until 2020, Reddit posts contained fewer than 10 mentions of delta-8-THC for every 100,000 cannabis posts annually. However, in 2020, these rates increased by 13 times the 2019 rate (to 99.2 mentions per 100,000 cannabis posts) and continued to increase into 2021 (349.5 mentions per 100,000 cannabis posts). Conclusions: Our study provides insights into emerging public health concerns around delta-8 THC, a novel substance about which little is known. Furthermore, we demonstrate the use of transformer-based unsupervised learning approaches to derive intelligible topics from highly unstructured discussions of delta-8 THC, which may help improve the timeliness of identification of emerging health concerns related to new substances. ",
doi="10.2196/49469",
url="https://www.jmir.org/2023/1/e49469",
url="http://www.ncbi.nlm.nih.gov/pubmed/38127427"
}


@Article{info:doi/10.2196/44912,
author="Frennesson, Felicia Nessie
and McQuire, Cheryl
and Aijaz Khan, Saher
and Barnett, Julie
and Zuccolo, Luisa",
title="Evaluating Messaging on Prenatal Health Behaviors Using Social Media Data: Systematic Review",
journal="J Med Internet Res",
year="2023",
month="Dec",
day="20",
volume="25",
pages="e44912",
keywords="acceptability",
keywords="design",
keywords="development",
keywords="effectiveness",
keywords="health behavior",
keywords="health messaging",
keywords="messaging",
keywords="prenatal health",
keywords="prenatal",
keywords="social media data",
keywords="social media",
keywords="tool",
abstract="Background: Social media platforms are increasingly being used to disseminate messages about prenatal health. However, to date, we lack a systematic assessment of how to evaluate the impact of official prenatal health messaging and campaigns using social media data. Objective: This study aims to review both the published and gray literature on how official prenatal health messaging and campaigns have been evaluated to date in terms of impact, acceptability, effectiveness, and unintended consequences, using social media data. Methods: A total of 6 electronic databases were searched and supplemented with the hand-searching of reference lists. Both published and gray literature were eligible for review. Data were analyzed using content analysis for descriptive data and a thematic synthesis approach to summarize qualitative evidence. A quality appraisal tool, designed especially for use with social media data, was used to assess the quality of the included articles. Results: A total of 11 studies were eligible for the review. The results showed that the most common prenatal health behavior targeted was alcohol consumption, and Facebook was the most commonly used source of social media data. The majority (n=6) of articles used social media data for descriptive purposes only. The results also showed that there was a lack of evaluation of the effectiveness, acceptability, and unintended consequences of the prenatal health message or campaign. Conclusions: Social media is a widely used and potentially valuable resource for communicating and evaluating prenatal health messaging. However, this review suggests that there is a need to develop and adopt sound methodology on how to evaluate prenatal health messaging using social media data, for the benefit of future research and to inform public health practice. ",
doi="10.2196/44912",
url="https://www.jmir.org/2023/1/e44912",
url="http://www.ncbi.nlm.nih.gov/pubmed/38117557"
}


@Article{info:doi/10.2196/51984,
author="Silver, A. Reginald
and Johnson, Chandrika",
title="Health Information Seeking Behavior on Social Networking Sites and Self-Treatment: Pilot Survey Study",
journal="Online J Public Health Inform",
year="2023",
month="Dec",
day="20",
volume="15",
pages="e51984",
keywords="health care seeking behavior",
keywords="online social networking",
keywords="sociodemographic factors",
keywords="community survey",
keywords="logistic regression",
keywords="self-treatment",
abstract="Background: Social networking site use and social network--based health information seeking behavior have proliferated to the point that the lines between seeking health information from credible social network--based sources and the decision to seek medical care or attempt to treat oneself have become blurred. Objective: We contribute to emerging research on health information seeking behavior by investigating demographic factors, social media use for health information seeking purposes, and the relationship between health information seeking and occurrences of self-treatment. Methods: Data were collected from an online survey in which participants were asked to describe sociodemographic factors about themselves, social media use patterns, perceptions about their motivations for health information seeking on social media platforms, and whether or not they attempted self-treatment after their social media--related health information seeking. We conducted a binomial logistic regression with self-treatment as a dichotomous categorical dependent variable. Results: Results indicate that significant predictors of self-treatment based on information obtained from social networking sites include race, exercise frequency, and degree of trust in the health-related information received. Conclusions: With an understanding of how sociodemographic factors might influence the decision to self-treat based on information obtained from social networking sites, health care providers can assist patients by educating them on credible social network--based sources of health information and discussing the importance of seeking medical advice from a health care provider. ",
doi="10.2196/51984",
url="https://ojphi.jmir.org/2023/1/e51984",
url="http://www.ncbi.nlm.nih.gov/pubmed/38179207"
}


@Article{info:doi/10.2196/46858,
author="Daynes-Kearney, Rosemary
and Gallagher, Stephen",
title="Online Support Groups for Family Caregivers: Scoping Review",
journal="J Med Internet Res",
year="2023",
month="Dec",
day="13",
volume="25",
pages="e46858",
keywords="caregivers",
keywords="carer",
keywords="caregiver",
keywords="caregiving",
keywords="informal care",
keywords="family care",
keywords="unpaid care",
keywords="spousal care",
keywords="carers",
keywords="online support groups",
keywords="scoping review",
keywords="review methods",
keywords="review methodology",
keywords="social support",
keywords="review",
keywords="support",
keywords="peer support",
keywords="online support",
keywords="development",
keywords="communication",
keywords="psychosocial",
keywords="life experience",
keywords="caregiver needs",
keywords="engagement",
abstract="Background: Caregiving can affect people of all ages and can have significant negative health impacts on family caregivers themselves. Research has shown that social support acts as a buffer against many negative health impacts. A common source of social support is support groups. Although traditionally, these groups were conducted in a face-to-face setting, the advent of the internet, social media applications, and the smartphone have seen online support groups (OSGs) develop as a space where many caregivers seek support. The number of OSGs has increased exponentially, but there is no clear consensus on what factors or characteristics of OSGs contribute to social support development within them or what types of OSGs are available to family caregivers. Objective: This study aimed to conduct a scoping review to contribute to the understanding of the types and characteristics of OSGs for family caregivers. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines, the CINAHL, PsychInfo, Psych Articles, Social Sciences, Communication Source, Medline, and Web of Science databases were searched for studies (caregiver focused, adults aged 18 years or older, online social support groups, caring for a living person, peer-reviewed journal publications on empirical research). In total, 19 studies were included in the review. The research questions were (1) what type of social support groups are online for adult family caregivers, (2) what the communication mediums and characteristics of these OSGs are, and (3) what psychosocial or other factors make OSGs successful or unsuccessful for participants. Results: In response to the first research question, we found that the majority of OSGs took place on public text-based forums and were illness specific. Where demographics were reported, participants were predominately women, White, and working with university-level education. There were a variety of caregiving relationships. For the second research question, the most common communication medium found was text-based communication, with the use of emojis, photos, and GIF (Graphics Interchange Format) files as part of these exchanges. Most frequently, the OSGs were asynchronous with a degree of anonymity, not time-limited by the frequency of contact or duration, and moderated by peer or professional moderators or facilitators. Results for the third research question explored the overarching categories of safe communication and engagement and group management. These described successful OSGs as having a focus on similar others with shared lived experiences communicated in a nonjudgmental space overseen by trained peer or professional facilitators. Conclusions: There are several key considerations for OSGs to be successful for family caregivers. A general recommendation for practitioners is to give importance to building active moderation and multifaceted structures of support to meet different levels of caregiver needs and the ability to engage. ",
doi="10.2196/46858",
url="https://www.jmir.org/2023/1/e46858",
url="http://www.ncbi.nlm.nih.gov/pubmed/38090796"
}


@Article{info:doi/10.2196/48267,
author="Wu, Nancy
and Wang, Joanne Susan
and Brazeau, Anne-Sophie
and Chan, Deborah
and Mussa, Joseph
and Nakhla, Meranda
and Elkeraby, Mariam
and Ell, Maryna
and Prevost, Melinda
and Lepine, Laurie
and Panagiotopoulos, Constadina
and Mukerji, Geetha
and Butalia, Sonia
and Henderson, M{\'e}lanie
and Da Costa, Deborah
and Rahme, Elham
and Dasgupta, Kaberi",
title="Supporting and Incentivizing Peer Leaders for an Internet-Based Private Peer Community for Youths With Type 1 Diabetes: Social Network and Directed Content Analysis",
journal="J Med Internet Res",
year="2023",
month="Dec",
day="12",
volume="25",
pages="e48267",
keywords="Facebook",
keywords="chronic disease communities",
keywords="internet-based communities",
keywords="type 1 diabetes",
keywords="adolescents",
keywords="young adults",
keywords="peer support",
abstract="Background: Youths with type 1 diabetes (T1D) frequently experience stigma. Internet-based peer communities can mitigate this through social support but require leaders to catalyze exchange. Whether nurturing potential leaders translates into a central role has not been well studied. Another issue understudied in such communities is lurking, the viewing of exchanges without commenting or posting. Objective: We aimed to assess the centrality of the peer leaders we selected, trained, and incentivized within the Canadian Virtual Peer Network (VPN)-T1D. This is a private Facebook (Meta Platforms, Inc) group that we created for persons aged 14 to 24 years with T1D. We specifically sought to (1) compare a quantitative estimate of network centrality between peer leaders and regular members, (2) assess the proportions of network exchanges that were social support oriented, and (3) assess proportions of high engagement (posts, comments, reactions, and votes) and low engagement (lurking) exchanges. Methods: We recruited peer leaders and members with T1D from prior study cohorts and clinics. We trained 10 leaders, provided them with a monthly stipend, and encouraged them to post on the private Facebook group we launched on June 21, 2017. We extracted all communications (posts, messages, reactions, polls, votes, and views) that occurred until March 20, 2020. We calculated each member's centrality (80\% of higher engagement communications comprising posts, comments, and reactions plus 20\% of members with whom they connected). We divided each member's centrality by the highest centrality to compute the relative centrality, and compared the mean values between leaders and members (linear regression). We calculated the proportions of communications that were posts, comments, reactions, and views without reaction. We performed content analysis with a social support framework (informational, emotional, esteem-related, network, and tangible support), applying a maximum of 3 codes per communication. Results: VPN-T1D gained 212 regular members and 10 peer leaders over 33 months; of these 222 members, 26 (11.7\%) exited. Peer leaders had 10-fold higher relative centrality than regular members (mean 0.53, SD 0.26 vs mean 0.04, SD 0.05; 0.49 difference; 95\% CI 0.44-0.53). Overall, 91.4\% (203/222) of the members connected at least once through posts, comments, or reactions. Among the 75,051 communications, there were 5109 (6.81\%) posts, comments, and polls, 6233 (8.31\%) reactions, and 63,709 (84.9\%) views (lurking). Moreover, 54.9\% (3430/6253) of codes applied were social support related, 66.4\% (2277/3430) of which were informational (eg, insurance and travel preparation), and 20.4\% (699/3430) of which were esteem related (eg, relieving blame). Conclusions: Designating, training, and incentivizing peer leaders may stimulate content exchange and creation. Social support was a key VPN-T1D deliverable. Although lurking accounted for a high proportion of the overall activity, even those demonstrating this type of passive participation likely derived benefits, given that the network exit rate was low. International Registered Report Identifier (IRRID): RR2-10.2196/18714 ",
doi="10.2196/48267",
url="https://www.jmir.org/2023/1/e48267",
url="http://www.ncbi.nlm.nih.gov/pubmed/38085568"
}


@Article{info:doi/10.2196/49380,
author="Li, Xiaoyu Jenny
and Yacyshyn, Elaine",
title="Thoughts and Experiences of Beh{\c{c}}et Disease From Participants on a Reddit Subforum: Qualitative Online Community Analysis",
journal="JMIR Form Res",
year="2023",
month="Dec",
day="12",
volume="7",
pages="e49380",
keywords="Bechet disease",
keywords="Beh{\c{c}}et",
keywords="online community",
keywords="Reddit",
keywords="vasculitis",
keywords="quality of life",
keywords="QoL",
keywords="qualitative",
keywords="community",
keywords="morbidity",
keywords="support",
keywords="diagnosis",
keywords="symptoms",
keywords="vascular",
keywords="vascular system",
keywords="vascular disease",
abstract="Background: Beh{\c{c}}et disease (BD) is a type of vasculitis with relapsing episodes and multisystemic clinical features, associated with significant morbidity and impact on patients' lives. People affected by BD often participate in discussions of their illness experiences. In-person support groups have limited physical accessibility and a relative lack of anonymity; however, online communities have become increasingly popular. Objective: This study investigates the perspectives and experiences of people affected by BD by examining the content shared and discussed on a subforum of the website Reddit---a popular online space for anonymous discussions. Methods: All discussion threads posted between March 9, 2021, and March 12, 2022, including posts and comments, were examined from the subforum ``r/Behcets,'' an anonymous online community of 1100 members as of March 2022. A Grounded Theory analysis was completed to identify themes and subthemes, and notable quotes were extracted from the threads. Parameters extracted from each post included the number of comments, net upvotes, category, and subcategories. Two research team members read the posts separately to identify initial codes and themes to ensure data saturation was achieved. Results: Six recurring themes were identified: (1) finding connectedness and perspectives through shared experiences, (2) struggles of the diagnostic odyssey, (3) sharing or inquiring about symptoms, (4) expressing strong emotions relating to the experience of BD, (5) the impact of BD on quality of life and personal relationships, as well as (6) COVID-19 and the COVID-19 vaccination in relation to BD. Subthemes within each theme were also identified and explored. Conclusions: This novel study provides a qualitative exploration of the perspectives and experiences of people affected by BD, shared in the anonymous and accessible online community of Reddit. The study found that people impacted by an illness seek to connect and receive validation through shared conditions and experiences. By examining the content shared in r/Behcets, this study highlights the needs of people affected by BD, identifying gaps and areas for improvement in the in-person support they receive. ",
doi="10.2196/49380",
url="https://formative.jmir.org/2023/1/e49380",
url="http://www.ncbi.nlm.nih.gov/pubmed/38085563"
}


@Article{info:doi/10.2196/46309,
author="Lee, David
and Jiang, Tao
and Crocker, Jennifer
and Way, Baldwin",
title="Social Media Use and Its Concurrent and Subsequent Relation to a Biological Marker of Inflammation: Short-Term Longitudinal Study",
journal="J Med Internet Res",
year="2023",
month="Dec",
day="8",
volume="25",
pages="e46309",
keywords="social media use",
keywords="inflammation",
keywords="physical health",
keywords="well-being",
keywords="screen time",
keywords="mental health",
keywords="social media",
keywords="biomarker",
keywords="chronic disease",
abstract="Background: Although many studies have examined the impact of social media use (SMU) on mental health, very few studies have examined the association of SMU with health-relevant biomarkers. Objective: Addressing this gap, we conducted a short-term longitudinal study examining the link between SMU and C-reactive protein (CRP), a biological marker of systemic inflammation predictive of major depression, chronic diseases, and mortality. Methods: We measured college students' weekly amount of SMU for 5 consecutive weeks objectively via the Screen Time app and collected blood samples at baseline and 5 weeks later. Results: In separate cross-sectional analyses conducted at phase 1 (baseline) and at phase 2 (5 weeks after baseline), objective SMU had a positive, concurrent association with CRP at both time points. Critically, in a longitudinal analysis, more SMU between phase 1 and phase 2 predicted increased CRP between these time points, suggesting that increased SMU led to heightened inflammation during that period. Conclusions: Although more research is needed to understand why SMU led to higher inflammation, the association between objective SMU and a marker of a biological process critical to physical health presents an intriguing opportunity for future research on social media effects. ",
doi="10.2196/46309",
url="https://www.jmir.org/2023/1/e46309",
url="http://www.ncbi.nlm.nih.gov/pubmed/38064253"
}


@Article{info:doi/10.2196/48402,
author="Manne, Sharon
and Wu, Yelena
and Buller, David
and Heckman, Carolyn
and Devine, Katie
and Frederick, Sara
and Solleder, Justin
and Schaefer, Alexis
and Lu, Shou-En",
title="The Effects of a Parent-Focused Social Media Intervention on Child Sun Safety: Pilot and Feasibility Study",
journal="JMIR Form Res",
year="2023",
month="Dec",
day="8",
volume="7",
pages="e48402",
keywords="health behavior",
keywords="health promotion and prevention",
keywords="parenting",
keywords="prevention science",
keywords="parents",
keywords="parent",
keywords="Facebook",
keywords="social media",
keywords="sun",
keywords="prevention",
keywords="skin",
keywords="dermatology",
abstract="Background: Middle childhood (ages 8-12 years) is a critical period for forming behavioral habits and reducing the risk for the development of skin cancer later in life. During this time, children develop more autonomy and spend more unsupervised time away from their parents. Professional agencies recommend that all children engage in regular sun protection behaviors and avoid the sun during peak daytime hours. Unfortunately, in middle childhood, child sun protection often declines and UV radiation exposure increases. Effective parenting involves balancing ways to encourage the child's increasing independence while providing practical assistance to ensure sun protection is implemented. Objective: The goal was to evaluate the feasibility, acceptability, and preliminary effects of Sun Safe Families, a Facebook group intervention for parents of children between 8 and 12 years of age. Methods: The team developed Facebook messages targeting parent knowledge, normative influences, sun safety barriers, planning and goal setting, confidence in implementing sun safety, communication, forming habits, and managing sun safety in risky situations. A total of 92 parents were enrolled, and the groups ran for 6 weeks. Feasibility was measured by enrollment and retention rates. Acceptability was measured by engagement in the Facebook groups. Satisfaction was assessed by a treatment evaluation. At pre- and post-intervention, parents completed measures of child sun protection, UV radiation exposure, sunburn, sun safety knowledge, child risk, barriers, sun protection self-efficacy, planning, sun safe habits, norms for child sun safety, and communication about sun safety. Results: Enrollment (64.3\%, 92/143) and retention (94.6\%, 87/92) were good. On average, participants viewed 67.6\% (56.8/84) of posts, ``liked'' 16.4\% (13.77/84) of posts, commented on 14.8\% (12.43/84) of posts, and voted on 46\% (6.4/14) of polls. Satisfaction was excellent. From pre- to post-intervention, there were significant increases in child sun protection, sun exposure, and sunburn (P<.01; moderate effect sizes), as well as statistically significant increases in planning and self-efficacy (P<.05) and family norms and parent communication (P<.01). Conclusions: This study demonstrated high survey retention, acceptability, and satisfaction with the intervention. There were promising preliminary effects on child sun protection behaviors and parent sun protection attitudes and communication with their child. Replication with a larger sample size and a comparison condition is warranted. ",
doi="10.2196/48402",
url="https://formative.jmir.org/2023/1/e48402",
url="http://www.ncbi.nlm.nih.gov/pubmed/38064250"
}


@Article{info:doi/10.2196/48550,
author="Davila, Carine
and Chan, H. Stephanie
and Gosline, Anna
and Arenas, Zamawa
and Kavanagh, Jane
and Feltz, Brian
and McCarthy, Elizabeth
and Pitts, Tyrone
and Ritchie, Christine",
title="Online Forums as a Tool for Broader Inclusion of Voices on Health Care Communication Experiences and Serious Illness Care: Mixed Methods Study",
journal="J Med Internet Res",
year="2023",
month="Dec",
day="6",
volume="25",
pages="e48550",
keywords="serious illness care",
keywords="serious illness communication",
keywords="mixed methods research",
keywords="community-engaged design",
keywords="equity in research",
keywords="online forum",
keywords="health care experiences",
keywords="internet",
keywords="illness",
keywords="marginalized community",
keywords="efficacy",
keywords="communication",
keywords="engagement",
keywords="quantitative survey",
keywords="health care",
abstract="Background: Existing health care research, including serious illness research, often underrepresents individuals from historically marginalized communities. Capturing the nuanced perspectives of individuals around their health care communication experiences is difficult. New research strategies are needed that increase engagement of individuals from diverse backgrounds. Objective: The aim of this study was to develop a mixed methods approach with qualitative online forums to better understand health communication experiences of individuals, including people from groups historically marginalized such as Black and Latino individuals; older adults; and people with low income, disability, or serious illness. Methods: We used a multiphase mixed methods, community-informed research approach to design study instruments and engage participants. We engaged a diverse group of collaborators with lived experience of navigating the health care system who provided feedback on instruments, added concepts for testing, and offered guidance on creating a safe experience for participants (phase 1). We conducted a national quantitative survey between April and May 2021 across intrapersonal, interpersonal, and systems-level domains, with particular focus on interpersonal communication between patients and clinicians (phase 2). We conducted two asynchronous, qualitative online forums, a technique used in market research, between June and August 2021, which allowed us to contextualize the learnings and test concepts and messages (phase 3). Using online forums allowed us to probe more deeply into results and hypotheses from the survey to better understand the ``whys'' and ``whats'' that surfaced and to test public messages to encourage action around health. Results: We engaged 46 community partners, including patients and clinicians from a Federally Qualified Health Center, to inform study instrument design. In the quantitative survey, 1854 adults responded, including 50.5\% women, 25.2\% individuals over 65 years old, and 51.9\% individuals with low income. Nearly two-thirds identified as non-Hispanic white (65.7\%), 10.4\% identified as non-Hispanic Black, and 15.5\% identified as Hispanic/Latino. An additional 580 individuals participated in online forums, including 60.7\% women, 17.4\% individuals over 65 years old, and 49.0\% individuals with low income. Among the participants, 70.3\% identified as non-Hispanic white, 16.0\% as non-Hispanic Black, and 9.5\% as Hispanic/Latino. We received rich, diverse input from our online forum participants, and they highlighted satisfaction and increased knowledge with engagement in the forums. Conclusions: We achieved modest overrepresentation of people who were over 65 years old, identified as non-Hispanic Black, and had low income in our online forums. The size of the online forums (N=580) reflected the voices of 93 Black and 55 Hispanic/Latino participants. Individuals who identify as Hispanic/Latino remained underrepresented, likely because the online forums were offered only in English. Overall, our findings demonstrate the feasibility of using the online forum qualitative approach in a mixed methods study to contextualize, clarify, and expound on quantitative findings when designing public health and clinical communications interventions. ",
doi="10.2196/48550",
url="https://www.jmir.org/2023/1/e48550",
url="http://www.ncbi.nlm.nih.gov/pubmed/38055311"
}


@Article{info:doi/10.2196/48975,
author="Rowson, C. Antonia
and Rowson, J. Saskia",
title="Derm-ographics: The Australian Dermatologist and Social Media",
journal="JMIR Dermatol",
year="2023",
month="Dec",
day="5",
volume="6",
pages="e48975",
keywords="dermatology",
keywords="social media",
keywords="patient education",
keywords="LinkedIn",
keywords="Facebook",
keywords="online presence",
keywords="dermatologist",
keywords="dermatologists",
keywords="demographic",
keywords="Twitter",
keywords="X",
keywords="YouTube",
keywords="TikTok",
keywords="ResearchGate",
keywords="Instagram",
keywords="provider",
keywords="physician",
keywords="technology use",
doi="10.2196/48975",
url="https://derma.jmir.org/2023/1/e48975",
url="http://www.ncbi.nlm.nih.gov/pubmed/38051576"
}


@Article{info:doi/10.2196/46611,
author="Tsulukidze, Maka
and Grande, W. Stuart
and Naslund, A. John",
title="An Active Model of Research Translation for the General Public: Content Analysis of a YouTube-Based Health Podcast",
journal="JMIR Form Res",
year="2023",
month="Dec",
day="5",
volume="7",
pages="e46611",
keywords="evidence translation",
keywords="user engagement",
keywords="consumer education",
keywords="online health information",
keywords="disseminating science",
keywords="health education",
abstract="Background: Online health information seeking is changing the way people engage with health care and the health system. Recent changes in practices related to seeking, accessing, and disseminating scientific research, and in particular health information, have enabled a high level of user engagement. Objective: This study aims to examine an innovative model of research translation, The Huberman Lab Podcast (HLP), developed by Andrew Huberman, Professor of Neurobiology and Ophthalmology at the Stanford School of Medicine. The HLP leverages social media to deliver health information translated into specific, actionable practices and health strategies directly to the general public. This research characterizes the HLP as an Active Model of Research Translation and assesses its potential as a framework for replicability and wider adoption. Methods: We applied conventional content analysis of the YouTube transcript data and directed content analysis of viewers' YouTube comments to 23 HLP episodes released from January to October 2021, reflecting the time of data analysis. We selected 7 episodes and a welcome video, to describe and identify key characteristics of the HLP model. We analyzed viewer comments for 18 episodes to determine whether viewers found the HLP content valuable, accessible, and easy to implement. Results: The key HLP features are direct-to-the-consumer, zero-cost, bilingual, and actionable content. We identified 3 main organizing categories and 10 subcategories as the key elements of the HLP: (1) Why: Educate and Empower and Bring Zero Cost to Consumer Information to the General Public; (2) What: Tools and Protocols; Underlying Mechanisms; and Grounded in Science; (3) How: Linear and Iterative Knowledge Building Process; Lecture-Style Sessions; Interactive and Consumer Informed; Easily Accessible; and Building the Community. Analysis of viewers' comments found strong consumer support for the key HLP model elements. Conclusions: This Active Model of Research Translation offers a way to synthesize scientific evidence and deliver it directly to end users in the form of actionable tools and education. Timely evidence translation using effective consumer engagement and education techniques appears to improve access and confidence related to health information use and reduces challenges to understanding and applying health information received from health providers. Framing complex content in an approachable manner, engaging the target audience, encouraging participation, and ensuring open access to the content meet current recommendations on innovative practices for leveraging social media or other digital platforms for disseminating science and research findings to the general public, and are likely key contributors to HLP impact and potential for success. The model offers a replicable framework for translating and disseminating scientific evidence. Similar active models of research translation can have implications for accessing health information and implementing health strategies for improved outcomes. Areas for further investigation are specific and measurable impacts on health, usability, and relevance of the model for reaching marginalized and high-risk populations. ",
doi="10.2196/46611",
url="https://formative.jmir.org/2023/1/e46611",
url="http://www.ncbi.nlm.nih.gov/pubmed/38051560"
}


@Article{info:doi/10.2196/49074,
author="Kim, Seoyun
and Cha, Junyeop
and Kim, Dongjae
and Park, Eunil",
title="Understanding Mental Health Issues in Different Subdomains of Social Networking Services: Computational Analysis of Text-Based Reddit Posts",
journal="J Med Internet Res",
year="2023",
month="Nov",
day="30",
volume="25",
pages="e49074",
keywords="mental health",
keywords="sentiment analysis",
keywords="mental disorder",
keywords="text analysis",
keywords="NLP",
keywords="natural language processing",
keywords="clustering",
abstract="Background: Users increasingly use social networking services (SNSs) to share their feelings and emotions. For those with mental disorders, SNSs can also be used to seek advice on mental health issues. One available SNS is Reddit, in which users can freely discuss such matters on relevant health diagnostic subreddits. Objective: In this study, we analyzed the distinctive linguistic characteristics in users' posts on specific mental disorder subreddits (depression, anxiety, bipolar disorder, borderline personality disorder, schizophrenia, autism, and mental health) and further validated their distinctiveness externally by comparing them with posts of subreddits not related to mental illness. We also confirmed that these differences in linguistic formulations can be learned through a machine learning process. Methods: Reddit posts uploaded by users were collected for our research. We used various statistical analysis methods in Linguistic Inquiry and Word Count (LIWC) software, including 1-way ANOVA and subsequent post hoc tests, to see sentiment differences in various lexical features within mental health--related subreddits and against unrelated ones. We also applied 3 supervised and unsupervised clustering methods for both cases after extracting textual features from posts on each subreddit using bidirectional encoder representations from transformers (BERT) to ensure that our data set is suitable for further machine learning or deep learning tasks. Results: We collected 3,133,509 posts of 919,722 Reddit users. The results using the data indicated that there are notable linguistic differences among the subreddits, consistent with the findings of prior research. The findings from LIWC analyses revealed that patients with each mental health issue show significantly different lexical and semantic patterns, such as word count or emotion, throughout their online social networking activities, with P<.001 for all cases. Furthermore, distinctive features of each subreddit group were successfully identified through supervised and unsupervised clustering methods, using the BERT embeddings extracted from textual posts. This distinctiveness was reflected in the Davies-Bouldin scores ranging from 0.222 to 0.397 and the silhouette scores ranging from 0.639 to 0.803 in the former case, with scores of 1.638 and 0.729, respectively, in the latter case. Conclusions: By taking a multifaceted approach, analyzing textual posts related to mental health issues using statistical, natural language processing, and machine learning techniques, our approach provides insights into aspects of recent lexical usage and information about the linguistic characteristics of patients with specific mental health issues, which can inform clinicians about patients' mental health in diagnostic terms to aid online intervention. Our findings can further promote research areas involving linguistic analysis and machine learning approaches for patients with mental health issues by identifying and detecting mentally vulnerable groups of people online. ",
doi="10.2196/49074",
url="https://www.jmir.org/2023/1/e49074",
url="http://www.ncbi.nlm.nih.gov/pubmed/38032730"
}


@Article{info:doi/10.2196/43700,
author="Sigalo, Nekabari
and Frias-Martinez, Vanessa",
title="Using COVID-19 Vaccine Attitudes Found in Tweets to Predict Vaccine Perceptions in Traditional Surveys: Infodemiology Study",
journal="JMIR Infodemiology",
year="2023",
month="Nov",
day="30",
volume="3",
pages="e43700",
keywords="social media",
keywords="Twitter",
keywords="COVID-19",
keywords="vaccine",
keywords="surveys",
keywords="SARS-CoV-2",
keywords="vaccinations",
keywords="hesitancy",
abstract="Background: Traditionally, surveys are conducted to answer questions related to public health but can be costly to execute. However, the information that researchers aim to extract from surveys could potentially be retrieved from social media, which possesses data that are highly accessible and lower in cost to collect. Objective: This study aims to evaluate whether attitudes toward COVID-19 vaccines collected from the Household Pulse Survey (HPS) could be predicted using attitudes extracted from Twitter (subsequently rebranded X). Ultimately, this study aimed to determine whether Twitter can provide us with similar information to that observed in traditional surveys or whether saving money comes at the cost of losing rich data. Methods: COVID-19 vaccine attitudes were extracted from the HPS conducted between January 6 and May 25, 2021. Twitter's streaming application programming interface was used to collect COVID-19 vaccine tweets during the same period. A sentiment and emotion analysis of tweets was conducted to examine attitudes toward the COVID-19 vaccine on Twitter. Generalized linear models and generalized linear mixed models were used to evaluate the ability of COVID-19 vaccine attitudes on Twitter to predict vaccine attitudes in the HPS. Results: The results revealed that vaccine perceptions expressed on Twitter performed well in predicting vaccine perceptions in the survey. Conclusions: These findings suggest that the information researchers aim to extract from surveys could potentially also be retrieved from a more accessible data source, such as Twitter. Leveraging Twitter data alongside traditional surveys can provide a more comprehensive and nuanced understanding of COVID-19 vaccine perceptions, facilitating evidence-based decision-making and tailored public health strategies. ",
doi="10.2196/43700",
url="https://infodemiology.jmir.org/2023/1/e43700",
url="http://www.ncbi.nlm.nih.gov/pubmed/37903294"
}


@Article{info:doi/10.2196/50152,
author="Noh, Youran
and Kim, Maryanne
and Hong, Hee Song",
title="Identification of Emotional Spectrums of Patients Taking an Erectile Dysfunction Medication: Ontology-Based Emotion Analysis of Patient Medication Reviews on Social Media",
journal="J Med Internet Res",
year="2023",
month="Nov",
day="29",
volume="25",
pages="e50152",
keywords="erectile dysfunction",
keywords="PDE5 inhibitor",
keywords="social media",
keywords="emotion analysis",
keywords="sentiment analysis",
keywords="emotions",
keywords="patient medication experience",
keywords="tailored patient medication",
keywords="patient-centered care",
keywords="men's health",
keywords="medications",
keywords="drugs",
abstract="Background: Patient medication reviews on social networking sites provide valuable insights into the experiences and sentiments of individuals taking specific medications. Understanding the emotional spectrum expressed by patients can shed light on their overall satisfaction with medication treatment. This study aims to explore the emotions expressed by patients taking phosphodiesterase type 5 (PDE5) inhibitors and their impact on sentiment. Objective: This study aimed to (1) identify the distribution of 6 Parrot emotions in patient medication reviews across different patient characteristics and PDE5 inhibitors, (2) determine the relative impact of each emotion on the overall sentiment derived from the language expressed in each patient medication review while controlling for different patient characteristics and PDE5 inhibitors, and (3) assess the predictive power of the overall sentiment in explaining patient satisfaction with medication treatment. Methods: A data set of patient medication reviews for sildenafil, vardenafil, and tadalafil was collected from 3 popular social networking sites such as WebMD, Ask-a-Patient, and Drugs.com. The Parrot emotion model, which categorizes emotions into 6 primary classes (surprise, anger, love, joy, sadness, and fear), was used to analyze the emotional content of the reviews. Logistic regression and sentiment analysis techniques were used to examine the distribution of emotions across different patient characteristics and PDE5 inhibitors and to quantify their contribution to sentiment. Results: The analysis included 3070 patient medication reviews. The most prevalent emotions expressed were joy and sadness, with joy being the most prevalent among positive emotions and sadness being the most prevalent among negative emotions. Emotion distributions varied across patient characteristics and PDE5 inhibitors. Regression analysis revealed that joy had the strongest positive impact on sentiment, while sadness had the most negative impact. The sentiment score derived from patient reviews significantly predicted patient satisfaction with medication treatment, explaining 19\% of the variance (increase in R2) when controlling for patient characteristics and PDE5 inhibitors. Conclusions: This study provides valuable insights into the emotional experiences of patients taking PDE5 inhibitors. The findings highlight the importance of emotions in shaping patient sentiment and satisfaction with medication treatment. Understanding these emotional dynamics can aid health care providers in better addressing patient needs and improving overall patient care. ",
doi="10.2196/50152",
url="https://www.jmir.org/2023/1/e50152",
url="http://www.ncbi.nlm.nih.gov/pubmed/38019570"
}


@Article{info:doi/10.2196/47849,
author="Thornton, Christopher
and Lanyi, Kate
and Wilkins, Georgina
and Potter, Rhiannon
and Hunter, Emily
and Kolehmainen, Niina
and Pearson, Fiona",
title="Scoping the Priorities and Concerns of Parents: Infodemiology Study of Posts on Mumsnet and Reddit",
journal="J Med Internet Res",
year="2023",
month="Nov",
day="28",
volume="25",
pages="e47849",
keywords="childhood",
keywords="child",
keywords="toddler",
keywords="infant",
keywords="behavior",
keywords="parent",
keywords="parenting",
keywords="topic modeling",
keywords="data mining",
keywords="social media",
keywords="infodemiology",
keywords="Reddit",
keywords="web-based forum",
keywords="well-being",
keywords="children",
keywords="data",
keywords="family health",
abstract="Background: Health technology innovation is increasingly supported by a bottom-up approach to priority setting, aiming to better reflect the concerns of its intended beneficiaries. Web-based forums provide parents with an outlet to share concerns, advice, and information related to parenting and the health and well-being of their children. They provide a rich source of data on parenting concerns and priorities that could inform future child health research and innovation. Objective: The aim of the study is to identify common concerns expressed on 2 major web-based forums and cluster these to identify potential family health concern topics as indicative priority areas for future research and innovation. Methods: We text-mined the r/Parenting subreddit (69,846 posts) and the parenting section of Mumsnet (99,848 posts) to create a large corpus of posts. A generative statistical model (latent Dirichlet allocation) was used to identify the most discussed topics in the corpus, and content analysis was applied to identify the parenting concerns found in a subset of posts. Results: A model with 25 topics produced the highest coherence and a wide range of meaningful parenting concern topics. The most frequently expressed parenting concerns are related to their child's sleep, self-care, eating (and food), behavior, childcare context, and the parental context including parental conflict. Topics directly associated with infants, such as potty training and bottle feeding, were more common on Mumsnet, while parental context and screen time were more common on r/Parenting. Conclusions: Latent Dirichlet allocation topic modeling can be applied to gain a rapid, yet meaningful overview of parent concerns expressed on a large and diverse set of social media posts and used to complement traditional insight gathering methods. Parents framed their concerns in terms of children's everyday health concerns, generating topics that overlap significantly with established family health concern topics. We provide evidence of the range of family health concerns found at these sources and hope this can be used to generate material for use alongside traditional insight gathering methods. ",
doi="10.2196/47849",
url="https://www.jmir.org/2023/1/e47849",
url="http://www.ncbi.nlm.nih.gov/pubmed/38015600"
}


@Article{info:doi/10.2196/45372,
author="Alzoubi, Hiba
and Karasneh, Reema
and Irshaidat, Sara
and Abuelhaija, Yussuf
and Abuorouq, Saleh
and Omeish, Haya
and Daromar, Shrouq
and Makhadmeh, Naheda
and Alqudah, Mohammad
and Abuawwad, T. Mohammad
and Taha, J. Mohammad J.
and Baniamer, Ansam
and Abu Serhan, Hashem",
title="Exploring the Use of YouTube as a Pathology Learning Tool and Its Relationship With Pathology Scores Among Medical Students: Cross-Sectional Study",
journal="JMIR Med Educ",
year="2023",
month="Nov",
day="24",
volume="9",
pages="e45372",
keywords="pathology",
keywords="medical students",
keywords="YouTube",
keywords="social media",
keywords="medical education",
keywords="online resources",
abstract="Background: YouTube is considered one of the most popular sources of information among college students. Objective: This study aimed to explore the use of YouTube as a pathology learning tool and its relationship with pathology scores among medical students at Jordanian public universities. Methods: This cross-sectional, questionnaire-based study included second-year to sixth-year medical students from 6 schools of medicine in Jordan. The questionnaire was distributed among the students using social platforms over a period of 2 months extending from August 2022 to October 2022. The questionnaire included 6 attributes. The first section collected demographic data, and the second section investigated the general use of YouTube and recorded material. The remaining 4 sections targeted the participants who used YouTube to learn pathology including using YouTube for pathology-related content. Results: As of October 2022, 699 students were enrolled in the study. More than 60\% (422/699, 60.4\%) of the participants were women, and approximately 50\% (354/699, 50.6\%) were second-year students. The results showed that 96.5\% (675/699) of medical students in Jordan were using YouTube in general and 89.1\% (623/699) were using it as a source of general information. YouTube use was associated with good and very good scores among the users. In addition, 82.3\% (575/699) of medical students in Jordan used YouTube as a learning tool for pathology in particular. These students achieved high scores, with 428 of 699 (61.2\%) students scoring above 70\%. Most participants (484/699, 69.2\%) reported that lectures on YouTube were more interesting than classic teaching and the lectures could enhance the quality of learning (533/699, 76.3\%). Studying via YouTube videos was associated with higher odds (odds ratio [OR] 3.86, 95\% CI 1.33-11.18) and lower odds (OR 0.27, 95\% CI 0.09-0.8) of achieving higher scores in the central nervous system and peripheral nervous system courses, respectively. Watching pathology lectures on YouTube was related to a better chance of attaining higher scores (OR 1.96, 95\% CI 1.08-3.57). Surprisingly, spending more time watching pathology videos on YouTube while studying for examinations corresponded with lower performance, with an OR of 0.46 (95\% CI 0.26-0.82). Conclusions: YouTube may play a role in enhancing pathology learning, and aiding in understanding, memorization, recalling information, and obtaining higher scores. Many medical students in Jordan have positive attitudes toward using YouTube as a supplementary pathology learning tool. Based on this, it is recommended that pathology instructors should explore the use of YouTube and other emerging educational tools as potential supplementary learning resources. ",
doi="10.2196/45372",
url="https://mededu.jmir.org/2023/1/e45372/"
}


@Article{info:doi/10.2196/49435,
author="Gable, M. Jessica S.
and Sauvayre, Romy
and Chauvi{\`e}re, C{\'e}dric",
title="Fight Against the Mandatory COVID-19 Immunity Passport on Twitter: Natural Language Processing Study",
journal="J Med Internet Res",
year="2023",
month="Nov",
day="23",
volume="25",
pages="e49435",
keywords="mandatory vaccination",
keywords="public policy",
keywords="public health measures",
keywords="COVID-19",
keywords="vaccine",
keywords="social media analysis",
keywords="Twitter",
keywords="natural language processing",
keywords="deep learning",
keywords="social media",
keywords="public health",
keywords="vaccination",
keywords="immunity",
keywords="social distancing",
keywords="neural network",
keywords="effectiveness",
abstract="Background: To contain and curb the spread of COVID-19, the governments of countries around the world have used different strategies (lockdown, mandatory vaccination, immunity passports, voluntary social distancing, etc). Objective: This study aims to examine the reactions produced by the public announcement of a binding political decision presented by the president of the French Republic, Emmanuel Macron, on July 12, 2021, which imposed vaccination on caregivers and an immunity passport on all French people to access restaurants, cinemas, bars, and so forth. Methods: To measure these announcement reactions, 901,908 unique tweets posted on Twitter (Twitter Inc) between July 12 and August 11, 2021, were extracted. A neural network was constructed to examine the arguments of the tweets and to identify the types of arguments used by Twitter users. Results: This study shows that in the debate about mandatory vaccination and immunity passports, mostly ``con'' arguments (399,803/847,725, 47\%; $\chi$26=952.8; P<.001) and ``scientific'' arguments (317,156/803,583, 39\%; $\chi$26=5006.8; P<.001) were used. Conclusions: This study shows that during July and August 2021, social events permeating the public sphere and discussions about mandatory vaccination and immunity passports collided on Twitter. Moreover, a political decision based on scientific arguments led citizens to challenge it using pseudoscientific arguments contesting the effectiveness of vaccination and the validity of these political decisions. ",
doi="10.2196/49435",
url="https://www.jmir.org/2023/1/e49435",
url="http://www.ncbi.nlm.nih.gov/pubmed/37850906"
}


@Article{info:doi/10.2196/52877,
author="Guetz, Bernhard
and Bidmon, Sonja",
title="Authors' Reply: ``The Problem of Investigating Causal Relationships Between Cognitive and Evaluative Variables''",
journal="J Med Internet Res",
year="2023",
month="Nov",
day="22",
volume="25",
pages="e52877",
keywords="social influence",
keywords="physician rating websites",
keywords="patient satisfaction",
keywords="eHealth literacy",
doi="10.2196/52877",
url="https://www.jmir.org/2023/1/e52877",
url="http://www.ncbi.nlm.nih.gov/pubmed/37991815"
}


@Article{info:doi/10.2196/45570,
author="Konerding, Uwe",
title="The Problem of Investigating Causal Relationships Between Cognitive and Evaluative Variables",
journal="J Med Internet Res",
year="2023",
month="Nov",
day="22",
volume="25",
pages="e45570",
keywords="social influence",
keywords="physician rating websites",
keywords="patient satisfaction",
keywords="eHealth literacy",
doi="10.2196/45570",
url="https://www.jmir.org/2023/1/e45570",
url="http://www.ncbi.nlm.nih.gov/pubmed/37991832"
}


@Article{info:doi/10.2196/44849,
author="Blok, J. David
and Simoski, Bojan
and van Woudenberg, J. Thabo
and Buijzen, Moniek",
title="The Usefulness of Web-Based Communication Data for Social Network Health Interventions: Agent-Based Modeling Study",
journal="JMIR Pediatr Parent",
year="2023",
month="Nov",
day="22",
volume="6",
pages="e44849",
keywords="agent-based modeling",
keywords="peer nomination network data",
keywords="physical activity",
keywords="social network analysis",
keywords="social network interventions",
keywords="web-based communication network data",
abstract="Background: Social network interventions are an effective approach to promote physical activity. These interventions are traditionally designed using self-reported peer nomination network data to represent social connections. However, there is unexplored potential in communication data exchanged through web-based messaging apps or social platforms, given the availability of these data, the developments in artificial intelligence to analyze these data, and the shift of personal communication to the web sphere. The implications of using web-based versus offline social networks on the effectiveness of social network interventions remain largely unexplored. Objective: This study aims to investigate the differences in the impact of social network interventions on physical activity levels (PALs) between networks derived from web-based communication and peer nomination data. Methods: We used the data on sociometric questionnaires, messages from a web-based communication app, and PAL (number of steps per day) of 408 participants in 21 school classes. We applied social network analysis to identify influential peers and agent-based modeling to simulate the diffusion of PAL and explore the impact of social network interventions on PAL among adolescents in school classes. Influential peers (n=63) were selected based on centrality measures (ie, in-degree, closeness, and betweenness) to spread the intervention. They received health education, which increased their PAL by 17\%. In sensitivity analyses, we tested the impact of a 5\%, 10\%, and 20\% increase in PAL among influential peers. Results: There was a 24\%-27\% overlap in selected influential peers between the 2 network representations. In general, the simulations showed that interventions could increase PAL by 5.0\%-5.8\% within 2 months. However, the predicted median impact on PAL was slightly higher in networks based on web-based communication data than peer nomination data for in-degree (5.7\%, IQR 5.5\%-6.1\% vs 5.5\%, IQR 5.2\%-5.8\%; P=.002), betweenness (5.6\%, IQR 5.4\%-5.9\% vs 5.0\%, IQR 4.7\%-5.3\%; P<.001), and closeness centrality (5.8\%, IQR 5.6\%-6.1\% vs 5.3\%, IQR 5.0\%-5.6\%; P<.001). A large variation in impact was observed between school classes (range 1.5\%-17.5\%). Lowering the effectiveness of health education from 17\% to 5\% would reduce the overall impact of the social network intervention by 3-fold in both networks. Conclusions: Our findings showed that network interventions based on web-based communication data could increase PAL. Web-based communication data may therefore be a valuable addition to peer nomination data for future social network intervention design. Artificial intelligence methods, including agent-based modeling, can help to design these network interventions and provide insights into the role of network characteristics in their effectiveness. ",
doi="10.2196/44849",
url="https://pediatrics.jmir.org/2023/1/e44849",
url="http://www.ncbi.nlm.nih.gov/pubmed/37991813"
}


@Article{info:doi/10.2196/48858,
author="Yang, Jinqing
and Liu, Zhifeng
and Wang, Qicong
and Lu, Na",
title="Factors Influencing the Answerability and Popularity of a Health-Related Post in the Question-and-Answer Community: Infodemiology Study of Metafilter",
journal="J Med Internet Res",
year="2023",
month="Nov",
day="17",
volume="25",
pages="e48858",
keywords="user behavior",
keywords="dynamic network analysis",
keywords="health consultation",
keywords="health question and answers community",
keywords="question-and-answer",
keywords="Q\&A",
keywords="negative binomial regression",
abstract="Background: The web-based health question-and-answer (Q\&A) community has become the primary and handy way for people to access health information and knowledge directly. Objective: The objective of our study is to investigate how content-related, context-related, and user-related variables influence the answerability and popularity of health-related posts based on a user-dynamic, social network, and topic-dynamic semantic network, respectively. Methods: Full-scale data on health consultations were acquired from the Metafilter Q\&A community. These variables were designed in terms of context, content, and contributors. Negative binomial regression models were used to examine the influence of these variables on the favorite and comment counts of a health-related post. Results: A total of 18,099 post records were collected from a well-known Q\&A community. The findings of this study include the following. Content-related variables have a strong impact on both the answerability and popularity of posts. Notably, sentiment values were positively related to favorite counts and negatively associated with comment counts. User-related variables significantly affected the answerability and popularity of posts. Specifically, participation intensity was positively related to comment count and negatively associated with favorite count. Sociability breadth only had a significant impact on comment count. Context-related variables have a more substantial influence on the popularity of posts than on their answerability. The topic diversity variable exhibits an inverse correlation with the comment count while manifesting a positive correlation with the favorite count. Nevertheless, topic intensity has a significant effect only on favorite count. Conclusions: The research results not only reveal the factors influencing the answerability and popularity of health-related posts, which can help them obtain high-quality answers more efficiently, but also provide a theoretical basis for platform operators to enhance user engagement within health Q\&A communities. ",
doi="10.2196/48858",
url="https://www.jmir.org/2023/1/e48858",
url="http://www.ncbi.nlm.nih.gov/pubmed/37976090"
}


@Article{info:doi/10.2196/43812,
author="Ge, Ying
and Yao, Dongning
and Ung, Lam Carolina Oi
and Xue, Yan
and Li, Meng
and Lin, Jiabao
and Hu, Hao
and Lai, Yunfeng",
title="Digital Medical Information Services Delivered by Pharmaceutical Companies via WeChat: Qualitative Analytical Study",
journal="J Med Internet Res",
year="2023",
month="Nov",
day="17",
volume="25",
pages="e43812",
keywords="digital medical information service",
keywords="pharmaceutical company",
keywords="WeChat",
keywords="social media",
keywords="digital health",
abstract="Background: Social media has become one of the primary information sources for medical professionals and patients. Pharmaceutical companies are committed to using various social media platforms to provide stakeholders with digital medical information services (DMISs), which remain experimental and immature. In China, WeChat tops the list of popular social media platforms. To date, little is known about the service model of DMISs delivered by pharmaceutical companies via WeChat. Objective: This study aims to explore the emerging service model of DMISs delivered by pharmaceutical companies via WeChat in China. Methods: This study applied a qualitative research design combining case study and documentary analysis to explore the DMISs of 6 leading pharmaceutical companies in China. Materials were collected from their official WeChat platforms. Thematic analysis was conducted on the data. Results: The DMISs of 6 pharmaceutical companies were investigated. Themes emerged regarding 2 essential information services delivered by pharmaceutical companies via WeChat: business operation services and DMISs (ie, public information services, professional services, science and education services, and e-commerce services). Business operation services mainly function to assist or facilitate the company's operations and development trends for general visitors. Public-oriented information services are realized through health science popularization, academic frontiers, product information, and road maps to hospitals and pharmacies. Internet hospital and pharmacy services are the main patient-oriented professional services. Medical staff--oriented science and education services commonly include continuing education, clinical assistance, academic research, and journal searching. Public-oriented e-commerce services include health products and health insurance. Conclusions: Pharmaceutical companies in China use WeChat to provide stakeholders with diversified DMISs, which remain in the exploratory stage. The service model of DMISs requires more distinct innovations to provide personalized digital health and patient-centric services. Moreover, specific regulations on the DMISs of pharmaceutical companies need to be established to guard public health interests. ",
doi="10.2196/43812",
url="https://www.jmir.org/2023/1/e43812",
url="http://www.ncbi.nlm.nih.gov/pubmed/37976079"
}


@Article{info:doi/10.2196/45660,
author="Carabot, Federico
and Donat-Vargas, Carolina
and Santoma-Vilaclara, Javier
and Ortega, A. Miguel
and Garc{\'i}a-Montero, Cielo
and Fraile-Mart{\'i}nez, Oscar
and Zaragoza, Cristina
and Monserrat, Jorge
and Alvarez-Mon, Melchor
and Alvarez-Mon, Angel Miguel",
title="Exploring Perceptions About Paracetamol, Tramadol, and Codeine on Twitter Using Machine Learning: Quantitative and Qualitative Observational Study",
journal="J Med Internet Res",
year="2023",
month="Nov",
day="14",
volume="25",
pages="e45660",
keywords="awareness",
keywords="codeine",
keywords="machine learning",
keywords="pain",
keywords="painkiller",
keywords="perception",
keywords="recreational use",
keywords="social media",
keywords="twitter",
abstract="Background: Paracetamol, codeine, and tramadol are commonly used to manage mild pain, and their availability without prescription or medical consultation raises concerns about potential opioid addiction. Objective: This study aims to explore the perceptions and experiences of Twitter users concerning these drugs. Methods: We analyzed the tweets in English or Spanish mentioning paracetamol, tramadol, or codeine posted between January 2019 and December 2020. Out of 152,056 tweets collected, 49,462 were excluded. The content was categorized using a codebook, distinguishing user types (patients, health care professionals, and institutions), and classifying medical content based on efficacy and adverse effects. Scientific accuracy and nonmedical content themes (commercial, economic, solidarity, and trivialization) were also assessed. A total of 1000 tweets for each drug were manually classified to train, test, and validate machine learning classifiers. Results: Of classifiable tweets, 42,840 mentioned paracetamol and 42,131 mentioned weak opioids (tramadol or codeine). Patients accounted for 73.10\% (60,771/83,129) of the tweets, while health care professionals and institutions received the highest like-tweet and tweet-retweet ratios. Medical content distribution significantly differed for each drug (P<.001). Nonmedical content dominated opioid tweets (23,871/32,307, 73.9\%), while paracetamol tweets had a higher prevalence of medical content (33,943/50,822, 66.8\%). Among medical content tweets, 80.8\% (41,080/50,822) mentioned drug efficacy, with only 6.9\% (3501/50,822) describing good or sufficient efficacy. Nonmedical content distribution also varied significantly among the different drugs (P<.001). Conclusions: Patients seeking relief from pain are highly interested in the effectiveness of drugs rather than potential side effects. Alarming trends include a significant number of tweets trivializing drug use and recreational purposes, along with a lack of awareness regarding side effects. Monitoring conversations related to analgesics on social media is essential due to common illegal web-based sales and purchases without prescriptions. ",
doi="10.2196/45660",
url="https://www.jmir.org/2023/1/e45660",
url="http://www.ncbi.nlm.nih.gov/pubmed/37962927"
}


@Article{info:doi/10.2196/45101,
author="Morena, Nina
and Ahisar, Yitzchok
and Wang, Xena
and Nguyen, Diana
and Rentschler, A. Carrie
and Meguerditchian, N. Ari",
title="Content Quality of YouTube Videos About Metastatic Breast Cancer in Young Women: Systematic Assessment",
journal="JMIR Cancer",
year="2023",
month="Nov",
day="14",
volume="9",
pages="e45101",
keywords="social media",
keywords="YouTube",
keywords="metastatic breast cancer",
keywords="breast cancer",
keywords="patient education",
keywords="health education",
keywords="patient literacy",
keywords="media literacy",
keywords="health literacy",
keywords="consumer health information",
keywords="assessment tool",
keywords="treatment",
keywords="false information",
keywords="women",
keywords="videos",
keywords="web-based",
abstract="Background: Young women with metastatic breast cancer (MBC) are part of a digitally connected generation yet are underserved in terms of information needs. YouTube is widely used to find and identify health information. The accessibility of health-related content on social media together with the rare and marginalized experiences of young women with MBC and the digital media practices of younger generations imply a considerable likelihood that young women with MBC will seek information and community on the internet. Objective: This study aims to assess the content quality of MBC YouTube videos and to identify themes in the experiences of young women with MBC based on YouTube videos. Methods: A systematic assessment of MBC YouTube videos using the search term ``metastatic breast cancer young'' was conducted in August 2021. The search was performed in an incognito browser and with no associated YouTube or Google account. Search results were placed in order from most to least views. Title, date uploaded, length, poster identity, number of likes, and number of comments were collected. Understandability and actionability were assessed using the Patient Education Materials Assessment Tool (PEMAT); information reliability and quality were assessed with DISCERN. Themes, sponsorships, and health care professionals' and patients' narratives were reported. Results: A total of 101 videos were identified. Of these, 78.2\% (n=79) included sponsorships. The mean PEMAT scores were 78.8\% (SD 15.3\%) and 43.1\% (SD 45.2\%) for understandability and actionability, respectively. The mean DISCERN score was 2.44 (SD 0.7) out of 5. Identified themes included treatment (n=67, 66.3\%), family relationship (n=46, 45.5\%), and motherhood (n=38, 37.6\%). Conclusions: YouTube videos about young women with MBC are highly understandable but demonstrate moderate rates of actionability, with low reliability and quality scores. Many have a commercial bias. While web-based materials have limitations, their potential to provide patient support is not fully developed. By acknowledging their patients' media habits, health care professionals can further develop a trusting bond with their patients, provide a space for open and honest discussions of web-based materials, and avoid any potential instances of confusion caused by misleading, inaccurate, or false web-based materials. ",
doi="10.2196/45101",
url="https://cancer.jmir.org/2023/1/e45101",
url="http://www.ncbi.nlm.nih.gov/pubmed/37737837"
}


@Article{info:doi/10.2196/50138,
author="Scales, David
and Hurth, Lindsay
and Xi, Wenna
and Gorman, Sara
and Radhakrishnan, Malavika
and Windham, Savannah
and Akunne, Azubuike
and Florman, Julia
and Leininger, Lindsey
and Gorman, Jack",
title="Addressing Antivaccine Sentiment on Public Social Media Forums Through Web-Based Conversations Based on Motivational Interviewing Techniques: Observational Study",
journal="JMIR Infodemiology",
year="2023",
month="Nov",
day="14",
volume="3",
pages="e50138",
keywords="anti-vaccine",
keywords="digital environment",
keywords="engagement",
keywords="health misinformation",
keywords="infodemic",
keywords="infodemiology",
keywords="information environment",
keywords="medical misinformation",
keywords="misinformation",
keywords="observational study",
keywords="social media engagement metrics",
keywords="social media",
abstract="Background: Health misinformation shared on social media can have negative health consequences; yet, there is a dearth of field research testing interventions to address health misinformation in real time, digitally, and in situ on social media. Objective: We describe a field study of a pilot program of ``infodemiologists'' trained with evidence-informed intervention techniques heavily influenced by principles of motivational interviewing. Here we provide a detailed description of the nature of infodemiologists' interventions on posts sharing misinformation about COVID-19 vaccines, present an initial evaluation framework for such field research, and use available engagement metrics to quantify the impact of these in-group messengers on the web-based threads on which they are intervening. Methods: We monitored Facebook (Meta Platforms, Inc) profiles of news organizations marketing to 3 geographic regions (Newark, New Jersey; Chicago, Illinois; and central Texas). Between December 2020 and April 2021, infodemiologists intervened in 145 Facebook news posts that generated comments containing either false or misleading information about vaccines or overt antivaccine sentiment. Engagement (emojis plus replies) data were collected on Facebook news posts, the initial comment containing misinformation (level 1 comment), and the infodemiologist's reply (level 2 reply comment). A comparison-group evaluation design was used, with numbers of replies, emoji reactions, and engagements for level 1 comments compared with the median metrics of matched comments using the Wilcoxon signed rank test. Level 2 reply comments (intervention) were also benchmarked against the corresponding metric of matched reply comments (control) using the Wilcoxon signed rank test (paired at the level 1 comment level). Infodemiologists' level 2 reply comments (intervention) and matched reply comments (control) were further compared using 3 Poisson regression models. Results: In total, 145 interventions were conducted on 132 Facebook news posts. The level 1 comments received a median of 3 replies, 3 reactions, and 7 engagements. The matched comments received a median of 1.5 (median of IQRs 3.75) engagements. Infodemiologists made 322 level 2 reply comments, precipitating 189 emoji reactions and a median of 0.5 (median of IQRs IQR 0) engagements. The matched reply comments received a median of 1 (median of IQRs 2.5) engagement. Compared to matched comments, level 1 comments received more replies, emoji reactions, and engagements. Compared to matched reply comments, level 2 reply comments received fewer and narrower ranges of replies, reactions, and engagements, except for the median comparison for replies. Conclusions: Overall, empathy-first communication strategies based on motivational interviewing garnered less engagement relative to matched controls. One possible explanation is that our interventions quieted contentious, misinformation-laden threads about vaccines on social media. This work reinforces research on accuracy nudges and cyberbullying interventions that also reduce engagement. More research leveraging field studies of real-time interventions is needed, yet data transparency by technology platforms will be essential to facilitate such experiments. ",
doi="10.2196/50138",
url="https://infodemiology.jmir.org/2023/1/e50138",
url="http://www.ncbi.nlm.nih.gov/pubmed/37962940"
}


@Article{info:doi/10.2196/51752,
author="Ezeilo, Ogechukwu Chidimma
and Leon, Nicholas
and Jajodia, Anushka
and Han, Hae-Ra",
title="Use of Social Media for Health Advocacy for Digital Communities: Descriptive Study",
journal="JMIR Form Res",
year="2023",
month="Nov",
day="14",
volume="7",
pages="e51752",
keywords="social media",
keywords="health advocacy",
keywords="community health",
keywords="Twitter",
keywords="health communication",
keywords="health promotion",
keywords="communication",
keywords="communications",
keywords="advocacy",
keywords="tweet",
keywords="tweets",
keywords="nurse",
keywords="nurses",
keywords="nursing",
abstract="Background: There has been a growth surge in the use of social media among individuals today. The widespread adoption of these platforms, coupled with their engaging features, presents a unique opportunity for the dissemination of health advocacy information. Social media is known as a powerful tool used to share health policy and advocacy efforts and disseminate health information to digital community members and networks. Yet, there is still a gap in the full exploitation of this powerful instrument, among health care professionals, for health advocacy campaigns. Objective: This paper aims to describe the process of mobilizing social media platforms such as Twitter (rebranded to X Corp in 2023) for health advocacy of the digital community. Additionally, it aims to share the lessons and insights gained during this digital health advocacy engagement process. Methods: We performed a comprehensive review of Twitter analytical data to examine the impact of our social media posts. We then consolidated these analytic reports with our meeting logs to describe our systematic, iterative, and collaborative design process to implement social media efforts and generate key lessons learned. Results: Our review of monthly Twitter analytical reports and regular team meeting logs revealed several themes for successful and less successful practices in relation to our social media--based health advocacy efforts. The successful practices noted by the team included using personable, picture-based tweets; using a series of posts on a particular topic rather than an isolated post; leveraging team members' and partners' collaborations in shared posts; incorporating hashtags in tweets; using a balanced mix of texts and graphics in posts; using inclusive (nondestigmatizing) languages in tweeted posts; and use of polls to share tweets. Among the many lessons learned, we also experienced limitations including a lack of comprehensive statistics on Twitter usage for health care--related purposes such as health advocacy and limits in collating the estimates of the actual impact made on the intended digital community members by our posts. Conclusions: Twitter has been successfully used in promoting health advocacy content, and the social media team aims to explore other social media platforms that have a wider reach than Twitter. We will continue making necessary adjustments in strategies, techniques, and styles to engage the audience as we expand onto new platforms like Instagram and TikTok for health advocacy promotions. ",
doi="10.2196/51752",
url="https://formative.jmir.org/2023/1/e51752",
url="http://www.ncbi.nlm.nih.gov/pubmed/37962914"
}


@Article{info:doi/10.2196/47977,
author="Li, Casey
and Salman, Maria
and Esmail, Tariq
and Matava, Clyde",
title="Use of Peer-Led Web-Based Platforms for Peer-Assisted Learning Among Canadian Anesthesia Residents and Fellows: Cross-Sectional Study",
journal="JMIR Form Res",
year="2023",
month="Nov",
day="13",
volume="7",
pages="e47977",
keywords="medical education",
keywords="anesthesia",
keywords="residents",
keywords="fellowship",
keywords="social media",
keywords="peer led",
keywords="peer assisted learning",
keywords="anesthesiology",
keywords="mobile device usage",
keywords="health care",
keywords="medical trainee",
keywords="perception",
keywords="mobile app",
keywords="digital health",
abstract="Background: Peer-assisted learning (PAL) using peer-led web-based platforms (PWPs), including social media, can be a highly effective method of supporting medical trainees. PWPs, such as mobile apps for sharing anesthesia resources and social media groups or discussion forums pertaining to anesthesia training, may play a role in facilitating anesthesia trainee-led web-based education. However, there have been many challenges facing anesthesia trainees when it comes to incorporating PWPs, especially social media and mobile apps for PAL. Objective: The primary objective of this survey was to assess the proportion of trainees that use social media and mobile apps. The secondary objective was to identify the trainees' perceptions on the use of social media and mobile apps for educational purposes, including PAL. Methods: This cross-sectional study was conducted through a survey administered via email at a single large academic center. The survey tool collected data between 2016 and 2017 on the following: demographic data (year of study, field of specialty), use of technology and web-based resources for medicine, use of social media platforms for anesthesia or training, benefits and barriers to future uses of social media for training, and ideas for trainee-led websites. Descriptive statistics were reported. Results: In total, 80 anesthesia trainees (51 residents and 29 fellows) responded to the survey (response rate of 33\% of out 240 trainees contacted). All trainees reported having a mobile device that most (n=61, 76\%) reported using multiple times a day to access medical resources. The highest perceived benefits of PWPs according to residents were that the most valuable information was available on-demand (n=27, 53\%), they saved time (n=27, 53\%), and they improved their overall learning experience within anesthesia (n=24, 47\%). In comparison, fellows thought that PWPs were beneficial because they provided multiple perspectives of a single topic (n=13, 45\%) and served as an additional platform to discuss ideas with peers (n=13, 45\%). The most popular platforms used by both residents and fellows were Facebook (residents: n=44, 86\%; fellows: n=26, 90\%) followed by LinkedIn (residents: n=21, 42\%; fellows: n=9, 29\%). Even though most anesthesia trainees used social media for personal reasons, only 26\% (n=21) reported having used resident- or fellow-driven PWP resources. Examples of PWPs that trainees used included anesthesia groups and a resident Dropbox resource folder. Conclusions: There was generally an acceptance for using PWPs for PAL as they provided various benefits for trainees at all levels of learning. PWPs have the potential to garner an increased sense of community and sharing within learning experiences throughout all levels of training.?The information gained from this survey will help inform the basis for developing an anesthesia trainee-led e-learning platform. ",
doi="10.2196/47977",
url="https://formative.jmir.org/2023/1/e47977",
url="http://www.ncbi.nlm.nih.gov/pubmed/37955954"
}


@Article{info:doi/10.2196/49416,
author="Al-Rawi, Ahmed
and Blackwell, Breanna
and Zemenchik, Kiana
and Lee, Kelley",
title="Twitter Misinformation Discourses About Vaping: Systematic Content Analysis",
journal="J Med Internet Res",
year="2023",
month="Nov",
day="10",
volume="25",
pages="e49416",
keywords="vaping",
keywords="e-cigarette",
keywords="smoking",
keywords="misinformation",
keywords="fact checking",
keywords="social media",
keywords="Twitter",
keywords="nicotine",
keywords="content analysis",
keywords="fact-checking",
keywords="disinformation",
keywords="weaponized",
keywords="health risk",
keywords="risk",
keywords="health education",
keywords="education",
keywords="communication",
keywords="electronic nicotine delivery systems",
keywords="ENDS",
abstract="Background: While there has been substantial analysis of social media content deemed to spread misinformation about electronic nicotine delivery systems use, the strategic use of misinformation accusations to undermine opposing views has received limited attention. Objective: This study aims to fill this gap by analyzing how social media users discuss the topic of misinformation related to electronic nicotine delivery systems, notably vaping products. Additionally, this study identifies and analyzes the actors commonly blamed for spreading such misinformation and how these claims support both the provaping and antivaping narratives. Methods: Using Twitter's (subsequently rebranded as X) academic application programming interface, we collected tweets referencing \#vape and \#vaping and keywords associated with fake news and misinformation. This study uses systematic content analysis to analyze the tweets and identify common themes and actors who discuss or possibly spread misinformation. Results: This study found that provape users dominate the platform regarding discussions about misinformation about vaping, with provaping tweets being more frequent and having higher overall user engagement. The most common narrative for provape tweets surrounds the conversation of vaping being perceived as safe. On the other hand, the most common topic from the antivape narrative is that vaping is indeed harmful. This study also points to a general distrust in authority figures, with news outlets, public health authorities, and political actors regularly accused of spreading misinformation, with both placing blame. However, specific actors differ depending on their positionalities. The vast number of accusations from provaping advocates is found to shape what is considered misinformation and works to silence other narratives. Additionally, allegations against reliable and proven sources, such as public health authorities, work to discredit assessments about the health impacts, which is detrimental to public health overall for both provaping and antivaping advocates. Conclusions: We conclude that the spread of misinformation and the accusations of misinformation dissemination using terms such as ``fact check,'' ``misinformation,'' ``fake news,'' and ``disinformation'' have become weaponized and co-opted by provaping actors to delegitimize criticisms about vaping and to increase confusion about the potential health risks. The study discusses the mixed types of impact of vaping on public health for both smokers and nonsmokers. Additionally, we discuss the implications for effective health education and communication about vaping and how misinformation claims can affect evidence-based discourse on Twitter as well as informed vaping decisions. ",
doi="10.2196/49416",
url="https://www.jmir.org/2023/1/e49416",
url="http://www.ncbi.nlm.nih.gov/pubmed/37948118"
}


@Article{info:doi/10.2196/49653,
author="Johnson, Hadley
and Herzog, Claire
and Shaver, L. Rob
and Hylwa, A. Sara",
title="A Deep Dive Into Instagram's Top Skinfluencers",
journal="JMIR Dermatol",
year="2023",
month="Nov",
day="10",
volume="6",
pages="e49653",
keywords="Instagram",
keywords="skinfluencer",
keywords="skinfluencers",
keywords="skin care",
keywords="social media",
keywords="general dermatology",
keywords="training",
keywords="dermatology",
keywords="influencer",
keywords="influencers",
keywords="skin",
doi="10.2196/49653",
url="https://derma.jmir.org/2023/1/e49653",
url="http://www.ncbi.nlm.nih.gov/pubmed/37948099"
}


@Article{info:doi/10.2196/42905,
author="Peri{\'c}, Zinaida
and Basak, Grzegorz
and Koenecke, Christian
and Moiseev, Ivan
and Chauhan, Jyoti
and Asaithambi, Sathyaraj
and Sagkriotis, Alexandros
and Gunes, Sibel
and Penack, Olaf",
title="Understanding the Needs and Lived Experiences of Patients With Graft-Versus-Host Disease: Real-World European Public Social Media Listening Study",
journal="JMIR Cancer",
year="2023",
month="Nov",
day="10",
volume="9",
pages="e42905",
keywords="graft-versus-host disease",
keywords="GVHD",
keywords="infoveillance",
keywords="patient journey",
keywords="quality of life",
keywords="real-world evidence",
keywords="social media listening",
keywords="social media",
abstract="Background: Graft-versus-host disease (GVHD) is the major cause of short- and long-term morbidity and mortality after allogeneic hematopoietic stem cell transplantation. Treatment options beyond corticosteroid therapy remain limited, and prolonged treatment often leads to impaired quality of life (QoL). A better understanding of the needs and experiences of patients with GVHD is required to improve patient care. Objective: The aim of this study is to explore different social media (SM) channels for gathering and analyzing the needs and experiences of patients and other stakeholders across 14 European countries. Methods: We conducted a retrospective analysis of SM data from the public domain. The Talkwalker social analytics tool collected data from open-access forums, blogs, and various social networking sites using predefined search strings. The raw data set derived from the aggregator tool was automatically screened for the relevancy of posts, generating the curated data set that was manually reviewed to identify posts that fell within the predefined inclusion and exclusion criteria. This final data set was then used for the deep-dive analysis. Results: A total of 9016 posts relating to GVHD were identified between April 2019 and April 2021. Deduplication and relevancy checks resulted in 325 insightful posts, with Twitter contributing 250 (77\%) posts; blogs, 49 (15\%) posts; forums, 13 (4\%) posts; Facebook, 7 (2\%) posts; and Instagram and YouTube, 4 (1\%) posts. Patients with GVHD were the primary stakeholders, contributing 63\% of all SM posts. In 234 posts, treatment was the most discussed stage of the patient journey (68\%), followed by symptoms (33\%), and diagnosis and tests (21\%). Among treatment-related posts (n=159), steroid therapy was most frequently reported (54/159, 34\%). Posts relating to treatment features (n=110) identified efficacy (45/110, 41\%), side effects (38/110, 35\%), and frequency and dosage (32/110, 29\%), as the most frequently discussed features. Symptoms associated with GVHD were described in 24\% (77/325) of posts, including skin-related conditions (49/77, 64\%), dry eyes or vision change (13/77, 17\%), pain and cramps (16/77, 21\%), and fatigue or muscle weakness (12/77, 16\%). The impacts of GVHD on QoL were discussed in 51\% (165/325) of all posts, with the emotional, physical and functional, social, and financial impacts mentioned in 69\% (114/165), 50\% (82/165), 5\% (8/165), and 2\% (3/165) of these posts, respectively. Unmet needs were reported by patients or caregivers in 24\% (77/325) of analyzed conversations, with treatment-related side effects being the most common (35/77, 45\%) among these posts. Conclusions: SM listening is a useful tool to identify medical needs. Treatment of GVHD, including treatment-related side effects, as well as its emotional and physical impact on QoL, are the major topics that GVHD stakeholders mention on SM. We encourage a structured discussion of these topics in interactions between health care providers and patients with GVHD. Trial Registration: Not applicable ",
doi="10.2196/42905",
url="https://cancer.jmir.org/2023/1/e42905",
url="http://www.ncbi.nlm.nih.gov/pubmed/37948101"
}


@Article{info:doi/10.2196/49753,
author="Zhou, Xinyu
and Song, Suhang
and Zhang, Ying
and Hou, Zhiyuan",
title="Deep Learning Analysis of COVID-19 Vaccine Hesitancy and Confidence Expressed on Twitter in 6 High-Income Countries: Longitudinal Observational Study",
journal="J Med Internet Res",
year="2023",
month="Nov",
day="6",
volume="25",
pages="e49753",
keywords="COVID-19 vaccine",
keywords="hesitancy",
keywords="confidence",
keywords="social media",
keywords="machine learning",
abstract="Background: An ongoing monitoring of national and subnational trajectory of COVID-19 vaccine hesitancy could offer support in designing tailored policies on improving vaccine uptake. Objective: We aim to track the temporal and spatial distribution of COVID-19 vaccine hesitancy and confidence expressed on Twitter during the entire pandemic period in major English-speaking countries. Methods: We collected 5,257,385 English-language tweets regarding COVID-19 vaccination between January 1, 2020, and June 30, 2022, in 6 countries---the United States, the United Kingdom, Australia, New Zealand, Canada, and Ireland. Transformer-based deep learning models were developed to classify each tweet as intent to accept or reject COVID-19 vaccination and the belief that COVID-19 vaccine is effective or unsafe. Sociodemographic factors associated with COVID-19 vaccine hesitancy and confidence in the United States were analyzed using bivariate and multivariable linear regressions. Results: The 6 countries experienced similar evolving trends of COVID-19 vaccine hesitancy and confidence. On average, the prevalence of intent to accept COVID-19 vaccination decreased from 71.38\% of 44,944 tweets in March 2020 to 34.85\% of 48,167 tweets in June 2022 with fluctuations. The prevalence of believing COVID-19 vaccines to be unsafe continuously rose by 7.49 times from March 2020 (2.84\% of 44,944 tweets) to June 2022 (21.27\% of 48,167 tweets). COVID-19 vaccine hesitancy and confidence varied by country, vaccine manufacturer, and states within a country. The democrat party and higher vaccine confidence were significantly associated with lower vaccine hesitancy across US states. Conclusions: COVID-19 vaccine hesitancy and confidence evolved and were influenced by the development of vaccines and viruses during the pandemic. Large-scale self-generated discourses on social media and deep learning models provide a cost-efficient approach to monitoring routine vaccine hesitancy. ",
doi="10.2196/49753",
url="https://www.jmir.org/2023/1/e49753",
url="http://www.ncbi.nlm.nih.gov/pubmed/37930788"
}


@Article{info:doi/10.2196/48710,
author="Leslie, Abimbola
and Okunromade, Omolola
and Sarker, Abeed",
title="Public Perceptions About Monkeypox on Twitter: Thematic Analysis",
journal="JMIR Form Res",
year="2023",
month="Nov",
day="3",
volume="7",
pages="e48710",
keywords="monkeypox",
keywords="social media",
keywords="public health",
keywords="Twitter",
keywords="perception",
keywords="digital platform",
keywords="infectious disease",
keywords="outbreak",
keywords="awareness",
keywords="analyses",
keywords="misinformation",
abstract="Background: Social media has emerged as an important source of information generated by large segments of the population, which can be particularly valuable during infectious disease outbreaks. The recent outbreak of monkeypox led to an increase in discussions about the topic on social media, thus presenting the opportunity to conduct studies based on the generated data. Objective: By analyzing posts from Twitter (subsequently rebranded X), we aimed to identify the topics of public discourse as well as knowledge and opinions about the monkeypox virus during the 2022 outbreak. Methods: We collected data from Twitter focusing on English-language posts containing key phrases like ``monkeypox,'' ``mpoxvirus,'' and ``monkey pox,'' as well as their hashtag equivalents from August to October 2022. We preprocessed the data using natural language processing to remove duplicates and filter out noise. We then selected a random sample from the collected posts. Three annotators reviewed a sample of the posts and created a guideline for coding based on discussion. Finally, the annotators analyzed, coded, and manually categorized them first into topics and then into coarse-grained themes. Disagreements were resolved via discussion among all authors. Results: A total of 128,615 posts were collected over a 3-month period, and 200 tweets were selected and included for manual analyses. The following 8 themes were generated from the Twitter posts: monkeypox doubts, media, monkeypox transmission, effect of monkeypox, knowledge of monkeypox, politics, monkeypox vaccine, and general comments. The most common themes from our study were monkeypox doubts and media, each accounting for 22\% (44/200) of the posts. The posts represented a mix of useful information reflecting emerging knowledge on the topic as well as misinformation. Conclusions: Social networks, such as Twitter, are useful sources of information in the early stages of outbreaks. Close to real-time identification and analyses of misinformation may help authorities take the necessary steps in a timely manner. ",
doi="10.2196/48710",
url="https://formative.jmir.org/2023/1/e48710",
url="http://www.ncbi.nlm.nih.gov/pubmed/37921866"
}


@Article{info:doi/10.2196/49300,
author="Dai, Jing
and Lyu, Fang
and Yu, Lin
and He, Yunyu",
title="Temporal and Emotional Variations in People's Perceptions of Mass Epidemic Infectious Disease After the COVID-19 Pandemic Using Influenza A as an Example: Topic Modeling and Sentiment Analysis Based on Weibo Data",
journal="J Med Internet Res",
year="2023",
month="Nov",
day="2",
volume="25",
pages="e49300",
keywords="mass epidemic infections",
keywords="sentiment analysis",
keywords="text mining",
keywords="spatial differences",
keywords="temporal differences",
keywords="influenza A",
keywords="COVID-19",
abstract="Background: The COVID-19 pandemic has had profound impacts on society, including public health, the economy, daily life, and social interactions. Social distancing measures, travel restrictions, and the influx of pandemic-related information on social media have all led to a significant shift in how individuals perceive and respond to health crises. In this context, there is a growing awareness of the role that social media platforms such as Weibo, among the largest and most influential social media sites in China, play in shaping public sentiment and influencing people's behavior during public health emergencies. Objective: This study aims to gain a comprehensive understanding of the sociospatial impact of mass epidemic infectious disease by analyzing the spatiotemporal variations and emotional orientations of the public after the COVID-19 pandemic. We use the outbreak of influenza A after the COVID-19 pandemic as a case study. Through temporal and spatial analyses, we aim to uncover specific variations in the attention and emotional orientations of people living in different provinces in China regarding influenza A. We sought to understand the societal impact of large-scale infectious diseases and the public's stance after the COVID-19 pandemic to improve public health policies and communication strategies. Methods: We selected Weibo as the data source and collected all influenza A--related Weibo posts from November 1, 2022, to March 31, 2023. These data included user names, geographic locations, posting times, content, repost counts, comments, likes, user types, and more. Subsequently, we used latent Dirichlet allocation topic modeling to analyze the public's focus as well as the bidirectional long short-term memory model to conduct emotional analysis. We further classified the focus areas and emotional orientations of different regions. Results: The research findings indicate that, compared with China's western provinces, the eastern provinces exhibited a higher volume of Weibo posts, demonstrating a greater interest in influenza A. Moreover, inland provinces displayed elevated levels of concern compared with coastal regions. In addition, female users of Weibo exhibited a higher level of engagement than male users, with regular users comprising the majority of user types. The public's focus was categorized into 23 main themes, with the overall emotional sentiment predominantly leaning toward negativity (making up 7562 out of 9111 [83\%] sentiments). Conclusions: The results of this study underscore the profound societal impact of the COVID-19 pandemic. People tend to be pessimistic toward new large-scale infectious diseases, and disparities exist in the levels of concern and emotional sentiments across different regions. This reflects diverse societal responses to health crises. By gaining an in-depth understanding of the public's attitudes and focal points regarding these infectious diseases, governments and decision makers can better formulate policies and action plans to cater to the specific needs of different regions and enhance public health awareness. ",
doi="10.2196/49300",
url="https://www.jmir.org/2023/1/e49300",
url="http://www.ncbi.nlm.nih.gov/pubmed/37917144"
}


@Article{info:doi/10.2196/46874,
author="Christodoulakis, Nicolette
and Abdelkader, Wael
and Lokker, Cynthia
and Cotterchio, Michelle
and Griffith, E. Lauren
and Vanderloo, M. Leigh
and Anderson, N. Laura",
title="Public Health Surveillance of Behavioral Cancer Risk Factors During the COVID-19 Pandemic: Sentiment and Emotion Analysis of Twitter Data",
journal="JMIR Form Res",
year="2023",
month="Nov",
day="2",
volume="7",
pages="e46874",
keywords="cancer risk factors",
keywords="Twitter",
keywords="sentiment analysis",
keywords="emotion analysis",
keywords="social media",
keywords="physical inactivity",
keywords="poor nutrition",
keywords="alcohol",
keywords="smoking",
abstract="Background: The COVID-19 pandemic and its associated public health mitigation strategies have dramatically changed patterns of daily life activities worldwide, resulting in unintentional consequences on behavioral risk factors, including smoking, alcohol consumption, poor nutrition, and physical inactivity. The infodemic of social media data may provide novel opportunities for evaluating changes related to behavioral risk factors during the pandemic. Objective: We explored the feasibility of conducting a sentiment and emotion analysis using Twitter data to evaluate behavioral cancer risk factors (physical inactivity, poor nutrition, alcohol consumption, and smoking) over time during the first year of the COVID-19 pandemic. Methods: Tweets during 2020 relating to the COVID-19 pandemic and the 4 cancer risk factors were extracted from the George Washington University Libraries Dataverse. Tweets were defined and filtered using keywords to create 4 data sets. We trained and tested a machine learning classifier using a prelabeled Twitter data set. This was applied to determine the sentiment (positive, negative, or neutral) of each tweet. A natural language processing package was used to identify the emotions (anger, anticipation, disgust, fear, joy, sadness, surprise, and trust) based on the words contained in the tweets. Sentiments and emotions for each of the risk factors were evaluated over time and analyzed to identify keywords that emerged. Results: The sentiment analysis revealed that 56.69\% (51,479/90,813) of the tweets about physical activity were positive, 16.4\% (14,893/90,813) were negative, and 26.91\% (24,441/90,813) were neutral. Similar patterns were observed for nutrition, where 55.44\% (27,939/50,396), 15.78\% (7950/50,396), and 28.79\% (14,507/50,396) of the tweets were positive, negative, and neutral, respectively. For alcohol, the proportions of positive, negative, and neutral tweets were 46.85\% (34,897/74,484), 22.9\% (17,056/74,484), and 30.25\% (22,531/74,484), respectively, and for smoking, they were 41.2\% (11,628/28,220), 24.23\% (6839/28,220), and 34.56\% (9753/28,220), respectively. The sentiments were relatively stable over time. The emotion analysis suggests that the most common emotion expressed across physical activity and nutrition tweets was trust (69,495/320,741, 21.67\% and 42,324/176,564, 23.97\%, respectively); for alcohol, it was joy (49,147/273,128, 17.99\%); and for smoking, it was fear (23,066/110,256, 20.92\%). The emotions expressed remained relatively constant over the observed period. An analysis of the most frequent words tweeted revealed further insights into common themes expressed in relation to some of the risk factors and possible sources of bias. Conclusions: This analysis provided insight into behavioral cancer risk factors as expressed on Twitter during the first year of the COVID-19 pandemic. It was feasible to extract tweets relating to all 4 risk factors, and most tweets had a positive sentiment with varied emotions across the different data sets. Although these results can play a role in promoting public health, a deeper dive via qualitative analysis can be conducted to provide a contextual examination of each tweet. ",
doi="10.2196/46874",
url="https://formative.jmir.org/2023/1/e46874",
url="http://www.ncbi.nlm.nih.gov/pubmed/37917123"
}


@Article{info:doi/10.2196/44420,
author="Dou, Xuelin
and Liu, Yang
and Liao, Aijun
and Zhong, Yuping
and Fu, Rong
and Liu, Lihong
and Cui, Canchan
and Wang, Xiaohong
and Lu, Jin",
title="Patient Journey Toward a Diagnosis of Light Chain Amyloidosis in a National Sample: Cross-Sectional Web-Based Study",
journal="JMIR Form Res",
year="2023",
month="Nov",
day="2",
volume="7",
pages="e44420",
keywords="systemic light chain amyloidosis",
keywords="AL amyloidosis",
keywords="rare disease",
keywords="big data",
keywords="network analysis",
keywords="machine model",
keywords="natural language processing",
keywords="web-based",
abstract="Background: Systemic light chain (AL) amyloidosis is a rare and multisystem disease associated with increased morbidity and a poor prognosis. Delayed diagnoses are common due to the heterogeneity of the symptoms. However, real-world insights from Chinese patients with AL amyloidosis have not been investigated. Objective: This study aimed to describe the journey to an AL amyloidosis diagnosis and to build an in-depth understanding of the diagnostic process from the perspective of both clinicians and patients to obtain a correct and timely diagnosis. Methods: Publicly available disease-related content from social media platforms between January 2008 and April 2021 was searched. After performing data collection steps with a machine model, a series of disease-related posts were extracted. Natural language processing was used to identify the relevance of variables, followed by further manual evaluation and analysis. Results: A total of 2204 valid posts related to AL amyloidosis were included in this study, of which 1968 were posted on haodf.com. Of these posts, 1284 were posted by men (median age 57, IQR 46-67 years); 1459 posts mentioned renal-related symptoms, followed by heart (n=833), liver (n=491), and stomach (n=368) symptoms. Furthermore, 1502 posts mentioned symptoms related to 2 or more organs. Symptoms for AL amyloidosis most frequently mentioned by suspected patients were nonspecific weakness (n=252), edema (n=196), hypertrophy (n=168), and swelling (n=140). Multiple physician visits were common, and nephrologists (n=265) and hematologists (n=214) were the most frequently visited specialists by suspected patients for initial consultation. Additionally, interhospital referrals were also commonly seen, centralizing in tertiary hospitals. Conclusions: Chinese patients with AL amyloidosis experienced referrals during their journey toward accurate diagnosis. Increasing awareness of the disease and early referral to a specialized center with expertise may reduce delayed diagnosis and improve patient management. ",
doi="10.2196/44420",
url="https://formative.jmir.org/2023/1/e44420",
url="http://www.ncbi.nlm.nih.gov/pubmed/37917132"
}


@Article{info:doi/10.2196/46296,
author="Nicmanis, Mitchell
and Chur-Hansen, Anna
and Linehan, Karen",
title="The Information Needs and Experiences of People Living With Cardiac Implantable Electronic Devices: Qualitative Content Analysis of Reddit Posts",
journal="JMIR Cardio",
year="2023",
month="Nov",
day="1",
volume="7",
pages="e46296",
keywords="implantable cardioverter defibrillator",
keywords="pacemaker",
keywords="cardiac resynchronization therapy",
keywords="social media",
keywords="patients",
keywords="peer support",
keywords="content analysis",
keywords="experiences",
abstract="Background: Cardiac implantable electronic devices (CIEDs) are used to treat a range of cardiovascular diseases and can lead to substantial clinical improvements. However, studies evaluating patients' experiences of living with these devices are sparse and have focused mainly on implantable cardioverter defibrillators. In addition, there has been limited evaluation of how people living with a CIED use social media to gain insight into their condition. Objective: This study aims to analyze posts from web-based communities called subreddits on the website Reddit, intended for people living with a CIED, to characterize the informational needs and experiences of patients. Methods: Reddit was systematically searched for appropriate subreddits, and we found 1 subreddit that could be included in the analysis. A Python-based web scraping script using the Reddit application programming interface was used to extract posts from this subreddit. Each post was individually screened for relevancy, and a register of participants' demographic information was created. Conventional qualitative content analysis was used to inductively classify the qualitative data collected into codes, subcategories, and overarching categories. Results: Of the 484 posts collected using the script, 186 were excluded, resulting in 298 posts from 196 participants being included in the analysis. The median age of the participants who reported this was 33 (IQR 22.0-39.5; range 17-72) years, and the majority had a permanent pacemaker. The content analysis yielded 5 overarching categories: use of the subreddit by participants, questions and experiences related to the daily challenges of living with a CIED, physical sequelae of CIED implantation, psychological experiences of living with a CIED, and questions and experiences related to health care while living with a CIED. These categories provided insight into the diverse experiences and informational needs of participants living with a CIED. The data predominantly represented the experiences of younger and more physically active participants. Conclusions: Social media provides a platform through which people living with a CIED can share information and provide support to their peers. Participants generally sought information about the experiences of others living with a CIED. This was often done to help overcome a range of challenges faced by participants, including the need to adapt to living with a CIED, difficulties with navigating health care, psychological difficulties, and various aversive physical sequelae. These challenges may be particularly difficult for younger and physically active people. Health care professionals may leverage peer support and other aid to help people overcome the challenges they face while living with a CIED. ",
doi="10.2196/46296",
url="https://cardio.jmir.org/2023/1/e46296",
url="http://www.ncbi.nlm.nih.gov/pubmed/37766632"
}


@Article{info:doi/10.2196/46897,
author="Seth, Rajeev
and Dhaliwal, K. Baldeep
and Miller, Emily
and Best, Tyler
and Sullivan, Alexis
and Thankachen, Betty
and Qaiyum, Yawar
and Shet, Anita",
title="Leveling the Research Playing Field: Decolonizing Global Health Research Through Web-Based Platforms",
journal="J Med Internet Res",
year="2023",
month="Oct",
day="31",
volume="25",
pages="e46897",
keywords="decolonization",
keywords="vaccination",
keywords="community",
keywords="community engagement",
keywords="health equity",
keywords="health research",
keywords="online",
keywords="online platform",
keywords="web-based platform",
keywords="systemic barrier",
keywords="diversity",
keywords="marginalized",
keywords="promote",
keywords="equity",
keywords="research",
doi="10.2196/46897",
url="https://www.jmir.org/2023/1/e46897",
url="http://www.ncbi.nlm.nih.gov/pubmed/37906225"
}


@Article{info:doi/10.2196/50013,
author="Carabot, Federico
and Fraile-Mart{\'i}nez, Oscar
and Donat-Vargas, Carolina
and Santoma, Javier
and Garcia-Montero, Cielo
and Pinto da Costa, Mariana
and Molina-Ruiz, M. Rosa
and Ortega, A. Miguel
and Alvarez-Mon, Melchor
and Alvarez-Mon, Angel Miguel",
title="Understanding Public Perceptions and Discussions on Opioids Through Twitter: Cross-Sectional Infodemiology Study",
journal="J Med Internet Res",
year="2023",
month="Oct",
day="31",
volume="25",
pages="e50013",
keywords="awareness",
keywords="epidemic",
keywords="fentanyl",
keywords="health communication",
keywords="infodemiology",
keywords="machine learning",
keywords="opioids",
keywords="recreational use",
keywords="social media listening",
keywords="Twitter",
keywords="user",
abstract="Background: Opioids are used for the treatment of refractory pain, but their inappropriate use has detrimental consequences for health. Understanding the current experiences and perceptions of patients in a spontaneous and colloquial environment regarding the key drugs involved in the opioid crisis is of utmost significance. Objective: The study aims to analyze Twitter content related to opioids, with objectives including characterizing users participating in these conversations, identifying prevalent topics and gauging public perception, assessing opinions on drug efficacy and tolerability, and detecting discussions related to drug dispensing, prescription, or acquisition. Methods: In this cross-sectional study, we gathered public tweets concerning major opioids posted in English or Spanish between January 1, 2019, and December 31, 2020. A total of 256,218 tweets were collected. Approximately 27\% (69,222/256,218) were excluded. Subsequently, 7000 tweets were subjected to manual analysis based on a codebook developed by the researchers. The remaining databases underwent analysis using machine learning classifiers. In the codebook, the type of user was the initial classification domain. We differentiated between patients, family members and friends, health care professionals, and institutions. Next, a distinction was made between medical and nonmedical content. If it was medical in nature, we classified it according to whether it referred to the drug's efficacy or adverse effects. In nonmedical content tweets, we analyzed whether the content referred to management issues (eg, pharmacy dispensation, medical appointment prescriptions, commercial advertisements, or legal aspects) or the trivialization of the drug. Results: Among the entire array of scrutinized pharmaceuticals, fentanyl emerged as the predominant subject, featuring in 27\% (39,997/148,335 posts) of the tweets. Concerning user categorization, roughly 70\% (101,259/148,335) were classified as patients. Nevertheless, tweets posted by health care professionals obtained the highest number of retweets (37/16,956, 0.2\% of their posts received over 100 retweets). We found statistically significant differences in the distribution concerning efficacy and side effects among distinct drug categories (P<.001). Nearly 60\% (84,401/148,335) of the posts were devoted to nonmedical subjects. Within this category, legal facets and recreational use surfaced as the most prevalent themes, while in the medical discourse, efficacy constituted the most frequent topic, with over 90\% (45,621/48,777) of instances characterizing it as poor or null. The opioid with the greatest proportion of tweets concerning legal considerations was fentanyl. Furthermore, fentanyl was the drug most frequently offered for sale on Twitter, while methadone generated the most tweets about pharmacy delivery. Conclusions: The opioid crisis is present on social media, where tweets discuss legal and recreational use. Opioid users are the most active participants, prioritizing medication efficacy over side effects. Surprisingly, health care professionals generate the most engagement, indicating their positive reception. Authorities must monitor web-based opioid discussions to detect illicit acquisitions and recreational use. ",
doi="10.2196/50013",
url="https://www.jmir.org/2023/1/e50013",
url="http://www.ncbi.nlm.nih.gov/pubmed/37906234"
}


@Article{info:doi/10.2196/48789,
author="Lan, Duo
and Ren, Wujiong
and Ni, Ke
and Zhu, Yicheng",
title="Topic and Trend Analysis of Weibo Discussions About COVID-19 Medications Before and After China's Exit from the Zero-COVID Policy: Retrospective Infoveillance Study",
journal="J Med Internet Res",
year="2023",
month="Oct",
day="27",
volume="25",
pages="e48789",
keywords="zero-COVID policy",
keywords="topic modeling",
keywords="Weibo",
keywords="COVID-19 medications",
keywords="social risk",
keywords="personal risk",
keywords="social media",
keywords="COVID-19",
keywords="China",
keywords="pandemic",
keywords="self-medication",
abstract="Background: After 3 years of its zero-COVID policy, China lifted its stringent pandemic control measures with the announcement of the 10 new measures on December 7, 2022. Existing estimates suggest 90\%-97\% of the total population was infected during December. This change created a massive demand for COVID-19 medications and treatments, either modern medicines or traditional Chinese medicine (TCM). Objective: This study aimed to explore (1) how China's exit from the zero-COVID policy impacted media and the public's attention to COVID-19 medications; (2) how social COVID-19 medication discussions were related to existing model estimates of daily cases during that period; (3) what the diversified themes and topics were and how they changed and developed from November 1 to December 31, 2022; and (4) which topics about COVID-19 medications were focused on by mainstream and self-media accounts during the exit. The answers to these questions could help us better understand the consequences of exit strategies and explore the utilities of Sina Weibo data for future infoveillance studies. Methods: Using a scrapper for data retrieval and the structural topic modeling (STM) algorithm for analysis, this study built 3 topic models (all data, before a policy change, and after a policy change) of relevant discussions on the Chinese social media platform Weibo. We compared topic distributions against existing estimates of daily cases and between models before and after the change. We also compared proportions of weibos published by mainstream versus self-media accounts over time on different topics. Results: We found that Weibo discussions shifted sharply from concerns of social risks (case tracking, governmental regulations, etc) to those of personal risks (symptoms, purchases, etc) surrounding COVID-19 infection after the exit from the zero-COVID policy. Weibo topics of ``symptom sharing'' and ``purchase and shortage'' of modern medicines correlated more strongly with existing susceptible-exposed-infected-recovered (SEIR) model estimates compared to ``TCM formulae'' and other topics. During the exit, mainstream accounts showed efforts to specifically engage in topics related to worldwide pandemic control policy comparison and regulations about import and reimbursement of medications. Conclusions: The exit from the zero-COVID policy in China was accompanied by a sudden increase in social media discussions about COVID-19 medications, the demand for which substantially increased after the exit. A large proportion of Weibo discussions were emotional and expressed increased risk concerns over medication shortage, unavailability, and delay in delivery. Topic keywords showed that self-medication was sometimes practiced alone or with unprofessional help from others, while mainstream accounts also tried to provide certain medication instructions. Of the 16 topics identified in all 3 STM models, only ``symptom sharing'' and ``purchase and shortage'' showed a considerable correlation with SEIR model estimates of daily cases. Future studies could consider topic exploration before conducting predictive infoveillance analysis, even with narrowly defined search criteria with Weibo data. ",
doi="10.2196/48789",
url="https://www.jmir.org/2023/1/e48789",
url="http://www.ncbi.nlm.nih.gov/pubmed/37889532"
}


@Article{info:doi/10.2196/48905,
author="Chi, Yu
and Chen, Huai-yu",
title="Investigating Substance Use via Reddit: Systematic Scoping Review",
journal="J Med Internet Res",
year="2023",
month="Oct",
day="25",
volume="25",
pages="e48905",
keywords="substance use",
keywords="systematic scoping review",
keywords="Reddit",
keywords="social media",
keywords="drug use",
keywords="tobacco use",
keywords="alcohol use",
abstract="Background: Reddit's (Reddit Inc) large user base, diverse communities, and anonymity make it a useful platform for substance use research. Despite a growing body of literature on substance use on Reddit, challenges and limitations must be carefully considered. However, no systematic scoping review has been conducted on the use of Reddit as a data source for substance use research. Objective: This review aims to investigate the use of Reddit for studying substance use by examining previous studies' objectives, reasons, limitations, and methods for using Reddit. In addition, we discuss the implications and contributions of previous studies and identify gaps in the literature that require further attention. Methods: A total of 7 databases were searched using keyword combinations including Reddit and substance-related keywords in April 2022. The initial search resulted in 456 articles, and 227 articles remained after removing duplicates. All included studies were peer reviewed, empirical, available in full text, and pertinent to Reddit and substance use, and they were all written in English. After screening, 60 articles met the eligibility criteria for the review, with 57 articles identified from the initial database search and 3 from the ancestry search. A codebook was developed, and qualitative content analysis was performed to extract relevant evidence related to the research questions. Results: The use of Reddit for studying substance use has grown steadily since 2015, with a sharp increase in 2021. The primary objective was to identify tendencies and patterns in various types of substance use discussions (52/60, 87\%). Reddit was also used to explore unique user experiences, propose methodologies, investigate user interactions, and develop interventions. A total of 9 reasons for using Reddit to study substance use were identified, such as the platform's anonymity, its widespread popularity, and the explicit topics of subreddits. However, 7 limitations were noted, including the platform's low representativeness of the general population with substance use and the lack of demographic information. Most studies use application programming interfaces for data collection and quantitative approaches for analysis, with few using qualitative approaches. Machine learning algorithms are commonly used for natural language processing tasks. The theoretical, methodological, and practical implications and contributions of the included articles are summarized and discussed. The most prevalent practical implications are investigating prevailing topics in Reddit discussions, providing recommendations for clinical practices and policies, and comparing Reddit discussions on substance use across various sources. Conclusions: This systematic scoping review provides an overview of Reddit's use as a data source for substance use research. Although the limitations of Reddit data must be considered, analyzing them can be useful for understanding patterns and user experiences related to substance use. Our review also highlights gaps in the literature and suggests avenues for future research. ",
doi="10.2196/48905",
url="https://www.jmir.org/2023/1/e48905",
url="http://www.ncbi.nlm.nih.gov/pubmed/37878361"
}


@Article{info:doi/10.2196/51712,
author="Chin, Hyojin
and Song, Hyeonho
and Baek, Gumhee
and Shin, Mingi
and Jung, Chani
and Cha, Meeyoung
and Choi, Junghoi
and Cha, Chiyoung",
title="The Potential of Chatbots for Emotional Support and Promoting Mental Well-Being in Different Cultures: Mixed Methods Study",
journal="J Med Internet Res",
year="2023",
month="Oct",
day="20",
volume="25",
pages="e51712",
keywords="chatbot",
keywords="depressive mood",
keywords="sad",
keywords="depressive discourse",
keywords="sentiment analysis",
keywords="conversational agent",
keywords="mental health",
keywords="health information",
keywords="cultural differences",
abstract="Background: Artificial intelligence chatbot research has focused on technical advances in natural language processing and validating the effectiveness of human-machine conversations in specific settings. However, real-world chat data remain proprietary and unexplored despite their growing popularity, and new analyses of chatbot uses and their effects on mitigating negative moods are urgently needed. Objective: In this study, we investigated whether and how artificial intelligence chatbots facilitate the expression of user emotions, specifically sadness and depression. We also examined cultural differences in the expression of depressive moods among users in Western and Eastern countries. Methods: This study used SimSimi, a global open-domain social chatbot, to analyze 152,783 conversation utterances containing the terms ``depress'' and ``sad'' in 3 Western countries (Canada, the United Kingdom, and the United States) and 5 Eastern countries (Indonesia, India, Malaysia, the Philippines, and Thailand). Study 1 reports new findings on the cultural differences in how people talk about depression and sadness to chatbots based on Linguistic Inquiry and Word Count and n-gram analyses. In study 2, we classified chat conversations into predefined topics using semisupervised classification techniques to better understand the types of depressive moods prevalent in chats. We then identified the distinguishing features of chat-based depressive discourse data and the disparity between Eastern and Western users. Results: Our data revealed intriguing cultural differences. Chatbot users in Eastern countries indicated stronger emotions about depression than users in Western countries (positive: P<.001; negative: P=.01); for example, Eastern users used more words associated with sadness (P=.01). However, Western users were more likely to share vulnerable topics such as mental health (P<.001), and this group also had a greater tendency to discuss sensitive topics such as swear words (P<.001) and death (P<.001). In addition, when talking to chatbots, people expressed their depressive moods differently than on other platforms. Users were more open to expressing emotional vulnerability related to depressive or sad moods to chatbots (74,045/148,590, 49.83\%) than on social media (149/1978, 7.53\%). Chatbot conversations tended not to broach topics that require social support from others, such as seeking advice on daily life difficulties, unlike on social media. However, chatbot users acted in anticipation of conversational agents that exhibit active listening skills and foster a safe space where they can openly share emotional states such as sadness or depression. Conclusions: The findings highlight the potential of chatbot-assisted mental health support, emphasizing the importance of continued technical and policy-wise efforts to improve chatbot interactions for those in need of emotional assistance. Our data indicate the possibility of chatbots providing helpful information about depressive moods, especially for users who have difficulty communicating emotions to other humans. ",
doi="10.2196/51712",
url="https://www.jmir.org/2023/1/e51712",
url="http://www.ncbi.nlm.nih.gov/pubmed/37862063"
}


@Article{info:doi/10.2196/50199,
author="Unlu, Ali
and Truong, Sophie
and Tammi, Tuukka
and Lohiniva, Anna-Leena",
title="Exploring Political Mistrust in Pandemic Risk Communication: Mixed-Method Study Using Social Media Data Analysis",
journal="J Med Internet Res",
year="2023",
month="Oct",
day="20",
volume="25",
pages="e50199",
keywords="political trust",
keywords="social media",
keywords="text classification",
keywords="topic modeling",
keywords="COVID-19",
keywords="Finland",
keywords="trust",
keywords="authority",
keywords="public health outcome",
keywords="pandemic",
keywords="perception",
keywords="mistrust",
keywords="interaction",
keywords="Twitter",
keywords="Facebook",
keywords="analysis",
keywords="computational method",
keywords="natural language processing",
keywords="misinformation",
keywords="communication",
keywords="crisis",
abstract="Background: This research extends prior studies by the Finnish Institute for Health and Welfare on pandemic-related risk perception, concentrating on the role of trust in health authorities and its impact on public health outcomes. Objective: The paper aims to investigate variations in trust levels over time and across social media platforms, as well as to further explore 12 subcategories of political mistrust. It seeks to understand the dynamics of political trust, including mistrust accumulation, fluctuations over time, and changes in topic relevance. Additionally, the study aims to compare qualitative research findings with those obtained through computational methods. Methods: Data were gathered from a large-scale data set consisting of 13,629 Twitter and Facebook posts from 2020 to 2023 related to COVID-19. For analysis, a fine-tuned FinBERT model with an 80\% accuracy rate was used for predicting political mistrust. The BERTopic model was also used for superior topic modeling performance. Results: Our preliminary analysis identifies 43 mistrust-related topics categorized into 9 major themes. The most salient topics include COVID-19 mortality, coping strategies, polymerase chain reaction testing, and vaccine efficacy. Discourse related to mistrust in authority is associated with perceptions of disease severity, willingness to adopt health measures, and information-seeking behavior. Our findings highlight that the distinct user engagement mechanisms and platform features of Facebook and Twitter contributed to varying patterns of mistrust and susceptibility to misinformation during the pandemic. Conclusions: The study highlights the effectiveness of computational methods like natural language processing in managing large-scale engagement and misinformation. It underscores the critical role of trust in health authorities for effective risk communication and public compliance. The findings also emphasize the necessity for transparent communication from authorities, concluding that a holistic approach to public health communication is integral for managing health crises effectively. ",
doi="10.2196/50199",
url="https://www.jmir.org/2023/1/e50199",
url="http://www.ncbi.nlm.nih.gov/pubmed/37862088"
}


@Article{info:doi/10.2196/47677,
author="Koskan, M. Alexis
and Sivanandam, Shalini
and Roschke, Kristy
and Irby, Jonathan
and Helitzer, L. Deborah
and Doebbeling, Bradley",
title="Sharing Reliable COVID-19 Information and Countering Misinformation: In-Depth Interviews With Information Advocates",
journal="JMIR Infodemiology",
year="2023",
month="Oct",
day="20",
volume="3",
pages="e47677",
keywords="COVID-19",
keywords="coronavirus",
keywords="pandemic",
keywords="infodemic",
keywords="misinformation",
keywords="social media",
keywords="qualitative research",
keywords="public health",
keywords="health communication",
abstract="Background: The rampant spread of misinformation about COVID-19 has been linked to a lower uptake of preventive behaviors such as vaccination. Some individuals, however, have been able to resist believing in COVID-19 misinformation. Further, some have acted as information advocates, spreading accurate information and combating misinformation about the pandemic. Objective: This work explores highly knowledgeable information advocates' perspectives, behaviors, and information-related practices. Methods: To identify participants for this study, we used outcomes of survey research of a national sample of 1498 adults to find individuals who scored a perfect or near-perfect score on COVID-19 knowledge questions and who also self-reported actively sharing or responding to news information within the past week. Among this subsample, we selected a diverse sample of 25 individuals to participate in a 1-time, phone-based, semistructured interview. Interviews were recorded and transcribed, and the team conducted an inductive thematic analysis. Results: Participants reported trusting in science, data-driven sources, public health, medical experts, and organizations. They had mixed levels of trust in various social media sites to find reliable health information, noting distrust in particular sites such as Facebook (Meta Platforms) and more trust in specific accounts on Twitter (X Corp) and Reddit (Advance Publications). They reported relying on multiple sources of information to find facts instead of depending on their intuition and emotions to inform their perspectives about COVID-19. Participants determined the credibility of information by cross-referencing it, identifying information sources and their potential biases, clarifying information they were unclear about with health care providers, and using fact-checking sites to verify information. Most participants reported ignoring misinformation. Others, however, responded to misinformation by flagging, reporting, and responding to it on social media sites. Some described feeling more comfortable responding to misinformation in person than online. Participants' responses to misinformation posted on the internet depended on various factors, including their relationship to the individual posting the misinformation, their level of outrage in response to it, and how dangerous they perceived it could be if others acted on such information. Conclusions: This research illustrates how well-informed US adults assess the credibility of COVID-19 information, how they share it, and how they respond to misinformation. It illustrates web-based and offline information practices and describes how the role of interpersonal relationships contributes to their preferences for acting on such information. Implications of our findings could help inform future training in health information literacy, interpersonal information advocacy, and organizational information advocacy. It is critical to continue working to share reliable health information and debunk misinformation, particularly since this information informs health behaviors. ",
doi="10.2196/47677",
url="https://infodemiology.jmir.org/2023/1/e47677",
url="http://www.ncbi.nlm.nih.gov/pubmed/37862066"
}


@Article{info:doi/10.2196/51702,
author="Gordon, D. Jacob
and Whitfield, L. Darren
and Mammadli, Tural
and Escobar-Viera, G. C{\'e}sar",
title="Social Support--Seeking Strategies on Social Media at the Intersection of Lesbian, Gay, Bisexual, Transgender, and Queer Identity, Race, and Ethnicity: Insights for Intervention From a Qualitative Study",
journal="JMIR Form Res",
year="2023",
month="Oct",
day="20",
volume="7",
pages="e51702",
keywords="intersectionality",
keywords="LGBTQ+",
keywords="minority stress",
keywords="sexual and gender minorities",
keywords="social media",
keywords="social support",
keywords="lesbian, gay, bisexual, transgender, and queer",
abstract="Background: Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) individuals experience a disproportionately higher prevalence of mental health challenges when compared to their heterosexual and cisgender counterparts. Moreover, they exhibit increased engagement with social media platforms relative to their peers. Understanding the intersectional dynamics of their identities is crucial in elucidating effective and safe approaches to garnering social support through social media channels. This exploration holds significance for informing future research endeavors and shaping targeted interventions to address the unique mental health needs of LGBTQ+ individuals. Objective: The purpose of this study was to explore the strategies used by Black, Hispanic, and non-Hispanic White LGBTQ+ young adults to acquire social support from social media. The study aimed to examine how these strategies may differ by race and ethnicity. Methods: We conducted semistructured interviews with LGBTQ+ young adults aged between 18 and 30 years recruited in the United States from social media. Of 52 participants, 12 (23\%) were Black, 12 (23\%) were Hispanic, and 28 (54\%) were non-Hispanic White. Thematic analysis was used to analyze the collected data. Results: The analysis uncovered both divergent and convergent strategies among participants of different races and ethnicities. Black and Hispanic young adults exhibited a preference for connecting with individuals who shared similar identities, seeking safety and tailored advice. Conversely, non-Hispanic White participants demonstrated minimal preference for identity-based advice. Seeking support from anonymous sources emerged as a strategy to avoid unwanted disclosure among Hispanic participants. Furthermore, all participants emphasized the importance of content filtering with family members to cultivate positive and supportive social media experiences. Conclusions: This study sheds light on the strategies used by LGBTQ+ individuals of different racial and ethnic backgrounds to seek social support from social media platforms. The findings underscore the importance of considering race and ethnicity when examining social support--seeking behaviors on social media in LGBTQ+ populations. The identified strategies provide valuable insights for the development of interventions that aim to leverage social support from social media to benefit the mental health of Black, Hispanic, and non-Hispanic White LGBTQ+ young adults. ",
doi="10.2196/51702",
url="https://formative.jmir.org/2023/1/e51702",
url="http://www.ncbi.nlm.nih.gov/pubmed/37862069"
}


@Article{info:doi/10.2196/50011,
author="Pathak, Nitin Gaurav
and Chandy, John Rithi
and Naini, Vidisha
and Razi, Shazli
and Feldman, R. Steven",
title="A Social Media Analysis of Pemphigus",
journal="JMIR Dermatol",
year="2023",
month="Oct",
day="19",
volume="6",
pages="e50011",
keywords="pemphigus",
keywords="social media",
keywords="pemphigus vulgaris",
keywords="Facebook",
keywords="YouTube",
keywords="Twitter",
keywords="Instagram",
keywords="dissemination",
keywords="medical information",
keywords="autoimmune disease",
keywords="diagnosis",
keywords="engagement",
keywords="educational",
keywords="content",
keywords="awareness",
doi="10.2196/50011",
url="https://derma.jmir.org/2023/1/e50011",
url="http://www.ncbi.nlm.nih.gov/pubmed/37856177"
}


@Article{info:doi/10.2196/48641,
author="Chau, Brian
and Taba, Melody
and Dodd, Rachael
and McCaffery, Kirsten
and Bonner, Carissa",
title="Twitch Data in Health Promotion Research: Protocol for a Case Study Exploring COVID-19 Vaccination Views Among Young People",
journal="JMIR Res Protoc",
year="2023",
month="Oct",
day="18",
volume="12",
pages="e48641",
keywords="twitch",
keywords="social media",
keywords="COVID-19",
keywords="vaccination communication",
keywords="video gaming",
keywords="gaming",
keywords="health promotion",
keywords="streaming",
abstract="Background: Social media platforms have emerged as a useful channel for health promotion communication, offering different channels to reach targeted populations. For example, social media has recently been used to disseminate information about COVID-19 vaccination across various demographics. Traditional modes of health communication such as television, health events, and newsletters may not reach all groups within a community. Health communications for younger generations are increasingly disseminated through social media to reflect key information sources. This paper explores a social media gaming platform as an alternative way to reach young people in health promotion research. Objective: This protocol study aimed to pilot-test the potential of Twitch, a live streaming platform initially designed for video gaming, to conduct health promotion research with young people. We used COVID-19 vaccination as a topical case study that was recommended by Australian health authorities at the time of the research. Methods: The research team worked with a Twitch Account Manager to design and test a case study within the guidelines and ethics protocols required by Twitch, identify suitable streamers to approach and establish a protocol for conducting research on the platform. This involved conducting a poll to initiate discussion about COVID-19 vaccination, monitoring the chat in 3 live Twitch sessions with 2 streamers to pilot the protocol, and briefly analyze Twitch chat logs to observe the range of response types that may be acquired from this methodology. Results: The Twitch streams provided logs and videos on demand that were derived from the live session. These included demographics of viewers, chat logs, and polling results. The results of the poll showed a range of engagement in health promotion for the case study topic: the majority of participants had received their vaccination by the time of the poll; however, there was still a proportion that had not received their vaccination yet or had decided to not be vaccinated. Analysis of the Twitch chat logs demonstrated a range of both positive and negative themes regarding health promotion for the case study topic. This included irrelevant comments, misinformation (compared to health authority information at the time of this study), comedic and conspiracy responses, as well as vaccine status, provaccine comments, and vaccine-hesitant comments. Conclusions: This study developed and tested a protocol for using Twitch data for health promotion research with young people. With live polling, open text discussion between participants and immediate responses to questions, Twitch can be used to collect both quantitative and qualitative research data from demographics that use social media. The platform also presents some challenges when engaging with independent streamers and sensitive health topics. This study provides an initial protocol for future researchers to use and build on. International Registered Report Identifier (IRRID): RR1-10.2196/48641 ",
doi="10.2196/48641",
url="https://www.researchprotocols.org/2023/1/e48641",
url="http://www.ncbi.nlm.nih.gov/pubmed/37851494"
}


@Article{info:doi/10.2196/46190,
author="Wong, W. Kirstie H. T.
and Lau, Y. Wallis C.
and Man, C. Kenneth K.
and Bilbow, Andrea
and Ip, Patrick
and Wei, Li",
title="Effectiveness of Facebook Groups and Pages on Participant Recruitment Into a Randomized Controlled Trial During the COVID-19 Pandemic: Descriptive Study",
journal="J Med Internet Res",
year="2023",
month="Oct",
day="17",
volume="25",
pages="e46190",
keywords="1-2-3 Magic, ADHD",
keywords="attention deficit/hyperactivity disorder",
keywords="behavioral parenting training",
keywords="BPT",
keywords="clinical trial",
keywords="COVID-19",
keywords="Facebook group",
keywords="Facebook page",
keywords="Facebook",
keywords="pediatric",
keywords="randomized controlled trial",
keywords="recruitment",
keywords="social media",
keywords="youth",
keywords="Zoom",
abstract="Background: In response to the unprecedented challenges posed by the COVID-19 pandemic, conventional recruitment approaches were halted, causing the suspension of numerous clinical trials. Previously, Facebook (Meta Platforms, Inc) has emerged as a promising tool for augmenting participant recruitment. While previous research has explored the use of Facebook for surveys and qualitative studies, its potential for recruiting participants into randomized controlled trials (RCTs) remains underexplored. Objective: This study aimed to comprehensively examine the effectiveness of using Facebook groups and pages to facilitate participant recruitment during the COVID-19 pandemic for an RCT on the effectiveness of a remote parenting program, 1-2-3 Magic, in families who have children with attention-deficit/hyperactivity disorder (ADHD) in the United Kingdom. Methods: We disseminated 5 Facebook posts with an attached digital flyer across 4 prominent ADHD UK support groups and pages run by the National Attention Deficit Disorder Information and Support Services, reaching an audience of around 16,000 individuals over 2 months (January 7 to March 4, 2022). Eligibility criteria mandated participants to be parents or caregivers of a child with diagnosed ADHD aged 12 years or younger, be residing in the United Kingdom, have access to stable internet, and have a device with the Zoom (Zoom Video Communications) app. Participants were required to have never attended 1-2-3 Magic training previously. Prospective participants expressed their interest through Microsoft Forms (Microsoft Corporation). The trial aimed to recruit 84 parents. It is important to note that the term ``parent'' or ``caregiver'' in the RCT and in this study within a trial refers to anybody who has legal responsibility for the child. Results: Overall, 478 individuals registered their interest through Microsoft Forms within the stipulated 2-month window. After the eligibility check, 135 participants were contacted for a baseline meeting through Zoom. The first 84 participants who attended a baseline meeting and returned a completed consent form were enrolled. Subsequently, another 16 participants were added, resulting in a final sample of 100 participants. This recruitment strategy incurred negligible expenses and demanded minimal human resources. The approach yielded favorable outcomes by efficiently attracting eligible participants in a condensed time frame, transcending geographical barriers throughout the United Kingdom, which would have been tedious to achieve through traditional recruitment methods. Conclusions: Our experience demonstrated that digital flyers posted in the targeted Facebook groups were a cost-effective and quick method for recruiting for an RCT, which opened during the COVID-19 pandemic when lockdown restrictions were in place in the United Kingdom. Trialists should consider this low-cost recruitment intervention for trials going forward, and in the case of a global pandemic, this novel recruitment method enabled the trial to continue where many have failed. Trial Registration: International Standard Randomized Controlled Trial Number (ISRCTN) 15281572; https://www.isrctn.com/ISRCTN15281572 ",
doi="10.2196/46190",
url="https://www.jmir.org/2023/1/e46190",
url="http://www.ncbi.nlm.nih.gov/pubmed/37847536"
}


@Article{info:doi/10.2196/47014,
author="Laison, Elolo Elda Kokoe
and Hamza Ibrahim, Mohamed
and Boligarla, Srikanth
and Li, Jiaxin
and Mahadevan, Raja
and Ng, Austen
and Muthuramalingam, Venkataraman
and Lee, Yi Wee
and Yin, Yijun
and Nasri, R. Bouchra",
title="Identifying Potential Lyme Disease Cases Using Self-Reported Worldwide Tweets: Deep Learning Modeling Approach Enhanced With Sentimental Words Through Emojis",
journal="J Med Internet Res",
year="2023",
month="Oct",
day="16",
volume="25",
pages="e47014",
keywords="Lyme disease",
keywords="Twitter",
keywords="BERT",
keywords="Bidirectional Encoder Representations from Transformers",
keywords="emojis",
keywords="machine learning",
keywords="natural language processing",
abstract="Background: Lyme disease is among the most reported tick-borne diseases worldwide, making it a major ongoing public health concern. An effective Lyme disease case reporting system depends on timely diagnosis and reporting by health care professionals, and accurate laboratory testing and interpretation for clinical diagnosis validation. A lack of these can lead to delayed diagnosis and treatment, which can exacerbate the severity of Lyme disease symptoms. Therefore, there is a need to improve the monitoring of Lyme disease by using other data sources, such as web-based data. Objective: We analyzed global Twitter data to understand its potential and limitations as a tool for Lyme disease surveillance. We propose a transformer-based classification system to identify potential Lyme disease cases using self-reported tweets. Methods: Our initial sample included 20,000 tweets collected worldwide from a database of over 1.3 million Lyme disease tweets. After preprocessing and geolocating tweets, tweets in a subset of the initial sample were manually labeled as potential Lyme disease cases or non-Lyme disease cases using carefully selected keywords. Emojis were converted to sentiment words, which were then replaced in the tweets. This labeled tweet set was used for the training, validation, and performance testing of DistilBERT (distilled version of BERT [Bidirectional Encoder Representations from Transformers]), ALBERT (A Lite BERT), and BERTweet (BERT for English Tweets) classifiers. Results: The empirical results showed that BERTweet was the best classifier among all evaluated models (average F1-score of 89.3\%, classification accuracy of 90.0\%, and precision of 97.1\%). However, for recall, term frequency-inverse document frequency and k-nearest neighbors performed better (93.2\% and 82.6\%, respectively). On using emojis to enrich the tweet embeddings, BERTweet had an increased recall (8\% increase), DistilBERT had an increased F1-score of 93.8\% (4\% increase) and classification accuracy of 94.1\% (4\% increase), and ALBERT had an increased F1-score of 93.1\% (5\% increase) and classification accuracy of 93.9\% (5\% increase). The general awareness of Lyme disease was high in the United States, the United Kingdom, Australia, and Canada, with self-reported potential cases of Lyme disease from these countries accounting for around 50\% (9939/20,000) of the collected English-language tweets, whereas Lyme disease--related tweets were rare in countries from Africa and Asia. The most reported Lyme disease--related symptoms in the data were rash, fatigue, fever, and arthritis, while symptoms, such as lymphadenopathy, palpitations, swollen lymph nodes, neck stiffness, and arrythmia, were uncommon, in accordance with Lyme disease symptom frequency. Conclusions: The study highlights the robustness of BERTweet and DistilBERT as classifiers for potential cases of Lyme disease from self-reported data. The results demonstrated that emojis are effective for enrichment, thereby improving the accuracy of tweet embeddings and the performance of classifiers. Specifically, emojis reflecting sadness, empathy, and encouragement can reduce false negatives. ",
doi="10.2196/47014",
url="https://www.jmir.org/2023/1/e47014",
url="http://www.ncbi.nlm.nih.gov/pubmed/37843893"
}


@Article{info:doi/10.2196/43701,
author="Batheja, Sapna
and Schopp, M. Emma
and Pappas, Samantha
and Ravuri, Siri
and Persky, Susan",
title="Characterizing Precision Nutrition Discourse on Twitter: Quantitative Content Analysis",
journal="J Med Internet Res",
year="2023",
month="Oct",
day="12",
volume="25",
pages="e43701",
keywords="nutrigenetics",
keywords="nutrigenomics",
keywords="precision nutrition",
keywords="Twitter",
keywords="credibility",
keywords="misinformation",
keywords="content analysis",
abstract="Background: It is possible that tailoring dietary approaches to an individual's genomic profile could provide optimal dietary inputs for biological functioning and support adherence to dietary management protocols. The science required for such nutrigenetic and nutrigenomic profiling is not yet considered ready for broad application by the scientific and medical communities; however, many personalized nutrition products are available in the marketplace, creating the potential for hype and misleading information on social media. Twitter provides a unique big data source that provides real-time information. Therefore, it has the potential to disseminate evidence-based health information, as well as misinformation. Objective: We sought to characterize the landscape of precision nutrition content on Twitter, with a specific focus on nutrigenetics and nutrigenomics. We focused on tweet authors, types of content, and presence of misinformation. Methods: Twitter Archiver was used to capture tweets from September 1, 2020, to December 1, 2020, using keywords related to nutrition and genetics. A random sample of tweets was coded using quantitative content analysis by 4 trained coders. Codebook-driven, quantified information about tweet authors, content details, information quality, and engagement metrics were compiled and analyzed. Results: The most common categories of tweets were precision nutrition products and nutrigenomic concepts. About a quarter (132/504, 26.2\%) of tweet authors presented themselves as science experts, medicine experts, or both. Nutrigenetics concepts most frequently came from authors with science and medicine expertise, and tweets about the influence of genes on weight were more likely to come from authors with neither type of expertise. A total of 14.9\% (75/504) of the tweets were noted to contain untrue information; these were most likely to occur in the nutrigenomics concepts topic category. Conclusions: By evaluating social media discourse on precision nutrition on Twitter, we made several observations about the content available in the information environment through which individuals can learn about related concepts and products. Tweet content was consistent with the indicators of medical hype, and the inclusion of potentially misleading and untrue information was common. We identified a contingent of users with scientific and medical expertise who were active in discussing nutrigenomics concepts and products and who may be encouraged to share credible expert advice on precision nutrition and tackle false information as this technology develops. ",
doi="10.2196/43701",
url="https://www.jmir.org/2023/1/e43701",
url="http://www.ncbi.nlm.nih.gov/pubmed/37824190"
}


@Article{info:doi/10.2196/47705,
author="Oudat, Qutaibah
and Bakas, Tamilyn",
title="Merits and Pitfalls of Social Media as a Platform for Recruitment of Study Participants",
journal="J Med Internet Res",
year="2023",
month="Oct",
day="11",
volume="25",
pages="e47705",
keywords="recruitment",
keywords="social media",
keywords="review",
keywords="study participant",
keywords="methods",
doi="10.2196/47705",
url="https://www.jmir.org/2023/1/e47705",
url="http://www.ncbi.nlm.nih.gov/pubmed/37819692"
}


@Article{info:doi/10.2196/45226,
author="Fr{\o}lunde, Sofie Anne
and Gren, Thiesen Susanne
and Fr{\o}strup, Grete Anne
and Poulsen, Bo Peter
and Vastrup, Skov Anne
and Vestergaard, Christian",
title="Outreach Through Facebook: Do Patients With Atopic Dermatitis Provide Clinically Relevant Information When Recruited for Surveys on Social Media?",
journal="JMIR Dermatol",
year="2023",
month="Oct",
day="5",
volume="6",
pages="e45226",
keywords="social media",
keywords="atopic dermatitis",
keywords="digital survey",
keywords="recruit",
keywords="patient perspectives",
keywords="patient-reported outcomes",
keywords="real-world data",
doi="10.2196/45226",
url="https://derma.jmir.org/2023/1/e45226",
url="http://www.ncbi.nlm.nih.gov/pubmed/37796547"
}


@Article{info:doi/10.2196/43060,
author="Tanner, P. Joshua
and Takats, Courtney
and Lathan, Stuart Hannah
and Kwan, Amy
and Wormer, Rachel
and Romero, Diana
and Jones, E. Heidi",
title="Approaches to Research Ethics in Health Research on YouTube: Systematic Review",
journal="J Med Internet Res",
year="2023",
month="Oct",
day="4",
volume="25",
pages="e43060",
keywords="data anonymization",
keywords="research ethics",
keywords="ethics",
keywords="informed consent",
keywords="public health",
keywords="research",
keywords="social media",
keywords="YouTube",
abstract="Background: YouTube has become a popular source of health care information, reaching an estimated 81\% of adults in 2021; approximately 35\% of adults in the United States have used the internet to self-diagnose a condition. Public health researchers are therefore incorporating YouTube data into their research, but guidelines for best practices around research ethics using social media data, such as YouTube, are unclear. Objective: This study aims to describe approaches to research ethics for public health research implemented using YouTube data. Methods: We implemented a systematic review of articles found in PubMed, SocINDEX, Web of Science, and PsycINFO following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. To be eligible to be included, studies needed to be published in peer-reviewed journals in English between January 1, 2006, and October 31, 2019, and include analyses on publicly available YouTube data on health or public health topics; studies using primary data collection, such as using YouTube for study recruitment, interventions, or dissemination evaluations, were not included. We extracted data on the presence of user identifying information, institutional review board (IRB) review, and informed consent processes, as well as research topic and methodology. Results: This review includes 119 articles from 88 journals. The most common health and public health topics studied were in the categories of chronic diseases (44/119, 37\%), mental health and substance use (26/119, 21.8\%), and infectious diseases (20/119, 16.8\%). The majority (82/119, 68.9\%) of articles made no mention of ethical considerations or stated that the study did not meet the definition of human participant research (16/119, 13.4\%). Of those that sought IRB review (15/119, 12.6\%), 12 out of 15 (80\%) were determined to not meet the definition of human participant research and were therefore exempt from IRB review, and 3 out of 15 (20\%) received IRB approval. None of the 3 IRB-approved studies contained identifying information; one was explicitly told not to include identifying information by their ethics committee. Only 1 study sought informed consent from YouTube users. Of 119 articles, 33 (27.7\%) contained identifying information about content creators or video commenters, one of which attempted to anonymize direct quotes by not including user information. Conclusions: Given the variation in practice, concrete guidelines on research ethics for social media research are needed, especially around anonymizing and seeking consent when using identifying information. Trial Registration: PROSPERO CRD42020148170; https://www.crd.york.ac.uk/prospero/display\_record.php?RecordID=148170 ",
doi="10.2196/43060",
url="https://www.jmir.org/2023/1/e43060",
url="http://www.ncbi.nlm.nih.gov/pubmed/37792443"
}


@Article{info:doi/10.2196/47970,
author="Billington, Olive Emma
and Hasselaar, M. Charley
and Kembel, Lorena
and Myagishima, C. Rebecca
and Arain, A. Mubashir",
title="Effectiveness and Cost of Using Facebook Recruitment to Elicit Canadian Women's Perspectives on Bone Health and Osteoporosis: Cross-Sectional Survey Study",
journal="J Med Internet Res",
year="2023",
month="Sep",
day="29",
volume="25",
pages="e47970",
keywords="osteoporosis",
keywords="bone health",
keywords="bone mineral density",
keywords="fracture",
keywords="survey",
keywords="Facebook",
keywords="advertisement",
keywords="recruitment",
keywords="women's health",
keywords="social media",
keywords="bone",
keywords="perspective",
abstract="Background: Surveys can help health researchers better understand the public's perspectives and needs regarding prevalent conditions such as osteoporosis, which affects more than two-thirds of postmenopausal women. However, recruitment of large cohorts for survey research can be time-consuming and expensive. With 2.9 billion active users across the globe and reasonable advertising costs, Facebook (Meta Platforms, Inc) has emerged as an effective recruitment tool for surveys, although previous studies have targeted young populations (<50 years of age) and none have focused on bone health. Objective: We assessed the effectiveness and cost of using Facebook to recruit Canadian women aged ?45 years to share their perspectives on bone health and osteoporosis via a web-based survey. Methods: We developed a 15-minute web-based survey with the goal of eliciting perspectives on bone health and osteoporosis. A Facebook advertisement was placed for 2 weeks in February 2022, during which time it was shown to women of age ?45 years who resided in Canada, inviting them to participate and offering a chance to win 1 of 5 CAD \$100 gift cards (at the time of this study [February 14, 2022], a currency exchange rate of CAD \$1=US \$0.79 was applicable). Those who clicked on the advertisement were taken to an eligibility screening question on the survey home screen. Individuals who confirmed eligibility were automatically directed to the first survey question. All individuals who answered the first survey question were considered participants and included in the analyses. We determined the survey reach, click rate, cooperation rate, completion rate, cost per click, and cost per participant. Sociodemographic characteristics of respondents were compared with data from the 2021 Canadian Census. Results: The Facebook advertisement was shown to 34,086 unique Facebook users, resulting in 2033 link clicks (click rate: 6.0\%). A total of 1320 individuals completed the eligibility screening question, 1195 started the survey itself (cooperation rate: 58.8\%), and 966 completed the survey (completion rate: 47.5\%). The cost of the advertising campaign was CAD \$280.12, resulting in a cost per click of CAD \$0.14 and a cost per participant of CAD \$0.23. The 1195 participants ranged in age from 45-89 years (mean 65, SD 7 years), 921 (93.7\%) were of White ethnicity, 854 (88.3\%) had completed some postsecondary education, and 637 (65.8\%) resided in urban areas. Responses were received from residents of all 10 Canadian provinces and 2 of 3 territories. When compared to 2021 Canadian Census data, postsecondary education and rural residence were overrepresented in our study population. Conclusions: Facebook advertising is an efficient, effective, and inexpensive way of recruiting large samples of older women for participation in web-based surveys for health research. However, it is important to recognize that this modality is a form of convenience sampling and the benefits of Facebook recruitment must be balanced with its limitations, which include selection bias and coverage error. ",
doi="10.2196/47970",
url="https://www.jmir.org/2023/1/e47970",
url="http://www.ncbi.nlm.nih.gov/pubmed/37773625"
}


@Article{info:doi/10.2196/48189,
author="Lustig, Andrew
and Brookes, Gavin",
title="Corpus-Based Discourse Analysis of a Reddit Community of Users of Crystal Methamphetamine: Mixed Methods Study",
journal="JMIR Infodemiology",
year="2023",
month="Sep",
day="29",
volume="3",
pages="e48189",
keywords="methamphetamine",
keywords="social media",
keywords="substance-related disorders",
keywords="discourse analysis",
keywords="mental health",
keywords="mixed methods",
keywords="corpus analysis",
keywords="web-based health",
abstract="Background: Methamphetamine is a highly addictive stimulant that affects the central nervous system. Crystal methamphetamine is a form of the drug resembling glass fragments or shiny bluish-white rocks that can be taken through smoking, swallowing, snorting, or injecting the powder once it has been dissolved in water or alcohol. Objective: The objective of this study is to examine how identities are socially (discursively) constructed by people who use methamphetamine within a subreddit for people who regularly use crystal meth. Methods: Using a mixed methods approach, we analyzed 1000 threads (318,422 words) from a subreddit for regular crystal meth users. The qualitative component of the analysis used concordancing and corpus-based discourse analysis to identify discursive themes informed by assemblage theory. The quantitative portion of the analysis used corpus linguistic techniques including keyword analysis to identify words occurring with statistically marked frequency in the corpus and collocation analysis to analyze their discursive context. Results: Our findings reveal that the subreddit contributors use a rich and varied lexicon to describe crystal meth and other substances, ranging from a neuroscientific register (eg, methamphetamine and dopamine) to informal vernacular (eg, meth, dope, and fent) and commercial appellations (eg, Adderall and Seroquel). They also use linguistic resources to construct symbolic boundaries between different types of methamphetamine users, differentiating between the esteemed category of ``functional addicts'' and relegating others to the stigmatized category of ``tweakers.'' In addition, contributors contest the dominant view that methamphetamine use inevitably leads to psychosis, arguing instead for a more nuanced understanding that considers the interplay of factors such as sleep deprivation, poor nutrition, and neglected hygiene. Conclusions: The subreddit contributors' discourse offers a ``set and setting'' perspective, which provides a fresh viewpoint on drug-induced psychosis and can guide future harm reduction strategies and research. In contrast to this view, many previous studies overlook the real-world complexities of methamphetamine use, perhaps due to the use of controlled experimental settings. Actual drug use, intoxication, and addiction are complex, multifaceted, and elusive phenomena that defy straightforward characterization. ",
doi="10.2196/48189",
url="https://infodemiology.jmir.org/2023/1/e48189",
url="http://www.ncbi.nlm.nih.gov/pubmed/37773617"
}


@Article{info:doi/10.2196/46488,
author="Uhawenimana, Claudien Thierry
and Musabwasoni, Sandra Marie Grace
and Nsengiyumva, Richard
and Mukamana, Donatilla",
title="Sexuality and Sexual and Reproductive Health Depiction in Social Media: Content Analysis of Kinyarwanda YouTube Channels",
journal="J Med Internet Res",
year="2023",
month="Sep",
day="27",
volume="25",
pages="e46488",
keywords="sexuality",
keywords="sexual and reproductive health",
keywords="Kinyarwanda YouTube channels",
keywords="content analysis",
keywords="social media",
keywords="media platform",
keywords="COVID-19",
abstract="Background: Social media platforms such as YouTube can be used to educate people of reproductive age about healthy and nonrisky sexual and reproductive health (SRH) practices and behaviors. However, there is a paucity of evidence to ascertain the authenticity of sexuality and SRH content on Kinyarwanda YouTube, making it difficult to determine the extent to which these topics are covered, the characteristics of available videos, and the themes covered by these videos. Objective: The aims of this study were (1) to determine the extent to which YouTube channels in Kinyarwanda-language videos address sexuality and SRH issues, identify the general characteristics of the available videos (type of video, when published, intention for the audience, and content focus), and the aspects of sexuality and SRH covered; and (2) to identify the themes covered by retrieved Kinyarwanda videos, and the extent to which the channels have been used to communicate issues of sexuality and SRH during the COVID-19 pandemic. Methods: Using a content analysis approach, we searched Kinyarwanda YouTube channels to analyze videos about sexuality and SRH. The adopted framework for data collection from social media platforms builds on three key steps: (1) development, (2) application, and (3) assessment of search filters. To be included, an audio and/or visual video had to be in Kinyarwanda and the video had to be directed to the general public. Descriptive statistics (frequency and percentages) were computed to characterize the basic characteristics of retrieved channels, portrayal of the videos, and presentation of sexuality and SRH themes that emerged from retrieved videos. Further analysis involved cross-tabulations to explore associations between the focus of the channel and the date when the channel was opened and the focus of the channel and who was involved in the video. Results: The YouTube search retrieved 21,506 videos that tackled sexuality and SRH topics. During the COVID-19 pandemic, there was a 4-fold increase (from 7.2\% to 30.6\%) in channels that solely focused on sexually explicit content. The majority of the 1369 retrieved channels (n=1150, 84.0\%) tackled the topic of sexuality, with sexually explicit content predominantly found in the majority of these videos (n=1082, 79\%), and only 16\% (n=287) of the videos covered SRH topics. Conclusions: This is the first study to analyze the use of YouTube in communicating about sexuality and SRH in the Kinyarwanda language. This study relied on videos that appeared online. Further research should gather information about who accesses the videos, and how channel owners and individuals involved in the videos perceive the impact of their videos on the Rwandan community's sexuality and SRH. ",
doi="10.2196/46488",
url="https://www.jmir.org/2023/1/e46488",
url="http://www.ncbi.nlm.nih.gov/pubmed/37756040"
}


@Article{info:doi/10.2196/47202,
author="Cornell, Samuel
and Brander, Robert
and Peden, Amy",
title="Selfie-Related Incidents: Narrative Review and Media Content Analysis",
journal="J Med Internet Res",
year="2023",
month="Sep",
day="27",
volume="25",
pages="e47202",
keywords="selfie",
keywords="aquatic locations",
keywords="death",
keywords="injury",
keywords="risk",
keywords="communication",
keywords="social media",
keywords="drowning",
keywords="mobile phone",
abstract="Background: Selfie-related injury has become a public health concern amid the near ubiquitous use of smartphones and social media apps. Of particular concern are selfie-related deaths at aquatic locations; areas often frequented because of their photogenic allure. Unfortunately, such places exhibit hazards inherent with their environment. Objective: This study aimed to ascertain current evidence regarding selfie-related injuries and recommended risk treatment measures in the academic literature as well as how selfie-related injuries and deaths were being reported by the media, allowing us to identify key challenges facing land managers and public health practitioners in mitigating selfie-related injuries and deaths. Methods: Between October and December 2022, we performed a narrative review of peer-reviewed literature published since January 2011. Literature was screened to identify causal factors implicated in selfie-related deaths and injuries, as well as risk treatments recommended. Furthermore, we used an environmental scan methodology to search for media reports of selfie-related injuries and deaths at aquatic locations in Australia and the United States. Individual cases of selfie-related aquatic injuries and deaths sourced from news reports were analyzed to assess epidemiological characteristics, and a thematic content analysis was conducted to identify key themes of news reporting on selfie-related deaths and injuries. Results: In total, 5 peer-reviewed studies were included. Four studies identified falls from height as the most common injury mechanism in selfie incidents. Drowning was the second most common cause of death. Recommended risk treatments were limited but included the adoption of ``no selfie zones,'' physical barriers, signage, and provision of information on dangerous locations to social media users. In total, 12 cases were identified from media reports (4 injuries and 8 fatalities; 7 in Australia and 5 in the United States). The mean age of the reported victims was 22.1 (SD 6.93) years with victims more likely to be female tourists. Content analysis revealed 3 key themes from media reports: ``blame,'' ``warning,'' and ``prevention and education.'' Few media reports (n=8) provided safety recommendations. Conclusions: The selfie-related incident phenomenon should be viewed as a public health problem that requires a public health risk communication response. To date, little attention has been paid to averting selfie-related incidents through behavior change methodologies or direct messaging to users, including through social media apps. Although previous research has recommended ``no selfie zones,'' barriers, and signage as ways to prevent selfie incidents, our results suggest this may not be enough, and it may be prudent to also engage in direct safety messaging to social media users. Media reporting of selfie incidents should focus on preventive messaging rather than blame or warning. ",
doi="10.2196/47202",
url="https://www.jmir.org/2023/1/e47202",
url="http://www.ncbi.nlm.nih.gov/pubmed/37756044"
}


@Article{info:doi/10.2196/41863,
author="Faviez, Carole
and Talmatkadi, Manissa
and Foulqui{\'e}, Pierre
and Mebarki, Adel
and Sch{\"u}ck, St{\'e}phane
and Burgun, Anita
and Chen, Xiaoyi",
title="Assessment of the Early Detection of Anosmia and Ageusia Symptoms in COVID-19 on Twitter: Retrospective Study",
journal="JMIR Infodemiology",
year="2023",
month="Sep",
day="25",
volume="3",
pages="e41863",
keywords="social media",
keywords="COVID-19",
keywords="anosmia",
keywords="ageusia",
keywords="infodemiology",
keywords="symptom",
keywords="Twitter",
keywords="psychological",
keywords="tweets",
keywords="pandemic",
keywords="rapid stage",
keywords="epidemic",
keywords="information",
keywords="knowledge",
keywords="online health",
keywords="misinformation",
keywords="education",
keywords="online education",
keywords="ehealth",
keywords="qualitative",
abstract="Background: During the unprecedented COVID-19 pandemic, social media has been extensively used to amplify the spread of information and to express personal health-related experiences regarding symptoms, including anosmia and ageusia, 2 symptoms that have been reported later than other symptoms. Objective: Our objective is to investigate to what extent Twitter users reported anosmia and ageusia symptoms in their tweets and if they connected them to COVID-19, to evaluate whether these symptoms could have been identified as COVID-19 symptoms earlier using Twitter rather than the official notice. Methods: We collected French tweets posted between January 1, 2020, and March 31, 2020, containing anosmia- or ageusia-related keywords. Symptoms were detected using fuzzy matching. The analysis consisted of 3 parts. First, we compared the coverage of anosmia and ageusia symptoms in Twitter and in traditional media to determine if the association between COVID-19 and anosmia or ageusia could have been identified earlier through Twitter. Second, we conducted a manual analysis of anosmia- and ageusia-related tweets to obtain quantitative and qualitative insights regarding their nature and to assess when the first associations between COVID-19 and these symptoms were established. We randomly annotated tweets from 2 periods: the early stage and the rapid spread stage of the epidemic. For each tweet, each symptom was annotated regarding 3 modalities: symptom (yes or no), associated with COVID-19 (yes, no, or unknown), and whether it was experienced by someone (yes, no, or unknown). Third, to evaluate if there was a global increase of tweets mentioning anosmia or ageusia in early 2020, corresponding to the beginning of the COVID-19 epidemic, we compared the tweets reporting experienced anosmia or ageusia between the first periods of 2019 and 2020. Results: In total, 832 (respectively 12,544) tweets containing anosmia (respectively ageusia) related keywords were extracted over the analysis period in 2020. The comparison to traditional media showed a strong correlation without any lag, which suggests an important reactivity of Twitter but no earlier detection on Twitter. The annotation of tweets from 2020 showed that tweets correlating anosmia or ageusia with COVID-19 could be found a few days before the official announcement. However, no association could be found during the first stage of the pandemic. Information about the temporality of symptoms and the psychological impact of these symptoms could be found in the tweets. The comparison between early 2020 and early 2019 showed no difference regarding the volumes of tweets. Conclusions: Based on our analysis of French tweets, associations between COVID-19 and anosmia or ageusia by web users could have been found on Twitter just a few days before the official announcement but not during the early stage of the pandemic. Patients share qualitative information on Twitter regarding anosmia or ageusia symptoms that could be of interest for future analyses. ",
doi="10.2196/41863",
url="https://infodemiology.jmir.org/2023/1/e41863",
url="http://www.ncbi.nlm.nih.gov/pubmed/37643302"
}


@Article{info:doi/10.2196/45695,
author="Cardwell, Trey Ethan
and Ludwick, Teralynn
and Fairley, Christopher
and Bourne, Christopher
and Chang, Shanton
and Hocking, S. Jane
and Kong, S. Fabian Y.",
title="Web-Based STI/HIV Testing Services Available for Access in Australia: Systematic Search and Analysis",
journal="J Med Internet Res",
year="2023",
month="Sep",
day="22",
volume="25",
pages="e45695",
keywords="STI/HIV testing",
keywords="STI/HIV",
keywords="self-testing",
keywords="sexual health",
keywords="web-based STI testing",
keywords="web-based STI/HIV testing",
abstract="Background: Sexually transmitted infection (STI) rates continue to rise in Australia, and timely access to testing and treatment is crucial to reduce transmission. Web-based services have been viewed as a way to improve timely access to STI/HIV testing and have proliferated in recent years. However, the regulation of these services in Australia is minimal, leading to concerns about their quality. The purpose of this review was to systematically identify web-based STI/HIV testing services available in Australia and assess them on aspects of quality, reliability, and accessibility. Objective: We aim to systematically identify and assess web-based STI/HIV testing services available in Australia. Methods: A Google search of Australian web-based services was conducted in March 2022 and repeated in September 2022 using Boolean operators and search terms related to test services (eg, on the internet or home), STIs (eg, chlamydia or gonorrhea), and test type (eg, self-test). The first 10 pages were assessed, and services were categorized as self-testing (ST; test at home), self-sampling (SS; sample at home and return to laboratory), or self-navigated pathology (SNP; specimens collected at pathology center). Website reliability was assessed against the Health on the Net Foundation code of conduct, and service quality was assessed using a scorecard that was developed based on similar reviews, Australian guidelines for in-person services, and UK standards. Additionally, we looked at measures of accessibility including cost, rural access, and time to test results. Results: Seventeen services were identified (8 ST, 2 SS, and 7 SNP). Only 4 services offered recommended testing for all 4 infections (chlamydia, gonorrhea, syphilis, and HIV) including genital, anorectal, and oropharyngeal sites, and 5 offered tests other than those recommended by Australian testing guidelines (eg, Ureaplasma). Nine services (1 SNP, 8 self-test) had no minimum age requirements for access. Reliability scores (scale 0-8) were similar between all services (range 4.75-8.0). Quality weighted scores (scale 0-58) were similar between SNP and SS services (average 44.89, SD 5.56 and 44.75, SD 1.77, respectively) but lower for ST services (22.66, SD 8.93; P=.002). Government-funded services were of higher quality than private services (43.54, SD 6.71 vs 29.43, SD 13.55; P=.03). The cost for services varied between SNP (Aus \$0-\$595; ie, US \$0-\$381.96), self-sample (Aus \$0; ie, US \$0), and ST (Aus \$0-\$135; ie, US \$0-\$86.66). The time to test results was much shorter for SNP services ({\textasciitilde}4 days) than for SS ({\textasciitilde}12 days) and ST ({\textasciitilde}14 days). Conclusions: This review identified considerable variability in the quality and reliability of the web-based STI/HIV testing services in Australia. Given the proliferation and use of these services will likely increase, it is imperative that Australia develops national standards to ensure the standard-of-care offered by web-based STI/HIV testing services is appropriate to protect Australian users from the impact of poorly performing and inappropriate tests. ",
doi="10.2196/45695",
url="https://www.jmir.org/2023/1/e45695",
url="http://www.ncbi.nlm.nih.gov/pubmed/37738083"
}


@Article{info:doi/10.2196/45665,
author="Youssef, Yasmin
and Scherer, Julian
and Niemann, Marcel
and Ansorg, J{\"o}rg
and Back, Alexander David
and Gehlen, Tobias",
title="Social Media Use Among Orthopedic and Trauma Surgeons in Germany: Cross-Sectional Survey Study",
journal="JMIR Form Res",
year="2023",
month="Sep",
day="22",
volume="7",
pages="e45665",
keywords="communication",
keywords="digitalization",
keywords="Facebook",
keywords="Germany",
keywords="implementation",
keywords="Instagram",
keywords="management",
keywords="musculoskeletal",
keywords="orthopedic surgeon",
keywords="orthopedic",
keywords="orthopedics and traumatology",
keywords="patient",
keywords="physician",
keywords="questionnaire",
keywords="social media management",
keywords="social media",
keywords="social networking",
keywords="surgeon",
keywords="trauma surgeon",
abstract="Background: Social media (SM) has gained importance in the health care sector as a means of communication and a source of information for physicians and patients. However, the scope of professional SM use by orthopedic and trauma surgeons remains largely unknown. Objective: This study presents an overview of professional SM use among orthopedic and trauma surgeons in Germany in terms of the platforms used, frequency of use, and SM content management. Methods: We developed a web-based questionnaire with 33 variables and 2 separate sections based on a review of current literature. This study analyzed the first section of the questionnaire and included questions on demographics, type of SM used, frequency of use, and SM content management. Statistical analysis was performed using SPSS (version 26.0). Subgroup analysis was performed for sex, age groups (<60 years vs ?60 years), and type of workplace (practice vs hospital). Differences between groups were assessed with a chi-square test for categorical data. Results: A total of 208 participants answered the questionnaire (166/208, 79.8\% male), of whom 70.2\% (146/208) were younger than 60 years and 77.4\% (161/208) worked in a practice. All participants stated that they use SM for private and professional purposes. On average, participants used 1.6 SM platforms for professional purposes. More than half had separate SM accounts for private and professional use. The most frequently used SM platforms were messenger apps (119/200, 59.5\%), employment-oriented SM (60/200, 30\%), and YouTube (54/200, 27\%). All other SM, including Facebook and Instagram, were only used by a minority of the participants. Women and younger participants were more likely to use Instagram (P<.001 and P=.03, respectively). The participants working in a hospital were more likely to use employment-oriented SM (P=.02) and messenger apps (P=.009) than participants working in a practice. In a professional context, 20.2\% (39/193) of the participants produced their own content on SM, 24.9\% (48/193) used SM daily, 39.9\% (77/193) used SM during work, and 13.8\% (26/188) stated that they checked the number of followers they had. Younger participants were more likely to have participated in professional SM training and to have separate private and professional accounts (P=.04 and P=.02, respectively). Younger participants tended toward increased production of their own content (P=.06). Conclusions: SM is commonly used for professional purposes by orthopedic and trauma surgeons in Germany. However, it seems that professional SM use is not exploited to its full potential, and a structured implementation into daily professional work routines is still lacking. SM can have a profound impact on medical practices and communication, so orthopedic and trauma surgeons in Germany should consider increasing their SM presence by actively contributing to SM. ",
doi="10.2196/45665",
url="https://formative.jmir.org/2023/1/e45665",
url="http://www.ncbi.nlm.nih.gov/pubmed/37738084"
}


@Article{info:doi/10.2196/45019,
author="Li, Ziyu
and Wu, Xiaoqian
and Xu, Lin
and Liu, Ming
and Huang, Cheng",
title="Hot Topic Recognition of Health Rumors Based on Anti-Rumor Articles on the WeChat Official Account Platform: Topic Modeling",
journal="J Med Internet Res",
year="2023",
month="Sep",
day="21",
volume="25",
pages="e45019",
keywords="topic model",
keywords="health rumors",
keywords="social media",
keywords="WeChat official account",
keywords="content analysis",
keywords="public health",
keywords="machine learning",
keywords="Twitter",
keywords="social network",
keywords="misinformation",
keywords="users",
keywords="disease",
keywords="diet",
abstract="Background: Social networks have become one of the main channels for obtaining health information. However, they have also become a source of health-related misinformation, which seriously threatens the public's physical and mental health. Governance of health-related misinformation can be implemented through topic identification of rumors on social networks. However, little attention has been paid to studying the types and routes of dissemination of health rumors on the internet, especially rumors regarding health-related information in Chinese social media. Objective: This study aims to explore the types of health-related misinformation favored by WeChat public platform users and their prevalence trends and to analyze the modeling results of the text by using the Latent Dirichlet Allocation model. Methods: We used a web crawler tool to capture health rumor--dispelling articles on WeChat rumor-dispelling public accounts. We collected information from health-debunking articles posted between January 1, 2016, and August 31, 2022. Following word segmentation of the collected text, a document topic generation model called Latent Dirichlet Allocation was used to identify and generalize the most common topics. The proportion distribution of the themes was calculated, and the negative impact of various health rumors in different periods was analyzed. Additionally, the prevalence of health rumors was analyzed by the number of health rumors generated at each time point. Results: We collected 9366 rumor-refuting articles from January 1, 2016, to August 31, 2022, from WeChat official accounts. Through topic modeling, we divided the health rumors into 8 topics, that is, rumors on prevention and treatment of infectious diseases (1284/9366, 13.71\%), disease therapy and its effects (1037/9366, 11.07\%), food safety (1243/9366, 13.27\%), cancer and its causes (946/9366, 10.10\%), regimen and disease (1540/9366, 16.44\%), transmission (914/9366, 9.76\%), healthy diet (1068/9366, 11.40\%), and nutrition and health (1334/9366, 14.24\%). Furthermore, we summarized the 8 topics under 4 themes, that is, public health, disease, diet and health, and spread of rumors. Conclusions: Our study shows that topic modeling can provide analysis and insights into health rumor governance. The rumor development trends showed that most rumors were on public health, disease, and diet and health problems. Governments still need to implement relevant and comprehensive rumor management strategies based on the rumors prevalent in their countries and formulate appropriate policies. Apart from regulating the content disseminated on social media platforms, the national quality of health education should also be improved. Governance of social networks should be clearly implemented, as these rapidly developed platforms come with privacy issues. Both disseminators and receivers of information should ensure a realistic attitude and disseminate health information correctly. In addition, we recommend that sentiment analysis--related studies be conducted to verify the impact of health rumor--related topics. ",
doi="10.2196/45019",
url="https://www.jmir.org/2023/1/e45019",
url="http://www.ncbi.nlm.nih.gov/pubmed/37733396"
}


@Article{info:doi/10.2196/48620,
author="Adebesin, Funmi
and Smuts, Hanlie
and Mawela, Tendani
and Maramba, George
and Hattingh, Marie",
title="The Role of Social Media in Health Misinformation and Disinformation During the COVID-19 Pandemic: Bibliometric Analysis",
journal="JMIR Infodemiology",
year="2023",
month="Sep",
day="20",
volume="3",
pages="e48620",
keywords="bibliometric analysis",
keywords="COVID-19",
keywords="fake news",
keywords="health disinformation",
keywords="health misinformation",
keywords="social media",
abstract="Background: The use of social media platforms to seek information continues to increase. Social media platforms can be used to disseminate important information to people worldwide instantaneously. However, their viral nature also makes it easy to share misinformation, disinformation, unverified information, and fake news. The unprecedented reliance on social media platforms to seek information during the COVID-19 pandemic was accompanied by increased incidents of misinformation and disinformation. Consequently, there was an increase in the number of scientific publications related to the role of social media in disseminating health misinformation and disinformation at the height of the COVID-19 pandemic. Health misinformation and disinformation, especially in periods of global public health disasters, can lead to the erosion of trust in policy makers at best and fatal consequences at worst. Objective: This paper reports a bibliometric analysis aimed at investigating the evolution of research publications related to the role of social media as a driver of health misinformation and disinformation since the start of the COVID-19 pandemic. Additionally, this study aimed to identify the top trending keywords, niche topics, authors, and publishers for publishing papers related to the current research, as well as the global collaboration between authors on topics related to the role of social media in health misinformation and disinformation since the start of the COVID-19 pandemic. Methods: The Scopus database was accessed on June 8, 2023, using a combination of Medical Subject Heading and author-defined terms to create the following search phrases that targeted the title, abstract, and keyword fields: (``Health*'' OR ``Medical'') AND (``Misinformation'' OR ``Disinformation'' OR ``Fake News'') AND (``Social media'' OR ``Twitter'' OR ``Facebook'' OR ``YouTube'' OR ``WhatsApp'' OR ``Instagram'' OR ``TikTok'') AND (``Pandemic*'' OR ``Corona*'' OR ``Covid*''). A total of 943 research papers published between 2020 and June 2023 were analyzed using Microsoft Excel (Microsoft Corporation), VOSviewer (Centre for Science and Technology Studies, Leiden University), and the Biblioshiny package in Bibliometrix (K-Synth Srl) for RStudio (Posit, PBC). Results: The highest number of publications was from 2022 (387/943, 41\%). Most publications (725/943, 76.9\%) were articles. JMIR published the most research papers (54/943, 5.7\%). Authors from the United States collaborated the most, with 311 coauthored research papers. The keywords ``Covid-19,'' ``social media,'' and ``misinformation'' were the top 3 trending keywords, whereas ``learning systems,'' ``learning models,'' and ``learning algorithms'' were revealed as the niche topics on the role of social media in health misinformation and disinformation during the COVID-19 outbreak. Conclusions: Collaborations between authors can increase their productivity and citation counts. Niche topics such as ``learning systems,'' ``learning models,'' and ``learning algorithms'' could be exploited by researchers in future studies to analyze the influence of social media on health misinformation and disinformation during periods of global public health emergencies. ",
doi="10.2196/48620",
url="https://infodemiology.jmir.org/2023/1/e48620",
url="http://www.ncbi.nlm.nih.gov/pubmed/37728981"
}


@Article{info:doi/10.2196/43630,
author="Fisher, Andrew
and Young, Maclaren Matthew
and Payer, Doris
and Pacheco, Karen
and Dubeau, Chad
and Mago, Vijay",
title="Automating Detection of Drug-Related Harms on Social Media: Machine Learning Framework",
journal="J Med Internet Res",
year="2023",
month="Sep",
day="19",
volume="25",
pages="e43630",
keywords="early warning system",
keywords="social media",
keywords="law enforcement",
keywords="public health",
keywords="new psychoactive substances",
keywords="development",
keywords="drug",
keywords="dosage",
keywords="Canada",
keywords="Twitter",
keywords="poisoning",
keywords="monitoring",
keywords="community",
keywords="public safety",
keywords="machine learning",
keywords="Fleiss",
keywords="tweet",
keywords="tweet annotations",
keywords="pharmacology",
keywords="addiction",
abstract="Background: A hallmark of unregulated drug markets is their unpredictability and constant evolution with newly introduced substances. People who use drugs and the public health workforce are often unaware of the appearance of new drugs on the unregulated market and their type, safe dosage, and potential adverse effects. This increases risks to people who use drugs, including the risk of unknown consumption and unintentional drug poisoning. Early warning systems (EWSs) can help monitor the landscape of emerging drugs in a given community by collecting and tracking up-to-date information and determining trends. However, there are currently few ways to systematically monitor the appearance and harms of new drugs on the unregulated market in Canada. Objective: The goal of this work is to examine how artificial intelligence can assist in identifying patterns of drug-related risks and harms, by monitoring the social media activity of public health and law enforcement groups. This information is beneficial in the form of an EWS as it can be used to identify new and emerging drug trends in various communities. Methods: To collect data for this study, 145 relevant Twitter accounts throughout Quebec (n=33), Ontario (n=78), and British Columbia (n=34) were manually identified. Tweets posted between August 23 and December 21, 2021, were collected via the application programming interface developed by Twitter for a total of 40,393 tweets. Next, subject matter experts (1) developed keyword filters that reduced the data set to 3746 tweets and (2) manually identified relevant tweets for monitoring and early warning efforts for a total of 464 tweets. Using this information, a zero-shot classifier was applied to tweets from step 1 with a set of keep (drug arrest, drug discovery, and drug report) and not-keep (drug addiction support, public safety report, and others) labels to see how accurately it could extract the tweets identified in step 2. Results: When looking at the accuracy in identifying relevant posts, the system extracted a total of 584 tweets and had an overlap of 392 out of 477 (specificity of {\textasciitilde}84.5\%) with the subject matter experts. Conversely, the system identified a total of 3162 irrelevant tweets and had an overlap of 3090 (sensitivity of {\textasciitilde}94.1\%) with the subject matter experts. Conclusions: This study demonstrates the benefits of using artificial intelligence to assist in finding relevant tweets for an EWS. The results showed that it can be quite accurate in filtering out irrelevant information, which greatly reduces the amount of manual work required. Although the accuracy in retaining relevant information was observed to be lower, an analysis showed that the label definitions can impact the results significantly and would therefore be suitable for future work to refine. Nonetheless, the performance is promising and demonstrates the usefulness of artificial intelligence in this domain. ",
doi="10.2196/43630",
url="https://www.jmir.org/2023/1/e43630",
url="http://www.ncbi.nlm.nih.gov/pubmed/37725410"
}


@Article{info:doi/10.2196/44656,
author="Bizzotto, Nicole
and Schulz, Johannes Peter
and de Bruijn, Gert-Jan",
title="The ``Loci'' of Misinformation and Its Correction in Peer- and Expert-Led Online Communities for Mental Health: Content Analysis",
journal="J Med Internet Res",
year="2023",
month="Sep",
day="18",
volume="25",
pages="e44656",
keywords="online communities",
keywords="social media",
keywords="mental health",
keywords="misinformation",
keywords="empowerment",
keywords="content analysis",
keywords="online community",
keywords="infodemiology",
keywords="information seeking",
keywords="help seeking",
keywords="information behavior",
keywords="online search",
keywords="search query",
keywords="information quality",
keywords="information accuracy",
abstract="Background: Mental health problems are recognized as a pressing public health issue, and an increasing number of individuals are turning to online communities for mental health to search for information and support. Although these virtual platforms have the potential to provide emotional support and access to anecdotal experiences, they can also present users with large amounts of potentially inaccurate information. Despite the importance of this issue, limited research has been conducted, especially on the differences that might emerge due to the type of content moderation of online communities: peer-led or expert-led. Objective: We aim to fill this gap by examining the prevalence, the communicative context, and the persistence of mental health misinformation on Facebook online communities for mental health, with a focus on understanding the mechanisms that enable effective correction of inaccurate information and differences between expert-led and peer-led groups. Methods: We conducted a content analysis of 1534 statements (from 144 threads) in 2 Italian-speaking Facebook groups. Results: The study found that an alarming number of comments (26.1\%) contained medically inaccurate information. Furthermore, nearly 60\% of the threads presented at least one misinformation statement without any correction attempt. Moderators were more likely to correct misinformation than members; however, they were not immune to posting content containing misinformation, which was an unexpected finding. Discussions about aspects of treatment (including side effects or treatment interruption) significantly increased the probability of encountering misinformation. Additionally, the study found that misinformation produced in the comments of a thread, rather than as the first post, had a lower probability of being corrected, particularly in peer-led communities. Conclusions: The high prevalence of misinformation in online communities, particularly when left uncorrected, underscores the importance of conducting additional research to identify effective mechanisms to prevent its spread. This is especially important given the study's finding that misinformation tends to be more prevalent around specific ``loci'' of discussion that, once identified, can serve as a starting point to develop strategies for preventing and correcting misinformation within them. ",
doi="10.2196/44656",
url="https://www.jmir.org/2023/1/e44656",
url="http://www.ncbi.nlm.nih.gov/pubmed/37721800"
}


@Article{info:doi/10.2196/46814,
author="Silva, Martha
and Anaba, Udochisom
and Jani Tulsani, Nrupa
and Sripad, Pooja
and Walker, Jonathan
and Aisiri, Adolor",
title="Gender-Based Violence Narratives in Internet-Based Conversations in Nigeria: Social Listening Study",
journal="J Med Internet Res",
year="2023",
month="Sep",
day="15",
volume="25",
pages="e46814",
keywords="gender-based violence",
keywords="social listening",
keywords="sexual health",
keywords="consent",
keywords="social media",
keywords="Twitter",
keywords="Nigeria",
keywords="gender inequalities",
keywords="discrimination",
keywords="natural language processing",
keywords="sexual consent",
abstract="Background: Overcoming gender inequities is a global priority recognized as essential for improved health and human development. Gender-based violence (GBV) is an extreme manifestation of gender inequities enacted in real-world and internet-based environments. In Nigeria, GBV has come to the forefront of attention since 2020, when a state of emergency was declared due to increased reporting of sexual violence. Understanding GBV-related social narratives is important to design public health interventions. Objective: We explore how gender-related internet-based conversations in Nigeria specifically related to sexual consent (actively agreeing to sexual behavior), lack of consent, and slut-shaming (stigmatization in the form of insults based on actual or perceived sexuality and behaviors) manifest themselves and whether they changed between 2017 and 2022. Additionally, we explore what role events or social movements have in shaping gender-related narratives in Nigeria. Methods: Social listening was carried out on 12,031 social media posts (Twitter, Facebook, forums, and blogs) and almost 2 million public searches (Google and Yahoo search engines) between April 2017 and May 2022. The data were analyzed using natural language processing to determine the most salient conversation thematic clusters, qualitatively analyze time trends in discourse, and compare data against selected key events. Results: Between 2017 and 2022, internet-based conversation about sexual consent increased 72,633\%, from an average 3 to 2182 posts per month, while slut-shaming conversation (perpetrating or condemning) shrunk by 9\%, from an average 3560 to 3253 posts per month. Thematic analysis shows conversation revolves around the objectification of women, poor comprehension of elements of sexual consent, and advocacy for public education about sexual consent. Additionally, posters created space for sexual empowerment and expressions of sex positivity, pushing back against others who weaponize posts in support of slut-shaming narrative. Time trend analysis shows a greater sense of empowerment in advocating for education around the legal age of consent for sexual activity, calling out double standards, and rejecting slut-shaming. However, analysis of emotions in social media posts shows anger was most prominent in sexual consent (n=1213, 73\%) and slut-shaming (n=226, 64\%) posts. Organic social movements and key events (\#ArewaMeToo and \#ChurchToo, the \#SexforGrades scandal, and the \#BBNaija television program) played a notable role in sparking discourse related to sexual consent and slut-shaming. Conclusions: Social media narratives are significantly impacted by popular culture events, mass media programs, social movements, and micro influencers speaking out against GBV. Hashtags, media clips, and other content can be leveraged effectively to spread awareness and spark conversation around evolving gender norms. Public health practitioners and other stakeholders including policymakers, researchers, and social advocates should be prepared to capitalize on social media events and discourse to help shape the conversation in support of a normative environment that rejects GBV in all its forms. ",
doi="10.2196/46814",
url="https://www.jmir.org/2023/1/e46814",
url="http://www.ncbi.nlm.nih.gov/pubmed/37713260"
}


@Article{info:doi/10.2196/49061,
author="Ng, Margaret Yee Man
and Hoffmann Pham, Katherine
and Luengo-Oroz, Miguel",
title="Exploring YouTube's Recommendation System in the Context of COVID-19 Vaccines: Computational and Comparative Analysis of Video Trajectories",
journal="J Med Internet Res",
year="2023",
month="Sep",
day="15",
volume="25",
pages="e49061",
keywords="algorithmic auditing",
keywords="antivaccine sentiment",
keywords="crowdsourcing",
keywords="recommendation systems",
keywords="watch history",
keywords="YouTube",
abstract="Background: Throughout the COVID-19 pandemic, there has been a concern that social media may contribute to vaccine hesitancy due to the wide availability of antivaccine content on social media platforms. YouTube has stated its commitment to removing content that contains misinformation on vaccination. Nevertheless, such claims are difficult to audit. There is a need for more empirical research to evaluate the actual prevalence of antivaccine sentiment on the internet. Objective: This study examines recommendations made by YouTube's algorithms in order to investigate whether the platform may facilitate the spread of antivaccine sentiment on the internet. We assess the prevalence of antivaccine sentiment in recommended videos and evaluate how real-world users' experiences are different from the personalized recommendations obtained by using synthetic data collection methods, which are often used to study YouTube's recommendation systems. Methods: We trace trajectories from a credible seed video posted by the World Health Organization to antivaccine videos, following only video links suggested by YouTube's recommendation system. First, we gamify the process by asking real-world participants to intentionally find an antivaccine video with as few clicks as possible. Having collected crowdsourced trajectory data from respondents from (1) the World Health Organization and United Nations system (nWHO/UN=33) and (2) Amazon Mechanical Turk (nAMT=80), we next compare the recommendations seen by these users to recommended videos that are obtained from (3) the YouTube application programming interface's RelatedToVideoID parameter (nRTV=40) and (4) from clean browsers without any identifying cookies (nCB=40), which serve as reference points. We develop machine learning methods to classify antivaccine content at scale, enabling us to automatically evaluate 27,074 video recommendations made by YouTube. Results: We found no evidence that YouTube promotes antivaccine content; the average share of antivaccine videos remained well below 6\% at all steps in users' recommendation trajectories. However, the watch histories of users significantly affect video recommendations, suggesting that data from the application programming interface or from a clean browser do not offer an accurate picture of the recommendations that real users are seeing. Real users saw slightly more provaccine content as they advanced through their recommendation trajectories, whereas synthetic users were drawn toward irrelevant recommendations as they advanced. Rather than antivaccine content, videos recommended by YouTube are likely to contain health-related content that is not specifically related to vaccination. These videos are usually longer and contain more popular content. Conclusions: Our findings suggest that the common perception that YouTube's recommendation system acts as a ``rabbit hole'' may be inaccurate and that YouTube may instead be following a ``blockbuster'' strategy that attempts to engage users by promoting other content that has been reliably successful across the platform. ",
doi="10.2196/49061",
url="https://www.jmir.org/2023/1/e49061",
url="http://www.ncbi.nlm.nih.gov/pubmed/37713243"
}


@Article{info:doi/10.2196/46153,
author="Llanes, D. Karla
and Ling, M. Pamela
and Guillory, Jamie
and Vogel, A. Erin",
title="Young Adults' Perceptions of and Intentions to Use Nicotine and Cannabis Vaporizers in Response to e-Cigarette or Vaping-Associated Lung Injury Instagram Posts: Experimental Study",
journal="J Med Internet Res",
year="2023",
month="Sep",
day="14",
volume="25",
pages="e46153",
keywords="EVALI",
keywords="risk perception, nicotine",
keywords="cannabis",
keywords="e-cigarettes",
keywords="young adult",
keywords="vaping",
keywords="social media",
keywords="Instagram",
keywords="harmful effect",
abstract="Background: Inhaling aerosolized nicotine and cannabis (colloquially called ``vaping'') is prevalent among young adults. Instagram influencers often promote both nicotine and cannabis vaporizer products. However, Instagram posts discouraging the use of both products received national media attention during the 2019 outbreak of e-cigarette or vaping-associated lung injury (EVALI). Objective: This experiment tested the impact of viewing Instagram posts about EVALI, varying in image and text valence, on young adults' perceived harmfulness of nicotine and cannabis products, perceived risk of nicotine and cannabis vaporizer use, and intentions to use nicotine and cannabis vaporizers in the future. Methods: Participants (N=1229) aged 18-25 (mean 21.40, SD 2.22) years were recruited through Qualtrics Research Services, oversampling for ever-use of nicotine or cannabis vaporizers (618/1229, 50.3\%). Participants were randomly assigned to view Instagram posts from young people portraying their experiences of EVALI in a 2 (image valence: positive or negative) {\texttimes} 2 (text valence: positive or negative) between-subjects experiment. Positive images were attractive and aesthetically pleasing selfies. The positive text was supportive and uplifting regarding quitting the use of vaporized products. Negative images and text were graphic and fear inducing. After viewing 3 posts, participants reported the perceived harmfulness of nicotine and cannabis products, the perceived risk of nicotine and cannabis vaporizer use, and intentions to use nicotine and cannabis vaporizers in the future. Ordinal logistic regression models assessed the main effects and interactions of image and text valence on perceived harmfulness and risk. Binary logistic regression models assessed the main effects and interactions of image and text valence on intentions to use nicotine and cannabis vaporizers. Analyses were adjusted for product use history. Results: Compared to viewing positive images, viewing negative images resulted in significantly greater perceived harm of nicotine (P=.02 for disposable pod-based vaporizers and P=.04 for other e-cigarette ``mods'' devices) and cannabis vaporized products (P=.01), greater perceived risk of nicotine vaporizers (P<.01), and lower odds of intentions to use nicotine (P=.02) but not cannabis (P=.43) vaporizers in the future. There were no significant main effects of text valence on perceived harm, perceived risk, and intentions to use nicotine and cannabis vaporized products. No significant interaction effects of image and text valence were found. Conclusions: Negative imagery in Instagram posts about EVALI may convey the risks of vaporized product use and discourage young adults from this behavior, regardless of the valence of the post's text. Public health messaging regarding EVALI on Instagram should emphasize the risk of cannabis vaporizer use, as young adults may otherwise believe that only nicotine vaporizer use increases their risk for EVALI. ",
doi="10.2196/46153",
url="https://www.jmir.org/2023/1/e46153",
url="http://www.ncbi.nlm.nih.gov/pubmed/37552552"
}


@Article{info:doi/10.2196/44461,
author="L{\"o}sch, Lea
and Zuiderent-Jerak, Teun
and Kunneman, Florian
and Syurina, Elena
and Bongers, Marloes
and Stein, L. Mart
and Chan, Michelle
and Willems, Willemine
and Timen, Aura",
title="Capturing Emerging Experiential Knowledge for Vaccination Guidelines Through Natural Language Processing: Proof-of-Concept Study",
journal="J Med Internet Res",
year="2023",
month="Sep",
day="14",
volume="25",
pages="e44461",
keywords="guidelines as topic",
keywords="COVID-19",
keywords="public health",
keywords="natural language processing",
keywords="NLP",
keywords="social media",
keywords="stakeholder engagement",
keywords="vaccine",
keywords="vaccination",
keywords="health policy",
keywords="coronavirus",
keywords="SARS-CoV-2",
abstract="Background: Experience-based knowledge and value considerations of health professionals, citizens, and patients are essential to formulate public health and clinical guidelines that are relevant and applicable to medical practice. Conventional methods for incorporating such knowledge into guideline development often involve a limited number of representatives and are considered to be time-consuming. Including experiential knowledge can be crucial during rapid guidance production in response to a pandemic but it is difficult to accomplish. Objective: This proof-of-concept study explored the potential of artificial intelligence (AI)--based methods to capture experiential knowledge and value considerations from existing data channels to make these insights available for public health guideline development. Methods: We developed and examined AI-based methods in relation to the COVID-19 vaccination guideline development in the Netherlands. We analyzed Dutch messages shared between December 2020 and June 2021 on social media and on 2 databases from the Dutch National Institute for Public Health and the Environment (RIVM), where experiences and questions regarding COVID-19 vaccination are reported. First, natural language processing (NLP) filtering techniques and an initial supervised machine learning model were developed to identify this type of knowledge in a large data set. Subsequently, structural topic modeling was performed to discern thematic patterns related to experiences with COVID-19 vaccination. Results: NLP methods proved to be able to identify and analyze experience-based knowledge and value considerations in large data sets. They provide insights into a variety of experiential knowledge that is difficult to obtain otherwise for rapid guideline development. Some topics addressed by citizens, patients, and professionals can serve as direct feedback to recommendations in the guideline. For example, a topic pointed out that although travel was not considered as a reason warranting prioritization for vaccination in the national vaccination campaign, there was a considerable need for vaccines for indispensable travel, such as cross-border informal caregiving, work or study, or accessing specialized care abroad. Another example is the ambiguity regarding the definition of medical risk groups prioritized for vaccination, with many citizens not meeting the formal priority criteria while being equally at risk. Such experiential knowledge may help the early identification of problems with the guideline's application and point to frequently occurring exceptions that might initiate a revision of the guideline text. Conclusions: This proof-of-concept study presents NLP methods as viable tools to access and use experience-based knowledge and value considerations, possibly contributing to robust, equitable, and applicable guidelines. They offer a way for guideline developers to gain insights into health professionals, citizens, and patients' experience-based knowledge, especially when conventional methods are difficult to implement. AI-based methods can thus broaden the evidence and knowledge base available for rapid guideline development and may therefore be considered as an important addition to the toolbox of pandemic preparedness. ",
doi="10.2196/44461",
url="https://www.jmir.org/2023/1/e44461",
url="http://www.ncbi.nlm.nih.gov/pubmed/37610972"
}


@Article{info:doi/10.2196/49220,
author="Malhotra, Kashish
and Kempegowda, Punith",
title="Appraising Unmet Needs and Misinformation Spread About Polycystic Ovary Syndrome in 85,872 YouTube Comments Over 12 Years: Big Data Infodemiology Study",
journal="J Med Internet Res",
year="2023",
month="Sep",
day="11",
volume="25",
pages="e49220",
keywords="polycystic ovary syndrome",
keywords="PCOS",
keywords="public",
keywords="YouTube",
keywords="global health",
keywords="online trends",
keywords="global equity",
keywords="infodemiology",
keywords="big data",
keywords="comments",
keywords="sentiment",
keywords="network analysis",
keywords="contextualization",
keywords="word association",
keywords="misinformation",
keywords="endocrinopathy",
keywords="women",
keywords="gender",
keywords="users",
keywords="treatment",
keywords="fatigue",
keywords="pain",
keywords="motherhood",
abstract="Background: Polycystic ovary syndrome (PCOS) is the most common endocrinopathy in women, resulting in substantial burden related to metabolic, reproductive, and psychological complications. While attempts have been made to understand the themes and sentiments of the public regarding PCOS at the local and regional levels, no study has explored worldwide views, mainly due to financial and logistical limitations. YouTube is one of the largest sources of health-related information, where many visitors share their views as questions or comments. These can be used as a surrogate to understand the public's perceptions. Objective: We analyzed the comments of all videos related to PCOS published on YouTube from May 2011 to April 2023 and identified trends over time in the comments, their context, associated themes, gender-based differences, and underlying sentiments. Methods: After extracting all the comments using the YouTube application programming interface, we contextually studied the keywords and analyzed gender differences using the Benjamini-Hochberg procedure. We applied a multidimensional approach to analyzing the content via association mining using Mozdeh. We performed network analysis to study associated themes using the Fruchterman-Reingold algorithm and then manually screened the comments for content analysis. The sentiments associated with YouTube comments were analyzed using SentiStrength. Results: A total of 85,872 comments from 940 PCOS videos on YouTube were extracted. We identified a specific gender for 13,106 comments. Of these, 1506 were matched to male users (11.5\%), and 11,601 comments to female users (88.5\%). Keywords including diagnosing PCOS, symptoms of PCOS, pills for PCOS (medication), and pregnancy were significantly associated with female users. Keywords such as herbal treatment, natural treatment, curing PCOS, and online searches were significantly associated with male users. The key themes associated with female users were symptoms of PCOS, positive personal experiences (themes such as helpful and love), negative personal experiences (fatigue and pain), motherhood (infertility and trying to conceive), self-diagnosis, and use of professional terminology detailing their journey. The key themes associated with male users were misinformation regarding the ``cure'' for PCOS, using natural and herbal remedies to cure PCOS, fake testimonies from spammers selling their courses and consultations, finding treatment for PCOS, and sharing perspectives of female family members. The overall average positive sentiment was 1.6651 (95\% CI 1.6593-1.6709), and the average negative sentiment was 1.4742 (95\% CI 1.4683-1.4802) with a net positive difference of 0.1909. Conclusions: There may be a disparity in views on PCOS between women and men, with the latter associated with non--evidence-based approaches and misinformation. The improving sentiment noticed with YouTube comments may reflect better health care services. Prioritizing and promoting evidence-based care and disseminating pragmatic online coverage is warranted to improve public sentiment and limit misinformation spread. ",
doi="10.2196/49220",
url="https://www.jmir.org/2023/1/e49220",
url="http://www.ncbi.nlm.nih.gov/pubmed/37695666"
}


@Article{info:doi/10.2196/49325,
author="Scotti Requena, Simone
and Pirkis, Jane
and Currier, Dianne
and Conway, Mike
and Lee, Simon
and Turnure, Jackie
and Cummins, Jennifer
and Nicholas, Angela",
title="An Evaluation of the Boys Do Cry Suicide Prevention Media Campaign on Twitter: Mixed Methods Approach",
journal="JMIR Form Res",
year="2023",
month="Sep",
day="7",
volume="7",
pages="e49325",
keywords="help-seeking",
keywords="masculinity",
keywords="media campaign",
keywords="men",
keywords="men's health",
keywords="mental health",
keywords="self-reliance",
keywords="social media",
keywords="suicide prevention",
keywords="suicide",
abstract="Background: In most countries, men are more likely to die by suicide than women. Adherence to dominant masculine norms, such as being self-reliant, is linked to suicide in men in Western cultures. We created a suicide prevention media campaign, ``Boys Do Cry,'' designed to challenge the ``self-reliance'' norm and encourage help-seeking in men. A music video was at the core of the campaign, which was an adapted version of the ``Boys Don't Cry'' song from ``The Cure.'' There is evidence that suicide prevention media campaigns can encourage help-seeking for mental health difficulties. Objective: We aimed to explore the reach, engagement, and themes of discussion prompted by the Boys Do Cry campaign on Twitter. Methods: We used Twitter analytics data to investigate the reach and engagement of the Boys Do Cry campaign, including analyzing the characteristics of tweets posted by the campaign's hosts. Throughout the campaign and immediately after, we also used Twitter data derived from the Twitter Application Programming Interface to analyze the tweeting patterns of users related to the campaign. In addition, we qualitatively analyzed the content of Boys Do Cry--related tweets during the campaign period. Results: During the campaign, Twitter users saw the tweets posted by the hosts of the campaign a total of 140,650 times and engaged with its content a total of 4477 times. The 10 highest-performing tweets by the campaign hosts involved either a video or an image. Among the 10 highest-performing tweets, the first was one that included the campaign's core video; the second was a screenshot of the tweet posted by Robert Smith, the lead singer of The Cure, sharing the Boys Do Cry campaign's video and tagging the campaign's hosts. In addition, the pattern of Twitter activity for the campaign-related tweets was considerably higher during the campaign than in the immediate postcampaign period, with half of the activity occurring during the first week of the campaign when Robert Smith promoted the campaign. Some of the key topics of discussions prompted by the Boys Do Cry campaign on Twitter involved users supporting the campaign; referencing the original song, band, or lead singer; reiterating the campaign's messages; and having emotional responses to the campaign. Conclusions: This study demonstrates that a brief media campaign such as Boys Do Cry can achieve good reach and engagement and can prompt discussions on Twitter about masculinity and suicide. Such discussions may lead to greater awareness about the importance of seeking help and providing support to those with mental health difficulties. However, this study suggests that longer, more intensive campaigns may be needed in order to amplify and sustain these results. ",
doi="10.2196/49325",
url="https://formative.jmir.org/2023/1/e49325",
url="http://www.ncbi.nlm.nih.gov/pubmed/37676723"
}


@Article{info:doi/10.2196/43825,
author="Kalinowski, Jolaade
and Idiong, Christie
and Blackman-Carr, Loneke
and Cooksey Stowers, Kristen
and Davis, Shard{\'e}
and Pan, Cindy
and Chhabra, Alisha
and Eaton, Lisa
and Gans, M. Kim
and Alexander, Ell Jay
and Pagoto, Sherry",
title="Leveraging the Black Girls Run Web-Based Community as a Supportive Community for Physical Activity Engagement: Mixed Methods Study",
journal="JMIR Form Res",
year="2023",
month="Sep",
day="7",
volume="7",
pages="e43825",
keywords="physical activity",
keywords="social media",
keywords="women's health",
keywords="African American women",
keywords="mHealth",
keywords="mobile health",
keywords="Facebook",
keywords="African American",
keywords="exercise",
keywords="web-based community",
keywords="web-based communities",
keywords="content analysis",
abstract="Background: About 59\%-73\% of Black women do not meet the recommended targets for physical activity (PA). PA is a key modifiable lifestyle factor that can help mitigate risk for chronic diseases such as obesity, diabetes, and hypertension that disproportionately affect Black women. Web-based communities focused on PA have been emerging in recent years as web-based gathering spaces to provide support for PA in specific populations. One example is Black Girls Run (BGR), which is devoted to promoting PA in Black women. Objective: The purpose of this study was to describe the content shared on the BGR public Facebook page to provide insight into how web-based communities engage Black women in PA and inform the development of web-based PA interventions for Black women. Methods: Using Facebook Crowdtangle, we collected posts (n=397) and associated engagement data from the BGR public Facebook page for the 6-month period between June 1, 2021, and December 31, 2021. We pooled data in Dedoose to analyze the qualitative data and conducted a content analysis of qualitative data. We quantified types of posts, post engagement, and compared post types on engagement: ``like,'' ``love,'' ``haha,'' ``wow,'' ``care,'' ``sad,'' ``angry,'' ``comments,'' and ``shares.'' Results: The content analysis revealed 8 categories of posts: shout-outs to members for achievements (n=122, 31\%), goals or motivational (n=65, 16\%), announcements (n=63, 16\%), sponsored or ads (n=54, 14\%), health related (n=47, 11\%), the lived Black experience (n=23, 6\%), self-care (n=15, 4\%), and holidays or greetings (n=8, 2\%). The 397 posts attracted a total of 55,354 engagements (reactions, comments, and shares). Associations between the number of engagement and post categories were analyzed using generalized linear models. Shout-out posts (n=22,268) elicited the highest average of total user engagement of 181.7 (SD 116.7), followed by goals or motivational posts (n=11,490) with an average total engagement of 160.1 (SD 125.2) and announcements (n=7962) having an average total engagement of 129.9 (SD 170.7). Significant statistical differences were found among the total engagement of posts ($\chi$72=80.99, P<.001), ``like'' ($\chi$72=119.37, P<.001), ``love'' ($\chi$72=63.995, P<.001), ``wow'' ($\chi$72=23.73, P<.001), ``care'' ($\chi$72=35.06, P<.001), ``comments'' ($\chi$72=80.55, P<.001), and ``shares'' ($\chi$72=71.28, P<.001). Conclusions: The majority of content on the BGR Facebook page (n=250, 63\%) was focused on celebrating member achievements, motivating members to get active, and announcing and promoting active events. These types of posts attracted 75\% of total post engagement. BGR appears to be a rich web-based community that offers social support for PA as well as culturally relevant health and social justice content. Web-based communities may be uniquely positioned to engage minoritized populations in health behavior. Further research should explore how and if web-based communities such as BGR can be interwoven into health interventions and health promotion. ",
doi="10.2196/43825",
url="https://formative.jmir.org/2023/1/e43825",
url="http://www.ncbi.nlm.nih.gov/pubmed/37676722"
}


@Article{info:doi/10.2196/49452,
author="Kureyama, Nari
and Terada, Mitsuo
and Kusudo, Maho
and Nozawa, Kazuki
and Wanifuchi-Endo, Yumi
and Fujita, Takashi
and Asano, Tomoko
and Kato, Akiko
and Mori, Makiko
and Horisawa, Nanae
and Toyama, Tatsuya",
title="Fact-Checking Cancer Information on Social Media in Japan: Retrospective Study Using Twitter",
journal="JMIR Form Res",
year="2023",
month="Sep",
day="6",
volume="7",
pages="e49452",
keywords="cancer",
keywords="fact-check",
keywords="misinformation",
keywords="social media",
keywords="twitter",
abstract="Background: The widespread use of social media has made it easier for patients to access cancer information. However, a large amount of misinformation and harmful information that could negatively impact patients' decision-making is also disseminated on social media platforms. Objective: We aimed to determine the actual amount of misinformation and harmful information as well as trends in the dissemination of cancer-related information on Twitter, a representative social media platform. Our findings can support decision-making among Japanese patients with cancer. Methods: Using the Twitter app programming interface, we extracted tweets containing the term ``cancer'' in Japanese that were posted between August and September of 2022. The eligibility criteria were the cancer-related tweets with the following information: (1) reference to the occurrence or prognosis of cancer, (2) recommendation or nonrecommendation of actions, (3) reference to the course of cancer treatment or adverse events, (4) results of cancer research, and (5) other cancer-related knowledge and information. Finally, we selected the top 100 tweets with the highest number of ``likes.'' For each tweet, 2 independent reviewers evaluated whether the information was factual or misinformation, and whether it was harmful or safe with the reasons for the decisions on the misinformation and harmful tweets. Additionally, we examined the frequency of information dissemination using the number of retweets for the top 100 tweets and investigated trends in the dissemination of information. Results: The extracted tweets totaled 69,875. Of the top 100 cancer-related tweets with the most ``likes'' that met the eligibility criteria, 44 (44\%) contained misinformation, 31 (31\%) contained harmful information, and 30 (30\%) contained both misinformation and harmful information. Misinformation was described as Unproven (29/94, 40.4\%), Disproven (19/94, 20.2\%), Inappropriate application (4/94, 4.3\%), Strength of evidence mischaracterized (14/94, 14.9\%), Misleading (18/94, 18\%), and Other misinformation (1/94, 1.1\%). Harmful action was described as Harmful action (9/59, 15.2\%), Harmful inaction (43/59, 72.9\%), Harmful interactions (3/59, 5.1\%), Economic harm (3/59, 5.1\%), and Other harmful information (1/59, 1.7\%). Harmful information was liked more often than safe information (median 95, IQR 43-1919 vs 75.0 IQR 43-10,747; P=.04). The median number of retweets for the leading 100 tweets was 13.5 (IQR 0-2197). Misinformation was retweeted significantly more often than factual information (median 29.0, IQR 0-502 vs 7.5, IQR 0-2197; P=.01); harmful information was also retweeted significantly more often than safe information (median 35.0, IQR 0-502 vs 8.0, IQR 0-2197; P=.002). Conclusions: It is evident that there is a prevalence of misinformation and harmful information related to cancer on Twitter in Japan and it is crucial to increase health literacy and awareness regarding this issue. Furthermore, we believe that it is important for government agencies and health care professionals to continue providing accurate medical information to support patients and their families in making informed decisions. ",
doi="10.2196/49452",
url="https://formative.jmir.org/2023/1/e49452",
url="http://www.ncbi.nlm.nih.gov/pubmed/37672310"
}


@Article{info:doi/10.2196/48581,
author="Neely, Stephen
and Hao, Feng",
title="Diagnosis Disclosure and Peer-to-Peer Information Seeking Among COVID-19--Infected Social Media Users: Survey of US-Based Adults",
journal="JMIR Form Res",
year="2023",
month="Sep",
day="5",
volume="7",
pages="e48581",
keywords="chronic health condition",
keywords="COVID-19",
keywords="diagnosis disclosure",
keywords="information seeking",
keywords="information sharing",
keywords="online health communities",
keywords="peer support",
keywords="social media",
keywords="social support",
keywords="survey sample",
abstract="Background: Research examining online health communities suggests that individuals affected by chronic health conditions can obtain valuable information and social support through participation in peer-to-peer web-based information exchanges, including information sharing and seeking behaviors. The risks and rewards of these same behaviors in the case of acute illnesses, such as COVID-19, are less well understood, though there is reason to believe that individuals with COVID-19 and other acute illnesses may accrue similar benefits. Objective: This study examines the propensity of American adults to disclose and discuss their COVID-19 diagnosis and symptoms on social media while actively infected with the SARS-CoV-2 virus, as well as to engage in peer-to-peer information seeking in order to better understand the illness that they are experiencing. Additionally, this study seeks to identify the motivations for these behaviors as well as their subsequent impacts on perceived social connectedness and health anxiety in patients with COVID-19. Methods: We conducted a representative survey of 2500 US-based adults using a sample purchased through an industry-leading market research provider. Participants were selected through a stratified quota sampling approach to ensure a representative sample of the US population. Balanced quotas were determined (by region of the country) for gender, age, race, ethnicity, and political affiliation. Responses were analyzed from 946 participants who reported having an active social media account and testing positive for COVID-19 at least once since the start of the pandemic. Results: The results show that only a small portion of social media users (166/946, 18\%) chose to disclose and discuss their COVID-19 diagnosis while infected with the virus. However, among those who did, an overwhelming majority (206/251, 82\%) said that doing so helped them feel more connected and supported while infected with the virus. A larger percentage of the 946 respondents (n=319, 34\%) engaged in peer-to-peer information seeking while infected with COVID-19. Among those who did, a large majority (301/319, 94\%) said that doing so was ``helpful,'' but more than one-third (115/319, 36\%) said that reading about other people's experiences made them ``more worried'' about having COVID-19, while 33\% (108/319) said that it made them ``less worried.'' Illness severity and political affiliation were significant predictors of both information sharing and seeking. Conclusions: The findings suggest that the benefits (and risks) associated with online health communities are germane to patients with acute illnesses such as COVID-19. It is recommended that public health officials and health care providers take a proactive approach to cultivating professionally moderated forums supporting peer-to-peer engagement during future outbreaks of COVID-19 and other acute illnesses in order to improve patient outcomes and promote social support and connectedness among infected patients. ",
doi="10.2196/48581",
url="https://formative.jmir.org/2023/1/e48581",
url="http://www.ncbi.nlm.nih.gov/pubmed/37669087"
}


@Article{info:doi/10.2196/45867,
author="Hirabayashi, Mai
and Shibata, Daisaku
and Shinohara, Emiko
and Kawazoe, Yoshimasa",
title="Influence of Tweets Indicating False Rumors on COVID-19 Vaccination: Case Study",
journal="JMIR Form Res",
year="2023",
month="Sep",
day="5",
volume="7",
pages="e45867",
keywords="coronavirus",
keywords="correlation",
keywords="COVID-19",
keywords="disinformation",
keywords="false information",
keywords="infodemiology",
keywords="misinformation",
keywords="rumor",
keywords="rumor-indication",
keywords="SARS-CoV-2",
keywords="social media",
keywords="tweet",
keywords="Twitter",
keywords="vaccination",
keywords="vaccine",
abstract="Background: As of December 2022, the outbreak of COVID-19 showed no sign of abating, continuing to impact people's lives, livelihoods, economies, and more. Vaccination is an effective way to achieve mass immunity. However, in places such as Japan, where vaccination is voluntary, there are people who choose not to receive the vaccine, even if an effective vaccine is offered. To promote vaccination, it is necessary to clarify what kind of information on social media can influence attitudes toward vaccines. Objective: False rumors and counterrumors are often posted and spread in large numbers on social media, especially during emergencies. In this paper, we regard tweets that contain questions or point out errors in information as counterrumors. We analyze counterrumors tweets related to the COVID-19 vaccine on Twitter. We aimed to answer the following questions: (1) what kinds of COVID-19 vaccine--related counterrumors were posted on Twitter, and (2) are the posted counterrumors related to social conditions such as vaccination status? Methods: We use the following data sets: (1) counterrumors automatically collected by the ``rumor cloud'' (18,593 tweets); and (2) the number of COVID-19 vaccine inoculators from September 27, 2021, to August 15, 2022, published on the Prime Minister's Office's website. First, we classified the contents contained in counterrumors. Second, we counted the number of COVID-19 vaccine--related counterrumors from data set 1. Then, we examined the cross-correlation coefficients between the numbers of data sets 1 and 2. Through this verification, we examined the correlation coefficients for the following three periods: (1) the same period of data; (2) the case where the occurrence of the suggestion of counterrumors precedes the vaccination (negative time lag); and (3) the case where the vaccination precedes the occurrence of counterrumors (positive time lag). The data period used for the validation was from October 4, 2021, to April 18, 2022. Results: Our classification results showed that most counterrumors about the COVID-19 vaccine were negative. Moreover, the correlation coefficients between the number of counterrumors and vaccine inoculators showed significant and strong positive correlations. The correlation coefficient was over 0.7 at ?8, ?7, and ?1 weeks of lag. Results suggest that the number of vaccine inoculators tended to increase with an increase in the number of counterrumors. Significant correlation coefficients of 0.5 to 0.6 were observed for lags of 1 week or more and 2 weeks or more. This implies that an increase in vaccine inoculators increases the number of counterrumors. These results suggest that the increase in the number of counterrumors may have been a factor in inducing vaccination behavior. Conclusions: Using quantitative data, we were able to reveal how counterrumors influence the vaccination status of the COVID-19 vaccine. We think that our findings would be a foundation for considering countermeasures of vaccination. ",
doi="10.2196/45867",
url="https://formative.jmir.org/2023/1/e45867",
url="http://www.ncbi.nlm.nih.gov/pubmed/37669092"
}


@Article{info:doi/10.2196/43995,
author="Zhang, Jiayuan
and Xu, Wei
and Lei, Cheng
and Pu, Yang
and Zhang, Yubo
and Zhang, Jingyu
and Yu, Hongfan
and Su, Xueyao
and Huang, Yanyan
and Gong, Ruoyan
and Zhang, Lijun
and Shi, Qiuling",
title="Using Clinician-Patient WeChat Group Communication Data to Identify Symptom Burdens in Patients With Uterine Fibroids Under Focused Ultrasound Ablation Surgery Treatment: Qualitative Study",
journal="JMIR Form Res",
year="2023",
month="Sep",
day="1",
volume="7",
pages="e43995",
keywords="social media",
keywords="group chats",
keywords="text mining",
keywords="free texts",
keywords="symptom burdens",
keywords="WeChat",
keywords="natural language processing",
keywords="NLP",
abstract="Background: Unlike research project--based health data collection (questionnaires and interviews), social media platforms allow patients to freely discuss their health status and obtain peer support. Previous literature has pointed out that both public and private social platforms can serve as data sources for analysis. Objective: This study aimed to use natural language processing (NLP) techniques to identify concerns regarding the postoperative quality of life and symptom burdens in patients with uterine fibroids after focused ultrasound ablation surgery. Methods: Screenshots taken from clinician-patient WeChat groups were converted into free texts using image text recognition technology and used as the research object of this study. From 408 patients diagnosed with uterine fibroids in Chongqing Haifu Hospital between 2010 and 2020, we searched for symptom burdens in over 900,000 words of WeChat group chats. We first built a corpus of symptoms by manually coding 30\% of the WeChat texts and then used regular expressions in Python to crawl symptom information from the remaining texts based on this corpus. We compared the results with a manual review (gold standard) of the same records. Finally, we analyzed the relationship between the population baseline data and conceptual symptoms; quantitative and qualitative results were examined. Results: A total of 408 patients with uterine fibroids were included in the study; 190,000 words of free text were obtained after data cleaning. The mean age of the patients was 39.94 (SD 6.81) years, and their mean BMI was 22.18 (SD 2.78) kg/m2. The median reporting times of the 7 major symptoms were 21, 26, 57, 2, 18, 30, and 49 days. Logistic regression models identified preoperative menstrual duration (odds ratio [OR] 1.14, 95\% CI 5.86-6.37; P=.009), age of menophania (OR --1.02 , 95\% CI 11.96-13.47; P=.03), and the number (OR 2.34, 95\% CI 1.45-1.83; P=.04) and size of fibroids (OR 0.12, 95\% CI 2.43-3.51; P=.04) as significant risk factors for postoperative symptoms. Conclusions: Unstructured free texts from social media platforms extracted by NLP technology can be used for analysis. By extracting the conceptual information about patients' health-related quality of life, we can adopt personalized treatment for patients at different stages of recovery to improve their quality of life. Python-based text mining of free-text data can accurately extract symptom burden and save considerable time compared to manual review, maximizing the utility of the extant information in population-based electronic health records for comparative effectiveness research. ",
doi="10.2196/43995",
url="https://formative.jmir.org/2023/1/e43995",
url="http://www.ncbi.nlm.nih.gov/pubmed/37656501"
}


@Article{info:doi/10.2196/46343,
author="Esener, Yildiz
and McCall, Terika
and Lakdawala, Adnan
and Kim, Heejun",
title="Seeking and Providing Social Support on Twitter for Trauma and Distress During the COVID-19 Pandemic: Content and Sentiment Analysis",
journal="J Med Internet Res",
year="2023",
month="Aug",
day="31",
volume="25",
pages="e46343",
keywords="COVID-19",
keywords="social support",
keywords="trauma",
keywords="distress",
keywords="posttraumatic stress disorder",
keywords="PTSD",
keywords="Twitter",
keywords="social media",
keywords="mental health",
abstract="Background: The COVID-19 pandemic can be recognized as a traumatic event that led to stressors, resulting in trauma or distress among the general population. Social support is vital in the management of these stressors, especially during a traumatic event, such as the COVID-19 pandemic. Because of the limited face-to-face interactions enforced by physical distancing regulations during the pandemic, people sought solace on social media platforms to connect with, and receive support from, one another. Hence, it is crucial to investigate the ways in which people seek and offer support on social media for mental health management. Objective: The research aimed to examine the types of social support (eg, emotional, informational, instrumental, and appraisal) sought and provided for trauma or distress on Twitter during the COVID-19 pandemic. In addition, this study aimed to gain insight into the difficulties and concerns of people during the pandemic by identifying the associations between terms representing the topics of interest related to trauma or distress and their corresponding sentiments. Methods: The study methods included content analysis to investigate the type of social support people sought for trauma or distress during the pandemic. Sentiment analysis was also performed to track the negative and positive sentiment tweets posted between January 1, 2020, and March 15, 2021. Association rule mining was used to uncover associations between terms and sentiments in tweets. In addition, the research used Kruskal-Wallis and Mann-Whitney U tests to determine whether the retweet count and like count varied based on the social support type. Results: Most Twitter users who indicated trauma or distress sought emotional support. Regarding sentiment, Twitter users mostly posted negative sentiment tweets, particularly in January 2021. An intriguing observation was that wearing masks could trigger and exacerbate trauma or distress. The results revealed that people mostly sought and provided emotional support on Twitter regarding difficulties with wearing masks, mental health status, financial hardships, and treatment methods for trauma or distress. In addition, tweets regarding emotional support received the most endorsements from other users, highlighting the critical role of social support in fostering a sense of community and reducing the feelings of isolation during the pandemic. Conclusions: This study demonstrates the potential of social media as a platform to exchange social support during challenging times and to identify the specific concerns (eg, wearing masks and exacerbated symptoms) of individuals with self-reported trauma or distress. The findings provide insights into the types of support that were most beneficial for those struggling with trauma or distress during the pandemic and may inform policy makers and health organizations regarding better practices for pandemic response and special considerations for groups with a history of trauma or distress. ",
doi="10.2196/46343",
url="https://www.jmir.org/2023/1/e46343",
url="http://www.ncbi.nlm.nih.gov/pubmed/37651178"
}


@Article{info:doi/10.2196/50346,
author="Dobbs, D. Page
and Boykin, Ames Allison
and Ezike, Nnamdi
and Myers, J. Aaron
and Colditz, B. Jason
and Primack, A. Brian",
title="Twitter Sentiment About the US Federal Tobacco 21 Law: Mixed Methods Analysis",
journal="JMIR Form Res",
year="2023",
month="Aug",
day="31",
volume="7",
pages="e50346",
keywords="social media",
keywords="Twitter",
keywords="Tobacco 21",
keywords="mixed methods",
keywords="tobacco policy",
keywords="sentiment",
keywords="tweet",
keywords="tweets",
keywords="tobacco",
keywords="smoke",
keywords="smoking",
keywords="smoker",
keywords="policy",
keywords="policies",
keywords="law",
keywords="regulation",
keywords="regulations",
keywords="laws",
keywords="attitude",
keywords="attitudes",
keywords="opinion",
keywords="opinions",
abstract="Background: On December 20, 2019, the US ``Tobacco 21'' law raised the minimum legal sales age of tobacco products to 21 years. Initial research suggests that misinformation about Tobacco 21 circulated via news sources on Twitter and that sentiment about the law was associated with particular types of tobacco products and included discussions about other age-related behaviors. However, underlying themes about this sentiment as well as temporal trends leading up to enactment of the law have not been explored. Objective: This study sought to examine (1) sentiment (pro-, anti-, and neutral policy) about Tobacco 21 on Twitter and (2) volume patterns (number of tweets) of Twitter discussions leading up to the enactment of the federal law. Methods: We collected tweets related to Tobacco 21 posted between September 4, 2019, and December 31, 2019. A 2\% subsample of tweets (4628/231,447) was annotated by 2 experienced, trained coders for policy-related information and sentiment. To do this, a codebook was developed using an inductive procedure that outlined the operational definitions and examples for the human coders to annotate sentiment (pro-, anti-, and neutral policy). Following the annotation of the data, the researchers used a thematic analysis to determine emergent themes per sentiment category. The data were then annotated again to capture frequencies of emergent themes. Concurrently, we examined trends in the volume of Tobacco 21--related tweets (weekly rhythms and total number of tweets over the time data were collected) and analyzed the qualitative discussions occurring at those peak times. Results: The most prevalent category of tweets related to Tobacco 21 was neutral policy (514/1113, 46.2\%), followed by antipolicy (432/1113, 38.8\%); 167 of 1113 (15\%) were propolicy or supportive of the law. Key themes identified among neutral tweets were news reports and discussion of political figures, parties, or government involvement in general. Most discussions were generated from news sources and surfaced in the final days before enactment. Tweets opposing Tobacco 21 mentioned that the law was unfair to young audiences who were addicted to nicotine and were skeptical of the law's efficacy and importance. Methods used to evade the law were found to be represented in both neutral and antipolicy tweets. Propolicy tweets focused on the protection of youth and described the law as a sensible regulatory approach rather than a complete ban of all products or flavored products. Four spikes in daily volume were noted, 2 of which corresponded with political speeches and 2 with the preparation and passage of the legislation. Conclusions: Understanding themes of public sentiment---as well as when Twitter activity is most active---will help public health professionals to optimize health promotion activities to increase community readiness and respond to enforcement needs including education for retailers and the general public. ",
doi="10.2196/50346",
url="https://formative.jmir.org/2023/1/e50346",
url="http://www.ncbi.nlm.nih.gov/pubmed/37651169"
}


@Article{info:doi/10.2196/44810,
author="Emanuel, K. Rebecca H.
and Docherty, D. Paul
and Lunt, Helen
and Campbell, E. Rebecca",
title="Comparing Literature- and Subreddit-Derived Laboratory Values in Polycystic Ovary Syndrome (PCOS): Validation of Clinical Data Posted on PCOS Reddit Forums",
journal="JMIR Form Res",
year="2023",
month="Aug",
day="25",
volume="7",
pages="e44810",
keywords="androgens",
keywords="clinical treatment",
keywords="cohort",
keywords="laboratory tests",
keywords="medical intervention",
keywords="metabolic markers",
keywords="online forum",
keywords="ovary",
keywords="PCOS",
keywords="polycystic ovary syndrome",
keywords="reddit",
keywords="reproductive hormones",
keywords="reproductive",
keywords="social media",
keywords="validation study",
abstract="Background: Polycystic ovary syndrome (PCOS) is a heterogeneous condition that affects 4\% to 21\% of people with ovaries. Inaccessibility or dissatisfaction with clinical treatment for PCOS has led to some individuals with the condition discussing their experiences in specialized web-based forums. Objective: This study explores the feasibility of using such web-based forums for clinical research purposes by gathering and analyzing laboratory test results posted in an active PCOS forum, specifically the PCOS subreddit hosted on Reddit. Methods: We gathered around 45,000 posts from the PCOS subreddit. A random subset of 5000 posts was manually read, and the presence of laboratory test results was labeled. These labeled posts were used to train a machine learning model to identify which of the remaining posts contained laboratory results. The laboratory results were extracted manually from the identified posts. These self-reported laboratory test results were compared with values in the published literature to assess whether the results were concordant with researcher-published values for PCOS cohorts. A total of 10 papers were chosen to represent published PCOS literature, with selection criteria including the Rotterdam diagnostic criteria for PCOS, a publication date within the last 20 years, and at least 50 participants with PCOS. Results: Overall, the general trends observed in the laboratory test results from the PCOS web-based forum were consistent with clinically reported PCOS. A number of results, such as follicle stimulating hormone, fasting insulin, and anti-Mullerian hormone, were concordant with published values for patients with PCOS. The high consistency of these results among the literature and when compared to the subreddit suggests that follicle stimulating hormone, fasting insulin, and anti-Mullerian hormone are more consistent across PCOS phenotypes than other test results. Some results, such as testosterone, sex hormone--binding globulin, and homeostasis model assessment--estimated insulin resistance index, were between those of PCOS literature values and normal values, as defined by clinical testing limits. Interestingly, other results, including dehydroepiandrosterone sulfate, luteinizing hormone, and fasting glucose, appeared to be slightly more dysregulated than those reported in the literature. Conclusions: The differences between the forum-posted results and those published in the literature may be due to the selection process in clinical studies and the possibility that the forum disproportionally describes PCOS phenotypes that are less likely to be alleviated with medical intervention. However, the degree of concordance in most laboratory test values implied that the PCOS web-based forum participants were representative of research-identified PCOS cohorts. This validation of the PCOS subreddit grants the possibility for more research into the contents of the subreddit and the idea of undertaking similar research using the contents of other medical internet forums. ",
doi="10.2196/44810",
url="https://formative.jmir.org/2023/1/e44810",
url="http://www.ncbi.nlm.nih.gov/pubmed/37624626"
}


@Article{info:doi/10.2196/45583,
author="Jones, M. Christopher
and Diethei, Daniel
and Sch{\"o}ning, Johannes
and Shrestha, Rehana
and Jahnel, Tina
and Sch{\"u}z, Benjamin",
title="Impact of Social Reference Cues on Misinformation Sharing on Social Media: Series of Experimental Studies",
journal="J Med Internet Res",
year="2023",
month="Aug",
day="24",
volume="25",
pages="e45583",
keywords="misinformation",
keywords="social media",
keywords="health literacy",
keywords="COVID-19",
keywords="fake news",
keywords="Twitter",
keywords="tweet",
keywords="infodemiology",
keywords="information behavior",
keywords="information sharing",
keywords="sharing behavior",
keywords="behavior change",
keywords="social cue",
keywords="social reference",
keywords="flag",
abstract="Background: Health-related misinformation on social media is a key challenge to effective and timely public health responses. Existing mitigation measures include flagging misinformation or providing links to correct information, but they have not yet targeted social processes. Current approaches focus on increasing scrutiny, providing corrections to misinformation (debunking), or alerting users prospectively about future misinformation (prebunking and inoculation). Here, we provide a test of a complementary strategy that focuses on the social processes inherent in social media use, in particular, social reinforcement, social identity, and injunctive norms. Objective: This study aimed to examine whether providing balanced social reference cues (ie, cues that provide information on users sharing and, more importantly, not sharing specific content) in addition to flagging COVID-19--related misinformation leads to reductions in sharing behavior and improvement in overall sharing quality. Methods: A total of 3 field experiments were conducted on Twitter's native social media feed (via a newly developed browser extension). Participants' feed was augmented to include misleading and control information, resulting in 4 groups: no-information control, Twitter's own misinformation warning (misinformation flag), social cue only, and combined misinformation flag and social cue. We tracked the content shared or liked by participants. Participants were provided with social information by referencing either their personal network on Twitter or all Twitter users. Results: A total of 1424 Twitter users participated in 3 studies (n=824, n=322, and n=278). Across all 3 studies, we found that social cues that reference users' personal network combined with a misinformation flag reduced the sharing of misleading but not control information and improved overall sharing quality. We show that this improvement could be driven by a change in injunctive social norms (study 2) but not social identity (study 3). Conclusions: Social reference cues combined with misinformation flags can significantly and meaningfully reduce the amount of COVID-19--related misinformation shared and improve overall sharing quality. They are a feasible and scalable way to effectively curb the sharing of COVID-19--related misinformation on social media. ",
doi="10.2196/45583",
url="https://www.jmir.org/2023/1/e45583",
url="http://www.ncbi.nlm.nih.gov/pubmed/37616030"
}


@Article{info:doi/10.2196/45150,
author="AL-Rumhi, Alya
and AL-Rasbi, Samira
and Momani, M. Aaliyah",
title="The Use of Social Media by Clinical Nurse Specialists at a Tertiary Hospital: Mixed Methods Study",
journal="JMIR Nursing",
year="2023",
month="Aug",
day="24",
volume="6",
pages="e45150",
keywords="social media",
keywords="clinical nurse specialist",
keywords="cross-sectional",
keywords="tertiary hospital",
keywords="Oman",
keywords="health education tool",
abstract="Background: Recently, many health care professionals, who use social media to communicate with patients and colleagues, share information about medical research and promote public health campaigns. Objective: This study aimed to examine the motives, barriers, and implementation of social media use among clinical nurse specialists in Oman. Methods: A mixed methods study was conducted among 47 clinical nurse specialists at Sultan Qaboos University Hospital between November and December 2020. Qualitative data were collected using an open-ended questionnaire and analyzed using thematic analysis, and quantitative data were collected with a questionnaire and analyzed using SPSS (version 21.0; IBM Corp). Results: Of the 47 clinical nurse specialists surveyed, 43 (91.5\%) responded. All respondents reported using social media applications, with WhatsApp being the most commonly used platform. Most respondents (n=18, 41.9\%) spent 1-2 hours per day on social media. The main motives for using social media were increasing knowledge, communication, reaching patients easily, and reducing the number of hospital visits. The main barriers to social media use were privacy concerns, time constraints, and a lack of awareness of legal guidelines for social media use in the workplace. All participants requested clear rules and regulations regarding the use of social media among health care providers in the future. Conclusions: Social media has the option to be a powerful institutional communication and health education tool for clinical nurse specialists in Oman. However, several obstacles must be addressed, including privacy concerns and the need for clear guidelines on social media use in the workplace. Our findings suggest that health care institutions and clinical nurse specialists must work together to overcome these impediments and leverage the benefits of social media for health care.Bottom of Form ",
doi="10.2196/45150",
url="https://nursing.jmir.org/2023/1/e45150",
url="http://www.ncbi.nlm.nih.gov/pubmed/37616026"
}


@Article{info:doi/10.2196/42669,
author="Vargas Meza, Xanat
and Park, Woo Han",
title="Information Circulation Among Spanish-Speaking and Caribbean Communities Related to COVID-19: Social Media--Based Multidimensional Analysis",
journal="J Med Internet Res",
year="2023",
month="Aug",
day="23",
volume="25",
pages="e42669",
keywords="COVID-19",
keywords="social media",
keywords="Spanish",
keywords="multidimensional analysis",
keywords="Caribbean",
keywords="accessibility",
abstract="Background: Scienti?c studies from North America and Europe tend to predominate the internet and bene?t English-speaking users. Meanwhile, the COVID-19 death rate was high at the onset of the pandemic in Spanish-speaking countries, and information about nearby Caribbean countries was rarely highlighted. Given the rise in social media use in these regions, the web-based dissemination of scientific information related to COVID-19 must be thoroughly examined. Objective: This study aimed to provide a multidimensional analysis of peer-reviewed information circulation related to COVID-19 in Spanish-speaking and Caribbean regions. Methods: COVID-19--related, peer-reviewed resources shared by web-based accounts located in Spanish-speaking and Caribbean regions were identified through the Altmetric website, and their information was collected. A multidimensional model was used to examine these resources, considering time, individuality, place, activity, and relations. Time was operationalized as the 6 dates of data collection, individuality as the knowledge area and accessibility level, place as the publication venue and affiliation countries, activity as the Altmetric score and number of mentions in the selected regions, and relations as coauthorship between countries and types of social media users who disseminated COVID-19--related information. Results: The highest information circulation peaks in Spanish-speaking countries were from April 2020 to August 2020 and from December 2020 to April 2021, whereas the highest peaks in Caribbean regions were from December 2019 to April 2020. Regarding Spanish-speaking regions, at the onset of the pandemic, scientific expertise was concentrated on a few peer-reviewed sources written in English. The top scienti?c journals mentioned were from English-speaking, westernized regions, whereas the top scienti?c authorships were from China. The most mentioned scientific resources were about breakthrough findings in the medical and health sciences area, written in highly technical language. The top relationships were self-loops in China, whereas international collaborations were between China and the United States. Argentina had high closeness and betweenness, and Spain had high closeness. On the basis of social media data, a combination of media outlets; educational institutions; and expert associations, particularly from Panama, influenced the diffusion of peer-reviewed information. Conclusions: We determined the diffusion patterns of peer-reviewed resources in Spanish-speaking countries and Caribbean territories. This study aimed to advance the management and analysis of web-based public data from non-white people to improve public health communication in their regions. ",
doi="10.2196/42669",
url="https://www.jmir.org/2023/1/e42669",
url="http://www.ncbi.nlm.nih.gov/pubmed/37402284"
}


@Article{info:doi/10.2196/43685,
author="Alvarez-Mon, Angel Miguel
and Pereira-Sanchez, Victor
and Hooker, R. Elizabeth
and Sanchez, Facundo
and Alvarez-Mon, Melchor
and Teo, R. Alan",
title="Content and User Engagement of Health-Related Behavior Tweets Posted by Mass Media Outlets From Spain and the United States Early in the COVID-19 Pandemic: Observational Infodemiology Study",
journal="JMIR Infodemiology",
year="2023",
month="Aug",
day="22",
volume="3",
pages="e43685",
keywords="COVID-19",
keywords="health communication",
keywords="social media",
keywords="Twitter",
keywords="health promotion",
keywords="public health",
keywords="mass media",
abstract="Background: During the early pandemic, there was substantial variation in public and government responses to COVID-19 in Europe and the United States. Mass media are a vital source of health information and news, frequently disseminating this information through social media, and may influence public and policy responses to the pandemic. Objective: This study aims to describe the extent to which major media outlets in the United States and Spain tweeted about health-related behaviors (HRBs) relevant to COVID-19, compare the tweeting patterns between media outlets of both countries, and determine user engagement in response to these tweets. Methods: We investigated tweets posted by 30 major media outlets (n=17, 57\% from Spain and n=13, 43\% from the United States) between December 1, 2019 and May 31, 2020, which included keywords related to HRBs relevant to COVID-19. We classified tweets into 6 categories: mask-wearing, physical distancing, handwashing, quarantine or confinement, disinfecting objects, or multiple HRBs (any combination of the prior HRB categories). Additionally, we assessed the likes and retweets generated by each tweet. Poisson regression analyses compared the average predicted number of likes and retweets between the different HRB categories and between countries. Results: Of 50,415 tweets initially collected, 8552 contained content associated with an HRB relevant to COVID-19. Of these, 600 were randomly chosen for training, and 2351 tweets were randomly selected for manual content analysis. Of the 2351 COVID-19--related tweets included in the content analysis, 62.91\% (1479/2351) mentioned at least one HRB. The proportion of COVID-19 tweets mentioning at least one HRB differed significantly between countries (P=.006). Quarantine or confinement was mentioned in nearly half of all the HRB tweets in both countries. In contrast, the least frequently mentioned HRBs were disinfecting objects in Spain 6.9\% (56/809) and handwashing in the United States 9.1\% (61/670). For tweets from the United States mentioning at least one HRB, disinfecting objects had the highest median likes and retweets, whereas mask-wearing-- and handwashing-related tweets achieved the highest median number of likes in Spain. Tweets from Spain that mentioned social distancing or disinfecting objects had a significantly lower predicted count of likes compared with tweets mentioning a different HRB (P=.02 and P=.01, respectively). Tweets from the United States that mentioned quarantine or confinement or disinfecting objects had a significantly lower predicted number of likes compared with tweets mentioning a different HRB (P<.001), whereas mask- and handwashing-related tweets had a significantly greater predicted number of likes (P=.04 and P=.02, respectively). Conclusions: The type of HRB content and engagement with media outlet tweets varied between Spain and the United States early in the pandemic. However, content related to quarantine or confinement and engagement with handwashing was relatively high in both countries. ",
doi="10.2196/43685",
url="https://infodemiology.jmir.org/2023/1/e43685",
url="http://www.ncbi.nlm.nih.gov/pubmed/37347948"
}


@Article{info:doi/10.2196/46415,
author="Griggs, Stephanie
and Ash, I. Garrett
and Pignatiello, Grant
and Papik, AnnMarie
and Huynh, Johnathan
and Leuchtag, Mary
and Hickman Jr, L. Ronald",
title="Internet-Based Recruitment and Retention of Young Adults With Type 1 Diabetes: Cross-Sectional Study",
journal="JMIR Form Res",
year="2023",
month="Aug",
day="22",
volume="7",
pages="e46415",
keywords="type 1 diabetes",
keywords="internet-based recruitment",
keywords="young adult",
keywords="diabetes",
keywords="diabetic",
keywords="type 1",
keywords="recruit",
keywords="research platform",
keywords="T1D",
keywords="social media",
keywords="research subject",
keywords="research participant",
keywords="study participant",
abstract="Background: Multiple research strategies are required to recruit and engage a representative cohort of young adults in diabetes research. In this report, we describe an approach for internet-based recruitment for a repeated-measures descriptive study. Objective: The objective of this cross-sectional study was to determine whether internet-based recruitment through multiple social media platforms, a clinical research platform, and cooperation with community partnerships---College Diabetes Network and Beyond Type 1---would serve as an effective way to recruit a representative sample of young adults aged 18-25 years with type 1 diabetes (T1D). Methods: We conducted a repeated-measures descriptive study. We captured enrollment rates and participant characteristics acquired from each social media platform through survey data and Facebook analytics. This study was advertised via paid postings across a combination of different social media platforms (eg, Facebook, Instagram, Twitter, and Reddit). We used quarterly application postings, quarterly newsletters, and participation in the ResearchMatch registry to identify potentially eligible participants from February 3, 2021, to June 6, 2022. Results: ResearchMatch proved to be the most cost-effective strategy overall, yielding the highest gender and racial diversity compared to other internet platforms (eg, Facebook, Instagram, Twitter, and Reddit), application postings (eg, Beyond Type 1), and newsletters (eg, College Diabetes Network and a local area college). However, we propose that the combination of these approaches yielded a larger, more diverse sample compared to any individual strategy. Our recruitment cost was US \$16.69 per eligible participant, with a 1.27\% conversion rate and a 30\% eligibility rate. Conclusions: Recruiting young adults with T1D across multiple internet-based platforms was an effective strategy to yield a moderately diverse sample. Leveraging various recruitment strategies is necessary to produce a representative sample of young adults with T1D. As the internet becomes a larger forum for study recruitment, participants from underrepresented backgrounds may continue engaging in research through advertisements on the internet and other internet-based recruitment platforms. ",
doi="10.2196/46415",
url="https://formative.jmir.org/2023/1/e46415",
url="http://www.ncbi.nlm.nih.gov/pubmed/37606985"
}


@Article{info:doi/10.2196/47317,
author="White, K. Becky
and Gombert, Arnault
and Nguyen, Tim
and Yau, Brian
and Ishizumi, Atsuyoshi
and Kirchner, Laura
and Le{\'o}n, Alicia
and Wilson, Harry
and Jaramillo-Gutierrez, Giovanna
and Cerquides, Jesus
and D'Agostino, Marcelo
and Salvi, Cristiana
and Sreenath, Shankar Ravi
and Rambaud, Kimberly
and Samhouri, Dalia
and Briand, Sylvie
and Purnat, D. Tina",
title="Using Machine Learning Technology (Early Artificial Intelligence--Supported Response With Social Listening Platform) to Enhance Digital Social Understanding for the COVID-19 Infodemic: Development and Implementation Study",
journal="JMIR Infodemiology",
year="2023",
month="Aug",
day="21",
volume="3",
pages="e47317",
keywords="infodemic",
keywords="sentiment",
keywords="narrative analysis",
keywords="social listening",
keywords="natural language processing",
keywords="social media",
keywords="public health",
keywords="pandemic preparedness",
keywords="pandemic response",
keywords="artificial intelligence",
keywords="AI text analytics",
keywords="COVID-19",
keywords="information voids",
keywords="machine learning",
abstract="Background: Amid the COVID-19 pandemic, there has been a need for rapid social understanding to inform infodemic management and response. Although social media analysis platforms have traditionally been designed for commercial brands for marketing and sales purposes, they have been underused and adapted for a comprehensive understanding of social dynamics in areas such as public health. Traditional systems have challenges for public health use, and new tools and innovative methods are required. The World Health Organization Early Artificial Intelligence--Supported Response with Social Listening (EARS) platform was developed to overcome some of these challenges. Objective: This paper describes the development of the EARS platform, including data sourcing, development, and validation of a machine learning categorization approach, as well as the results from the pilot study. Methods: Data for EARS are collected daily from web-based conversations in publicly available sources in 9 languages. Public health and social media experts developed a taxonomy to categorize COVID-19 narratives into 5 relevant main categories and 41 subcategories. We developed a semisupervised machine learning algorithm to categorize social media posts into categories and various filters. To validate the results obtained by the machine learning--based approach, we compared it to a search-filter approach, applying Boolean queries with the same amount of information and measured the recall and precision. Hotelling T2 was used to determine the effect of the classification method on the combined variables. Results: The EARS platform was developed, validated, and applied to characterize conversations regarding COVID-19 since December 2020. A total of 215,469,045 social posts were collected for processing from December 2020 to February 2022. The machine learning algorithm outperformed the Boolean search filters method for precision and recall in both English and Spanish languages (P<.001). Demographic and other filters provided useful insights on data, and the gender split of users in the platform was largely consistent with population-level data on social media use. Conclusions: The EARS platform was developed to address the changing needs of public health analysts during the COVID-19 pandemic. The application of public health taxonomy and artificial intelligence technology to a user-friendly social listening platform, accessible directly by analysts, is a significant step in better enabling understanding of global narratives. The platform was designed for scalability; iterations and new countries and languages have been added. This research has shown that a machine learning approach is more accurate than using only keywords and has the benefit of categorizing and understanding large amounts of digital social data during an infodemic. Further technical developments are needed and planned for continuous improvements, to meet the challenges in the generation of infodemic insights from social media for infodemic managers and public health professionals. ",
doi="10.2196/47317",
url="https://infodemiology.jmir.org/2023/1/e47317",
url="http://www.ncbi.nlm.nih.gov/pubmed/37422854"
}


@Article{info:doi/10.2196/43703,
author="Sigalo, Nekabari
and Awasthi, Naman
and Abrar, Mohammad Saad
and Frias-Martinez, Vanessa",
title="Using COVID-19 Vaccine Attitudes on Twitter to Improve Vaccine Uptake Forecast Models in the United States: Infodemiology Study of Tweets",
journal="JMIR Infodemiology",
year="2023",
month="Aug",
day="21",
volume="3",
pages="e43703",
keywords="social media",
keywords="Twitter",
keywords="COVID-19",
keywords="vaccine",
keywords="surveys",
keywords="SARS-CoV-2",
keywords="vaccinations",
keywords="hesitancy",
keywords="vaccine hesitancy",
keywords="forecast model",
keywords="vaccine uptake",
keywords="health promotion",
keywords="infodemiology",
keywords="health information",
keywords="misinformation",
abstract="Background: Since the onset of the COVID-19 pandemic, there has been a global effort to develop vaccines that protect against COVID-19. Individuals who are fully vaccinated are far less likely to contract and therefore transmit the virus to others. Researchers have found that the internet and social media both play a role in shaping personal choices about vaccinations. Objective: This study aims to determine whether supplementing COVID-19 vaccine uptake forecast models with the attitudes found in tweets improves over baseline models that only use historical vaccination data. Methods: Daily COVID-19 vaccination data at the county level was collected for the January 2021 to May 2021 study period. Twitter's streaming application programming interface was used to collect COVID-19 vaccine tweets during this same period. Several autoregressive integrated moving average models were executed to predict the vaccine uptake rate using only historical data (baseline autoregressive integrated moving average) and individual Twitter-derived features (autoregressive integrated moving average exogenous variable model). Results: In this study, we found that supplementing baseline forecast models with both historical vaccination data and COVID-19 vaccine attitudes found in tweets reduced root mean square error by as much as 83\%. Conclusions: Developing a predictive tool for vaccination uptake in the United States will empower public health researchers and decisionmakers to design targeted vaccination campaigns in hopes of achieving the vaccination threshold required for the United States to reach widespread population protection. ",
doi="10.2196/43703",
url="https://infodemiology.jmir.org/2023/1/e43703",
url="http://www.ncbi.nlm.nih.gov/pubmed/37390402"
}


@Article{info:doi/10.2196/47530,
author="Quijote, Llew Kirk
and Casta{\~n}eda, Therese Arielle Marie
and Guevara, Edgar Bryan
and Tangtatco, Aileen Jennifer",
title="A Descriptive Analysis of Dermatology Content and Creators on Social Media in the Philippines",
journal="JMIR Dermatol",
year="2023",
month="Aug",
day="21",
volume="6",
pages="e47530",
keywords="social media",
keywords="dermatology",
keywords="dermatologist",
keywords="creator",
keywords="content",
keywords="impact",
keywords="Philippines",
keywords="Facebook",
keywords="Instagram",
keywords="Twitter",
keywords="TikTok",
keywords="YouTube",
doi="10.2196/47530",
url="https://derma.jmir.org/2023/1/e47530",
url="http://www.ncbi.nlm.nih.gov/pubmed/37603392"
}


@Article{info:doi/10.2196/45146,
author="Shin, Hocheol
and Yuniar, Tri Cindra
and Oh, SuA
and Purja, Sujata
and Park, Sera
and Lee, Haeun
and Kim, Eunyoung",
title="The Adverse Effects and Nonmedical Use of Methylphenidate Before and After the Outbreak of COVID-19: Machine Learning Analysis",
journal="J Med Internet Res",
year="2023",
month="Aug",
day="16",
volume="25",
pages="e45146",
keywords="methylphenidate",
keywords="attention-deficit/hyperactivity disorder (ADHD)",
keywords="social network services",
keywords="adverse effect",
keywords="nonmedical use",
keywords="machine learning",
keywords="deep learning",
keywords="child",
keywords="adolescent",
keywords="psychiatric disorder",
abstract="Background: Methylphenidate is an effective first-line treatment for attention-deficit/hyperactivity disorder (ADHD). However, many adverse effects of methylphenidate have been recorded from randomized clinical trials and patient-reported outcomes, but it is difficult to determine abuse from them. In the context of COVID-19, it is important to determine how drug use evaluation, as well as misuse of drugs, have been affected by the pandemic. As people share their reasons for using medication, patient sentiments, and the effects of medicine on social networking services (SNSs), the application of machine learning and SNS data can be a method to overcome the limitations. Proper machine learning models could be evaluated to validate the effects of the COVID-19 pandemic on drug use. Objective: To analyze the effect of the COVID-19 pandemic on the use of methylphenidate, this study analyzed the adverse effects and nonmedical use of methylphenidate and evaluated the change in frequency of nonmedical use based on SNS data before and after the outbreak of COVID-19. Moreover, the performance of 4 machine learning models for classifying methylphenidate use based on SNS data was compared. Methods: In this cross-sectional study, SNS data on methylphenidate from Twitter, Facebook, and Instagram from January 2019 to December 2020 were collected. The frequency of adverse effects, nonmedical use, and drug use before and after the COVID-19 pandemic were compared and analyzed. Interrupted time series analysis about the frequency and trends of nonmedical use of methylphenidate was conducted for 24 months from January 2019 to December 2020. Using the labeled training data set and features, the following 4 machine learning models were built using the data, and their performance was evaluated using F-1 scores: na{\"i}ve Bayes classifier, random forest, support vector machine, and long short-term memory. Results: This study collected 146,352 data points and detected that 4.3\% (6340/146,352) were firsthand experience data. Psychiatric problems (521/1683, 31\%) had the highest frequency among the adverse effects. The highest frequency of nonmedical use was for studies or work (741/2016, 36.8\%). While the frequency of nonmedical use before and after the outbreak of COVID-19 has been similar (odds ratio [OR] 1.02 95\% CI 0.91-1.15), its trend has changed significantly due to the pandemic (95\% CI 2.36-22.20). Among the machine learning models, RF had the highest performance of 0.75. Conclusions: The trend of nonmedical use of methylphenidate has changed significantly due to the COVID-19 pandemic. Among the machine learning models using SNS data to analyze the adverse effects and nonmedical use of methylphenidate, the random forest model had the highest performance. ",
doi="10.2196/45146",
url="https://www.jmir.org/2023/1/e45146",
url="http://www.ncbi.nlm.nih.gov/pubmed/37585250"
}


@Article{info:doi/10.2196/43011,
author="Dasgupta, Pritam
and Amin, Janaki
and Paris, Cecile
and MacIntyre, Raina C.",
title="News Coverage of Face Masks in Australia During the Early COVID-19 Pandemic: Topic Modeling Study",
journal="JMIR Infodemiology",
year="2023",
month="Aug",
day="16",
volume="3",
pages="e43011",
keywords="face masks",
keywords="mask",
keywords="COVID-19",
keywords="web-based news",
keywords="community sentiment",
keywords="topic modeling",
keywords="latent Dirichlet allocation",
abstract="Background: During the COVID-19 pandemic, web-based media coverage of preventative strategies proliferated substantially. News media was constantly informing people about changes in public health policy and practices such as mask-wearing. Hence, exploring news media content on face mask use is useful to analyze dominant topics and their trends. Objective: The aim of the study was to examine news related to face masks as well as to identify related topics and temporal trends in Australian web-based news media during the early COVID-19 pandemic period. Methods: Following data collection from the Google News platform, a trend analysis on the mask-related news titles from Australian news publishers was conducted. Then, a latent Dirichlet allocation topic modeling algorithm was applied along with evaluation matrices (quantitative and qualitative measures). Afterward, topic trends were developed and analyzed in the context of mask use during the pandemic. Results: A total of 2345 face mask--related eligible news titles were collected from January 25, 2020, to January 25, 2021. Mask-related news showed an increasing trend corresponding to increasing COVID-19 cases in Australia. The best-fitted latent Dirichlet allocation model discovered 8 different topics with a coherence score of 0.66 and a perplexity measure of --11.29. The major topics were T1 (mask-related international affairs), T2 (introducing mask mandate in places such as Melbourne and Sydney), and T4 (antimask sentiment). Topic trends revealed that T2 was the most frequent topic in January 2021 (77 news titles), corresponding to the mandatory mask-wearing policy in Sydney. Conclusions: This study demonstrated that Australian news media reflected a wide range of community concerns about face masks, peaking as COVID-19 incidence increased. Harnessing the news media platforms for understanding the media agenda and community concerns may assist in effective health communication during a pandemic response. ",
doi="10.2196/43011",
url="https://infodemiology.jmir.org/2023/1/e43011",
url="http://www.ncbi.nlm.nih.gov/pubmed/37379362"
}


@Article{info:doi/10.2196/45381,
author="Goel, Rahul
and Modhukur, Vijayachitra
and T{\"a}{\"a}r, Katrin
and Salumets, Andres
and Sharma, Rajesh
and Peters, Maire",
title="Users' Concerns About Endometriosis on Social Media: Sentiment Analysis and Topic Modeling Study",
journal="J Med Internet Res",
year="2023",
month="Aug",
day="15",
volume="25",
pages="e45381",
keywords="endometriosis",
keywords="latent Dirichlet allocation",
keywords="pain",
keywords="Reddit",
keywords="sentiment analysis",
keywords="social media",
keywords="surgery",
keywords="topic modeling",
keywords="user engagement",
abstract="Background: Endometriosis is a debilitating and difficult-to-diagnose gynecological disease. Owing to limited information and awareness, women often rely on social media platforms as a support system to engage in discussions regarding their disease-related concerns. Objective: This study aimed to apply computational techniques to social media posts to identify discussion topics about endometriosis and to identify themes that require more attention from health care professionals and researchers. We also aimed to explore whether, amid the challenging nature of the disease, there are themes within the endometriosis community that gather posts with positive sentiments. Methods: We retrospectively extracted posts from the subreddits r/Endo and r/endometriosis from January 2011 to April 2022. We analyzed 45,693 Reddit posts using sentiment analysis and topic modeling--based methods in machine learning. Results: Since 2011, the number of posts and comments has increased steadily. The posts were categorized into 11 categories, and the highest number of posts were related to either asking for information (Question); sharing the experiences (Rant/Vent); or diagnosing and treating endometriosis, especially surgery (Surgery related). Sentiment analysis revealed that 92.09\% (42,077/45,693) of posts were associated with negative sentiments, only 2.3\% (1053/45,693) expressed positive feelings, and there were no categories with more positive than negative posts. Topic modeling revealed 27 major topics, and the most popular topics were Surgery, Questions/Advice, Diagnosis, and Pain. The Survey/Research topic, which brought together most research-related posts, was the last in terms of posts. Conclusions: Our study shows that posts on social media platforms can provide insights into the concerns of women with endometriosis symptoms. The analysis of the posts confirmed that women with endometriosis have to face negative emotions and pain daily. The large number of posts related to asking questions shows that women do not receive sufficient information from physicians and need community support to cope with the disease. Health care professionals should pay more attention to the symptoms and diagnosis of endometriosis, discuss these topics with patients to reduce their dissatisfaction with doctors, and contribute more to the overall well-being of women with endometriosis. Researchers should also become more involved in social media and share new science-based knowledge regarding endometriosis. ",
doi="10.2196/45381",
url="https://www.jmir.org/2023/1/e45381",
url="http://www.ncbi.nlm.nih.gov/pubmed/37581905"
}


@Article{info:doi/10.2196/44453,
author="Byrne, Catrin
and Pfeffer, E. Paul
and De Simoni, Anna",
title="Experiences of Diagnosis, Symptoms, and Use of Reliever Inhalers in Patients With Asthma and Concurrent Inducible Laryngeal Obstruction or Breathing Pattern Disorder: Qualitative Analysis of a UK Asthma Online Community",
journal="J Med Internet Res",
year="2023",
month="Aug",
day="14",
volume="25",
pages="e44453",
keywords="asthma",
keywords="breathing pattern disorder",
keywords="inducible laryngeal obstruction",
keywords="BPD",
keywords="ILO",
keywords="short-acting beta-agonist",
keywords="salbutamol",
keywords="breathing disorder",
keywords="breathing",
keywords="chest tightness",
keywords="community",
keywords="symptoms",
keywords="diagnosis",
abstract="Background: Breathing pattern disorders (BPDs) and inducible laryngeal obstruction (ILO) cause similar symptoms to asthma, including dyspnea and chest tightness, with an estimated prevalence of up to one-fifth of patients with asthma. Both conditions can be comorbid with asthma, and there is evidence that they are misdiagnosed and mistreated as asthma. Objective: This study aims to explore whether the symptoms of ILO and BPD were topics of discussion in a UK asthma online health community and patient experiences of diagnosis and treatment, in particular their use of reliever inhalers. Methods: A qualitative thematic analysis was performed with posts from an asthma community between 2018 and 2022. A list of key ILO or BPD symptoms was created from the literature. Posts were identified using the search terms ``blue inhaler'' and ``breath'' and included if describing key symptoms. Discussion threads of included posts were also analyzed. Results: The search retrieved a total of 1127 relevant posts: 1069 written by 302 users and 58 posted anonymously. All participants were adults, except 2 who were parents writing about their children. Sex and age were only available for 1.66\% (5/302; 3 females and 2 males) and 9.93\% (30/302) of participants (27 to 73 years old), respectively. The average number of posts written by each participant was 3.54 (range 1-63). Seven participants wrote >20 posts each. Participants experiencing undiagnosed ILO or BPD symptoms, whether or not comorbid with asthma, expressed frustration with the ``one-size-fits-all'' approach to diagnosis, as many felt that their asthma diagnosis did not fully explain symptoms. Some suspected or were formally diagnosed with BPD or ILO, the latter reporting relief on receiving a diagnosis and appropriate management. Participants showed awareness of their inappropriate salbutamol use or overuse due to lack of effect on symptoms. BPD and ILO symptoms were frequently comorbid with asthma. The asthma online community was a valuable resource: engagement with peers not only brought comfort but also prompted action with some going back to their clinicians and reaching a diagnosis and appropriate management. Conclusions: Undiagnosed ILO and BPD symptoms and lack of effects of asthma treatment were topics of discussion in an asthma online community, caused distress and frustration in participants, and affected their relationship with health care professionals, showing that patients experiencing BPD and ILO have unmet needs. Clinicians' education on BPD and ILO diagnosis and management, as well as increased access to appropriate management options, such as respiratory physiotherapy and speech and language therapy, are warranted particularly in primary care. Qualitative evidence that engagement with the online community resulted in patients taking action going back to their clinicians and reaching a diagnosis of ILO and BPD prompts future research on online peer support from an established online health community as a self-management resource for patients. ",
doi="10.2196/44453",
url="https://www.jmir.org/2023/1/e44453",
url="http://www.ncbi.nlm.nih.gov/pubmed/37578820"
}


@Article{info:doi/10.2196/44813,
author="Raggatt, Michelle
and Wright, C. Cassandra J.
and Sacks-Davis, Rachel
and Dietze, M. Paul
and Hellard, E. Margaret
and Hocking, S. Jane
and Lim, C. Megan S.",
title="Identifying the Most Effective Recruitment Strategy Using Financial Reimbursements for a Web-Based Peer Network Study With Young People Aged 16-18 Years: Protocol for a Randomized Controlled Trial",
journal="JMIR Res Protoc",
year="2023",
month="Aug",
day="11",
volume="12",
pages="e44813",
keywords="young adult",
keywords="incentive reimbursement",
keywords="research subject",
keywords="study participant",
keywords="financial",
keywords="research subject recruitment",
keywords="social network",
keywords="peer network",
keywords="web-based network",
keywords="randomized",
keywords="friend",
keywords="recruit",
keywords="incentive",
keywords="reimburse",
keywords="reward",
keywords="incentivized",
keywords="youth",
keywords="adolescent",
keywords="teenage",
keywords="recruitment",
keywords="reinforcing factor",
keywords="enabling factor",
keywords="disambiguation",
keywords="intrinsic incentive",
keywords="extrinsic incentive",
keywords="motivation",
keywords="reward system",
keywords="positive reinforcement",
keywords="compensation",
keywords="monetary",
keywords="remuneration",
keywords="remunerative incentive",
keywords="financial incentive",
keywords="bonus",
keywords="stipend",
keywords="donation",
abstract="Background: Peers are an important determinant of health and well-being during late adolescence; however, there is limited quantitative research examining peer influence. Previous peer network research with adolescents faced methodological limitations and difficulties recruiting young people. Objective: This study aims to determine whether a web-based peer network survey is effective at recruiting adolescent peer networks by comparing 2 strategies for reimbursement. Methods: This study will use a 2-group randomized trial design to test the effectiveness of reimbursements for peer referral in a web-based cross-sectional peer network survey. Young people aged 16-18 years recruited through Instagram, Snapchat, and a survey panel will be randomized to receive either scaled group reimbursement (the experimental group) or fixed individual reimbursement (the control group). All participants will receive a reimbursement of Aus \$5 (US \$3.70) for their own survey completion. In the experimental group (scaled group reimbursement), all participants within a peer network will receive an additional Aus \$5 (US \$3.70) voucher for each referred participant who completes the study, up to a maximum total value of Aus \$30 (US \$22.20) per participant. In the control group (fixed individual reimbursement), participants will only be reimbursed for their own survey completion. Participants' peer networks are assessed during the survey by asking about their close friends. A unique survey link will be generated to share with the participant's nominated friends for the recruitment of secondary participants. Outcomes are the proportion of a participant's peer network and the number of referred peers who complete the survey. The required sample size is 306 primary participants. Using a multilevel logistic regression model, we will assess the effect of the reimbursement intervention on the proportion of primary participants' close friends who complete the survey. The secondary aim is to determine participant characteristics that are associated with successfully recruiting close friends. Young people aged 16-18 years were involved in the development of the study design through focus groups and interviews (n=26). Results: Participant recruitment commenced in 2022. Conclusions: A longitudinal web-based social network study could provide important data on how social networks and their influence change over time. This trial aims to determine whether scaled group reimbursement can increase the number of peers referred. The outcomes of this trial will improve the recruitment of young people to web-based network studies of sensitive health issues. International Registered Report Identifier (IRRID): DERR1-10.2196/44813 ",
doi="10.2196/44813",
url="https://www.researchprotocols.org/2023/1/e44813",
url="http://www.ncbi.nlm.nih.gov/pubmed/37566448"
}


@Article{info:doi/10.2196/40003,
author="Long, Memphis
and Forbes, E. Laura
and Papagerakis, Petros
and Lieffers, L. Jessica R.",
title="YouTube Videos on Nutrition and Dental Caries: Content Analysis",
journal="JMIR Infodemiology",
year="2023",
month="Aug",
day="10",
volume="3",
pages="e40003",
keywords="dental caries",
keywords="diet",
keywords="nutrition",
keywords="YouTube",
keywords="internet",
keywords="consumer health information",
abstract="Background: Dental caries is the most common health condition worldwide, and nutrition and dental caries have a strong interconnected relationship. Foods and eating behaviors can be both harmful (eg, sugar) and healthful (eg, meal spacing) for dental caries. YouTube is a popular source for the public to access information. To date, there is no information available on the nutrition and dental caries content of easily accessible YouTube videos. Objective: This study aimed to analyze the content of YouTube videos on nutrition and dental caries. Methods: In total, 6 YouTube searches were conducted using keywords related to nutrition and dental caries. The first 20 videos were selected from each search. Video content was scored (17 possible points; higher scores were associated with more topics covered) by 2 individuals based on the inclusion of information regarding various foods and eating behaviors that impact dental caries risk. For each video, information on video characteristics (ie, view count, length, number of likes, number of dislikes, and video age) was captured. Videos were divided into 2 groups by view rate (views/day); differences in scores and types of nutrition messages between groups were determined using nonparametric statistics. Results: In total, 42 videos were included. Most videos were posted by or featured oral health professionals (24/42, 57\%). The mean score was 4.9 (SD 3.4) out of 17 points. Videos with >30 views/day (high view rate; 20/42, 48\% videos) had a trend toward a lower score (mean 4.0, SD 3.7) than videos with ?30 views/day (low view rate; 22/42, 52\%; mean 5.8, SD 3.0; P=.06), but this result was not statistically significant. Sugar was the most consistently mentioned topic in the videos (31/42, 74\%). No other topics were mentioned in more than 50\% of videos. Low--view rate videos were more likely to mention messaging on acidic foods and beverages (P=.04), water (P=.09), and frequency of sugar intake (P=.047) than high--view rate videos. Conclusions: Overall, the analyzed videos had low scores for nutritional and dental caries content. This study provides insights into the messaging available on nutrition and dental caries for the public and guidance on how to make improvements in this area. ",
doi="10.2196/40003",
url="https://infodemiology.jmir.org/2023/1/e40003",
url="http://www.ncbi.nlm.nih.gov/pubmed/37561564"
}


@Article{info:doi/10.2196/47798,
author="Mitsuhashi, Toshiharu",
title="Assessing Vulnerability to Surges in Suicide-Related Tweets Using Japan Census Data: Case-Only Study",
journal="JMIR Form Res",
year="2023",
month="Aug",
day="10",
volume="7",
pages="e47798",
keywords="case-only approach",
keywords="mass media",
keywords="public health",
keywords="social media",
keywords="suicidal risk",
keywords="suicide prevention",
keywords="suicide",
keywords="suicide-related tweets",
keywords="Twitter",
abstract="Background: As the use of social media becomes more widespread, its impact on health cannot be ignored. However, limited research has been conducted on the relationship between social media and suicide. Little is known about individuals' vulnerable to suicide, especially when social media suicide information is extremely prevalent. Objective: This study aims to identify the characteristics underlying individuals' vulnerability to suicide brought about by an increase in suicide-related tweets, thereby contributing to public health. Methods: A case-only design was used to investigate vulnerability to suicide using individual data of people who died by suicide and tweet data from January 1, 2011, through December 31, 2014. Mortality data were obtained from Japanese government statistics, and tweet data were provided by a commercial service. Tweet data identified the days when suicide-related tweets surged, and the date-keyed merging was performed by considering 3 and 7 lag days. For the merged data set for analysis, the logistic regression model was fitted with one of the personal characteristics of interest as a dependent variable and the dichotomous exposure variable. This analysis was performed to estimate the interaction between the surges in suicide-related tweets and personal characteristics of the suicide victims as case-only odds ratios (ORs) with 95\% CIs. For the sensitivity analysis, unexpected deaths other than suicide were considered. Results: During the study period, there were 159,490 suicides and 115,072 unexpected deaths, and the number of suicide-related tweets was 2,804,999. Following the 3-day lag of a highly tweeted day, there were significant interactions for those who were aged 40 years or younger (OR 1.09, 95\% CI 1.03-1.15), male (OR 1.12, 95\% CI 1.07-1.18), divorced (OR 1.11, 95\% CI 1.03 1.19), unemployed (OR 1.12, 95\% CI 1.02-1.22), and living in urban areas (OR 1.26, 95\% CI 1.17 1.35). By contrast, widowed individuals had significantly lower interactions (OR 0.83, 95\% CI 0.77-0.89). Except for unemployment, significant relationships were also observed for the 7-day lag. For the sensitivity analysis, no significant interactions were observed for other unexpected deaths in the 3-day lag, and only the widowed had a significantly larger interaction than those who were married (OR 1.08, 95\% CI 1.02-1.15) in the 7-day lag. Conclusions: This study revealed the interactions of personal characteristics associated with susceptibility to suicide-related tweets. In addition, a few significant relationships were observed in the sensitivity analysis, suggesting that such an interaction is specific to suicide deaths. In other words, individuals with these characteristics, such as being young, male, unemployed, and divorced, may be vulnerable to surges in suicide-related tweets. Thus, minimizing public health strain by identifying people who are vulnerable and susceptible to a surge in suicide-related information on the internet is necessary. ",
doi="10.2196/47798",
url="https://formative.jmir.org/2023/1/e47798",
url="http://www.ncbi.nlm.nih.gov/pubmed/37561553"
}


@Article{info:doi/10.2196/45277,
author="McQuade, N. Casey
and Simonson, G. Michael
and Ehrenberger, A. Kristen
and Kohli, Amar",
title="Developing a Web-Based Asynchronous Case Discussion Format on Social Media to Teach Clinical Reasoning: Mixed Methods Study",
journal="JMIR Med Educ",
year="2023",
month="Aug",
day="9",
volume="9",
pages="e45277",
keywords="case discussion",
keywords="case report",
keywords="clinical reasoning",
keywords="clinical vignette",
keywords="junior doctor",
keywords="junior physician",
keywords="medical education",
keywords="medical student",
keywords="morning report",
keywords="report style",
keywords="resident",
keywords="social media",
keywords="trainee",
keywords="Twitter",
abstract="Background: Case-based learning conferences are valuable to trainees, but growing clinical demands hinder consistent attendance. Social media increasingly acts as a venue for trainees to supplement their education asynchronously. We designed and implemented a web-based asynchronous clinical case discussion series on the Twitter social media platform to fill this educational gap. Objective: The aim of this mixed methods study is to examine the nature of interactions among web-based case discussion participants and assess local attitudes regarding the educational intervention. Methods: Starting in February 2018, we posted clinical vignettes to a dedicated Twitter account with the prompt ``What else do you want to know?'' to stimulate discussion. The authors replied in real time when case discussion participants requested additional details. Additional data about the case were posted at regular intervals to the discussion thread to advance the overall case discussion. Participants were asked to explain their reasoning and support their conclusions when appropriate. Web-based engagement was assessed using Twitter Analytics. Participants' posts were qualitatively analyzed for themes, with special attention to examples of using clinical reasoning skills. A codebook of types of participant posts and interactions was refined iteratively. Local engagement and attitudes at our institution were assessed by surveying internal medicine trainees (n=182) and faculty (n=165) after 6 months. Results: Over a 6-month period, 11 live case discussions were engaged with by users 1773 times. A total of 86 Twitter profiles spanning 22 US states and 6 countries contributed to discussions among participants and the authors. Participants from all training levels were present, ranging from students to faculty. Interactions among participants and the case moderators were most commonly driven by clinical reasoning, including hypothesis-driven information gathering, discussing the differential diagnosis, and data interpretation or organization. Of 71 respondents to the local survey, 29 (41\%) reported having a Twitter account. Of the 29 respondents with Twitter accounts, 17 (59\%) reported participating in the case discussions. Respondents agreed that case participation increased both their clinical reasoning skills (15/17, 88\%) and clinical knowledge (13/17, 76\%). Conclusions: A social media--based serialized case discussion was a feasible asynchronous teaching method for engaging web-based learners of all levels in a clinical reasoning discussion. Further study should examine what factors drive trainee participation in web-based case discussions and under what circumstances asynchronous discussion might be preferred over in-person teaching activities. ",
doi="10.2196/45277",
url="https://mededu.jmir.org/2023/1/e45277",
url="http://www.ncbi.nlm.nih.gov/pubmed/37556191"
}


@Article{info:doi/10.2196/48140,
author="Thang, J. Christopher
and Garate, David
and Thang, Joseph
and Lipoff, B. Jules
and Barbieri, S. John",
title="Short-Form Medical Media: A Multi-Platform Analysis of Acne Treatment Information in TikTok Videos, Instagram Reels, and YouTube Shorts",
journal="JMIR Dermatol",
year="2023",
month="Aug",
day="9",
volume="6",
pages="e48140",
keywords="general dermatology",
keywords="medical dermatology",
keywords="acne",
keywords="acne treatment",
keywords="social media",
keywords="TikTok",
keywords="Instagram Reels",
keywords="YouTube Shorts",
keywords="YouTube",
keywords="Instagram",
keywords="video",
keywords="dermatology",
keywords="skin",
keywords="patient education",
keywords="health information",
keywords="online information",
keywords="dermatologist",
doi="10.2196/48140",
url="https://derma.jmir.org/2023/1/e48140",
url="http://www.ncbi.nlm.nih.gov/pubmed/37624704"
}


@Article{info:doi/10.2196/46841,
author="Zhao, Yusui
and Xu, Shuiyang
and Zhang, Xuehai
and Wang, Lei
and Huang, Yu
and Wu, Shuxian
and Wu, Qingqing",
title="The Effectiveness of Improving Infectious Disease--Specific Health Literacy Among Residents: WeChat-Based Health Education Intervention Program",
journal="JMIR Form Res",
year="2023",
month="Aug",
day="9",
volume="7",
pages="e46841",
keywords="effectiveness",
keywords="health education",
keywords="infectious disease-specific health literacy",
keywords="intervention",
keywords="WeChat",
abstract="Background: Infectious disease--specific health literacy (IDSHL) has become an important determinant of infectious disease incidence. It can not only reduce the incidence of re-emerging infectious diseases, but also effectively prevent the emergence of new infectious diseases such as COVID-19. WeChat, as a new media, has been proven to greatly reduce the chance of infectious diseases spreading from person to person, especially in case of respiratory infections. However, there is currently no concrete health education invention program to improve IDSHL using a WeChat public account. Objective: The aims of this study were as follows: (1) to determine the IDSHL of the population in Zhejiang, China; (2) to develop a health education program for the improvement of IDSHL using a WeChat public account; and (3) to evaluate the effectiveness of the health education program that was implemented in the prevention of infectious disease outbreaks. Methods: We used a standardized questionnaire, which consisted of 28 closed-ended questions, to measure the level and score of IDSHL before and after intervention. A multiple-stage stratified random sampling technique was used to select study participants from Zhejiang province in China, who were further divided randomly into 2 groups: the intervention and control groups. From July 2014 to January 2015, a WeChat-based health education intervention program was carried out on the intervention group. Standard descriptive statistics and chi-square and t tests were conducted to analyze the data. Results: A total of 3001 residents participated in the baseline survey of this study. At baseline, participant IDSHL rates were 73.29\% and 72.12\% for the intervention and control groups, respectively ($\Chi$21=0.5; P=.50). After 7 months of intervention, 9.90\% (297/3001) of participants dropped out of the study. Of the lost participants, 119 were from the intervention group and 178 were from the control group. There were significant differences between follow-up and lost participants with respect to age (P=.04), marital status (P=.02) and occupations (P=.002). After intervention, the intervention group scores in the different domains were higher than those in the control group (infectious disease--related knowledge, prevention, management, or treatment, identification of pathogens and infection sources, and cognitive ability). There were significant improvements in the IDSHL of participants in both the intervention and control groups ($\Chi$21=135.9; P<.001 vs $\Chi$21=9.1; P=.003), and there was a greater change in the IDSHL among the intervention group participants than among the control group participants (1230/1359, 90.51\% vs 1038/1359, 77.17\%). Conclusions: The health education intervention program using a WeChat public account proved to be an effective, feasible, and well-accepted means to improve the IDSHL of the general population. In the future, this health education intervention program can be used as a reference for prevention and treatment of infectious diseases. ",
doi="10.2196/46841",
url="https://formative.jmir.org/2023/1/e46841",
url="http://www.ncbi.nlm.nih.gov/pubmed/37556189"
}


@Article{info:doi/10.2196/44888,
author="Beltzer, L. Miranda
and Daniel, E. Katharine
and Daros, R. Alexander
and Teachman, A. Bethany",
title="Changes in Learning From Social Feedback After Web-Based Interpretation Bias Modification: Secondary Analysis of a Digital Mental Health Intervention Among Individuals With High Social Anxiety Symptoms",
journal="JMIR Form Res",
year="2023",
month="Aug",
day="9",
volume="7",
pages="e44888",
keywords="social anxiety",
keywords="reinforcement learning",
keywords="cognitive bias modification",
keywords="interpretation bias",
keywords="reward learning",
keywords="probabilistic learning",
keywords="Q-learning",
keywords="digital intervention",
abstract="Background: Biases in social reinforcement learning, or the process of learning to predict and optimize behavior based on rewards and punishments in the social environment, may underlie and maintain some negative cognitive biases that are characteristic of social anxiety. However, little is known about how cognitive and behavioral interventions may change social reinforcement learning in individuals who are anxious. Objective: This study assessed whether a scalable, web-based cognitive bias modification for interpretations (CBM-I) intervention changed social reinforcement learning biases in participants with high social anxiety symptoms. This study focused on 2 types of social reinforcement learning relevant to social anxiety: learning about other people and learning about one's own social performance. Methods: Participants (N=106) completed 2 laboratory sessions, separated by 5 weeks of ecological momentary assessment tracking emotion regulation strategy use and affect. Approximately half (n=51, 48.1\%) of the participants completed up to 6 brief daily sessions of CBM-I in week 3. Participants completed a task that assessed social reinforcement learning about other people in both laboratory sessions and a task that assessed social reinforcement learning about one's own social performance in the second session. Behavioral data from these tasks were computationally modeled using Q-learning and analyzed using mixed effects models. Results: After the CBM-I intervention, participants updated their beliefs about others more slowly (P=.04; Cohen d=?0.29) but used what they learned to make more accurate decisions (P=.005; Cohen d=0.20), choosing rewarding faces more frequently. These effects were not observed among participants who did not complete the CBM-I intervention. Participants who completed the CBM-I intervention also showed less-biased updating about their social performance than participants who did not complete the CBM-I intervention, learning similarly from positive and negative feedback and from feedback on items related to poor versus good social performance. Regardless of the intervention condition, participants at session 2 versus session 1 updated their expectancies about others more from rewarding (P=.003; Cohen d=0.43) and less from punishing outcomes (P=.001; Cohen d=?0.47), and they became more accurate at learning to avoid punishing faces (P=.001; Cohen d=0.20). Conclusions: Taken together, our results provide initial evidence that there may be some beneficial effects of both the CBM-I intervention and self-tracking of emotion regulation on social reinforcement learning in individuals who are socially anxious, although replication will be important. ",
doi="10.2196/44888",
url="https://formative.jmir.org/2023/1/e44888",
url="http://www.ncbi.nlm.nih.gov/pubmed/37556186"
}


@Article{info:doi/10.2196/45069,
author="Zaidi, Zainab
and Ye, Mengbin
and Samon, Fergus
and Jama, Abdisalan
and Gopalakrishnan, Binduja
and Gu, Chenhao
and Karunasekera, Shanika
and Evans, Jamie
and Kashima, Yoshihisa",
title="Topics in Antivax and Provax Discourse: Yearlong Synoptic Study of COVID-19 Vaccine Tweets",
journal="J Med Internet Res",
year="2023",
month="Aug",
day="8",
volume="25",
pages="e45069",
keywords="COVID-19 vaccine",
keywords="vaccine hesitancy",
keywords="antivax",
keywords="stance detection",
keywords="topic modeling",
keywords="misinformation",
keywords="disinformation",
abstract="Background: Developing an understanding of the public discourse on COVID-19 vaccination on social media is important not only for addressing the ongoing COVID-19 pandemic but also for future pathogen outbreaks. There are various research efforts in this domain, although, a need still exists for a comprehensive topic-wise analysis of tweets in favor of and against COVID-19 vaccines. Objective: This study characterizes the discussion points in favor of and against COVID-19 vaccines posted on Twitter during the first year of the pandemic. The aim of this study was primarily to contrast the views expressed by both camps, their respective activity patterns, and their correlation with vaccine-related events. A further aim was to gauge the genuineness of the concerns expressed in antivax tweets. Methods: We examined a Twitter data set containing 75 million English tweets discussing the COVID-19 vaccination from March 2020 to March 2021. We trained a stance detection algorithm using natural language processing techniques to classify tweets as antivax or provax and examined the main topics of discourse using topic modeling techniques. Results: Provax tweets (37 million) far outnumbered antivax tweets (10 million) and focused mostly on vaccine development, whereas antivax tweets covered a wide range of topics, including opposition to vaccine mandate and concerns about safety. Although some antivax tweets included genuine concerns, there was a large amount of falsehood. Both stances discussed many of the same topics from opposite viewpoints. Memes and jokes were among the most retweeted messages. Most tweets from both stances (9,007,481/10,566,679, 85.24\% antivax and 24,463,708/37,044,507, 66.03\% provax tweets) came from dual-stance users who posted both provax and antivax tweets during the observation period. Conclusions: This study is a comprehensive account of COVID-19 vaccine discourse in the English language on Twitter from March 2020 to March 2021. The broad range of discussion points covered almost the entire conversation, and their temporal dynamics revealed a significant correlation with COVID-19 vaccine--related events. We did not find any evidence of polarization and prevalence of antivax discourse over Twitter. However, targeted countering of falsehoods is important because only a small fraction of antivax discourse touched on a genuine issue. Future research should examine the role of memes and humor in driving web-based social media activity. ",
doi="10.2196/45069",
url="https://www.jmir.org/2023/1/e45069",
url="http://www.ncbi.nlm.nih.gov/pubmed/37552535"
}


@Article{info:doi/10.2196/44774,
author="Wang, Yijun
and Chukwusa, Emeka
and Koffman, Jonathan
and Curcin, Vasa",
title="Public Opinions About Palliative and End-of-Life Care During the COVID-19 Pandemic: Twitter-Based Content Analysis",
journal="JMIR Form Res",
year="2023",
month="Aug",
day="7",
volume="7",
pages="e44774",
keywords="palliative care",
keywords="end-of-life care",
keywords="COVID-19",
keywords="Twitter",
keywords="public opinions",
abstract="Background: Palliative and end-of-life care (PEoLC) played a critical role in relieving distress and providing grief support in response to the heavy toll caused by the COVID-19 pandemic. However, little is known about public opinions concerning PEoLC during the pandemic. Given that social media have the potential to collect real-time public opinions, an analysis of this evidence is vital to guide future policy-making. Objective: This study aimed to use social media data to investigate real-time public opinions regarding PEoLC during the COVID-19 crisis and explore the impact of vaccination programs on public opinions about PEoLC. Methods: This Twitter-based study explored tweets across 3 English-speaking countries: the United States, the United Kingdom, and Canada. From October 2020 to March 2021, a total of 7951 PEoLC-related tweets with geographic tags were retrieved and identified from a large-scale COVID-19 Twitter data set through the Twitter application programming interface. Topic modeling realized through a pointwise mutual information--based co-occurrence network and Louvain modularity was used to examine latent topics across the 3 countries and across 2 time periods (pre- and postvaccination program periods). Results: Commonalities and regional differences among PEoLC topics in the United States, the United Kingdom, and Canada were identified specifically: cancer care and care facilities were of common interest to the public across the 3 countries during the pandemic; the public expressed positive attitudes toward the COVID-19 vaccine and highlighted the protection it affords to PEoLC professionals; and although Twitter users shared their personal experiences about PEoLC in the web-based community during the pandemic, this was more prominent in the United States and Canada. The implementation of the vaccination programs raised the profile of the vaccine discussion; however, this did not influence public opinions about PEoLC. Conclusions: Public opinions on Twitter reflected a need for enhanced PEoLC services during the COVID-19 pandemic. The insignificant impact of the vaccination program on public discussion on social media indicated that public concerns regarding PEoLC continued to persist even after the vaccination efforts. Insights gleaned from public opinions regarding PEoLC could provide some clues for policy makers on how to ensure high-quality PEoLC during public health emergencies. In this post--COVID-19 era, PEoLC professionals may wish to continue to examine social media and learn from web-based public discussion how to ease the long-lasting trauma caused by this crisis and prepare for public health emergencies in the future. Besides, our results showed social media's potential in acting as an effective tool to reflect public opinions in the context of PEoLC. ",
doi="10.2196/44774",
url="https://formative.jmir.org/2023/1/e44774",
url="http://www.ncbi.nlm.nih.gov/pubmed/37368840"
}


@Article{info:doi/10.2196/43020,
author="Furth, Garrett
and Marroquin, A. Nathaniel
and Kirk, Jessica
and Ajmal, Hamza
and Szeto, D. Mindy
and Zueger, Morgan
and Quinn, P. Alyssa
and Carboni, Alexa
and Dellavalle, P. Robert",
title="Cutaneous Manifestations of Anabolic-Androgenic Steroid Use in Bodybuilders and the Dermatologist's Role in Patient Care",
journal="JMIR Dermatol",
year="2023",
month="Aug",
day="3",
volume="6",
pages="e43020",
keywords="anabolic steroids",
keywords="androgenic steroids",
keywords="anabolic-androgenic steroids",
keywords="acne",
keywords="acne fulminans",
keywords="isotretinoin",
keywords="bodybuilding",
keywords="bodybuilder",
keywords="social media",
keywords="skin",
keywords="dermatology",
keywords="dermatologist",
keywords="athlete",
keywords="sport",
keywords="steroid",
keywords="cutaneous",
doi="10.2196/43020",
url="https://derma.jmir.org/2023/1/e43020",
url="http://www.ncbi.nlm.nih.gov/pubmed/37632935"
}


@Article{info:doi/10.2196/32592,
author="van Gastel, Dani{\"e}lle
and Antheunis, L. Marjolijn
and Tenfelde, Kim
and van de Graaf, L. Dani{\"e}lle
and Geerts, Marieke
and Nieboer, E. Theodoor
and Bongers, Y. Marlies",
title="Social Support Among Women With Potential Essure-Related Complaints: Analysis of Facebook Group Content",
journal="JMIR Form Res",
year="2023",
month="Aug",
day="3",
volume="7",
pages="e32592",
keywords="Essure",
keywords="social support",
keywords="Facebook",
keywords="sterilization",
keywords="patient online communities",
keywords="social media",
keywords="social networks",
abstract="Background: Social support groups are an important resource for people to cope with problems. Previous studies have reported the different types of support in these groups, but little is known about the type of reactions that sharing of personal experiences induce among members. It is important to know how and to what extent members of support groups influence each other regarding the consumption of medical care. We researched this in a web-based Facebook group of women sterilized with Essure. Essure was a device intended for permanent contraception. From 2015 onward, women treated with Essure for tubal occlusion raised safety concerns and numerous complaints. Objective: This study aimed to evaluate the use of social support in a Facebook community named ``Essure problemen Nederland'' (EPN; in English, ``Essure problems in the Netherlands''). Methods: All posts in the closed Facebook group EPN between March 8 and May 8, 2018, were included. In total, 3491 Facebook posts were analyzed using a modified version of the Social Support Behavior Codes framework created by Cutrona and Suhr in 1992. Posts were abstracted and aggregated into a database. Two investigators evaluated the posts, developed a modified version of the Social Support Behavior Codes framework, and applied the codes to the collected data. Results: We found that 92\% of messages contained a form of social support. In 68.8\% of posts, social support was provided, and in 31.2\% of posts, social support was received. Informational and emotional support was the most frequently used form of provided social support (40.6\% and 55.5\%, respectively). The same distribution was seen with received social support: informational support in 81.5\% and emotional support in 17.4\% of cases. Our analysis showed a strong correlation between providing or receiving social support and the main form of social support (P<.001). In a total of only 74 (2.2\%) cases, women advised each other to seek medical care. Conclusions: The main purpose of women in the EPN Facebook group was to provide and receive informational or emotional support or both. ",
doi="10.2196/32592",
url="https://formative.jmir.org/2023/1/e32592",
url="http://www.ncbi.nlm.nih.gov/pubmed/37535412"
}


@Article{info:doi/10.2196/48786,
author="Meksawasdichai, Sununtha
and Lerksuthirat, Tassanee
and Ongphiphadhanakul, Boonsong
and Sriphrapradang, Chutintorn",
title="Perspectives and Experiences of Patients With Thyroid Cancer at a Global Level: Retrospective Descriptive Study of Twitter Data",
journal="JMIR Cancer",
year="2023",
month="Aug",
day="2",
volume="9",
pages="e48786",
keywords="data mining",
keywords="internet",
keywords="natural language processing",
keywords="sentiment analysis",
keywords="social media",
keywords="thyroid neoplasms",
keywords="twitter",
keywords="tweet",
keywords="tweets",
keywords="neoplasm",
keywords="neoplasms",
keywords="cancer",
keywords="oncology",
keywords="thyroid",
keywords="NLP",
keywords="perspective",
keywords="perspectives",
keywords="sentiment",
keywords="sentiments",
keywords="experience",
keywords="experiences",
abstract="Background: Twitter has become a popular platform for individuals to broadcast their daily experiences and opinions on a wide range of topics and emotions. Tweets from patients with cancer could offer insights into their needs. However, limited research has been conducted using Twitter data to understand the needs of patients with cancer despite the substantial amount of health-related data posted on the platform daily. Objective: This study aimed to uncover the potential of using Twitter data to understand the perspectives and experiences of patients with thyroid cancer at a global level. Methods: ?This retrospective descriptive study collected tweets relevant to thyroid cancer in 2020 using the Twitter scraping tool. Only English-language tweets were included, and data preprocessing was performed to remove irrelevant tweets, duplicates, and retweets. Both tweets and Twitter users were manually classified into various groups based on the content. Each tweet underwent sentiment analysis and was classified as either positive, neutral, or negative. Results: A total of 13,135 tweets related to thyroid cancer were analyzed. The authors of the tweets included patients with thyroid cancer (3225 tweets, 24.6\%), patient's families and friends (2449 tweets, 18.6\%), medical journals and media (1733 tweets, 13.2\%), health care professionals (1093 tweets, 8.3\%), and medical health organizations (940 tweets, 7.2\%), respectively. The most discussed topics related to living with cancer (3650 tweets, 27.8\%), treatment (2891 tweets, 22\%), diagnosis (1613 tweets, 12.3\%), risk factors and prevention (1137 tweets, 8.7\%), and research (953 tweets, 7.3\%). An average of 36 tweets pertaining to thyroid cancer were posted daily. Notably, the release of a film addressing thyroid cancer and the public disclosure of a news reporter's personal diagnosis of thyroid cancer resulted in a significant escalation in the volume of tweets. From the sentiment analysis, 53.5\% (7025/13,135) of tweets were classified as neutral statements and 32.7\% (4299/13,135) of tweets expressed negative emotions. Tweets from patients with thyroid cancer had the highest proportion of negative emotion (1385/3225 tweets, 42.9\%), particularly when discussing symptoms. Conclusions: ?This study provides new insights on using?Twitter data as a valuable data source to understand the experiences of patients with thyroid cancer. Twitter may provide an opportunity to improve patient and physician engagement or apply as a potential research data source. ",
doi="10.2196/48786",
url="https://cancer.jmir.org/2023/1/e48786",
url="http://www.ncbi.nlm.nih.gov/pubmed/37531163"
}


@Article{info:doi/10.2196/48405,
author="Parker, A. Maria
and Valdez, Danny
and Rao, K. Varun
and Eddens, S. Katherine
and Agley, Jon",
title="Results and Methodological Implications of the Digital Epidemiology of Prescription Drug References Among Twitter Users: Latent Dirichlet Allocation (LDA) Analyses",
journal="J Med Internet Res",
year="2023",
month="Jul",
day="28",
volume="25",
pages="e48405",
keywords="Twitter",
keywords="LDA",
keywords="drug use",
keywords="digital epidemiology",
keywords="unsupervised analysis",
keywords="tweet",
keywords="tweets",
keywords="social media",
keywords="epidemiology",
keywords="epidemiological",
keywords="machine learning",
keywords="text mining",
keywords="data mining",
keywords="pharmacy",
keywords="pharmaceutic",
keywords="pharmaceutical",
keywords="pharmaceuticals",
keywords="drug",
keywords="prescription",
keywords="NLP",
keywords="natural language processing",
abstract="Background: Social media is an important information source for a growing subset of the population and can likely be leveraged to provide insight into the evolving drug overdose epidemic. Twitter can provide valuable insight into trends, colloquial information available to potential users, and how networks and interactivity might influence what people are exposed to and how they engage in communication around drug use. Objective: This exploratory study was designed to investigate the ways in which unsupervised machine learning analyses using natural language processing could identify coherent themes for tweets containing substance names. Methods: This study involved harnessing data from Twitter, including large-scale collection of brand name (N=262,607) and street name (N=204,068) prescription drug--related tweets and use of unsupervised machine learning analyses (ie, natural language processing) of collected data with data visualization to identify pertinent tweet themes. Latent Dirichlet allocation (LDA) with coherence score calculations was performed to compare brand (eg, OxyContin) and street (eg, oxys) name tweets. Results: We found people discussed drug use differently depending on whether a brand name or street name was used. Brand name categories often contained political talking points (eg, border, crime, and political handling of ongoing drug mitigation strategies). In contrast, categories containing street names occasionally referenced drug misuse, though multiple social uses for a term (eg, Sonata) muddled topic clarity. Conclusions: Content in the brand name corpus reflected discussion about the drug itself and less often reflected personal use. However, content in the street name corpus was notably more diverse and resisted simple LDA categorization. We speculate this may reflect effective use of slang terminology to clandestinely discuss drug-related activity. If so, straightforward analyses of digital drug-related communication may be more difficult than previously assumed. This work has the potential to be used for surveillance and detection of harmful drug use information. It also might be used for appropriate education and dissemination of information to persons engaged in drug use content on Twitter. ",
doi="10.2196/48405",
url="https://www.jmir.org/2023/1/e48405",
url="http://www.ncbi.nlm.nih.gov/pubmed/37505795"
}


@Article{info:doi/10.2196/43749,
author="Lazard, J. Allison
and Nicolla, Sydney
and Vereen, N. Rhyan
and Pendleton, Shanetta
and Charlot, Marjory
and Tan, Hung-Jui
and DiFranzo, Dominic
and Pulido, Marlyn
and Dasgupta, Nabarun",
title="Exposure and Reactions to Cancer Treatment Misinformation and Advice: Survey Study",
journal="JMIR Cancer",
year="2023",
month="Jul",
day="28",
volume="9",
pages="e43749",
keywords="cancer",
keywords="misinformation",
keywords="social media",
keywords="prosocial intervening",
keywords="treatment",
keywords="false information",
keywords="alternative medicine",
keywords="information spread",
keywords="dissemination",
keywords="infodemiology",
keywords="mobile phone",
abstract="Background: Cancer treatment misinformation, or false claims about alternative cures, often spreads faster and farther than true information on social media. Cancer treatment misinformation can harm the psychosocial and physical health of individuals with cancer and their cancer care networks by causing distress and encouraging people to abandon support, potentially leading to deviations from evidence-based care. There is a pressing need to understand how cancer treatment misinformation is shared and uncover ways to reduce misinformation. Objective: We aimed to better understand exposure and reactions to cancer treatment misinformation, including the willingness of study participants to prosocially intervene and their intentions to share Instagram posts with cancer treatment misinformation. Methods: We conducted a survey on cancer treatment misinformation among US adults in December 2021. Participants reported their exposure and reactions to cancer treatment misinformation generally (saw or heard, source, type of advice, and curiosity) and specifically on social media (platform, believability). Participants were then randomly assigned to view 1 of 3 cancer treatment misinformation posts or an information post and asked to report their willingness to prosocially intervene and their intentions to share. Results: Among US adult participants (N=603; mean age 46, SD 18.83 years), including those with cancer and cancer caregivers, almost 1 in 4 (142/603, 23.5\%) received advice about alternative ways to treat or cure cancer. Advice was primarily shared through family (39.4\%) and friends (37.3\%) for digestive (30.3\%) and natural (14.1\%) alternative cancer treatments, which generated curiosity among most recipients (106/142, 74.6\%). More than half of participants (337/603, 55.9\%) saw any cancer treatment misinformation on social media, with significantly higher exposure for those with cancer (53/109, 70.6\%) than for those without cancer (89/494, 52.6\%; P<.001). Participants saw cancer misinformation on Facebook (39.8\%), YouTube (27\%), Instagram (22.1\%), and TikTok (14.1\%), among other platforms. Participants (429/603, 71.1\%) thought cancer treatment misinformation was true, at least sometimes, on social media. More than half (357/603, 59.2\%) were likely to share any cancer misinformation posts shown. Many participants (412/603, 68.3\%) were willing to prosocially intervene for any cancer misinformation posts, including flagging the cancer treatment misinformation posts as false (49.7\%-51.4\%) or reporting them to the platform (48.1\%-51.4\%). Among the participants, individuals with cancer and those who identified as Black or Hispanic reported greater willingness to intervene to reduce cancer misinformation but also higher intentions to share misinformation. Conclusions: Cancer treatment misinformation reaches US adults through social media, including on widely used platforms for support. Many believe that social media posts about alternative cancer treatment are true at least some of the time. The willingness of US adults, including those with cancer and members of susceptible populations, to prosocially intervene could initiate the necessary community action to reduce cancer treatment misinformation if coupled with strategies to help individuals discern false claims. ",
doi="10.2196/43749",
url="https://cancer.jmir.org/2023/1/e43749",
url="http://www.ncbi.nlm.nih.gov/pubmed/37505790"
}


@Article{info:doi/10.2196/43210,
author="Delnoij, J. Diana M.
and Derks, Meggie
and Koolen, Laura
and Shekary, Shuka
and Suitela, Jozua",
title="Using Patient Blogs on Social Media to Assess the Content Validity of Patient-Reported Outcome Measures: Qualitative Analysis of Patient-Written Blogs",
journal="JMIR Form Res",
year="2023",
month="Jul",
day="28",
volume="7",
pages="e43210",
keywords="patient stories",
keywords="patient-reported outcome measure",
keywords="PROM",
keywords="social media",
keywords="narrative",
keywords="patient story",
keywords="storytelling",
keywords="blogger",
keywords="experiential",
keywords="experience",
keywords="content validity",
keywords="content analysis",
keywords="qualitative",
keywords="cross sectional",
keywords="cross-sectional",
keywords="chronic disease",
keywords="noncommunicable diseases",
keywords="NCD",
keywords="rheumatoid arthritis",
keywords="Parkinson disease, diabetes mellitus",
keywords="diabetes",
keywords="type II diabetes",
keywords="cancer",
keywords="breast cancer",
keywords="oncology",
keywords="International Consortium for Health Outcome Measurement",
keywords="ICHOM",
keywords="data dictionary",
keywords="Health Assessment Questionnaire",
keywords="HAQ",
keywords="Parkinson Disease Quality of Life Questionnaire",
keywords="PDQ",
keywords="inductive",
keywords="inductive code",
abstract="Background: Patient-reported outcome measures (PROMs) are questionnaires that measure patient outcomes related to quality of life, health, and functioning, and are increasingly used to assess important outcomes from the patient's perspective. For PROMs to contribute to better health and better care, it is vital that their content validity be adequate. This requires patient involvement in various steps of PROM development. PROM developers not only recognize the benefits of patient involvement but also report difficulties in recruiting patients and experience patient involvement as time-consuming, logistically challenging, and expensive. Objective: This study seeks to explore different strategies for disclosing the experiential knowledge of patients, namely through analyzing patient stories on the web and social media. The research questions are as follows: (1) how do bloggers living with a disease experience their health-related quality of life? (2) How are these experiences reflected in the domains and items of PROMs related to their disease? Methods: First, a qualitative analysis of blogs written by patients was performed. Second, subthemes and underlying codes resulting from this qualitative analysis were systematically compared with the domains and items in PROMs for the respective diseases that the bloggers write about. Blogs were identified via the Google search engine between December 2019 and May 2021. Results: Bloggers describe a wide range of experiences regarding their physical functioning and health; mental well-being; social network and support; daily life, education, work, and leisure; coping; and self-management. Bloggers also write about their positive and negative experiences with health care delivery, the organization of health care, and health care professionals. In general, patients' experiences as described in blogs were reflected in the domains and items of the PROMs related to their disease. However, except for diabetes mellitus, in all the sets of PROMs, potentially missing topics could be identified. Similarly, with the exception of Parkinson disease, all PROMs address issues that patients did not write about in their blogs and that might therefore be redundant. Conclusions: Web-based patient stories in the form of blogs reveal how people living with a certain disease experience their health-related quality of life. These stories enable analyses of patients' experiences that can be used to assess the content validity of PROMs. This can be a useful step for researchers who are looking for sets of measuring instruments that match their purposes. ",
doi="10.2196/43210",
url="https://formative.jmir.org/2023/1/e43210",
url="http://www.ncbi.nlm.nih.gov/pubmed/37505797"
}


@Article{info:doi/10.2196/45757,
author="Xia, Xinming
and Zhang, Yi
and Jiang, Wenting
and Wu, Yuhao Connor",
title="Staying Home, Tweeting Hope: Mixed Methods Study of Twitter Sentiment Geographical Index During US Stay-At-Home Orders",
journal="J Med Internet Res",
year="2023",
month="Jul",
day="24",
volume="25",
pages="e45757",
keywords="COVID-19",
keywords="Twitter",
keywords="stay-at-home orders",
keywords="dynamics of public opinion",
keywords="multiperiod difference-in-differences model",
abstract="Background: Stay-at-home orders were one of the controversial interventions to curb the spread of COVID-19 in the United States. The stay-at-home orders, implemented in 51 states and territories between March 7 and June 30, 2020, impacted the lives of individuals and communities and accelerated the heavy usage of web-based social networking sites. Twitter sentiment analysis can provide valuable insight into public health emergency response measures and allow for better formulation and timing of future public health measures to be released in response to future public health emergencies. Objective: This study evaluated how stay-at-home orders affect Twitter sentiment in the United States. Furthermore, this study aimed to understand the feedback on stay-at-home orders from groups with different circumstances and backgrounds. In addition, we particularly focused on vulnerable groups, including older people groups with underlying medical conditions, small and medium enterprises, and low-income groups. Methods: We constructed a multiperiod difference-in-differences regression model based on the Twitter sentiment geographical index quantified from 7.4 billion geo-tagged tweets data to analyze the dynamics of sentiment feedback on stay-at-home orders across the United States. In addition, we used moderated effects analysis to assess differential feedback from vulnerable groups. Results: We combed through the implementation of stay-at-home orders, Twitter sentiment geographical index, and the number of confirmed cases and deaths in 51 US states and territories. We identified trend changes in public sentiment before and after the stay-at-home orders. Regression results showed that stay-at-home orders generated a positive response, contributing to a recovery in Twitter sentiment. However, vulnerable groups faced greater shocks and hardships during the COVID-19 pandemic. In addition, economic and demographic characteristics had a significant moderating effect. Conclusions: This study showed a clear positive shift in public opinion about COVID-19, with this positive impact occurring primarily after stay-at-home orders. However, this positive sentiment is time-limited, with 14 days later allowing people to be more influenced by the status quo and trends, so feedback on the stay-at-home orders is no longer positively significant. In particular, negative sentiment is more likely to be generated in states with a large proportion of vulnerable groups, and the policy plays a limited role. The pandemic hit older people, those with underlying diseases, and small and medium enterprises directly but hurt states with cross-cutting economic situations and more complex demographics over time. Based on large-scale Twitter data, this sociological perspective allows us to monitor the evolution of public opinion more directly, assess the impact of social events on public opinion, and understand the heterogeneity in the face of pandemic shocks. ",
doi="10.2196/45757",
url="https://www.jmir.org/2023/1/e45757",
url="http://www.ncbi.nlm.nih.gov/pubmed/37486758"
}


@Article{info:doi/10.2196/41582,
author="Marani, Husayn
and Song, Yunju Melodie
and Jamieson, Margaret
and Roerig, Monika
and Allin, Sara",
title="Public Officials' Engagement on Social Media During the Rollout of the COVID-19 Vaccine: Content Analysis of Tweets",
journal="JMIR Infodemiology",
year="2023",
month="Jul",
day="20",
volume="3",
pages="e41582",
keywords="Twitter",
keywords="COVID-19",
keywords="vaccines",
keywords="sentiment analysis",
keywords="public officials",
abstract="Background: Social media is an important way for governments to communicate with the public. This is particularly true in times of crisis, such as the COVID-19 pandemic, during which government officials played a strong role in promoting public health measures such as vaccines. Objective: In Canada, provincial COVID-19 vaccine rollout was delivered in 3 phases aligned with federal government COVID-19 vaccine guidance for priority populations. In this study, we examined how Canadian public officials used Twitter to engage with the public about vaccine rollout and how this engagement has shaped public response to vaccines across jurisdictions. Methods: We conducted a content analysis of tweets posted between December 28, 2020, and August 31, 2021. Leveraging the social media artificial intelligence tool Brandwatch Analytics, we constructed a list of public officials in 3 jurisdictions (Ontario, Alberta, and British Columbia) organized across 6 public official types and then conducted an English and French keyword search for tweets about vaccine rollout and delivery that mentioned, retweeted, or replied to the public officials. We identified the top 30 tweets with the highest impressions in each jurisdiction in each of the 3 phases (approximately a 26-day window) of the vaccine rollout. The metrics of engagement (impressions, retweets, likes, and replies) from the top 30 tweets per phase in each jurisdiction were extracted for additional annotation. We specifically annotated sentiment toward public officials' vaccine responses (ie, positive, negative, and neutral) in each tweet and annotated the type of social media engagement. A thematic analysis of tweets was then conducted to add nuance to extracted data characterizing sentiment and interaction type. Results: Among the 6 categories of public officials, 142 prominent accounts were included from Ontario, Alberta, and British Columbia. In total, 270 tweets were included in the content analysis and 212 tweets were direct tweets by public officials. Public officials mostly used Twitter for information provision (139/212, 65.6\%), followed by horizontal engagement (37/212, 17.5\%), citizen engagement (24/212, 11.3\%), and public service announcements (12/212, 5.7\%). Information provision by government bodies (eg, provincial government and public health authorities) or municipal leaders is more prominent than tweets by other public official groups. Neutral sentiment accounted for 51.5\% (139/270) of all the tweets, whereas positive sentiment was the second most common sentiment (117/270, 43.3\%). In Ontario, 60\% (54/90) of the tweets were positive. Negative sentiment (eg, public officials criticizing vaccine rollout) accounted for 12\% (11/90) of all the tweets. Conclusions: As governments continue to promote the uptake of the COVID-19 booster doses, findings from this study are useful in informing how governments can best use social media to engage with the public to achieve democratic goals. ",
doi="10.2196/41582",
url="https://infodemiology.jmir.org/2023/1/e41582",
url="http://www.ncbi.nlm.nih.gov/pubmed/37315194"
}


@Article{info:doi/10.2196/36132,
author="Kulandaivelu, Yalinie
and Hamilton, Jill
and Banerjee, Ananya
and Gruzd, Anatoliy
and Patel, Barkha
and Stinson, Jennifer",
title="Social Media Interventions for Nutrition Education Among Adolescents: Scoping Review",
journal="JMIR Pediatr Parent",
year="2023",
month="Jul",
day="20",
volume="6",
pages="e36132",
keywords="adolescents",
keywords="digital health intervention",
keywords="food literacy",
keywords="health literacy",
keywords="nutrition",
keywords="peer education",
keywords="peer support",
keywords="social media",
abstract="Background: Adolescence is a critical period for reinforcing healthy dietary behaviors and supporting the development of cooking skills. Social media may be an avenue for supporting these behaviors, as it is popular among adolescents and can improve access to nutrition education interventions. This study sought to understand the optimal implementation of effective social media--based nutrition education interventions to inform the implementation of future social media--based nutrition education interventions. Objective: A scoping review of the characteristics, feasibility, effectiveness, and factors influencing social media--based nutrition education interventions for adolescents was conducted. Methods: We searched MEDLINE, Embase, CINAHL, Web of Science, and PsycINFO databases using a predefined search strategy. Primary research articles were independently screened and included if they involved adolescent populations (10-18 years old) and delivered nutrition education through social media. The information on intervention characteristics, feasibility, effectiveness, and factors influencing social media--based nutrition education interventions was extracted. Results: A total of 28 publications out of 20,557 met the eligibility criteria. Twenty-five nutrition interventions were examined by 28 studies. Fourteen interventions used homegrown social media platforms, 8 used Facebook, and 2 used Instagram. Feasibility outcomes were infrequently reported, and the cost of intervention delivery was not reported. Engagement with interventions was variable; high engagement was not required to elicit significant improvements in dietary behaviors. Tailoring interventions, offering practical content, meaningful peer support, and involving families and communities facilitated successful interventions. Strategies to address engagement and technical issues were varied. Conclusions: Emerging evidence demonstrates that social media interventions for adolescent nutrition are acceptable and improve nutrition outcomes. Future interventions should strengthen peer support components and tailor delivery to specific populations. Further research should examine engagement, adherence, and the impact of interventions on behavioral and physical outcomes. This review is the first to examine the use of social media as the primary medium for nutrition education for adolescent populations. The analysis used in this review argues the importance of peer support in social media--based nutrition interventions and the need for user-centered design of the interventions. ",
doi="10.2196/36132",
url="https://pediatrics.jmir.org/2023/1/e36132",
url="http://www.ncbi.nlm.nih.gov/pubmed/37471119"
}


@Article{info:doi/10.2196/45267,
author="Yang, Genevieve
and King, G. Sarah
and Lin, Hung-Mo
and Goldstein, Z. Rita",
title="Emotional Expression on Social Media Support Forums for Substance Cessation: Observational Study of Text-Based Reddit Posts",
journal="J Med Internet Res",
year="2023",
month="Jul",
day="19",
volume="25",
pages="e45267",
keywords="sentiment analysis",
keywords="text mining",
keywords="addiction phenotype",
keywords="subjective experience phenotype",
keywords="naturalistic big data",
keywords="natural language processing",
keywords="phenomenology",
keywords="experience sampling",
abstract="Background: Substance use disorder is characterized by distinct cognitive processes involved in emotion regulation as well as unique emotional experiences related to the relapsing cycle of drug use and recovery. Web-based communities and the posts they generate represent an unprecedented resource for studying subjective emotional experiences, capturing population types and sizes not typically available in the laboratory. Here, we mined text data from Reddit, a social media website that hosts discussions from pseudonymous users on specific topic forums, including forums for individuals who are trying to abstain from using drugs, to explore the putative specificity of the emotional experience of substance cessation. Objective: An important motivation for this study was to investigate transdiagnostic clues that could ultimately be used for mental health outreach. Specifically, we aimed to characterize the emotions associated with cessation of 3 major substances and compare them to emotional experiences reported in nonsubstance cessation posts, including on forums related to psychiatric conditions of high comorbidity with addiction. Methods: Raw text from 2 million posts made, respectively, in the fall of 2020 (discovery data set) and fall of 2019 (replication data set) were obtained from 394 forums hosted by Reddit through the application programming interface. We quantified emotion word frequencies in 3 substance cessation forums for alcohol, nicotine, and cannabis topic categories and performed comparisons with general forums. Emotion word frequencies were classified into distinct categories and represented as a multidimensional emotion vector for each forum. We further quantified the degree of emotional resemblance between different forums by computing cosine similarity on these vectorized representations. For substance cessation posts with self-reported time since last use, we explored changes in the use of emotion words as a function of abstinence duration. Results: Compared to posts from general forums, substance cessation posts showed more expressions of anxiety, disgust, pride, and gratitude words. ``Anxiety'' emotion words were attenuated for abstinence durations >100 days compared to shorter durations (t12=3.08, 2-tailed; P=.001). The cosine similarity analysis identified an emotion profile preferentially expressed in the cessation posts across substances, with lesser but still prominent similarities to posts about social anxiety and attention-deficit/hyperactivity disorder. These results were replicated in the 2019 (pre--COVID-19) data and were distinct from control analyses using nonemotion words. Conclusions: We identified a unique subjective experience phenotype of emotions associated with the cessation of 3 major substances, replicable across 2 time periods, with changes as a function of abstinence duration. Although to a lesser extent, this phenotype also quantifiably resembled the emotion phenomenology of other relevant subjective experiences (social anxiety and attention-deficit/hyperactivity disorder). Taken together, these transdiagnostic results suggest a novel approach for the future identification of at-risk populations, allowing for the development and deployment of specific and timely interventions. ",
doi="10.2196/45267",
url="https://www.jmir.org/2023/1/e45267",
url="http://www.ncbi.nlm.nih.gov/pubmed/37467010"
}


@Article{info:doi/10.2196/34742,
author="Szeto, D. Mindy
and Mamo, V. Andrina
and Kamel, Kevin
and Olayinka, T. Jadesola
and Patel, M. Payal
and Hamp, Austin
and Anderson, Jarett
and Kim, S. Lori
and Yemc, G. Madeleine
and Sivesind, E. Torunn
and Dellavalle, P. Robert",
title="Analysis of Dermatology Content by Top Influencers on Twitter and Their Academic Impact: Cross-Sectional Study",
journal="JMIR Dermatol",
year="2023",
month="Jul",
day="18",
volume="6",
pages="e34742",
keywords="dermatology",
keywords="social media",
keywords="Twitter",
keywords="influencers",
keywords="publication citations",
keywords="h-index",
keywords="board certified",
keywords="board certification",
keywords="education",
doi="10.2196/34742",
url="https://derma.jmir.org/2023/1/e34742",
url="http://www.ncbi.nlm.nih.gov/pubmed/37632915"
}


@Article{info:doi/10.2196/43901,
author="Wang, Yanyan
and Zhang, Jin",
title="A Study on User-Oriented Subjects of Child Abuse on Wikipedia: Temporal Analysis of Wikipedia History Versions and Traffic Data",
journal="J Med Internet Res",
year="2023",
month="Jul",
day="17",
volume="25",
pages="e43901",
keywords="child abuse",
keywords="user-oriented subject",
keywords="subject schema",
keywords="subject change",
keywords="popularity trend",
keywords="temporal analysis",
keywords="Wikipedia",
abstract="Background: Many people turn to online open encyclopedias such as Wikipedia to seek knowledge about child abuse. However, the information available on this website is often disorganized and incomplete. Objective: The aim of this study is to analyze Wikipedia's coverage of child abuse and provide a more accessible way for users to browse child abuse--related content. The study explored the main themes and subjects related to child abuse on Wikipedia and proposed a multilayer user-oriented subject schema from the general users' perspective. Methods: The knowledge of child abuse on Wikipedia is presented in the child abuse--related articles on it. The study analyzed child abuse--related articles on Wikipedia, examining their history versions and yearly page views data to reveal the evolution of content and popularity. The themes and subjects were identified from the articles' text using the open coding, self-organizing map, and n-gram approaches. The subjects in different periods were compared to reveal changes in content. Results: This study collected and investigated 241 associated Wikipedia articles and their history versions and traffic data. Four facets were identified: (1) maltreatment behavior (n=118, 48.9\%); (2) people and environment (n=28, 11.6\%); (3) problems and risks (n=33, 13.7\%); and (4) protection and support (n=62, 25.7\%). A total of 8 themes and 51 subjects were generated from the text, and a user-oriented subject schema linking the facets, themes, subjects, and articles was created. Maltreatment behavior (number of total views = 1.15 {\texttimes} 108) was the most popular facet viewed by users, while people and environment (number of total views = 2.42 {\texttimes} 107) was the least popular. The popularity of child abuse increased from 2010 to 2014 but decreased after that. Conclusions: The user-oriented subject schema provides an easier way for users to seek information and learn about child abuse. The knowledge of child abuse on Wikipedia covers the harms done to children, the problems caused by child abuse, the protection of children, and the people involved in child abuse. However, there was an inconsistency between the interests of general users and Wikipedia editors, and the child abuse knowledge on Wikipedia was found to be deficient, lacking content about typical child abuse types. To meet users' needs, health information creators need to generate more information to fill the knowledge gap. ",
doi="10.2196/43901",
url="https://www.jmir.org/2023/1/e43901",
url="http://www.ncbi.nlm.nih.gov/pubmed/37459149"
}


@Article{info:doi/10.2196/46345,
author="Kite, James
and Chan, Lilian
and MacKay, Kathryn
and Corbett, Lucy
and Reyes-Marcelino, Gillian
and Nguyen, Binh
and Bellew, William
and Freeman, Becky",
title="A Model of Social Media Effects in Public Health Communication Campaigns: Systematic Review",
journal="J Med Internet Res",
year="2023",
month="Jul",
day="14",
volume="25",
pages="e46345",
keywords="awareness",
keywords="behavior change",
keywords="campaign development",
keywords="campaign evaluation",
keywords="engagement",
keywords="hierarchy of effects",
keywords="social media",
keywords="systematic review",
abstract="Background: Social media platforms are frequently used in health communication campaigns. Common understandings of campaign effects posit a sequential and linear series of steps from exposure to behavior change, commonly known as the hierarchy of effects model (HOE). These concepts need to be reevaluated in the age of social media, which are interactional and communal. Objective: This review aims to update the traditional HOE for health communication campaigns in the context of social media, including identifying indicators of effectiveness and how these are conceptualized to lead to health-related outcomes. Methods: We conducted a systematic review of studies following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines reporting on the use of social media as part of health communication campaigns, extracting campaign information such as objectives, platforms used, and measures of campaign performance. We used these data, combined with our understanding of the HOE, to develop an updated conceptual model of social media campaign effects. Results: We identified 99 eligible studies reporting on 93 campaigns, published between 2012 and 2022. The campaigns were conducted in over 20 countries, but nearly half (n=42) were conducted in the United States. Campaigns targeted a variety of health issues and predominantly used Facebook, Twitter, Instagram, and YouTube. Most campaigns (n=81) set objectives targeting awareness or individual behavior change. Process measures (n=68; eg, reach and impressions) and engagement measures (n=73; eg, likes and retweets) were reported most frequently, while two-fifths (n=42) did not report any outcomes beyond engagement, such as changes in knowledge, behavior, or social norms. Most campaigns (n=55) collected measures that did not allow them to determine if the campaign objective had been met; that is, they were process evaluations only. Based on our review, our updated model suggests that campaign exposure can lead to individual behavior change and improved health outcomes, either through a direct or indirect pathway. Indirect pathways include exposure through social and policy changes. ``Engagement'' is positioned as critical to success, replacing awareness in the traditional HOE, and all types of engagement are treated as equal and good. No consideration is being given to potential negative engagement, such as the distribution of misinformation. Additionally, the process is no longer linear and sequential, with circular pathways evident, such as engagement not only influencing behavior change but also generating additional exposure to campaign messages. Conclusions: Our review has highlighted a change in conventional understandings of how campaigns can influence health outcomes in the age of social media. The updated model we propose provides social media campaigners with a starting point to develop and tailor campaign messages and allows evaluators to identify critical assumptions to test, including the role and value of ``engagement.'' Trial Registration: PROSPERO CRD42021287257; https://www.crd.york.ac.uk/prospero/display\_record.php?RecordID=287257 ",
doi="10.2196/46345",
url="https://www.jmir.org/2023/1/e46345",
url="http://www.ncbi.nlm.nih.gov/pubmed/37450325"
}


@Article{info:doi/10.2196/45707,
author="Booth, Alison
and Manson, Stephanie
and Halhol, Sonia
and Merinopoulou, Evie
and Raluy-Callado, Mireia
and Hareendran, Asha
and Knoll, Stefanie",
title="Using Health-Related Social Media to Understand the Experiences of Adults With Lung Cancer in the Era of Immuno-Oncology and Targeted Therapies: Observational Study",
journal="JMIR Cancer",
year="2023",
month="Jul",
day="12",
volume="9",
pages="e45707",
keywords="non-small cell lung cancer",
keywords="data science",
keywords="machine learning",
keywords="natural language processing",
keywords="social media data",
keywords="patient experience",
keywords="patient preference",
keywords="immunotherapy",
keywords="targeted therapies",
keywords="lung cancer",
keywords="social media",
abstract="Background: The treatment of non--small cell lung cancer (NSCLC) has evolved dramatically with the approval of immuno-oncology (IO) and targeted therapies (TTs). Insights on the patient experience with these therapies and their impacts are lacking. Health-related social media has been increasingly used by patients to share their disease and treatment experiences, thus representing a valuable source of real-world data to understand the patient's voice and uncover potential unmet needs. Objective: This study aimed to describe the experiences of patients with NSCLC as reported in discussions posted on lung cancer--specific social media with respect to their disease symptoms and associated impacts. Methods: Publicly available posts (2010-2019) were extracted from selected lung cancer-- or NSCLC-specific websites. Social media users (patients and caregivers posting on these websites) were stratified by metastatic- and adjuvant-eligible subgroups and treatment received using natural language processing (NLP) and machine learning methods. Automated identification of symptoms was conducted using NLP. Qualitative data analysis (QDA) was conducted on random samples of posts mentioning pain-related, fatigue-related, respiratory-related, or infection-related symptoms to capture the patient experience with these and associated impacts. Results: Overall, 1724 users (50,390 posts) and 574 users (4531 posts) were included in the metastatic group and adjuvant group, respectively. Among users in the metastatic group, pain, discomfort, and fatigue were the most commonly mentioned symptoms (49.7\% and 39.6\%, respectively), and in the QDA (258 posts from 134 users), the most frequent impacts related to physical impairments, sleep, and eating habits. Among users in the adjuvant group, pain, discomfort, and respiratory symptoms were the most commonly mentioned (44.8\% and 23.9\%, respectively), and impacts identified in the QDA (154 posts from 92 users) were mostly related to physical functioning. Conclusions: Findings from this exploratory observational analysis of social media among patients and caregivers informed the lived experience of NSCLC in the era of novel therapies, shedding light on most reported symptoms and their impacts. These findings can be used to inform future research on NSCLC treatment development and patient management. ",
doi="10.2196/45707",
url="https://cancer.jmir.org/2023/1/e45707",
url="http://www.ncbi.nlm.nih.gov/pubmed/37436789"
}


@Article{info:doi/10.2196/47328,
author="Shankar, Kavitha
and Chandrasekaran, Ranganathan
and Jeripity Venkata, Pruthvinath
and Miketinas, Derek",
title="Investigating the Role of Nutrition in Enhancing Immunity During the COVID-19 Pandemic: Twitter Text-Mining Analysis",
journal="J Med Internet Res",
year="2023",
month="Jul",
day="10",
volume="25",
pages="e47328",
keywords="social media",
keywords="nutrition discourse",
keywords="text mining",
keywords="immunity building",
keywords="food groups",
keywords="Twitter",
keywords="nutrition",
keywords="food",
keywords="immunity",
keywords="COVID-19",
keywords="diet",
keywords="immune system",
keywords="assessment",
keywords="tweets",
keywords="dieticians",
keywords="nutritionists",
abstract="Background: The COVID-19 pandemic has brought to the spotlight the critical role played by a balanced and healthy diet in bolstering the human immune system. There is burgeoning interest in nutrition-related information on social media platforms like Twitter. There is a critical need to assess and understand public opinion, attitudes, and sentiments toward nutrition-related information shared on Twitter. Objective: This study uses text mining to analyze nutrition-related messages on Twitter to identify and analyze how the general public perceives various food groups and diets for improving immunity to the SARS-CoV-2 virus. Methods: We gathered 71,178 nutrition-related tweets that were posted between January 01, 2020, and September 30, 2020. The Correlated Explanation text mining algorithm was used to identify frequently discussed topics that users mentioned as contributing to immunity building against SARS-CoV-2. We assessed the relative importance of these topics and performed a sentiment analysis. We also qualitatively examined the tweets to gain a closer understanding of nutrition-related topics and food groups. Results: Text-mining yielded 10 topics that users discussed frequently on Twitter, viz proteins, whole grains, fruits, vegetables, dairy-related, spices and herbs, fluids, supplements, avoidable foods, and specialty diets. Supplements were the most frequently discussed topic (23,913/71,178, 33.6\%) with a higher proportion (20,935/23,913, 87.75\%) exhibiting a positive sentiment with a score of 0.41. Consuming fluids (17,685/71,178, 24.85\%) and fruits (14,807/71,178, 20.80\%) were the second and third most frequent topics with favorable, positive sentiments. Spices and herbs (8719/71,178, 12.25\%) and avoidable foods (8619/71,178, 12.11\%) were also frequently discussed. Negative sentiments were observed for a higher proportion of avoidable foods (7627/8619, 84.31\%) with a sentiment score of --0.39. Conclusions: This study identified 10 important food groups and associated sentiments that users discussed as a means to improve immunity. Our findings can help dieticians and nutritionists to frame appropriate interventions and diet programs. ",
doi="10.2196/47328",
url="https://www.jmir.org/2023/1/e47328",
url="http://www.ncbi.nlm.nih.gov/pubmed/37428522"
}


@Article{info:doi/10.2196/44603,
author="Cummins, A. Jack
and Lipworth, D. Adam",
title="Reddit and Google Activity Related to Non-COVID Epidemic Diseases Surged at Start of COVID-19 Pandemic: Retrospective Study",
journal="JMIR Form Res",
year="2023",
month="Jul",
day="6",
volume="7",
pages="e44603",
keywords="COVID-19",
keywords="Reddit",
keywords="Google Trends",
keywords="chikungunya",
keywords="Ebola",
keywords="H1N1",
keywords="Middle Eastern respiratory syndrome",
keywords="MERS",
keywords="severe acute respiratory syndrome",
keywords="SARS",
keywords="Zika",
keywords="infectious disease",
keywords="social media",
keywords="search data",
keywords="search query",
keywords="web-based search",
keywords="information behavior",
keywords="information seeking",
keywords="public interest",
abstract="Background: Resources such as Google Trends and Reddit provide opportunities to gauge real-time popular interest in public health issues. Despite the potential for these publicly available and free resources to help optimize public health campaigns, use for this purpose has been limited. Objective: The purpose of this study is to determine whether early public awareness of COVID-19 correlated with elevated public interest in other infectious diseases of public health importance. Methods: Google Trends search data and Reddit comment data were analyzed from 2018 through 2020 for the frequency of keywords ``chikungunya,'' ``Ebola,'' ``H1N1,'' ``MERS,'' ``SARS,'' and ``Zika,'' 6 highly publicized epidemic diseases in recent decades. After collecting Google Trends relative popularity scores for each of these 6 terms, unpaired 2-tailed t tests were used to compare the 2020 weekly scores for each term to their average level over the 3-year study period. The number of Reddit comments per month with each of these 6 terms was collected and then adjusted for the total estimated Reddit monthly comment volume to derive a measure of relative use, analogous to the Google Trends popularity score. The relative monthly incidence of comments with each search term was then compared to the corresponding search term's pre-COVID monthly comment data, again using unpaired 2-tailed t tests. P value cutoffs for statistical significance were determined a priori with a Bonferroni correction. Results: Google Trends and Reddit data both demonstrate large and statistically significant increases in the usage of each evaluated disease term through at least the initial months of the pandemic. Google searches and Reddit comments that included any of the evaluated infectious disease search terms rose significantly in the first months of 2020 above their baseline usage, peaking in March 2020. Google searches for ``SARS'' and ``MERS'' remained elevated for the entirety of the 2020 calendar year, as did Reddit comments with the words ``Ebola,'' ``H1N1,'' ``MERS,'' and ``SARS'' (P<.001, for each weekly or monthly comparison, respectively). Conclusions: Google Trends and Reddit can readily be used to evaluate real-time general interest levels in public health--related topics, providing a tool to better time and direct public health initiatives that require a receptive target audience. The start of the COVID-19 pandemic correlated with increased public interest in other epidemic infectious diseases. We have demonstrated that for 6 distinct infectious causes of epidemics over the last 2 decades, public interest rose substantially and rapidly with the outbreak of COVID-19. Our data suggests that for at least several months after the initial outbreak, the public may have been particularly receptive to dialogue on these topics. Public health officials should consider using Google Trends and social media data to identify patterns of engagement with public health topics in real time and to optimize the timing of public health campaigns. ",
doi="10.2196/44603",
url="https://formative.jmir.org/2023/1/e44603",
url="http://www.ncbi.nlm.nih.gov/pubmed/37256832"
}


@Article{info:doi/10.2196/47210,
author="Zheng, Shusen
and Tong, Xinyu
and Wan, Dalong
and Hu, Chen
and Hu, Qing
and Ke, Qinghong",
title="Quality and Reliability of Liver Cancer--Related Short Chinese Videos on TikTok and Bilibili: Cross-Sectional Content Analysis Study",
journal="J Med Internet Res",
year="2023",
month="Jul",
day="5",
volume="25",
pages="e47210",
keywords="liver cancer",
keywords="short videos",
keywords="information quality",
keywords="social media",
keywords="TikTok",
keywords="Bilibili",
keywords="GQS",
keywords="global quality score",
keywords="DISCERN",
keywords="reliability",
abstract="Background: Liver cancer incidence has been increasing in China in the recent years, leading to increased public concern regarding the burden of this disease. Short videos on liver cancer are disseminated through TikTok and Bilibili apps, which have gained popularity in recent years as an easily accessible source of health information. However, the credibility, quality, and usefulness of the information in these short videos and the professional knowledge of the individuals uploading health information--based videos in these platforms have not yet been evaluated. Objective: Our study aims to assess the quality of the information in Chinese short videos on liver cancer shared on the TikTok and Bilibili short video--sharing platforms. Methods: In March 2023, we assessed the top 100 Chinese short videos on liver cancer in TikTok and Bilibili (200 videos in total) for their information quality and reliability by using 2 rating tools, namely, global quality score (GQS) and the DISCERN instrument. Correlation and Poisson regression analyses were applied to discuss the factors that could impact video quality. Results: Compared to Bilibili, TikTok is more popular, although the length of the videos on TikTok is shorter than that of the videos on Bilibili (P<.001). The quality of the short videos on liver cancer in TikTok and Bilibili was not satisfactory, with median GQS of 3 (IQR 2-4) and 2 (IQR 1-5) and median DISCERN scores of 5 (IQR 4-6) and 4 (IQR 2-7), respectively. In general, the quality of videos sourced from professional institutions and individuals was better than that of those sourced from nonprofessionals, and videos involving disease-related knowledge were of better quality than those covering news and reports. No significant differences were found in the quality of videos uploaded by individuals from different professions, with the exception of those uploaded by traditional Chinese medicine professionals, which demonstrated poorer quality. Only video shares were positively correlated with the GQS (r=0.17, P=.01), and no video variables could predict the video quality. Conclusions: Our study shows that the quality of short videos on health information related to liver cancer is poor on Bilibili and TikTok, but videos uploaded by health care professionals can be considered reliable in terms of comprehensiveness and content quality. Thus, short videos providing medical information on TikTok and Bilibili must be carefully considered for scientific soundness by active information seekers before they make decisions on their health care management. ",
doi="10.2196/47210",
url="https://www.jmir.org/2023/1/e47210",
url="http://www.ncbi.nlm.nih.gov/pubmed/37405825"
}


@Article{info:doi/10.2196/42260,
author="Qian, Yuxing
and Liu, Zhenghao
and Lee, J. Edmund W.
and Wang, Yixi
and Ni, Zhenni",
title="Exploring the Incentive Function of Virtual Academic Degrees in a Chinese Online Smoking Cessation Community: Qualitative Content Analysis",
journal="J Med Internet Res",
year="2023",
month="Jul",
day="4",
volume="25",
pages="e42260",
keywords="online smoking cessation community",
keywords="motivational affordances",
keywords="virtual academic degrees",
keywords="digital incentives",
keywords="content analysis",
abstract="Background: Previous studies on online smoking cessation communities (OSCCs) have shown how such networks contribute to members' health outcomes from behavior influence and social support perspectives. However, these studies rarely considered the incentive function of OSCCs. One of the ways OSCCs motivate smoking cessation behaviors is through digital incentives. Objective: This study aims to explore the incentive function of a novel digital incentive in a Chinese OSCC---the awarding of academic degrees---to promote smoking cessation. It specifically focuses on ``Smoking Cessation Bar,'' an OSCC in the popular web-based Chinese forum Baidu Tieba. Methods: We collected discussions about the virtual academic degrees (N= 1193) from 540 members of the ``Smoking Cessation Bar.'' The time frame of the data set was from November 15, 2012, to November 3, 2021. Drawing upon motivational affordances theory, 2 coders qualitatively coded the data. Results: We identified five key topics of discussion, including members' (1) intention to get virtual academic degrees (n=38, 2.47\%), (2) action to apply for the degrees (n=312, 20.27\%), (3) feedback on the accomplishment of goals (n=203, 13.19\%), (4) interpersonal interaction (n=794, 51.59\%), and (5) expression of personal feelings (n=192, 12.48\%). Most notably, the results identified underlying social and psychological motivations behind using the forum to discuss obtaining academic degrees for smoking cessation. Specifically, members were found to engage in sharing behavior (n=423, 27.49\%) over other forms of interaction such as providing recommendations or encouragement. Moreover, expressions of personal feelings about achieving degrees were generally positive. It was possible that members hid their negative feelings (such as doubt, carelessness, and dislike) in the discussion. Conclusions: The virtual academic degrees in the OSCC created opportunities for self-presentation for participants. They also improved their self-efficacy to persist in smoking cessation by providing progressive challenges. They served as social bonds connecting different community members, triggering interpersonal interactions, and inducing positive feelings. They also helped realize members' desire to influence or to be influenced by others. Similar nonfinancial rewards could be adopted in various smoking cessation projects to enhance participation and sustainability. ",
doi="10.2196/42260",
url="https://www.jmir.org/2023/1/e42260",
url="http://www.ncbi.nlm.nih.gov/pubmed/37402146"
}


@Article{info:doi/10.2196/46342,
author="Pleasants, Elizabeth
and Ryan, Holmes Julia
and Ren, Cheng
and Prata, Ndola
and Gomez, Manchikanti Anu
and Marshall, Cassondra",
title="Exploring Language Used in Posts on r/birthcontrol: Case Study Using Data From Reddit Posts and Natural Language Processing to Advance Contraception Research",
journal="J Med Internet Res",
year="2023",
month="Jun",
day="30",
volume="25",
pages="e46342",
keywords="contraception",
keywords="big data",
keywords="Reddit",
keywords="social networking site",
keywords="contraceptive side effects",
keywords="natural language processing",
keywords="reproductive autonomy",
abstract="Background: Contraceptive choice is central to reproductive autonomy. The internet, including social networking sites like Reddit, is an important resource for people seeking contraceptive information and support. A subreddit dedicated to contraception, r/birthcontrol, provides a platform for people to post about contraception. Objective: This study explored the use of r/birthcontrol, from the inception of the subreddit through the end of 2020. We describe the web-based community, identify distinctive interests and themes based upon the textual content of posts, and explore the content of posts with the most user engagement (ie, ``popular'' posts). Methods: Data were obtained from the PushShift Reddit application programming interface from the establishment of r/birthcontrol to the start date of analysis (July 21, 2011, to December 31, 2020). User interactions within the subreddit were analyzed to describe community use over time, specifically the commonality of use based on the volume of posts, the length of posts (character count), and the proportion of posts with any and each flair applied. ``Popular'' posts on r/birthcontrol were determined based on the number of comments and ``scores,'' or upvotes minus downvotes; popular posts had 9 comments and a score of ?3. Term Frequency-Inverse Document Frequency (TF-IDF) analyses were run on all posts with flairs applied, posts within each flair group, and popular posts within each flair group to characterize and compare the distinctive language used in each group. Results: There were 105,485 posts to r/birthcontrol during the study period, with the volume of posts increasing over time. Within the time frame for which flairs were available on r/birthcontrol (after February 4, 2016), users applied flairs to 78\% (n=73,426) of posts. Most posts contained exclusively textual content (n=66,071, 96\%), had comments (n=59,189, 86\%), and had a score (n=66,071, 96\%). Posts averaged 731 characters in length (median 555). ``SideEffects!?'' was the most frequently used flair overall (n=27,530, 40\%), while ``Experience'' (n=719, 31\%) and ``SideEffects!?'' (n=672, 29\%) were most common among popular posts. TF-IDF analyses of all posts showed interest in contraceptive methods, menstrual experiences, timing, feelings, and unprotected sex. While TF-IDF results for posts with each flair varied, the contraceptive pill, menstrual experiences, and timing were discussed across flair groups. Among popular posts, intrauterine devices and contraceptive use experiences were often discussed. Conclusions: People commonly wrote about contraceptive side effects and experiences using methods, highlighting the value of r/birthcontrol as a space to post about aspects of contraceptive use that are not well addressed by clinical contraceptive counseling. The value of real-time, open-access data on contraceptive users' interests is especially high given the shifting landscape of and increasing constraints on reproductive health care in the United States. ",
doi="10.2196/46342",
url="https://www.jmir.org/2023/1/e46342",
url="http://www.ncbi.nlm.nih.gov/pubmed/37389907"
}


@Article{info:doi/10.2196/45024,
author="Yang, Kunhao
and Tanaka, Mikihito",
title="Crowdsourcing Knowledge Production of COVID-19 Information on Japanese Wikipedia in the Face of Uncertainty: Empirical Analysis",
journal="J Med Internet Res",
year="2023",
month="Jun",
day="29",
volume="25",
pages="e45024",
keywords="scientific uncertainty",
keywords="COVID-19",
keywords="Wikipedia",
keywords="crowdsourcing information production",
abstract="Background: A worldwide overabundance of information comprising misinformation, rumors, and propaganda concerning COVID-19 has been observed in addition to the pandemic. By addressing this data confusion, Wikipedia has become an important source of information. Objective: This study aimed to investigate how the editors of Wikipedia have handled COVID-19--related information. Specifically, it focused on 2 questions: What were the knowledge preferences of the editors who participated in producing COVID-19--related information? and How did editors with different knowledge preferences collaborate? Methods: This study used a large-scale data set, including >2 million edits in the histories of 1857 editors who edited 133 articles related to COVID-19 on Japanese Wikipedia. Machine learning methods, including graph neural network methods, Bayesian inference, and Granger causality analysis, were used to establish the editors' topic proclivity and collaboration patterns. Results: Overall, 3 trends were observed. Two groups of editors were involved in the production of information on COVID-19. One group had a strong preference for sociopolitical topics (social-political group), and the other group strongly preferred scientific and medical topics (scientific-medical group). The social-political group played a central role (contributing 16,544,495/23,485,683, 70.04\% of bits of content and 57,969/76,673, 75.61\% of the references) in the information production part of the COVID-19 articles on Wikipedia, whereas the scientific-medical group played only a secondary role. The severity of the pandemic in Japan activated the editing behaviors of the social-political group, leading them to contribute more to COVID-19 information production on Wikipedia while simultaneously deactivating the editing behaviors of the scientific-medical group, resulting in their less contribution to COVID-19 information production on Wikipedia (Pearson correlation coefficient=0.231; P<.001). Conclusions: The results of this study showed that lay experts (ie, Wikipedia editors) in the fields of science and medicine tended to remain silent when facing high scientific uncertainty related to the pandemic. Considering the high quality of the COVID-19--related articles on Japanese Wikipedia, this research also suggested that the sidelining of the science and medicine editors in discussions is not necessarily a problem. Instead, the social and political context of the issues with high scientific uncertainty is more important than the scientific discussions that support accuracy. ",
doi="10.2196/45024",
url="https://www.jmir.org/2023/1/e45024",
url="http://www.ncbi.nlm.nih.gov/pubmed/37384371"
}


@Article{info:doi/10.2196/39831,
author="Dunn, Tyler
and Patel, Shyam
and Milam, J. Adam
and Brinkman, Joseph
and Gorlin, Andrew
and Harbell, W. Monica",
title="Influence of Social Media on Applicant Perceptions of Anesthesiology Residency Programs During the COVID-19 Pandemic: Quantitative Survey",
journal="JMIR Med Educ",
year="2023",
month="Jun",
day="29",
volume="9",
pages="e39831",
keywords="anesthesiology residency",
keywords="application",
keywords="COVID-19 pandemic",
keywords="social media",
keywords="impact",
keywords="residency",
keywords="anesthesia",
keywords="anesthesiology",
keywords="pandemic",
keywords="effectiveness",
keywords="restrictions",
keywords="barriers",
keywords="rotations",
keywords="visits",
keywords="interviews",
keywords="applicants",
keywords="perception",
keywords="students",
keywords="program",
abstract="Background: Social media may be an effective tool in residency recruitment, given its ability to engage a broad audience; however, there are limited data regarding the influence of social media on applicants' evaluation of anesthesiology residency programs. Objective: This study evaluates the influence of social media on applicants' perceptions of anesthesiology residency programs during the COVID-19 pandemic to allow programs to evaluate the importance of a social media presence for residency recruitment. The study also sought to understand if there were differences in the use of social media by applicant demographic characteristics (eg, race, ethnicity, gender, and age). We hypothesized that given the COVID-19 pandemic restrictions on visiting rotations and the interview process, the social media presence of anesthesiology residency programs would have a positive impact on the recruitment process and be an effective form of communication about program characteristics. Methods: All anesthesiology residency applicants who applied to Mayo Clinic Arizona were emailed a survey in October 2020 along with statements regarding the anonymity and optional nature of the survey. The 20-item Qualtrics survey included questions regarding subinternship rotation completion, social media resource use and impact (eg, ``residency-based social media accounts positively impacted my opinion of the program''), and applicant demographic characteristics. Descriptive statistics were examined, and perceptions of social media were stratified by gender, race, and ethnicity; a factor analysis was performed, and the resulting scale was regressed on race, ethnicity, age, and gender. Results: The survey was emailed to 1091 individuals who applied to the Mayo Clinic Arizona anesthesiology residency program; there were 640 unique responses recorded (response rate=58.6\%). Nearly 65\% of applicants reported an inability to complete 2 or more planned subinternships due to COVID-19 restrictions (n=361, 55.9\%), with 25\% of applicants reporting inability to do any visiting student rotations (n=167). Official program websites (91.5\%), Doximity (47.6\%), Instagram (38.5\%), and Twitter (19.4\%) were reported as the most used resources by applicants. The majority of applicants (n=385, 67.3\%) agreed that social media was an effective means to inform applicants, and 57.5\% (n=328) of them indicated that social media positively impacted their perception of the program. An 8-item scale with good reliability was created, representing the importance of social media (Cronbach $\alpha$=.838). There was a positive and statistically significant relationship such that male applicants (standardized $\beta$=.151; P=.002) and older applicants ($\beta$=.159; P<.001) had less trust and reliance in social media for information regarding anesthesiology residency programs. The applicants' race and ethnicity were not associated with the social media scale ($\beta$=--.089; P=.08). Conclusions: Social media was an effective means to inform applicants, and generally positively impacted applicants' perception of programs. Thus, residency programs should consider investing time and resources toward building a social media presence to improve resident recruitment. ",
doi="10.2196/39831",
url="https://mededu.jmir.org/2023/1/e39831",
url="http://www.ncbi.nlm.nih.gov/pubmed/37205642"
}


@Article{info:doi/10.2196/41997,
author="Weber, Matthew
and Armour, L. Veronica
and Lindstadt, Calandra
and Yanovitzky, Itzhak",
title="Testing Multiple Methods to Effectively Promote Use of a Knowledge Portal to Health Policy Makers: Quasi-Experimental Evaluation",
journal="J Med Internet Res",
year="2023",
month="Jun",
day="28",
volume="25",
pages="e41997",
keywords="depression",
keywords="depression screening",
keywords="policy making",
keywords="Google Ads",
keywords="analytics",
keywords="knowledge brokers",
keywords="knowledge sharing",
keywords="online",
keywords="resources",
keywords="teen",
keywords="young adult",
keywords="effectiveness",
abstract="Background: Health policy makers and advocates increasingly utilize online resources for policy-relevant knowledge. Knowledge brokering is one potential mechanism to encourage the use of research evidence in policy making, but the mechanisms of knowledge brokerage in online spaces are understudied. This work looks at knowledge brokerage through the launch of Project ASPEN, an online knowledge portal developed in response to a New Jersey legislative act that established a pilot program for adolescent depression screening for young adults in grades 7-12. Objective: This study compares the ability to drive policy brief downloads by policy makers and advocates from the Project ASPEN knowledge portal using a variety of online methods to promote the knowledge portal. Methods: The knowledge portal was launched on February 1, 2022, and a Google Ad campaign was run between February 27, 2022, and March 26, 2022. Subsequently, a targeted social media campaign, an email campaign, and tailored research presentations were used to promote the website. Promotional activities ended on May 31, 2022. Website analytics were used to track a variety of actions including new users coming to the website, page views, and policy brief downloads. Statistical analysis was used to assess the efficacy of different approaches. Results: The campaign generated 2837 unique user visits to the knowledge portal and 4713 page views. In addition, the campaign generated 6.5 policy web page views/day and 0.7 policy brief downloads/day compared with 1.8 views/day and 0.5 downloads/day in the month following the campaign. The rate of policy brief page view conversions was significantly higher for Google Ads compared with other channels such as email (16.0 vs 5.4; P<.001) and tailored research presentations (16.0 vs 0.8; P<.001). The download conversion rate for Google Ads was significantly higher compared with social media (1.2 vs 0.1; P<.001) and knowledge brokering activities (1.2 vs 0.2; P<.001). By contrast, the download conversion rate for the email campaign was significantly higher than that for social media (1.0 vs 0.1; P<.001) and tailored research presentations (1.0 vs 0.2; P<.001). While Google Ads for this campaign cost an average of US \$2.09 per click, the cost per conversion was US \$11 per conversion to drive targeted policy web page views and US \$147 per conversion to drive policy brief downloads. While other approaches drove less traffic, those approaches were more targeted and cost-effective. Conclusions: Four tactics were tested to drive user engagement with policy briefs on the Project ASPEN knowledge portal. Google Ads was shown to be effective in driving a high volume of policy web page views but was ineffective in terms of relative costs. More targeted approaches such as email campaigns and tailored research presentations given to policy makers and advocates to promote the use of research evidence on the knowledge portal website are likely to be more effective when balancing goals and cost-effectiveness. ",
doi="10.2196/41997",
url="https://www.jmir.org/2023/1/e41997",
url="http://www.ncbi.nlm.nih.gov/pubmed/37379073"
}


@Article{info:doi/10.2196/46604,
author="Tao, Xiangyu
and Fisher, Celia",
title="Associations Among Web-Based Civic Engagement and Discrimination, Web-Based Social Support, and Mental Health and Substance Use Risk Among LGBT Youth: Cross-Sectional Survey Study",
journal="J Med Internet Res",
year="2023",
month="Jun",
day="26",
volume="25",
pages="e46604",
keywords="lesbian, gay, bisexual, and transgender or nonbinary",
keywords="LGBT adolescents",
keywords="social media",
keywords="discrimination",
keywords="social support",
keywords="mental health",
keywords="substance use",
abstract="Background: Social media use is ubiquitous among lesbian, gay, bisexual, and transgender or nonbinary (LGBT) adolescents. The time spent on LGBT sites and involvement in social justice--oriented web-based civic activities can increase exposure to heterosexist and transphobic posts, resulting in increases in depression, anxiety, and substance use. Collaborative social justice civic engagement may also increase LGBT adolescents' social support on the web, which may buffer the mental health and substance use risks associated with web-based discrimination. Objective: Drawing on the minority stress and stress-buffering hypotheses, this study aimed to test time spent on LGBT sites, involvement in web-based social justice activities, the mediating effect of web-based discrimination, and the moderating effect of web-based social support on mental health and substance use. Methods: An anonymous web-based survey conducted from October 20 to November 18, 2022, analyzed data from 571 respondents (mean age 16.4, SD 1.1 years): 125 cisgender lesbian girls, 186 cisgender gay boys, 111 cisgender bisexual adolescents, and 149 transgender or nonbinary adolescents. Measures included demographics, web-based LGBT identity disclosure, hours per week spent on LGBT social media sites, engagement in web-based social justice activities (Online Civic Engagement Behavior Construct), exposure to web-based discrimination (Online Victimization Scale), web-based social support (adapted from scales examining web-based interactions), depressive and anxiety symptoms, and substance use (the Patient Health Questionnaire modified for Adolescents; Generalized Anxiety Disorder 7-item; and Car, Relax, Alone, Forget, Friends, Trouble Screening Test). Results: The time spent on LGBT social media sites was unrelated to web-based discrimination after civic engagement was accounted for (90\% CI ?0.007 to 0.004). Web-based social justice civic engagement was positively associated with social support ($\beta$=.4, 90\% CI 0.2-0.4), exposure to discrimination ($\beta$=.6, 90\% CI 0.5-0.7), and higher substance use risk ($\beta$=.2, 90\% CI 0.2-0.6). Consistent with minority stress theory, exposure to web-based discrimination fully mediated the positive association between LGBT justice civic engagement and depressive ($\beta$=.3, 90\% CI 0.2-0.4) and anxiety symptoms ($\beta$=.3, 90\% CI 0.2-0.4). Web-based social support did not moderate the association between exposure to discrimination with depressive (90\% CI ?0.07 to 0.1) and anxiety symptoms (90\% CI ?0.06 to 0.1) and substance use (90\% CI ?0.04 to 0.01). Conclusions: This study highlights the importance of examining LGBT youth's specific web-based activities and the need for future research to focus on the intersectional experiences of LGBT adolescents from racial and ethnic minoritized groups through culturally sensitive questions. This study also calls for social media platforms to implement policies that mitigate the effects of algorithms that expose youth to heterosexist and transphobic messaging, such as adopting machine learning algorithms that can efficiently recognize and remove harmful content. ",
doi="10.2196/46604",
url="https://www.jmir.org/2023/1/e46604",
url="http://www.ncbi.nlm.nih.gov/pubmed/37358882"
}


@Article{info:doi/10.2196/43349,
author="Fu, Jiaqi
and Li, Chaixiu
and Zhou, Chunlan
and Li, Wenji
and Lai, Jie
and Deng, Shisi
and Zhang, Yujie
and Guo, Zihan
and Wu, Yanni",
title="Methods for Analyzing the Contents of Social Media for Health Care: Scoping Review",
journal="J Med Internet Res",
year="2023",
month="Jun",
day="26",
volume="25",
pages="e43349",
keywords="social media",
keywords="health care",
keywords="internet information",
keywords="content analysis",
keywords="big data mining",
keywords="review method",
keywords="scoping",
keywords="online information",
keywords="methodology",
abstract="Background: Given the rapid development of social media, effective extraction and analysis of the contents of social media for health care have attracted widespread attention from health care providers. As far as we know, most of the reviews focus on the application of social media, and there is a lack of reviews that integrate the methods for analyzing social media information for health care. Objective: This scoping review aims to answer the following 4 questions: (1) What types of research have been used to investigate social media for health care, (2) what methods have been used to analyze the existing health information on social media, (3) what indicators should be applied to collect and evaluate the characteristics of methods for analyzing the contents of social media for health care, and (4) what are the current problems and development directions of methods used to analyze the contents of social media for health care? Methods: A scoping review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was conducted. We searched PubMed, the Web of Science, EMBASE, the Cumulative Index to Nursing and Allied Health Literature, and the Cochrane Library for the period from 2010 to May 2023 for primary studies focusing on social media and health care. Two independent reviewers screened eligible studies against inclusion criteria. A narrative synthesis of the included studies was conducted. Results: Of 16,161 identified citations, 134 (0.8\%) studies were included in this review. These included 67 (50.0\%) qualitative designs, 43 (32.1\%) quantitative designs, and 24 (17.9\%) mixed methods designs. The applied research methods were classified based on the following aspects: (1) manual analysis methods (content analysis methodology, grounded theory, ethnography, classification analysis, thematic analysis, and scoring tables) and computer-aided analysis methods (latent Dirichlet allocation, support vector machine, probabilistic clustering, image analysis, topic modeling, sentiment analysis, and other natural language processing technologies), (2) categories of research contents, and (3) health care areas (health practice, health services, and health education). Conclusions: Based on an extensive literature review, we investigated the methods for analyzing the contents of social media for health care to determine the main applications, differences, trends, and existing problems. We also discussed the implications for the future. Traditional content analysis is still the mainstream method for analyzing social media content, and future research may be combined with big data research. With the progress of computers, mobile phones, smartwatches, and other smart devices, social media information sources will become more diversified. Future research can combine new sources, such as pictures, videos, and physiological signals, with online social networking to adapt to the development trend of the internet. More medical information talents need to be trained in the future to better solve the problem of network information analysis. Overall, this scoping review can be useful for a large audience that includes researchers entering the field. ",
doi="10.2196/43349",
url="https://www.jmir.org/2023/1/e43349",
url="http://www.ncbi.nlm.nih.gov/pubmed/37358900"
}


@Article{info:doi/10.2196/46575,
author="Brehon, Katelyn
and MacIsaac, Rob
and Bhatia, Zahra
and Buck, Taryn
and Charbonneau, Rebecca
and Crochetiere, Steven
and Donia, Scott
and Daoust, Jason
and Ho, Chester
and Kainth, Hardeep
and Loewen, Janee
and Lorch, Brandice
and Mastrodimos, Kiesha
and Neunzig, Brittney
and Papathanassoglou, Elizabeth
and Parmar, Rajvir
and Pohar Manhas, Kiran
and Tenove, Terry
and Velji, Elysha
and Loyola-Sanchez, Adalberto",
title="Outcomes of Implementing a Webinar-Based Strategy to Improve Spinal Cord Injury Knowledge and Community Building: Convergent Mixed Methods Study",
journal="JMIR Rehabil Assist Technol",
year="2023",
month="Jun",
day="23",
volume="10",
pages="e46575",
keywords="spinal cord injury",
keywords="telehealth",
keywords="webinars",
keywords="mixed methods",
keywords="implementation",
abstract="Background: COVID-19 disrupted services received by persons with spinal cord injury (SCI) worldwide. The International Disability Alliance declared the need for a disability-inclusive response to the COVID-19 crisis, as decreased access to health care services for individuals living with varying levels of function was unacceptable. As a result, an SCI community in Canada created a novel webinar-based strategy aimed at improving access to self-management information for people living with SCI and other stakeholders. However, although telehealth practices have previously been used effectively in SCI management and rehabilitation, little to no scholarship has investigated the outcomes of implementing a webinar-based telehealth strategy in this population. Objective: This study aims to understand the outcomes of implementing the webinar series. Specifically, the authors aimed to determine the reach of the series; understand its impact on social connectedness, perceptions of disability, and overall quality of interactions among persons with SCI, their families, service providers, and the public at large; and explore the long-term sustainability of the initiative. Methods: The authors implemented a community-based participatory strategy to define a convergent mixed methods design to triangulate qualitative and quantitative data collected simultaneously. Quantitative methods included pop-up questions administered during the live webinars, surveys administered following webinars, and an analysis of YouTube analytics. Qualitative methods included semistructured interviews with persons with SCI and health care providers who attended at least one webinar. The results were integrated, following methods adapted from Creswell and Clark. Results: A total of 234 individuals attended at least 1 of the 6 webinars that took place during the 6-month study period. In total, 13.2\% (31/234) of the participants completed the postwebinar survey, and 23\% (7/31) participated in the semistructured interviews. The reach of the webinar series was mainly to persons with SCI, followed by health professionals, with most of them living in urban areas. The topics sexuality and research were the most viewed on YouTube. The knowledge disseminated during the webinars was mainly perceived as valid and useful, related to the fact that the presentation format involved people with lived experience and clinical experts. The webinars did not necessarily help build a new extended community of people involved in SCI but helped strengthen the existing community of people with SCI in Alberta. The webinar positively influenced the perceptions of normality and disability regarding people with SCI. The webinar format was perceived as highly usable and accessible. Conclusions: The webinar series was associated with improved participant knowledge of what is possible to achieve after an SCI and their perceptions of disability. The long-term implementation of this initiative is feasible, but further considerations to increase its reach to rural areas and ensure the integration of diverse individuals should be taken. ",
doi="10.2196/46575",
url="https://rehab.jmir.org/2023/1/e46575",
url="http://www.ncbi.nlm.nih.gov/pubmed/37351945"
}


@Article{info:doi/10.2196/44226,
author="Neil-Sztramko, E. Sarah
and Dobbins, Maureen
and Williams, Allison",
title="Evaluation of a Knowledge Mobilization Campaign to Promote Support for Working Caregivers in Canada: Quantitative Evaluation",
journal="JMIR Form Res",
year="2023",
month="Jun",
day="22",
volume="7",
pages="e44226",
keywords="informal caregiver",
keywords="knowledge mobilization",
keywords="social media",
keywords="workplace standard",
abstract="Background: As population demographics continue to shift, many employees will also be tasked with providing informal care to a friend or family member. The balance between working and caregiving can greatly strain carer-employees. Caregiver-friendly work environments can help reduce this burden. However, there is little awareness of the benefits of these workplace practices, and they have not been widely adopted in Canada. An awareness-generating campaign with the core message ``supporting caregivers at work makes good business sense'' was created leading up to Canada's National Caregivers Day on April 5, 2022. Objective: Our primary objective is to describe the campaign's reach and engagement, including social media, email, and website activity, and our secondary objective is to compare engagement metrics across social media platforms. Methods: An awareness-generating campaign was launched on September 22, 2021, with goals to (1) build awareness about the need for caregiver-friendly workplaces and (2) direct employees and employers to relevant resources on a campaign website. Content was primarily delivered through 4 social media platforms (Twitter, LinkedIn, Facebook, and Instagram), and supplemented by direct emails through a campaign partner, and through webinars. Total reach, defined as the number of impressions, and quality of engagement, defined per social media platform as the engagement rate per post, average site duration, and page depth, were captured and compared through site-specific analytics on Facebook, Instagram, Twitter, and LinkedIn throughout the awareness-generating campaign. The number of views, downloads, bounce rate, and time on the page for the website were counted using Google Analytics. Open and click-through rates were measured using email analytics, and webinar registrants and attendees were also tracked. Results: Data were collected from September 22, 2021, to April 12, 2022. During this time, 30 key messages were developed and disseminated through 74 social media tiles. While Facebook posts generated the most extensive reach (137,098 impressions), the quality of the engagement was low (0.561 engagement per post). Twitter resulted in the highest percentage of impressions that resulted in engagement (24\%), and those who viewed resources through Twitter spent a substantial amount of time on the page (3 minute 5 second). Website users who visited the website through Instagram spent the most time on the website (5 minute 44 second) and had the greatest page depth (2.20 pages), and the overall reach was low (3783). Recipients' engagement with email content met industry standards. Webinar participation ranged from 57 to 78 attendees. Conclusions: This knowledge mobilization campaign reached a large audience and generated engagement in content. Twitter is most helpful for this type of knowledge mobilization. Further work is needed to evaluate the characteristics of individuals engaging in this content and to work more closely with employers and employees to move from engagement and awareness to adopt caregiver-friendly workplace practices. ",
doi="10.2196/44226",
url="https://formative.jmir.org/2023/1/e44226",
url="http://www.ncbi.nlm.nih.gov/pubmed/37347525"
}


@Article{info:doi/10.2196/44586,
author="Lotto, Matheus
and Zakir Hussain, Irfhana
and Kaur, Jasleen
and Butt, Ahmad Zahid
and Cruvinel, Thiago
and Morita, P. Plinio",
title="Analysis of Fluoride-Free Content on Twitter: Topic Modeling Study",
journal="J Med Internet Res",
year="2023",
month="Jun",
day="20",
volume="25",
pages="e44586",
keywords="fluoride",
keywords="health information",
keywords="infodemiology",
keywords="infoveillance",
keywords="misinformation",
keywords="social media",
keywords="Twitter",
keywords="oral care",
keywords="healthy lifestyle",
keywords="hygiene",
abstract="Background: Although social media has the potential to spread misinformation, it can also be a valuable tool for elucidating the social factors that contribute to the onset of negative beliefs. As a result, data mining has become a widely used technique in infodemiology and infoveillance research to combat misinformation effects. On the other hand, there is a lack of studies that specifically aim to investigate misinformation about fluoride on Twitter. Web-based individual concerns on the side effects of fluoridated oral care products and tap water stimulate the emergence and propagation of convictions that boost antifluoridation activism. In this sense, a previous content analysis--driven study demonstrated that the term fluoride-free was frequently associated with antifluoridation interests. Objective: This study aimed to analyze ``fluoride-free'' tweets regarding their topics and frequency of publication over time. Methods: A total of 21,169 tweets published in English between May 2016 and May 2022 that included the keyword ``fluoride-free'' were retrieved by the Twitter application programming interface. Latent Dirichlet allocation (LDA) topic modeling was applied to identify the salient terms and topics. The similarity between topics was calculated through an intertopic distance map. Moreover, an investigator manually assessed a sample of tweets depicting each of the most representative word groups that determined specific issues. Lastly, additional data visualization was performed regarding the total count of each topic of fluoride-free record and its relevance over time, using Elastic Stack software. Results: We identified 3 issues by applying the LDA topic modeling: ``healthy lifestyle'' (topic 1), ``consumption of natural/organic oral care products'' (topic 2), and ``recommendations for using fluoride-free products/measures'' (topic 3). Topic 1 was related to users' concerns about leading a healthier lifestyle and the potential impacts of fluoride consumption, including its hypothetical toxicity. Complementarily, topic 2 was associated with users' personal interests and perceptions of consuming natural and organic fluoride-free oral care products, whereas topic 3 was linked to users' recommendations for using fluoride-free products (eg, switching from fluoridated toothpaste to fluoride-free alternatives) and measures (eg, consuming unfluoridated bottled water instead of fluoridated tap water), comprising the propaganda of dental products. Additionally, the count of tweets on fluoride-free content decreased between 2016 and 2019 but increased again from 2020 onward. Conclusions: Public concerns toward a healthy lifestyle, including the adoption of natural and organic cosmetics, seem to be the main motivation of the recent increase of ``fluoride-free'' tweets, which can be boosted by the propagation of fluoride falsehoods on the web. Therefore, public health authorities, health professionals, and legislators should be aware of the spread of fluoride-free content on social media to create and implement strategies against their potential health damage for the population. ",
doi="10.2196/44586",
url="https://www.jmir.org/2023/1/e44586",
url="http://www.ncbi.nlm.nih.gov/pubmed/37338975"
}


@Article{info:doi/10.2196/45787,
author="Kato, Mio
and Yoshimatsu, Fumi
and Saito, Tomoya",
title="Trends in Media Coverage During the Monkeypox Outbreak: Content Analysis",
journal="J Med Internet Res",
year="2023",
month="Jun",
day="19",
volume="25",
pages="e45787",
keywords="risk perception",
keywords="protection motivation theory",
keywords="agenda setting",
keywords="news media",
keywords="media",
keywords="infectious disease",
keywords="monkeypox",
doi="10.2196/45787",
url="https://www.jmir.org/2023/1/e45787",
url="http://www.ncbi.nlm.nih.gov/pubmed/37335596"
}


@Article{info:doi/10.2196/47256,
author="Cascalheira, J. Cory
and Flinn, E. Ryan
and Zhao, Yuxuan
and Klooster, Dannie
and Laprade, Danica
and Hamdi, Muhammad Shah
and Scheer, R. Jillian
and Gonzalez, Alejandra
and Lund, M. Emily
and Gomez, N. Ivan
and Saha, Koustuv
and De Choudhury, Munmun",
title="Models of Gender Dysphoria Using Social Media Data for Use in Technology-Delivered Interventions: Machine Learning and Natural Language Processing Validation Study",
journal="JMIR Form Res",
year="2023",
month="Jun",
day="16",
volume="7",
pages="e47256",
keywords="gender diverse",
keywords="gender dysphoria",
keywords="social media",
keywords="social computing",
keywords="digital health",
keywords="mobile phone",
abstract="Background: The optimal treatment for gender dysphoria is medical intervention, but many transgender and nonbinary people face significant treatment barriers when seeking help for gender dysphoria. When untreated, gender dysphoria is associated with depression, anxiety, suicidality, and substance misuse. Technology-delivered interventions for transgender and nonbinary people can be used discretely, safely, and flexibly, thereby reducing treatment barriers and increasing access to psychological interventions to manage distress that accompanies gender dysphoria. Technology-delivered interventions are beginning to incorporate machine learning (ML) and natural language processing (NLP) to automate intervention components and tailor intervention content. A critical step in using ML and NLP in technology-delivered interventions is demonstrating how accurately these methods model clinical constructs. Objective: This study aimed to determine the preliminary effectiveness of modeling gender dysphoria with ML and NLP, using transgender and nonbinary people's social media data. Methods: Overall, 6 ML models and 949 NLP-generated independent variables were used to model gender dysphoria from the text data of 1573 Reddit (Reddit Inc) posts created on transgender- and nonbinary-specific web-based forums. After developing a codebook grounded in clinical science, a research team of clinicians and students experienced in working with transgender and nonbinary clients used qualitative content analysis to determine whether gender dysphoria was present in each Reddit post (ie, the dependent variable). NLP (eg, n-grams, Linguistic Inquiry and Word Count, word embedding, sentiment, and transfer learning) was used to transform the linguistic content of each post into predictors for ML algorithms. A k-fold cross-validation was performed. Hyperparameters were tuned with random search. Feature selection was performed to demonstrate the relative importance of each NLP-generated independent variable in predicting gender dysphoria. Misclassified posts were analyzed to improve future modeling of gender dysphoria. Results: Results indicated that a supervised ML algorithm (ie, optimized extreme gradient boosting [XGBoost]) modeled gender dysphoria with a high degree of accuracy (0.84), precision (0.83), and speed (1.23 seconds). Of the NLP-generated independent variables, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) clinical keywords (eg, dysphoria and disorder) were most predictive of gender dysphoria. Misclassifications of gender dysphoria were common in posts that expressed uncertainty, featured a stressful experience unrelated to gender dysphoria, were incorrectly coded, expressed insufficient linguistic markers of gender dysphoria, described past experiences of gender dysphoria, showed evidence of identity exploration, expressed aspects of human sexuality unrelated to gender dysphoria, described socially based gender dysphoria, expressed strong affective or cognitive reactions unrelated to gender dysphoria, or discussed body image. Conclusions: Findings suggest that ML- and NLP-based models of gender dysphoria have significant potential to be integrated into technology-delivered interventions. The results contribute to the growing evidence on the importance of incorporating ML and NLP designs in clinical science, especially when studying marginalized populations. ",
doi="10.2196/47256",
url="https://formative.jmir.org/2023/1/e47256",
url="http://www.ncbi.nlm.nih.gov/pubmed/37327053"
}


@Article{info:doi/10.2196/43037,
author="Anto, Ailin
and Asif, Omar Rafey
and Basu, Arunima
and Kanapathipillai, Dylan
and Salam, Haadi
and Selim, Rania
and Zaman, Jahed
and Eisingerich, Benedikt Andreas",
title="Exploring the Impact of Social Media on Anxiety Among University Students in the United Kingdom: Qualitative Study",
journal="JMIR Form Res",
year="2023",
month="Jun",
day="16",
volume="7",
pages="e43037",
keywords="social media",
keywords="anxiety",
keywords="university student",
keywords="university",
keywords="college",
keywords="student",
keywords="qualitative",
keywords="mental health",
keywords="mental well-being",
keywords="thematic analysis",
keywords="stress",
keywords="health care professional",
keywords="humanistic",
keywords="social science",
keywords="undergraduate",
keywords="narrative inquiry",
keywords="social network",
keywords="United Kingdom",
abstract="Background: The rapid surge in social media platforms has significant implications for users' mental health, particularly anxiety. In the case of social media, the impact on mental well-being has been highlighted by multiple stakeholders as a cause for concern. However, there has been limited research into how the association between social media and anxiety arises, specifically among university students---the generation that has seen the introduction and evolution of social media, and currently lives through the medium. Extant systematic literature reviews within this area of research have not yet focused on university students or anxiety, rather predominantly investigating adolescents or generalized mental health symptoms and disorders. Furthermore, there is little to no qualitative data exploring the association between social media and anxiety among university students. Objective: The purpose of this study is to conduct a systematic literature review of the existing literature and a qualitative study that aims to develop foundational knowledge around the association of social media and anxiety among university students and enhance extant knowledge and theory. Methods: A total of 29 semistructured interviews were conducted, comprising 19 male students (65.5\%) and 10 female students (34.5\%) with a mean age of 21.5 years. All students were undergraduates from 6 universities across the United Kingdom, with most students studying in London (89.7\%). Participants were enrolled through a homogenous purposive sampling technique via social media channels, word of mouth, and university faculties. Recruitment was suspended at the point of data saturation. Participants were eligible for the study if they were university students in the United Kingdom and users of social media. Results: Thematic analysis resulted in 8 second-order themes: 3 mediating factors that decrease anxiety levels and 5 factors that increase anxiety levels. Social media decreased anxiety through positive experiences, social connectivity, and escapism. Social media increased anxiety through stress, comparison, fear of missing out, negative experiences, and procrastination. Conclusions: This qualitative study sheds critical light on how university students perceive how social media affects their anxiety levels. Students revealed that social media did impact their anxiety levels and considered it an important factor in their mental health. Thus, it is essential to educate stakeholders, including students, university counselors, and health care professionals, about the potential impact of social media on students' anxiety levels. Since anxiety is a multifactorial condition, pinpointing the main stressors in a person's life, such as social media use, may help manage these patients more effectively. The current research highlights that there are also many benefits to social media, and uncovering these may help in producing more holistic management plans for anxiety, reflective of the students' social media usage. ",
doi="10.2196/43037",
url="https://formative.jmir.org/2023/1/e43037",
url="http://www.ncbi.nlm.nih.gov/pubmed/37327030"
}


@Article{info:doi/10.2196/46793,
author="Li, Ju-Shuang
and Gu, Yu-Zhou
and Hou, Feng-Su
and Lu, Yong-Heng
and Fan, Xiao-Ru
and Qiu, Jia-Ling
and Yang, Qing-Ling
and Gu, Jing
and Li, Jing-Hua
and Xu, Roman Dong
and Hao, Chun",
title="Delivery of WeChat-Based HIV Result e-Reports in Social Networks for Recruitment of High-Risk Population: Baseline Data From a Cluster Randomized Controlled Trial",
journal="J Med Internet Res",
year="2023",
month="Jun",
day="15",
volume="25",
pages="e46793",
keywords="social network strategy",
keywords="HIV result e-report",
keywords="recruitment",
keywords="MSM",
abstract="Background: Disclosure of infectious disease status to social network peers can facilitate reaching and early detection among high-risk populations. In this era of social media, globally, HIV/AIDS represents a high burden of infectious disease. Thus, delivery of an HIV result e-report via social media presents a new approach that has the potential to improve contact with and enrollment of the high-risk population in research studies and routine practice. Objective: This study explores the effectiveness and associated factors of a recruitment strategy (ie, WeChat-based HIV e-report delivery in social networks) on the enrollment of men who have sex with men (MSM) for an HIV testing intervention study. Methods: This was an enrollment result analysis of an ongoing cluster randomized controlled trial (RCT) aiming to promote HIV testing among MSM. Recruitment of potential participants was based on the unit of an egocentric social network, which includes 1 core member (an offline tested ego as the recruiter) and several network members (online alters as network associates). Alters' enrollment and alters' transformation to ego-recruiters (alter-ego) were measured as outcomes. Recruitment outcomes were compared between the exchangeable and regular e-report groups of the RCT. Associated factors of both outcomes were also investigated, including sociodemographic characteristics, health behaviors, social network characteristics, e-report types, and online delivery information. Binary outcomes were modeled using logistic models, with Firth correction for rare events. Qualitative interviews were conducted to understand facilitators and barriers in detail for alter-ego as the subsequent wave's recruiter. Results: The e-report of 1157 egos who tested offline were delivered to 5165 alters in 3 recruitment waves; eventually, 1162 eligible alters enrolled in this RCT (response rate: 22.5\%). In the exchangeable e-report group, 544 egos recruited 467 alters, of which 35 alters transformed to alter-egos (7.5\%), whereas in the regular e-report group, 613 egos recruited 695 alters, of which 40 alters transformed to alter-egos (5.8\%). Alters' enrollment at first wave was associated with a higher number of e-reports being forwarded by the egos. Alters' transformation to alter-egos for the subsequent wave was associated with the exchangeable e-report, higher income, being a Guangzhou resident, unprotected anal intercourse, preferring self-testing, and viewing senders' e-reports frequently. Qualitative interviews revealed that the lack of awareness of e-reports' function and inadequate access to e-reports at offline testing facilities were major barriers to alters' transformation to offline ego-recruiters. Conclusions: The delivery of e-report was feasible in MSM social network, and the success and sustainability of online recruitment depended on high levels of familiarity among MSM with the digital tool. The HIV e-report exchange mechanism might promote MSM to test HIV offline to get their own e-report for exchange in the community. The e-report provides an innovative recruitment method with great potential to trace direct contacts for infectious diseases studies. ",
doi="10.2196/46793",
url="https://www.jmir.org/2023/1/e46793",
url="http://www.ncbi.nlm.nih.gov/pubmed/37318850"
}


@Article{info:doi/10.2196/43845,
author="Mark, Erica
and Nguyen, Joseph
and Choudhary, Fatima
and Lipoff, B. Jules",
title="Impact of, Factors for the Success of, and Concerns Regarding Transplant Patients' Skin Cancer Campaigns: Observational Study",
journal="JMIR Dermatol",
year="2023",
month="Jun",
day="14",
volume="6",
pages="e43845",
keywords="GoFundMe",
keywords="transplant",
keywords="skin cancer",
keywords="nonmelanoma skin cancer",
keywords="crowdfunding",
keywords="fundraising",
keywords="crowdsourcing",
keywords="insurance",
keywords="demographic",
keywords="squamous cell carcinoma",
keywords="basal cell carcinoma",
keywords="multivariate linear regression",
keywords="binary logistic regression",
abstract="Background: Due to rising health care costs, patients have sought alternative ways of addressing medical expenses. In particular, transplant patients have complex and expensive medical needs---including skin cancer surveillance---that may not be fully covered by insurance. One such method of financing medical costs is by crowdsourcing through web-based platforms, most notably GoFundMe. Objective: Previous work identified factors associated with GoFundMe campaigns' fundraising success for dermatologic diseases. We sought to characterize these factors in transplant recipients' campaigns for funds raised for covering skin cancer--related costs. These factors include demographics, campaign traits, and subjective themes. Methods: From January to April 2022, we analyzed GoFundMe campaigns using the following search terms chosen on the basis of author consensus: ``transplant skin cancer,'' ``transplant basal cell,'' ``transplant squamous,'' ``transplant melanoma,'' and ``dermatologist transplant.'' Demographic data were coded from campaign text or subjectively coded based on author consensus. Campaigns were read completely by 2 independent coders and associated with up to 3 different themes. Linear regression was performed to examine the qualities associated with success, which was defined as funds raised when controlling for campaign goals. Logistic regression was used to examine qualities associated with extremely successful campaigns, defined as those raising funds over 1.5 times the IQR. Results: Across 82 campaigns, we identified several factors that were associated with fundraiser success. Patients who experienced complications during infectious disease treatment, those who received a pancreas transplant, or those who died from their disease raised significantly more money. Patients older than 61 years raised significantly less money. Extremely successful campaigns (>US \$20,177) were associated with campaigners who emphasized a disability from their disease, those who were reluctant to ask for help, or those who died due to their disease. Conclusions: Demographic and thematic factors are associated with transplant patients' skin cancer--related fundraising success, favoring those who are younger, in more extreme situations, and appear reluctant to ask for help; these findings are consistent with those of previous studies. Additionally, transplant patients have complex and expensive dermatologic needs that may not be fully covered by insurance, as reflected in their GoFundMe campaigns. The most commonly mentioned reasons for fundraising included living expenses or loss of income, inadequate or no insurance, and end-of-life costs. Our findings may inform transplant patients how to maximize the success of their campaigns and highlight gaps in health care coverage for skin cancer--related costs. Limitations include the possibility for misclassification due to the data abstraction process and limiting data collection to fundraisers available on GoFundMe while excluding those on other websites. Further research should investigate the ethical implications of crowdfunding, financial needs of this patient population, and potential ways to improve access to routine skin cancer surveillance among patients receiving transplants. ",
doi="10.2196/43845",
url="https://derma.jmir.org/2023/1/e43845",
url="http://www.ncbi.nlm.nih.gov/pubmed/37632922"
}


@Article{info:doi/10.2196/45897,
author="Mao, Lingchao
and Chu, Emily
and Gu, Jinghong
and Hu, Tao
and Weiner, J. Bryan
and Su, Yanfang",
title="A 4D Theoretical Framework for Measuring Topic-Specific Influence on Twitter: Development and Usability Study on Dietary Sodium Tweets",
journal="J Med Internet Res",
year="2023",
month="Jun",
day="13",
volume="25",
pages="e45897",
keywords="social media",
keywords="health education",
keywords="health promotion",
keywords="dissemination strategy",
keywords="influence",
keywords="Twitter",
keywords="activity",
keywords="priority",
keywords="originality",
keywords="popularity",
abstract="Background: Social media has emerged as a prominent approach for health education and promotion. However, it is challenging to understand how to best promote health-related information on social media platforms such as Twitter. Despite commercial tools and prior studies attempting to analyze influence, there is a gap to fill in developing a publicly accessible and consolidated framework to measure influence and analyze dissemination strategies. Objective: We aimed to develop a theoretical framework to measure topic-specific user influence on Twitter and to examine its usability by analyzing dietary sodium tweets to support public health agencies in improving their dissemination strategies. Methods: We designed a consolidated framework for measuring influence that can capture topic-specific tweeting behaviors. The core of the framework is a summary indicator of influence decomposable into 4 dimensions: activity, priority, originality, and popularity. These measures can be easily visualized and efficiently computed for any Twitter account without the need for private access. We demonstrated the proposed methods by using a case study on dietary sodium tweets with sampled stakeholders and then compared the framework with a traditional measure of influence. Results: More than half a million dietary sodium tweets from 2006 to 2022 were retrieved for 16 US domestic and international stakeholders in 4 categories, that is, public agencies, academic institutions, professional associations, and experts. We discovered that World Health Organization, American Heart Association, Food and Agriculture Organization of the United Nations (UN-FAO), and World Action on Salt (WASH) were the top 4 sodium influencers in the sample. Each had different strengths and weaknesses in their dissemination strategies, and 2 stakeholders with similar overall influence, that is, UN-FAO and WASH, could have significantly different tweeting patterns. In addition, we identified exemplars in each dimension of influence. Regarding tweeting activity, a dedicated expert published more sodium tweets than any organization in the sample in the past 16 years. In terms of priority, WASH had more than half of its tweets dedicated to sodium. UN-FAO had both the highest proportion of original sodium tweets and posted the most popular sodium tweets among all sampled stakeholders. Regardless of excellence in 1 dimension, the 4 most influential stakeholders excelled in at least 2 out of 4 dimensions of influence. Conclusions: Our findings demonstrate that our method not only aligned with a traditional measure of influence but also advanced influence analysis by analyzing the 4 dimensions that contribute to topic-specific influence. This consolidated framework provides quantifiable measures for public health entities to understand their bottleneck of influence and refine their social media campaign strategies. Our framework can be applied to improve the dissemination of other health topics as well as assist policy makers and public campaign experts to maximize population impact. ",
doi="10.2196/45897",
url="https://www.jmir.org/2023/1/e45897",
url="http://www.ncbi.nlm.nih.gov/pubmed/37310774"
}


@Article{info:doi/10.2196/45556,
author="Campbell, I. Cynthia
and Chen, Ching-Hua
and Adams, R. Sara
and Asyyed, Asma
and Athale, R. Ninad
and Does, B. Monique
and Hassanpour, Saeed
and Hichborn, Emily
and Jackson-Morris, Melanie
and Jacobson, C. Nicholas
and Jones, K. Heather
and Kotz, David
and Lambert-Harris, A. Chantal
and Li, Zhiguo
and McLeman, Bethany
and Mishra, Varun
and Stanger, Catherine
and Subramaniam, Geetha
and Wu, Weiyi
and Zegers, Christopher
and Marsch, A. Lisa",
title="Patient Engagement in a Multimodal Digital Phenotyping Study of Opioid Use Disorder",
journal="J Med Internet Res",
year="2023",
month="Jun",
day="13",
volume="25",
pages="e45556",
keywords="opioid use disorder",
keywords="digital phenotyping",
keywords="medication for opioid use disorder",
keywords="MOUD",
keywords="ecological momentary assessment",
keywords="EMA",
keywords="passive sensing",
keywords="social media",
keywords="opioid",
keywords="OUD",
keywords="data collection",
keywords="smartphone",
keywords="digital health",
abstract="Background: Multiple digital data sources can capture moment-to-moment information to advance a robust understanding of opioid use disorder (OUD) behavior, ultimately creating a digital phenotype for each patient. This information can lead to individualized interventions to improve treatment for OUD. Objective: The aim is to examine patient engagement with multiple digital phenotyping methods among patients receiving buprenorphine medication for OUD. Methods: The study enrolled 65 patients receiving buprenorphine for OUD between June 2020 and January 2021 from 4 addiction medicine programs in an integrated health care delivery system in Northern California. Ecological momentary assessment (EMA), sensor data, and social media data were collected by smartphone, smartwatch, and social media platforms over a 12-week period. Primary engagement outcomes were meeting measures of minimum phone carry (?8 hours per day) and watch wear (?18 hours per day) criteria, EMA response rates, social media consent rate, and data sparsity. Descriptive analyses, bivariate, and trend tests were performed. Results: The participants' average age was 37 years, 47\% of them were female, and 71\% of them were White. On average, participants met phone carrying criteria on 94\% of study days, met watch wearing criteria on 74\% of days, and wore the watch to sleep on 77\% of days. The mean EMA response rate was 70\%, declining from 83\% to 56\% from week 1 to week 12. Among participants with social media accounts, 88\% of them consented to providing data; of them, 55\% of Facebook, 54\% of Instagram, and 57\% of Twitter participants provided data. The amount of social media data available varied widely across participants. No differences by age, sex, race, or ethnicity were observed for any outcomes. Conclusions: To our knowledge, this is the first study to capture these 3 digital data sources in this clinical population. Our findings demonstrate that patients receiving buprenorphine treatment for OUD had generally high engagement with multiple digital phenotyping data sources, but this was more limited for the social media data. International Registered Report Identifier (IRRID): RR2-10.3389/fpsyt.2022.871916 ",
doi="10.2196/45556",
url="https://www.jmir.org/2023/1/e45556",
url="http://www.ncbi.nlm.nih.gov/pubmed/37310787"
}


@Article{info:doi/10.2196/45187,
author="Gresenz, Roan Carole
and Singh, Lisa
and Wang, Yanchen
and Haber, Jaren
and Liu, Yaguang",
title="Development and Assessment of a Social Media--Based Construct of Firearm Ownership: Computational Derivation and Benchmark Comparison",
journal="J Med Internet Res",
year="2023",
month="Jun",
day="13",
volume="25",
pages="e45187",
keywords="criterion validity",
keywords="firearms ownership",
keywords="gun violence",
keywords="machine learning",
keywords="social media data",
abstract="Background: Gun violence research is characterized by a dearth of data available for measuring key constructs. Social media data may offer a potential opportunity to significantly reduce that gap, but developing methods for deriving firearms-related constructs from social media data and understanding the measurement properties of such constructs are critical precursors to their broader use. Objective: This study aimed to develop a machine learning model of individual-level firearm ownership from social media data and assess the criterion validity of a state-level construct of ownership. Methods: We used survey responses to questions on firearm ownership linked with Twitter data to construct different machine learning models of firearm ownership. We externally validated these models using a set of firearm-related tweets hand-curated from the Twitter Streaming application programming interface and created state-level ownership estimates using a sample of users collected from the Twitter Decahose application programming interface. We assessed the criterion validity of state-level estimates by comparing their geographic variance to benchmark measures from the RAND State-Level Firearm Ownership Database. Results: We found that the logistic regression classifier for gun ownership performs the best with an accuracy of 0.7 and an F1-score of 0.69. We also found a strong positive correlation between Twitter-based estimates of gun ownership and benchmark ownership estimates. For states meeting a threshold requirement of a minimum of 100 labeled Twitter users, the Pearson and Spearman correlation coefficients are 0.63 (P<.001) and 0.64 (P<.001), respectively. Conclusions: Our success in developing a machine learning model of firearm ownership at the individual level with limited training data as well as a state-level construct that achieves a high level of criterion validity underscores the potential of social media data for advancing gun violence research. The ownership construct is an important precursor for understanding the representativeness of and variability in outcomes that have been the focus of social media analyses in gun violence research to date, such as attitudes, opinions, policy stances, sentiments, and perspectives on gun violence and gun policy. The high criterion validity we achieved for state-level gun ownership suggests that social media data may be a useful complement to traditional sources of information on gun ownership such as survey and administrative data, especially for identifying early signals of changes in geographic patterns of gun ownership, given the immediacy of the availability of social media data, their continuous generation, and their responsiveness. These results also lend support to the possibility that other computationally derived, social media--based constructs may be derivable, which could lend additional insight into firearm behaviors that are currently not well understood. More work is needed to develop other firearms-related constructs and to assess their measurement properties. ",
doi="10.2196/45187",
url="https://www.jmir.org/2023/1/e45187",
url="http://www.ncbi.nlm.nih.gov/pubmed/37310779"
}


@Article{info:doi/10.2196/42363,
author="Kim, Hyunuk
and Proctor, R. Chris
and Walker, Dylan
and McCarthy, R. Ronan",
title="Understanding the Consumption of Antimicrobial Resistance--Related Content on Social Media: Twitter Analysis",
journal="J Med Internet Res",
year="2023",
month="Jun",
day="12",
volume="25",
pages="e42363",
keywords="antimicrobial resistance",
keywords="AMR",
keywords="social media",
keywords="Twitter",
keywords="engagement",
keywords="antimicrobial",
keywords="effective",
keywords="public health",
keywords="awareness",
keywords="disease",
keywords="microbiology",
keywords="pathogen",
keywords="development",
abstract="Background: Antimicrobial resistance (AMR) is one of the most pressing concerns in our society. Today, social media can function as an important channel to disseminate information about AMR. The way in which this information is engaged with depends on a number of factors, including the target audience and the content of the social media post. Objective: The aim of this study is to better understand how AMR-related content is consumed on the social media platform Twitter and to understand some of the drivers of engagement. This is essential to designing effective public health strategies, raising awareness about antimicrobial stewardship, and enabling academics to effectively promote their research on social media. Methods: We took advantage of unrestricted access to the metrics associated with the Twitter bot @AntibioticResis, which has over 13,900 followers. This bot posts the latest AMR research in the format of a title and a URL link to the PubMed page for an article. The tweets do not contain other attributes such as author, affiliation, or journal. Therefore, engagement with the tweets is only affected by the words used in the titles. Using negative binomial regression models, we measured the impact of pathogen names in paper titles, academic attention inferred from publication counts, and general attention estimated from Twitter on URL clicks to AMR research papers. Results: Followers of @AntibioticResis consisted primarily of health care professionals and academic researchers whose interests comprised mainly AMR, infectious diseases, microbiology, and public health. Three World Health Organization (WHO) critical priority pathogens---Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacteriaceae---were positively associated with URL clicks. Papers with shorter titles tended to have more engagements. We also described some key linguistic characteristics that should be considered when a researcher is trying to maximize engagement with their publication. Conclusions: Our finding suggests that specific pathogens gain more attention on Twitter than others and that the levels of attention do not necessarily correspond to their status on the WHO priority pathogen list. This suggests that more targeted public health strategies may be needed to raise awareness about AMR among specific pathogens. Analysis of follower data suggests that in the busy schedules of health care professionals, social media offers a fast and accessible gateway to staying abreast of the latest developments in this field. ",
doi="10.2196/42363",
url="https://www.jmir.org/2023/1/e42363",
url="http://www.ncbi.nlm.nih.gov/pubmed/37307042"
}


@Article{info:doi/10.2196/39484,
author="Lane, M. Jamil
and Habib, Daniel
and Curtis, Brenda",
title="Linguistic Methodologies to Surveil the Leading Causes of Mortality: Scoping Review of Twitter for Public Health Data",
journal="J Med Internet Res",
year="2023",
month="Jun",
day="12",
volume="25",
pages="e39484",
keywords="Twitter",
keywords="public health interventions",
keywords="surveillance data",
keywords="health communication",
keywords="natural language processing",
abstract="Background: Twitter has become a dominant source of public health data and a widely used method to investigate and understand public health--related issues internationally. By leveraging big data methodologies to mine Twitter for health-related data at the individual and community levels, scientists can use the data as a rapid and less expensive source for both epidemiological surveillance and studies on human behavior. However, limited reviews have focused on novel applications of language analyses that examine human health and behavior and the surveillance of several emerging diseases, chronic conditions, and risky behaviors. Objective: The primary focus of this scoping review was to provide a comprehensive overview of relevant studies that have used Twitter as a data source in public health research to analyze users' tweets to identify and understand physical and mental health conditions and remotely monitor the leading causes of mortality related to emerging disease epidemics, chronic diseases, and risk behaviors. Methods: A literature search strategy following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) extended guidelines for scoping reviews was used to search specific keywords on Twitter and public health on 5 databases: Web of Science, PubMed, CINAHL, PsycINFO, and Google Scholar. We reviewed the literature comprising peer-reviewed empirical research articles that included original research published in English-language journals between 2008 and 2021. Key information on Twitter data being leveraged for analyzing user language to study physical and mental health and public health surveillance was extracted. Results: A total of 38 articles that focused primarily on Twitter as a data source met the inclusion criteria for review. In total, two themes emerged from the literature: (1) language analysis to identify health threats and physical and mental health understandings about people and societies and (2) public health surveillance related to leading causes of mortality, primarily representing 3 categories (ie, respiratory infections, cardiovascular disease, and COVID-19). The findings suggest that Twitter language data can be mined to detect mental health conditions, disease surveillance, and death rates; identify heart-related content; show how health-related information is shared and discussed; and provide access to users' opinions and feelings. Conclusions: Twitter analysis shows promise in the field of public health communication and surveillance. It may be essential to use Twitter to supplement more conventional public health surveillance approaches. Twitter can potentially fortify researchers' ability to collect data in a timely way and improve the early identification of potential health threats. Twitter can also help identify subtle signals in language for understanding physical and mental health conditions. ",
doi="10.2196/39484",
url="https://www.jmir.org/2023/1/e39484",
url="http://www.ncbi.nlm.nih.gov/pubmed/37307062"
}


@Article{info:doi/10.2196/44356,
author="Morita, Pelegrini Plinio
and Zakir Hussain, Irfhana
and Kaur, Jasleen
and Lotto, Matheus
and Butt, Ahmad Zahid",
title="Tweeting for Health Using Real-time Mining and Artificial Intelligence--Based Analytics: Design and Development of a Big Data Ecosystem for Detecting and Analyzing Misinformation on Twitter",
journal="J Med Internet Res",
year="2023",
month="Jun",
day="9",
volume="25",
pages="e44356",
keywords="big data",
keywords="deep learning",
keywords="infodemics",
keywords="misinformation",
keywords="social media",
keywords="infoveillance",
abstract="Background: Digital misinformation, primarily on social media, has led to harmful and costly beliefs in the general population. Notably, these beliefs have resulted in public health crises to the detriment of governments worldwide and their citizens. However, public health officials need access to a comprehensive system capable of mining and analyzing large volumes of social media data in real time. Objective: This study aimed to design and develop a big data pipeline and ecosystem (UbiLab Misinformation Analysis System [U-MAS]) to identify and analyze false or misleading information disseminated via social media on a certain topic or set of related topics. Methods: U-MAS is a platform-independent ecosystem developed in Python that leverages the Twitter V2 application programming interface and the Elastic Stack. The U-MAS expert system has 5 major components: data extraction framework, latent Dirichlet allocation (LDA) topic model, sentiment analyzer, misinformation classification model, and Elastic Cloud deployment (indexing of data and visualizations). The data extraction framework queries the data through the Twitter V2 application programming interface, with queries identified by public health experts. The LDA topic model, sentiment analyzer, and misinformation classification model are independently trained using a small, expert-validated subset of the extracted data. These models are then incorporated into U-MAS to analyze and classify the remaining data. Finally, the analyzed data are loaded into an index in the Elastic Cloud deployment and can then be presented on dashboards with advanced visualizations and analytics pertinent to infodemiology and infoveillance analysis. Results: U-MAS performed efficiently and accurately. Independent investigators have successfully used the system to extract significant insights into a fluoride-related health misinformation use case (2016 to 2021). The system is currently used for a vaccine hesitancy use case (2007 to 2022) and a heat wave--related illnesses use case (2011 to 2022). Each component in the system for the fluoride misinformation use case performed as expected. The data extraction framework handles large amounts of data within short periods. The LDA topic models achieved relatively high coherence values (0.54), and the predicted topics were accurate and befitting to the data. The sentiment analyzer performed at a correlation coefficient of 0.72 but could be improved in further iterations. The misinformation classifier attained a satisfactory correlation coefficient of 0.82 against expert-validated data. Moreover, the output dashboard and analytics hosted on the Elastic Cloud deployment are intuitive for researchers without a technical background and comprehensive in their visualization and analytics capabilities. In fact, the investigators of the fluoride misinformation use case have successfully used the system to extract interesting and important insights into public health, which have been published separately. Conclusions: The novel U-MAS pipeline has the potential to detect and analyze misleading information related to a particular topic or set of related topics. ",
doi="10.2196/44356",
url="https://www.jmir.org/2023/1/e44356",
url="http://www.ncbi.nlm.nih.gov/pubmed/37294603"
}


@Article{info:doi/10.2196/45184,
author="Solans Noguero, David
and Ram{\'i}rez-Cifuentes, Diana
and R{\'i}ssola, Andr{\'e}s Esteban
and Freire, Ana",
title="Gender Bias When Using Artificial Intelligence to Assess Anorexia Nervosa on Social Media: Data-Driven Study",
journal="J Med Internet Res",
year="2023",
month="Jun",
day="8",
volume="25",
pages="e45184",
keywords="anorexia nervosa",
keywords="gender bias",
keywords="artificial intelligence",
keywords="social media",
abstract="Background: Social media sites are becoming an increasingly important source of information about mental health disorders. Among them, eating disorders are complex psychological problems that involve unhealthy eating habits. In particular, there is evidence showing that signs and symptoms of anorexia nervosa can be traced in social media platforms. Knowing that input data biases tend to be amplified by artificial intelligence algorithms and, in particular, machine learning, these methods should be revised to mitigate biased discrimination in such important domains. Objective: The main goal of this study was to detect and analyze the performance disparities across genders in algorithms trained for the detection of anorexia nervosa on social media posts. We used a collection of automated predictors trained on a data set in Spanish containing cases of 177 users that showed signs of anorexia (471,262 tweets) and 326 control cases (910,967 tweets). Methods: We first inspected the predictive performance differences between the algorithms for male and female users. Once biases were detected, we applied a feature-level bias characterization to evaluate the source of such biases and performed a comparative analysis of such features and those that are relevant for clinicians. Finally, we showcased different bias mitigation strategies to develop fairer automated classifiers, particularly for risk assessment in sensitive domains. Results: Our results revealed concerning predictive performance differences, with substantially higher false negative rates (FNRs) for female samples (FNR=0.082) compared with male samples (FNR=0.005). The findings show that biological processes and suicide risk factors were relevant for classifying positive male cases, whereas age, emotions, and personal concerns were more relevant for female cases. We also proposed techniques for bias mitigation, and we could see that, even though disparities can be mitigated, they cannot be eliminated. Conclusions: We concluded that more attention should be paid to the assessment of biases in automated methods dedicated to the detection of mental health issues. This is particularly relevant before the deployment of systems that are thought to assist clinicians, especially considering that the outputs of such systems can have an impact on the diagnosis of people at risk. ",
doi="10.2196/45184",
url="https://www.jmir.org/2023/1/e45184",
url="http://www.ncbi.nlm.nih.gov/pubmed/37289496"
}


@Article{info:doi/10.2196/43841,
author="Edinger, Andy
and Valdez, Danny
and Walsh-Buhi, Eric
and Trueblood, S. Jennifer
and Lorenzo-Luaces, Lorenzo
and Rutter, A. Lauren
and Bollen, Johan",
title="Misinformation and Public Health Messaging in the Early Stages of the Mpox Outbreak: Mapping the Twitter Narrative With Deep Learning",
journal="J Med Internet Res",
year="2023",
month="Jun",
day="6",
volume="25",
pages="e43841",
keywords="COVID-19",
keywords="deep learning",
keywords="misinformation",
keywords="monkeypox",
keywords="mpox",
keywords="outbreak",
keywords="public health",
keywords="social media",
keywords="Twitter",
abstract="Background: Shortly after the worst of the COVID-19 pandemic, an outbreak of mpox introduced another critical public health emergency. Like the COVID-19 pandemic, the mpox outbreak was characterized by a rising prevalence of public health misinformation on social media, through which many US adults receive and engage with news. Digital misinformation continues to challenge the efforts of public health officials in providing accurate and timely information to the public. We examine the evolving topic distributions of social media narratives during the mpox outbreak to map the tension between rapidly diffusing misinformation and public health communication. Objective: This study aims to observe topical themes occurring in a large-scale collection of tweets about mpox using deep learning. Methods: We leveraged a data set comprised of all mpox-related tweets that were posted between May 7, 2022, and July 23, 2022. We then applied Sentence Bidirectional Encoder Representations From Transformers (S-BERT) to the content of each tweet to generate a representation of its content in high-dimensional vector space, where semantically similar tweets will be located closely together. We projected the set of tweet embeddings to a 2D map by applying principal component analysis and Uniform Manifold Approximation Projection (UMAP). Finally, we group these data points into 7 topical clusters using k-means clustering and analyze each cluster to determine its dominant topics. We analyze the prevalence of each cluster over time to evaluate longitudinal thematic changes. Results: Our deep-learning pipeline revealed 7 distinct clusters of content: (1) cynicism, (2) exasperation, (3) COVID-19, (4) men who have sex with men, (5) case reports, (6) vaccination, and (7) World Health Organization (WHO). Clusters that largely communicated erroneous or irrelevant information began earlier and grew faster, reaching a wider audience than later communications by official instances and health officials. Conclusions: Within a few weeks of the first reported mpox cases, an avalanche of mostly false, misleading, irrelevant, or damaging information started to circulate on social media. Official institutions, including the WHO, acted promptly, providing case reports and accurate information within weeks, but were overshadowed by rapidly spreading social media chatter. Our results point to the need for real-time monitoring of social media content to optimize responses to public health emergencies. ",
doi="10.2196/43841",
url="https://www.jmir.org/2023/1/e43841",
url="http://www.ncbi.nlm.nih.gov/pubmed/37163694"
}


@Article{info:doi/10.2196/47225,
author="Wang, Siqin
and Ning, Huan
and Huang, Xiao
and Xiao, Yunyu
and Zhang, Mengxi
and Yang, Fan Ellie
and Sadahiro, Yukio
and Liu, Yan
and Li, Zhenlong
and Hu, Tao
and Fu, Xiaokang
and Li, Zi
and Zeng, Ye",
title="Public Surveillance of Social Media for Suicide Using Advanced Deep Learning Models in Japan: Time Series Study From 2012 to 2022",
journal="J Med Internet Res",
year="2023",
month="Jun",
day="2",
volume="25",
pages="e47225",
keywords="suicide",
keywords="suicidal ideation",
keywords="suicide-risk identification",
keywords="natural language processing",
keywords="social media",
keywords="Japan",
abstract="Background: Social media platforms have been increasingly used to express suicidal thoughts, feelings, and acts, raising public concerns over time. A large body of literature has explored the suicide risks identified by people's expressions on social media. However, there is not enough evidence to conclude that social media provides public surveillance for suicide without aligning suicide risks detected on social media with actual suicidal behaviors. Corroborating this alignment is a crucial foundation for suicide prevention and intervention through social media and for estimating and predicting suicide in countries with no reliable suicide statistics. Objective: This study aimed to corroborate whether the suicide risks identified on social media align with actual suicidal behaviors. This aim was achieved by tracking suicide risks detected by 62 million tweets posted in Japan over a 10-year period and assessing the locational and temporal alignment of such suicide risks with actual suicide behaviors recorded in national suicide statistics. Methods: This study used a human-in-the-loop approach to identify suicide-risk tweets posted in Japan from January 2013 to December 2022. This approach involved keyword-filtered data mining, data scanning by human efforts, and data refinement via an advanced natural language processing model termed Bidirectional Encoder Representations from Transformers. The tweet-identified suicide risks were then compared with actual suicide records in both temporal and spatial dimensions to validate if they were statistically correlated. Results: Twitter-identified suicide risks and actual suicide records were temporally correlated by month in the 10 years from 2013 to 2022 (correlation coefficient=0.533; P<.001); this correlation coefficient is higher at 0.652 when we advanced the Twitter-identified suicide risks 1 month earlier to compare with the actual suicide records. These 2 indicators were also spatially correlated by city with a correlation coefficient of 0.699 (P<.001) for the 10-year period. Among the 267 cities with the top quintile of suicide risks identified from both tweets and actual suicide records, 73.5\% (n=196) of cities overlapped. In addition, Twitter-identified suicide risks were at a relatively lower level after midnight compared to a higher level in the afternoon, as well as a higher level on Sundays and Saturdays compared to weekdays. Conclusions: Social media platforms provide an anonymous space where people express their suicidal thoughts, ideation, and acts. Such expressions can serve as an alternative source to estimating and predicting suicide in countries without reliable suicide statistics. It can also provide real-time tracking of suicide risks, serving as an early warning for suicide. The identification of areas where suicide risks are highly concentrated is crucial for location-based mental health planning, enabling suicide prevention and intervention through social media in a spatially and temporally explicit manner. ",
doi="10.2196/47225",
url="https://www.jmir.org/2023/1/e47225",
url="http://www.ncbi.nlm.nih.gov/pubmed/37267022"
}


@Article{info:doi/10.2196/43548,
author="Zenone, Marco
and Snyder, Jeremy
and B{\'e}lisle-Pipon, Jean-Christophe
and Caulfield, Timothy
and van Schalkwyk, May
and Maani, Nason",
title="Advertising Alternative Cancer Treatments and Approaches on Meta Social Media Platforms: Content Analysis",
journal="JMIR Infodemiology",
year="2023",
month="May",
day="31",
volume="3",
pages="e43548",
keywords="cancer",
keywords="advertising",
keywords="misinformation",
keywords="false hope",
keywords="Meta",
keywords="Facebook",
keywords="Instagram",
keywords="Messenger",
keywords="social media",
keywords="exploitation",
keywords="infodemiology",
keywords="cancer treatment",
keywords="online health information",
abstract="Background: Alternative cancer treatment is associated with a greater risk of death than cancer patients undergoing conventional treatments. Anecdotal evidence suggests cancer patients view paid advertisements promoting alternative cancer treatment on social media, but the extent and nature of this advertising remain unknown. This context suggests an urgent need to investigate alternative cancer treatment advertising on social media. Objective: This study aimed to systematically analyze the advertising activities of prominent alternative cancer treatment practitioners on Meta platforms, including Facebook, Instagram, Messenger, and Audience Network. We specifically sought to determine (1) whether paid advertising for alternative cancer treatment occurs on Meta social media platforms, (2) the strategies and messages of alternative cancer providers to reach and appeal to prospective patients, and (3) how the efficacy of alternative treatments is portrayed. Methods: Between December 6, 2021, and December 12, 2021, we collected active advertisements from alternative cancer clinics using the Meta Ad Library. The information collected included identification number, URL, active/inactive status, dates launched/ran, advertiser page name, and a screenshot (image) or recording (video) of the advertisement. We then conducted a content analysis to determine how alternative cancer providers communicate the claimed benefits of their services and evaluated how they portrayed alternative cancer treatment efficacy. Results: We identified 310 paid advertisements from 11 alternative cancer clinics on Meta (Facebook, Instagram, or Messenger) marketing alternative treatment approaches, care, and interventions. Alternative cancer providers appealed to prospective patients through eight strategies: (1) advertiser representation as a legitimate medical provider (n=289, 93.2\%); (2) appealing to persons with limited treatments options (n=203, 65.5\%); (3) client testimonials (n=168, 54.2\%); (4) promoting holistic approaches (n=121, 39\%); (5) promoting messages of care (n=81, 26.1\%); (6) rhetoric related to science and research (n=72, 23.2\%); (7) rhetoric pertaining to the latest technology (n=63, 20.3\%); and (8) focusing treatment on cancer origins and cause (n=43, 13.9\%). Overall, 25.8\% (n=80) of advertisements included a direct statement claiming provider treatment can cure cancer or prolong life. Conclusions: Our results provide evidence alternative cancer providers are using Meta advertising products to market scientifically unsupported cancer treatments. Advertisements regularly referenced ``alternative'' and ``natural'' treatment approaches to cancer. Imagery and text content that emulated evidence-based medical providers created the impression that the offered treatments were effective medical options for cancer. Advertisements exploited the hope of patients with terminal and poor prognoses by sharing testimonials of past patients who allegedly were cured or had their lives prolonged. We recommend that Meta introduce a mandatory, human-led authorization process that is not reliant upon artificial intelligence for medical-related advertisers before giving advertising permissions. Further research should focus on the conflict of interest between social media platforms advertising products and public health. ",
doi="10.2196/43548",
url="https://infodemiology.jmir.org/2023/1/e43548",
url="http://www.ncbi.nlm.nih.gov/pubmed/37256649"
}


@Article{info:doi/10.2196/45171,
author="Cao, Yiding
and Rajendran, Suraj
and Sundararajan, Prathic
and Law, Royal
and Bacon, Sarah
and Sumner, A. Steven
and Masuda, Naoki",
title="Web-Based Social Networks of Individuals With Adverse Childhood Experiences: Quantitative Study",
journal="J Med Internet Res",
year="2023",
month="May",
day="30",
volume="25",
pages="e45171",
keywords="adverse childhood experience",
keywords="ACE",
keywords="social networks",
keywords="Twitter",
keywords="Reddit",
keywords="childhood",
keywords="abuse",
keywords="neglect",
keywords="violence",
keywords="substance use",
keywords="coping strategy",
keywords="coping",
keywords="interpersonal connection",
keywords="web-based connection",
keywords="behavior",
keywords="social connection",
keywords="resilience",
abstract="Background: Adverse childhood experiences (ACEs), which include abuse and neglect and various household challenges such as exposure to intimate partner violence and substance use in the home, can have negative impacts on the lifelong health of affected individuals. Among various strategies for mitigating the adverse effects of ACEs is to enhance connectedness and social support for those who have experienced them. However, how the social networks of those who experienced ACEs differ from the social networks of those who did not is poorly understood. Objective: In this study, we used Reddit and Twitter data to investigate and compare social networks between individuals with and without ACE exposure. Methods: We first used a neural network classifier to identify the presence or absence of public ACE disclosures in social media posts. We then analyzed egocentric social networks comparing individuals with self-reported ACEs with those with no reported history. Results: We found that, although individuals reporting ACEs had fewer total followers in web-based social networks, they had higher reciprocity in following behavior (ie, mutual following with other users), a higher tendency to follow and be followed by other individuals with ACEs, and a higher tendency to follow back individuals with ACEs rather than individuals without ACEs. Conclusions: These results imply that individuals with ACEs may try to actively connect with others who have similar previous traumatic experiences as a positive connection and coping strategy. Supportive interpersonal connections on the web for individuals with ACEs appear to be a prevalent behavior and may be a way to enhance social connectedness and resilience in those who have experienced ACEs. ",
doi="10.2196/45171",
url="https://www.jmir.org/2023/1/e45171",
url="http://www.ncbi.nlm.nih.gov/pubmed/37252791"
}


@Article{info:doi/10.2196/44714,
author="Lenti, Jacopo
and Mejova, Yelena
and Kalimeri, Kyriaki
and Panisson, Andr{\'e}
and Paolotti, Daniela
and Tizzani, Michele
and Starnini, Michele",
title="Global Misinformation Spillovers in the Vaccination Debate Before and During the COVID-19 Pandemic: Multilingual Twitter Study",
journal="JMIR Infodemiology",
year="2023",
month="May",
day="24",
volume="3",
pages="e44714",
keywords="vaccination hesitancy",
keywords="vaccine",
keywords="misinformation",
keywords="Twitter",
keywords="social media",
keywords="COVID-19",
abstract="Background: Antivaccination views pervade online social media, fueling distrust in scientific expertise and increasing the number of vaccine-hesitant individuals. Although previous studies focused on specific countries, the COVID-19 pandemic has brought the vaccination discourse worldwide, underpinning the need to tackle low-credible information flows on a global scale to design effective countermeasures. Objective: This study aimed to quantify cross-border misinformation flows among users exposed to antivaccination (no-vax) content and the effects of content moderation on vaccine-related misinformation. Methods: We collected 316 million vaccine-related Twitter (Twitter, Inc) messages in 18 languages from October 2019 to March 2021. We geolocated users in 28 different countries and reconstructed a retweet network and cosharing network for each country. We identified communities of users exposed to no-vax content by detecting communities in the retweet network via hierarchical clustering and manual annotation. We collected a list of low-credibility domains and quantified the interactions and misinformation flows among no-vax communities of different countries. Results: The findings showed that during the pandemic, no-vax communities became more central in the country-specific debates and their cross-border connections strengthened, revealing a global Twitter antivaccination network. US users are central in this network, whereas Russian users also became net exporters of misinformation during vaccination rollout. Interestingly, we found that Twitter's content moderation efforts, in particular the suspension of users following the January 6 US Capitol attack, had a worldwide impact in reducing the spread of misinformation about vaccines. Conclusions: These findings may help public health institutions and social media platforms mitigate the spread of health-related, low-credibility information by revealing vulnerable web-based communities. ",
doi="10.2196/44714",
url="https://infodemiology.jmir.org/2023/1/e44714",
url="http://www.ncbi.nlm.nih.gov/pubmed/37223965"
}


@Article{info:doi/10.2196/42097,
author="Elkaim, M. Lior
and Levett, J. Jordan
and Niazi, Farbod
and Alvi, A. Mohammed
and Shlobin, A. Nathan
and Linzey, R. Joseph
and Robertson, Faith
and Bokhari, Rakan
and Alotaibi, M. Naif
and Lasry, Oliver",
title="Cervical Myelopathy and Social Media: Mixed Methods Analysis",
journal="J Med Internet Res",
year="2023",
month="May",
day="22",
volume="25",
pages="e42097",
keywords="social media",
keywords="twitter",
keywords="cervical",
keywords="myelopathy",
keywords="spine",
keywords="neurological",
keywords="condition",
keywords="degenerative",
keywords="patient",
keywords="caretaker",
keywords="clinician",
keywords="researcher",
keywords="user",
keywords="tweets",
keywords="engagement",
keywords="online",
keywords="education",
keywords="support",
abstract="Background: Degenerative cervical myelopathy (DCM) is a progressive neurologic condition caused by age-related degeneration of the cervical spine. Social media has become a crucial part of many patients' lives; however, little is known about social media use pertaining to DCM. Objective: This manuscript describes the landscape of social media use and DCM in patients, caretakers, clinicians, and researchers. Methods: A comprehensive search of the entire Twitter application programing interface database from inception to March 2022 was performed to identify all tweets about cervical myelopathy. Data on Twitter users included geographic location, number of followers, and number of tweets. The number of tweet likes, retweets, quotes, and total engagement were collected. Tweets were also categorized based on their underlying themes. Mentions pertaining to past or upcoming surgical procedures were recorded. A natural language processing algorithm was used to assign a polarity score, subjectivity score, and analysis label to each tweet for sentiment analysis. Results: Overall, 1859 unique tweets from 1769 accounts met the inclusion criteria. The highest frequency of tweets was seen in 2018 and 2019, and tweets decreased significantly in 2020 and 2021. Most (888/1769, 50.2\%) of the tweets' authors were from the United States, United Kingdom, or Canada. Account categorization showed that 668 of 1769 (37.8\%) users discussing DCM on Twitter were medical doctors or researchers, 415 of 1769 (23.5\%) were patients or caregivers, and 201 of 1769 (11.4\%) were news media outlets. The 1859 tweets most often discussed research (n=761, 40.9\%), followed by spreading awareness or informing the public on DCM (n=559, 30.1\%). Tweets describing personal patient perspectives on living with DCM were seen in 296 (15.9\%) posts, with 65 (24\%) of these discussing upcoming or past surgical experiences. Few tweets were related to advertising (n=31, 1.7\%) or fundraising (n=7, 0.4\%). A total of 930 (50\%) tweets included a link, 260 (14\%) included media (ie, photos or videos), and 595 (32\%) included a hashtag. Overall, 847 of the 1859 tweets (45.6\%) were classified as neutral, 717 (38.6\%) as positive, and 295 (15.9\%) as negative. Conclusions: When categorized thematically, most tweets were related to research, followed by spreading awareness or informing the public on DCM. Almost 25\% (65/296) of tweets describing patients' personal experiences with DCM discussed past or upcoming surgical interventions. Few posts pertained to advertising or fundraising. These data can help identify areas for improvement of public awareness online, particularly regarding education, support, and fundraising. ",
doi="10.2196/42097",
url="https://www.jmir.org/2023/1/e42097",
url="http://www.ncbi.nlm.nih.gov/pubmed/37213188"
}


@Article{info:doi/10.2196/44587,
author="Goldman, Nina
and Willem, Theresa
and Buyx, Alena
and Zimmermann, M. Bettina",
title="Practical Benefits, Challenges, and Recommendations on Social Media Recruitment: Multi-Stakeholder Interview Study",
journal="J Med Internet Res",
year="2023",
month="May",
day="22",
volume="25",
pages="e44587",
keywords="social media",
keywords="recruitment",
keywords="benefits",
keywords="challenges",
keywords="recommendations",
keywords="medical study",
keywords="interview",
keywords="research study",
keywords="strategy",
abstract="Background: The increasing use of social media opens new opportunities for recruiting patients for research studies. However, systematic evaluations indicate that the success of social media recruitment in terms of cost-effectiveness and representativeness depends on the type of study and its purpose. Objective: This study aims to explore the practical benefits and challenges of recruiting study participants with social media in the context of clinical and nonclinical studies and provide a summary of expert advice on how to conduct social media--based recruitment. Methods: We conducted semistructured interviews with 6 patients with hepatitis B who use social media and 30 experts from the following disciplines: (1) social media researchers or social scientists, (2) practical experts for social media recruitment, (3) legal experts, (4) ethics committee members, and (5) clinical researchers. The interview transcripts were analyzed using thematic analysis. Results: We found diverging expert opinions regarding the challenges and benefits of social media recruitment for research studies in four domains: (1) resources needed, (2) representativeness, (3) web-based community building, and (4) privacy considerations. Moreover, the interviewed experts provided practical advice on how to promote a research study via social media. Conclusions: Even though recruitment strategies should always be sensitive to individual study contexts, a multiplatform approach (recruiting via several different social media platforms) with mixed-methods recruitment (web-based and offline recruitment channels) is the most beneficial recruitment strategy for many research studies. The different recruitment methods complement each other and may contribute to improving the reach of the study, the recruitment accrual, and the representativeness of the sample. However, it is important to assess the context- and project-specific appropriateness and usefulness of social media recruitment before designing the recruitment strategy. ",
doi="10.2196/44587",
url="https://www.jmir.org/2023/1/e44587",
url="http://www.ncbi.nlm.nih.gov/pubmed/37213177"
}


@Article{info:doi/10.2196/45772,
author="Sadasivan, Chikku
and Cruz, Christofer
and Dolgoy, Naomi
and Hyde, Ashley
and Campbell, Sandra
and McNeely, Margaret
and Stroulia, Eleni
and Tandon, Puneeta",
title="Examining Patient Engagement in Chatbot Development Approaches for Healthy Lifestyle and Mental Wellness Interventions: Scoping Review",
journal="J Particip Med",
year="2023",
month="May",
day="22",
volume="15",
pages="e45772",
keywords="chatbots",
keywords="virtual assistants",
keywords="patient involvement",
keywords="patient engagement",
keywords="codevelopment",
abstract="Background: Chatbots are growing in popularity as they offer a range of potential benefits to end users and service providers. Objective: Our scoping review aimed to explore studies that used 2-way chatbots to support healthy eating, physical activity, and mental wellness interventions. Our objectives were to report the nontechnical (eg, unrelated to software development) approaches for chatbot development and to examine the level of patient engagement in these reported approaches. Methods: Our team conducted a scoping review following the framework proposed by Arksey and O'Malley. Nine electronic databases were searched in July 2022. Studies were selected based on our inclusion and exclusion criteria. Data were then extracted and patient involvement was assessed. Results: 16 studies were included in this review. We report several approaches to chatbot development, assess patient involvement where possible, and reveal the limited detail available on reporting of patient involvement in the chatbot implementation process. The reported approaches for development included: collaboration with knowledge experts, co-design workshops, patient interviews, prototype testing, the Wizard of Oz (WoZ) procedure, and literature review. Reporting of patient involvement in development was limited; only 3 of the 16 included studies contained sufficient information to evaluate patient engagement using the Guidance for Reporting Involvement of Patients and Public (GRIPP2). Conclusions: The approaches reported in this review and the identified limitations can guide the inclusion of patient engagement and the improved documentation of engagement in the chatbot development process for future health care research. Given the importance of end user involvement in chatbot development, we hope that future research will more systematically report on chatbot development and more consistently and actively engage patients in the codevelopment process. ",
doi="10.2196/45772",
url="https://jopm.jmir.org/2023/1/e45772",
url="http://www.ncbi.nlm.nih.gov/pubmed/37213199"
}


@Article{info:doi/10.2196/45554,
author="Chasca, Whitney
and Nerada, Samantha
and Zenone, Marco
and Barbic, Skye",
title="TikTok and \#OccupationalTherapy: Cross-sectional Study",
journal="JMIR Form Res",
year="2023",
month="May",
day="19",
volume="7",
pages="e45554",
keywords="TikTok",
keywords="occupational therapy",
keywords="health professional",
keywords="knowledge translation",
keywords="social media",
keywords="education",
keywords="treatment",
keywords="community",
keywords="quality control",
keywords="information",
keywords="platform",
abstract="Background: Medical providers use the short-form video social media platform TikTok to share information related to their scope of practice and insights about their professions. Videos under the hashtag \#occupationaltherapy on TikTok have over 100 million views, but there is no evidence investigating how occupational therapy information and knowledge are shared on the platform. Objective: The purpose of this cross-sectional study is to describe TikTok content with the hashtag \#occupationaltherapy and investigate how occupational therapy is portrayed. Methods: We performed a content analysis on the top 500 TikTok videos under the hashtag \#occupationaltherapy. We analyzed occupational therapy content themes (occupational therapy intervention, education, student training, universal design, and humor), practice settings (pediatrics, generalists, dementia, hand therapy, neurology, occupational therapy students, older adults, mental health, and unknown), and sentiments (positive, negative, and neutral). Results: The videos in our sample (n=500) received 175,862,994 views. The 2 most prevalent content areas were education (n=210) and occupational therapy interventions (n=146). The overall sentiment of the videos was positive (n=302). The most frequently observed practice settings in the videos were pediatrics (n=131) and generalists (n=129). Most videos did not state that it was occupational therapy (n=222) or misused the hashtag (n=131). Conclusions: TikTok has the potential for occupational therapists to share innovations, build communities of practice, and engage in collaborative efforts to share information about occupational therapists' unique roles with diverse populations. Future research is needed to monitor the quality of information and debunk inaccuracies. ",
doi="10.2196/45554",
url="https://formative.jmir.org/2023/1/e45554",
url="http://www.ncbi.nlm.nih.gov/pubmed/37204836"
}


@Article{info:doi/10.2196/43439,
author="Chen, Liuliu
and Jeong, Jiwon
and Simpkins, Bridgette
and Ferrara, Emilio",
title="Exploring the Behavior of Users With Attention-Deficit/Hyperactivity Disorder on Twitter: Comparative Analysis of Tweet Content and User Interactions",
journal="J Med Internet Res",
year="2023",
month="May",
day="17",
volume="25",
pages="e43439",
keywords="social media",
keywords="mental health",
keywords="attention-deficit/hyperactivity disorder",
keywords="ADHD",
keywords="Twitter",
keywords="behaviors",
keywords="interactions",
abstract="Background: With the widespread use of social media, people share their real-time thoughts and feelings via interactions on these platforms, including those revolving around mental health problems. This can provide a new opportunity for researchers to collect health-related data to study and analyze mental disorders. However, as one of the most common mental disorders, there are few studies regarding the manifestations of attention-deficit/hyperactivity disorder (ADHD) on social media. Objective: This study aims to examine and identify the different behavioral patterns and interactions of users with ADHD on Twitter through the text content and metadata of their posted tweets. Methods: First, we built 2 data sets: an ADHD user data set containing 3135 users who explicitly reported having ADHD on Twitter and a control data set made up of 3223 randomly selected Twitter users without ADHD. All historical tweets of users in both data sets were collected. We applied mixed methods in this study. We performed Top2Vec topic modeling to extract topics frequently mentioned by users with ADHD and those without ADHD and used thematic analysis to further compare the differences in contents that were discussed by the 2 groups under these topics. We used a distillBERT sentiment analysis model to calculate the sentiment scores for the emotion categories and compared the sentiment intensity and frequency. Finally, we extracted users' posting time, tweet categories, and the number of followers and followings from the metadata of tweets and compared the statistical distribution of these features between ADHD and non-ADHD groups. Results: In contrast to the control group of the non-ADHD data set, users with ADHD tweeted about the inability to concentrate and manage time, sleep disturbance, and drug abuse. Users with ADHD felt confusion and annoyance more frequently, while they felt less excitement, caring, and curiosity (all P<.001). Users with ADHD were more sensitive to emotions and felt more intense feelings of nervousness, sadness, confusion, anger, and amusement (all P<.001). As for the posting characteristics, compared with controls, users with ADHD were more active in posting tweets (P=.04), especially at night between midnight and 6 AM (P<.001); posting more tweets with original content (P<.001); and following fewer people on Twitter (P<.001). Conclusions: This study revealed how users with ADHD behave and interact differently on Twitter compared with those without ADHD. On the basis of these differences, researchers, psychiatrists, and clinicians can use Twitter as a potentially powerful platform to monitor and study people with ADHD, provide additional health care support to them, improve the diagnostic criteria of ADHD, and design complementary tools for automatic ADHD detection. ",
doi="10.2196/43439",
url="https://www.jmir.org/2023/1/e43439",
url="http://www.ncbi.nlm.nih.gov/pubmed/37195757"
}


@Article{info:doi/10.2196/40005,
author="Pollack, Catherine
and Gilbert-Diamond, Diane
and Onega, Tracy
and Vosoughi, Soroush
and O'Malley, James A.
and Emond, A. Jennifer",
title="Obesity-Related Discourse on Facebook and Instagram Throughout the COVID-19 Pandemic: Comparative Longitudinal Evaluation",
journal="JMIR Infodemiology",
year="2023",
month="May",
day="16",
volume="3",
pages="e40005",
keywords="obesity",
keywords="Facebook",
keywords="Instagram",
keywords="COVID-19",
keywords="social media",
keywords="news",
keywords="infodemiology",
keywords="public health",
keywords="online health information",
abstract="Background: COVID-19 severity is amplified among individuals with obesity, which may have influenced mainstream media coverage of the disease by both improving understanding of the condition and increasing weight-related stigma. Objective: We aimed to measure obesity-related conversations on Facebook and Instagram around key dates during the first year of the COVID-19 pandemic. Methods: Public Facebook and Instagram posts were extracted for 29-day windows in 2020 around January 28 (the first US COVID-19 case), March 11 (when COVID-19 was declared a global pandemic), May 19 (when obesity and COVID-19 were linked in mainstream media), and October 2 (when former US president Trump contracted COVID-19 and obesity was mentioned most frequently in the mainstream media). Trends in daily posts and corresponding interactions were evaluated using interrupted time series. The 10 most frequent obesity-related topics on each platform were also examined. Results: On Facebook, there was a temporary increase in 2020 in obesity-related posts and interactions on May 19 (posts +405, 95\% CI 166 to 645; interactions +294,930, 95\% CI 125,986 to 463,874) and October 2 (posts +639, 95\% CI 359 to 883; interactions +182,814, 95\% CI 160,524 to 205,105). On Instagram, there were temporary increases in 2020 only in interactions on May 19 (+226,017, 95\% CI 107,323 to 344,708) and October 2 (+156,974, 95\% CI 89,757 to 224,192). Similar trends were not observed in controls. Five of the most frequent topics overlapped (COVID-19, bariatric surgery, weight loss stories, pediatric obesity, and sleep); additional topics specific to each platform included diet fads, food groups, and clickbait. Conclusions: Social media conversations surged in response to obesity-related public health news. Conversations contained both clinical and commercial content of possibly dubious accuracy. Our findings support the idea that major public health announcements may coincide with the spread of health-related content (truthful or otherwise) on social media. ",
doi="10.2196/40005",
url="https://infodemiology.jmir.org/2023/1/e40005",
url="http://www.ncbi.nlm.nih.gov/pubmed/37191990"
}


@Article{info:doi/10.2196/46084,
author="Xue, Jia
and Zhang, Bolun
and Zhang, Qiaoru
and Hu, Ran
and Jiang, Jielin
and Liu, Nian
and Peng, Yingdong
and Li, Ziqian
and Logan, Judith",
title="Using Twitter-Based Data for Sexual Violence Research: Scoping Review",
journal="J Med Internet Res",
year="2023",
month="May",
day="15",
volume="25",
pages="e46084",
keywords="Twitter data",
keywords="sexual violence",
keywords="sexual assault",
keywords="scoping review",
keywords="review method",
keywords="data analysis",
keywords="data collection",
keywords="Twitter",
keywords="social media",
keywords="women's health",
keywords="violence",
keywords="abuse",
keywords="public health",
keywords="domestic violence",
abstract="Background: Scholars have used data from in-person interviews, administrative systems, and surveys for sexual violence research. Using Twitter as a data source for examining the nature of sexual violence is a relatively new and underexplored area of study. Objective: We aimed to perform a scoping review of the current literature on using Twitter data for researching sexual violence, elaborate on the validity of the methods, and discuss the implications and limitations of existing studies. Methods: We performed a literature search in the following 6 databases: APA PsycInfo (Ovid), Scopus, PubMed, International Bibliography of Social Sciences (ProQuest), Criminal Justice Abstracts (EBSCO), and Communications Abstracts (EBSCO), in April 2022. The initial search identified 3759 articles that were imported into Covidence. Seven independent reviewers screened these articles following 2 steps: (1) title and abstract screening, and (2) full-text screening. The inclusion criteria were as follows: (1) empirical research, (2) focus on sexual violence, (3) analysis of Twitter data (ie, tweets or Twitter metadata), and (4) text in English. Finally, we selected 121 articles that met the inclusion criteria and coded these articles. Results: We coded and presented the 121 articles using Twitter-based data for sexual violence research. About 70\% (89/121, 73.6\%) of the articles were published in peer-reviewed journals after 2018. The reviewed articles collectively analyzed about 79.6 million tweets. The primary approaches to using Twitter as a data source were content text analysis (112/121, 92.5\%) and sentiment analysis (31/121, 25.6\%). Hashtags (103/121, 85.1\%) were the most prominent metadata feature, followed by tweet time and date, retweets, replies, URLs, and geotags. More than a third of the articles (51/121, 42.1\%) used the application programming interface to collect Twitter data. Data analyses included qualitative thematic analysis, machine learning (eg, sentiment analysis, supervised machine learning, unsupervised machine learning, and social network analysis), and quantitative analysis. Only 10.7\% (13/121) of the studies discussed ethical considerations. Conclusions: We described the current state of using Twitter data for sexual violence research, developed a new taxonomy describing Twitter as a data source, and evaluated the methodologies. Research recommendations include the following: development of methods for data collection and analysis, in-depth discussions about ethical norms, exploration of specific aspects of sexual violence on Twitter, examination of tweets in multiple languages, and decontextualization of Twitter data. This review demonstrates the potential of using Twitter data in sexual violence research. ",
doi="10.2196/46084",
url="https://www.jmir.org/2023/1/e46084",
url="http://www.ncbi.nlm.nih.gov/pubmed/37184899"
}


@Article{info:doi/10.2196/45684,
author="Roberts-Lewis, F. Sarah
and Baxter, A. Helen
and Mein, Gill
and Quirke-McFarlane, Sophia
and Leggat, J. Fiona
and Garner, M. Hannah
and Powell, Martha
and White, Sarah
and Bearne, Lindsay",
title="The Use of Social Media for Dissemination of Research Evidence to Health and Social Care Practitioners: Protocol for a Systematic Review",
journal="JMIR Res Protoc",
year="2023",
month="May",
day="12",
volume="12",
pages="e45684",
keywords="dissemination",
keywords="health care",
keywords="podcast",
keywords="practitioners",
keywords="research evidence",
keywords="social care",
keywords="social media",
keywords="social networking",
keywords="Twitter",
keywords="videos",
abstract="Background: Effective dissemination of research to health and social care practitioners enhances clinical practice and evidence-based care. Social media use has potential to facilitate dissemination to busy practitioners. Objective: This is a protocol for a systematic review that will quantitatively synthesize evidence of the effectiveness of social media, compared with no social media, for dissemination of research evidence to health and social care practitioners. Social media platforms, formats, and sharing mechanisms used for effective dissemination of research evidence will also be identified and compared. Methods: Electronic database searches (MEDLINE, PsycINFO, CINAHL, ERIC, LISTA, and OpenGrey) will be conducted from January 1, 2010, to January 10, 2023, for studies published in English. Randomized, nonrandomized, pre-post study designs or case studies evaluating the effect of social media on dissemination of research evidence to postregistration health and social care practitioners will be included. Studies that do not involve social media or dissemination or those that evaluate dissemination of nonresearch information (eg, multisource educational materials) to students or members of the public only, or without quantitative data on outcomes of interest, will be excluded. Screening will be carried out by 2 independent reviewers. Data extraction and quality assessment, using either the Cochrane tool for assessing risk of bias or the Newcastle-Ottawa Scale, will be completed by 2 independent reviewers. Outcomes of interest will be reported in 4 domains (reach, engagement, dissemination, and impact). Data synthesis will include quantitative comparisons using narrative text, tables, and figures. A meta-analysis of standardized pooled effects will be undertaken, and subgroup analyses will be applied, if appropriate. Results: Searches and screening will be completed by the end of May 2023. Data extraction and analyses will be completed by the end of July 2023, after which findings will be synthesized and reported by the end of October 2023. Conclusions: This systematic review will summarize the evidence for the effectiveness of social media for the dissemination of research evidence to health and social care practitioners. The limitations of the evidence may include multiple outcomes or methodological heterogeneity that limit meta-analyses, potential risk of bias in included studies, and potential publication bias. The limitations of the study design may include potential insensitivity of the electronic database search strategy. The findings from this review will inform the dissemination practice of health and care research. Trial Registration: PROSPERO CRD42022378793; https://www.crd.york.ac.uk/prospero/display\_record.php?RecordID=378793 International Registered Report Identifier (IRRID): DERR1-10.2196/45684 ",
doi="10.2196/45684",
url="https://www.researchprotocols.org/2023/1/e45684",
url="http://www.ncbi.nlm.nih.gov/pubmed/37171840"
}


@Article{info:doi/10.2196/44307,
author="Maleki, Negar
and Padmanabhan, Balaji
and Dutta, Kaushik",
title="The Effect of Monetary Incentives on Health Care Social Media Content: Study Based on Topic Modeling and Sentiment Analysis",
journal="J Med Internet Res",
year="2023",
month="May",
day="11",
volume="25",
pages="e44307",
keywords="health care analytics",
keywords="social media",
keywords="incentive mechanisms",
keywords="content analysis",
keywords="contrastive topic modeling",
abstract="Background: While there is high-quality online health information, a lot of recent work has unfortunately highlighted significant issues with the health content on social media platforms (eg, fake news and misinformation), the consequences of which are severe in health care. One solution is to investigate methods that encourage users to post high-quality content. Objective: Incentives have been shown to work in many domains, but until recently, there was no method to provide financial incentives easily on social media for users to generate high-quality content. This study investigates the following question: What effect does the provision of incentives have on the creation of social media health care content? Methods: We analyzed 8328 health-related posts from an incentive-based platform (Steemit) and 1682 health-related posts from a traditional platform (Reddit). Using topic modeling and sentiment analysis--based methods in machine learning, we analyzed these posts across the following 3 dimensions: (1) emotion and language style using the IBM Watson Tone Analyzer service, (2) topic similarity and difference from contrastive topic modeling, and (3) the extent to which posts resemble clickbait. We also conducted a survey using 276 Amazon Mechanical Turk (MTurk) users and asked them to score the quality of Steemit and Reddit posts. Results: Using the Watson Tone Analyzer in a sample of 2000 posts from Steemit and Reddit, we found that more than double the number of Steemit posts had a confident language style compared with Reddit posts (77 vs 30). Moreover, 50\% more Steemit posts had analytical content and 33\% less Steemit posts had a tentative language style compared with Reddit posts (619 vs 430 and 416 vs 627, respectively). Furthermore, more than double the number of Steemit posts were considered joyful compared with Reddit posts (435 vs 200), whereas negative posts (eg, sadness, fear, and anger) were 33\% less on Steemit than on Reddit (384 vs 569). Contrastive topic discovery showed that only 20\% (2/10) of topics were common, and Steemit had more unique topics than Reddit (5 vs 3). Qualitatively, Steemit topics were more informational, while Reddit topics involved discussions, which may explain some of the quantitative differences. Manual labeling marked more Steemit headlines as clickbait than Reddit headlines (66 vs 26), and machine learning model labeling consistently identified a higher percentage of Steemit headlines as clickbait than Reddit headlines. In the survey, MTurk users said that at least 57\% of Steemit posts had better quality than Reddit posts, and they were at least 52\% more likely to like and comment on Steemit posts than Reddit posts. Conclusions: It is becoming increasingly important to ensure high-quality health content on social media; therefore, incentive-based social media could be important in the design of next-generation social platforms for health information. ",
doi="10.2196/44307",
url="https://www.jmir.org/2023/1/e44307",
url="http://www.ncbi.nlm.nih.gov/pubmed/37166952"
}


@Article{info:doi/10.2196/43596,
author="Keddem, Shimrit
and Agha, Aneeza
and Morawej, Sabrina
and Buck, Amy
and Cronholm, Peter
and Sonalkar, Sarita
and Kearney, Matthew",
title="Characterizing Twitter Content About HIV Pre-exposure Prophylaxis (PrEP) for Women: Qualitative Content Analysis",
journal="J Med Internet Res",
year="2023",
month="May",
day="11",
volume="25",
pages="e43596",
keywords="HIV pre-exposure prophylaxis",
keywords="women",
keywords="Twitter",
keywords="social media",
keywords="health communication",
keywords="communication",
keywords="HIV",
keywords="barrier",
keywords="awareness",
keywords="tweets",
keywords="application",
keywords="prevention",
abstract="Background: HIV remains a persistent health problem in the United States, especially among women. Approved in 2012, HIV pre-exposure prophylaxis (PrEP) is a daily pill or bimonthly injection that can be taken by individuals at increased risk of contracting HIV to reduce their risk of new infection. Women who are at risk of HIV face numerous barriers to HIV services and information, underscoring the critical need for strategies to increase awareness of evidence-based HIV prevention methods, such as HIV PrEP, among women. Objective: We aimed to identify historical trends in the use of Twitter hashtags specific to women and HIV PrEP and explore content about women and PrEP shared through Twitter. Methods: This was a qualitative descriptive study using a purposive sample of tweets containing hashtags related to women and HIV PrEP from 2009 to 2022. Tweets were collected via Twitter's API. Each Twitter user profile, tweet, and related links were coded using content analysis, guided by the framework of the Health Belief Model (HBM) to generate results. We used a factor analysis to identify salient clusters of tweets. Results: A total of 1256 tweets from 396 unique users were relevant to our study focus of content about PrEP specifically for women (1256/2908, 43.2\% of eligible tweets). We found that this sample of tweets was posted mostly by organizations. The 2 largest groups of individual users were activists and advocates (61/396, 15.4\%) and personal users (54/396, 13.6\%). Among individual users, most were female (100/166, 60\%) and American (256/396, 64.6\%). The earliest relevant tweet in our sample was posted in mid-2014 and the number of tweets significantly decreased after 2018. We found that 61\% (496/820) of relevant tweets contained links to informational websites intended to provide guidance and resources or promote access to PrEP. Most tweets specifically targeted people of color, including through the use of imagery and symbolism. In addition to inclusive imagery, our factor analysis indicated that more than a third of tweets were intended to share information and promote PrEP to people of color. Less than half of tweets contained any HBM concepts, and only a few contained cues to action. Lastly, while our sample included only tweets relevant to women, we found that the tweets directed to lesbian, gay, bisexual, transgender, queer (LGBTQ) audiences received the highest levels of audience engagement. Conclusions: These findings point to several areas for improvement in future social media campaigns directed at women about PrEP. First, future posts would benefit from including more theoretical constructs, such as self-efficacy and cues to action. Second, organizations posting on Twitter should continue to broaden their audience and followers to reach more people. Lastly, tweets should leverage the momentum and strategies used by the LGBTQ community to reach broader audiences and destigmatize PrEP use across all communities. ",
doi="10.2196/43596",
url="https://www.jmir.org/2023/1/e43596",
url="http://www.ncbi.nlm.nih.gov/pubmed/37166954"
}


@Article{info:doi/10.2196/43191,
author="Bekalu, Awoke Mesfin
and Sato, Taisuke
and Viswanath, K.",
title="Conceptualizing and Measuring Social Media Use in Health and Well-being Studies: Systematic Review",
journal="J Med Internet Res",
year="2023",
month="May",
day="10",
volume="25",
pages="e43191",
keywords="social media",
keywords="health",
keywords="well-being",
keywords="conceptualization",
keywords="measurement",
keywords="technology use",
keywords="screen time",
keywords="computer use",
keywords="usage",
keywords="addict",
abstract="Background: Despite an increasing number of studies revealing both the benefits and harms of social media use on well-being, there is heterogeneity and a lack of consensus on how social media use is conceptualized, defined, and measured. Additionally, little is known whether existing literature focuses on ill-being or well-being outcomes and whether studies use theories. Objective: The main objective of this review was to examine (1) how social media use has been conceptualized and measured, (2) what health and well-being outcomes have been focused on, and (3) whether studies used theories. Methods: Studies were located through a comprehensive search strategy involving 4 steps. First, keyword searches were conducted on 6 major databases: PubMed, Web of Science, PsycINFO, Embase, ProQuest, and Annual Reviews. Second, a search was conducted on Google Scholar using the same sets of search terms, and the first 100 results were examined. Third, the reference sections of reviews identified in the first 2 rounds of searches were examined, and finally, the reference lists of the final set of papers included in the review were searched. Through a multistage screening, papers that met our inclusion criteria were analyzed. Results: The review included a total of 233 papers published between 2007 and 2020 in 51 different countries. While 66 (28\%) of the studies investigated the effects of the problematic use or addiction of social media on health and well-being, 167 (72\%) studied the effects of social media use as a ``normal'' behavior. Most of the studies used measures assessing the time users spend using social media. Most of the studies that examined the effects of problematic social media use or addiction used addiction scales. Most studies examined the association of social media use with mental illnesses such as depression, anxiety, self-esteem, and loneliness. While there are a considerable number of studies investigating physical health outcomes such as self-rated health, sleep, and sitting time or lack of physical activity, relatively a small number of studies examined social, psychological, and emotional well-being. Most of the studies 183 (79\%) did not use any theory. Conclusions: Most studies conceptualized social media use as a ``normal'' behavior and mostly used time-spent measures, whereas a considerable number of studies conceptualized social media use as an addiction and used various addiction measures. The studies disproportionately focused on investigating the associations of social media use with negative health and well-being outcomes. The findings suggest the need for going beyond time spent to more sophisticated measurement approaches that consider the multiplicity of activities that users perform on social media platforms and the need for more theory-based studies on the association of social media use with not only negative well-being or ``ill-being'' but also with positive health and well-being outcomes. ",
doi="10.2196/43191",
url="https://www.jmir.org/2023/1/e43191",
url="http://www.ncbi.nlm.nih.gov/pubmed/37163319"
}


@Article{info:doi/10.2196/43961,
author="Alatorre, Selenne
and Schwarz, G. Aviva
and Egan, A. Kelsey
and Feldman, R. Amanda
and Rosa, Marielis
and Wang, L. Monica",
title="Exploring Social Media Preferences for Healthy Weight Management Interventions Among Adolescents of Color: Mixed Methods Study",
journal="JMIR Pediatr Parent",
year="2023",
month="May",
day="8",
volume="6",
pages="e43961",
keywords="social media",
keywords="adolescents of color",
keywords="obesity disparities",
keywords="disparity",
keywords="disparities",
keywords="healthy weight management",
keywords="health education",
keywords="child health",
keywords="mHealth",
keywords="mobile health",
keywords="weight",
keywords="obese",
keywords="obesity",
keywords="child",
keywords="pediatric",
keywords="adolescent",
keywords="adolescence",
keywords="preference",
keywords="health behavior",
keywords="mobile phone",
abstract="Background: Social media holds promise as an intervention platform to engage youths in healthy weight management and target racial inequities in obesity. Objective: This mixed methods study aimed to examine social media habits, preferences, and obesity-related behaviors (eg, diet and physical activity) among adolescents of color and understand preferences for healthy weight management interventions delivered via social media. Methods: This mixed methods study is comprised of a cross-sectional web-based survey and a series of digital focus groups. Study participants (English-speaking youths of color ages 14-18 years) were recruited from high schools and youth-based community settings in Massachusetts and California. For surveys, participants were invited to complete an anonymous web-based survey assessing self-reported sociodemographics, social media habits and preferences, health behaviors (diet, physical activity, sleep, and screen time), and height and weight. For focus groups, participants were invited to participate in 45- to 60-minute web-based group discussions assessing social media habits, preferred social media platforms, and preferences for physical activity and nutrition intervention content and delivery. Survey data were analyzed descriptively; focus group transcripts were analyzed using a directed content analysis approach. Results: A total of 101 adolescents completed the survey and 20 adolescents participated in a total of 3 focus groups. Participants reported most frequently using TikTok, followed by Instagram, Snapchat, and Twitter; preference for platform varied by purpose of use (eg, content consumption, connection, or communication). TikTok emerged as the platform of choice as an engaging way to learn about various topics, including desired health information on physical fitness and diet. Conclusions: Findings from this study suggest that social media platforms can be an engaging way to reach adolescents of color. Data will inform future social media--based interventions to engage adolescents of color in healthy weight management content. ",
doi="10.2196/43961",
url="https://pediatrics.jmir.org/2023/1/e43961",
url="http://www.ncbi.nlm.nih.gov/pubmed/37155230"
}


@Article{info:doi/10.2196/45281,
author="Simhadri, Suguna
and Yalamanchi, Sriha
and Stone, Sean
and Srinivasan, Mythily",
title="Perceptions on Oral Ulcers From Facebook Page Categories: Observational Study",
journal="JMIR Form Res",
year="2023",
month="May",
day="8",
volume="7",
pages="e45281",
keywords="oral ulcer",
keywords="internet",
keywords="Facebook",
keywords="information",
keywords="apthous stomatitis",
keywords="cold sore",
abstract="Background: Oral ulcers are a common condition affecting a considerable proportion of the population, and they are often associated with trauma and stress. They are very painful, and interfere with eating. As they are usually considered an annoyance, people may turn to social media for potential management options. Facebook is one of the most commonly accessed social media platforms and is the primary source of news information, including health information, for a significant percentage of American adults. Given the increasing importance of social media as a source of health information, potential remedies, and prevention strategies, it is essential to understand the type and quality of information available on Facebook regarding oral ulcers. Objective: The goal of our study was to evaluate information on recurrent oral ulcers that can be accessed via the most popular social media network---Facebook. Methods: We performed a keyword search of Facebook pages on 2 consecutive days in March 2022, using duplicate, newly created accounts, and then anonymized all posts. The collected pages were filtered, using predefined criteria to include only English-language pages wherein oral ulcer information was posted by the general public and to exclude pages created by professional dentists, associated professionals, organizations, and academic researchers. The selected pages were then screened for page origin and Facebook categories. Results: Our initial keyword search yielded 517 pages; interestingly however, only 112 (22\%) of pages had information relevant to oral ulcers, and 405 (78\%) had irrelevant information, with ulcers being mentioned in relation to other parts of the human body. Excluding professional pages and pages without relevant posts resulted in 30 pages, of which 9 (30\%) were categorized as ``health/beauty'' pages or as ``product/service'' pages, 3 (10\%) were categorized as ``medical \& health'' pages, and 5 (17\%) were categorized as ``community'' pages. Majority of the pages (22/30, 73\%) originated from 6 countries; most originated from the United States (7 pages), followed by India (6 pages). There was little information on oral ulcer prevention, long-term treatment, and complications. Conclusions: Facebook, in oral ulcer information dissemination, appears to be primarily used as an adjunct to business enterprises for marketing or for enhancing access to a product. Consequently, it was unsurprising that there was little information on oral ulcer prevention, long-term treatment, and complications. Although we made efforts to identify and select Facebook pages related to oral ulcers, we did not manually verify the authenticity or accuracy of the pages included in our analysis, potentially limiting the reliability of our findings or resulting in bias toward specific products or services. Although this work forms something of a pilot project, we plan to expand the project to encompass text mining for content analysis and include multiple social media platforms in the future. ",
doi="10.2196/45281",
url="https://formative.jmir.org/2023/1/e45281",
url="http://www.ncbi.nlm.nih.gov/pubmed/37155234"
}


@Article{info:doi/10.2196/44754,
author="Malhotra, Kashish
and Dagli, Marcel Mert
and Santangelo, Gabrielle
and Wathen, Connor
and Ghenbot, Yohannes
and Goyal, Kashish
and Bawa, Ashvind
and Ozturk, K. Ali
and Welch, C. William",
title="The Digital Impact of Neurosurgery Awareness Month: Retrospective Infodemiology Study",
journal="JMIR Form Res",
year="2023",
month="May",
day="8",
volume="7",
pages="e44754",
keywords="\#NeurosurgeryAwarenessMonth",
keywords="\#Neurosurgery",
keywords="Neurosurgery Awareness Month",
keywords="neurosurgery",
keywords="neural",
keywords="neuro",
keywords="health care awareness event",
keywords="health care",
keywords="awareness",
keywords="infodemiology",
keywords="social media",
keywords="campaign",
keywords="neuroscience",
keywords="neurological",
keywords="sentiment",
keywords="public opinion",
keywords="Google Trends",
keywords="tweet",
keywords="Twitter",
keywords="brain",
keywords="cognition",
keywords="cognitive",
keywords="machine learning algorithm",
keywords="network analysis",
keywords="digital media",
keywords="sentiment analysis",
keywords="node",
keywords="Sentiment Viz",
keywords="scatterplot",
keywords="circumplex model",
abstract="Background: Neurosurgery Awareness Month (August) was initiated by the American Association of Neurological Surgeons with the aim of bringing neurological conditions to the forefront and educating the public about these conditions. Digital media is an important tool for disseminating information and connecting with influencers, general public, and other stakeholders. Hence, it is crucial to understand the impact of awareness campaigns such as Neurosurgery Awareness Month to optimize resource allocation, quantify the efficiency and reach of these initiatives, and identify areas for improvement. Objective: The purpose of our study was to examine the digital impact of Neurosurgery Awareness Month globally and identify areas for further improvement. Methods: We used 4 social media (Twitter) assessment tools (Sprout Social, SocioViz, Sentiment Viz, and Symplur) and Google Trends to extract data using various search queries. Using regression analysis, trends were studied in the total number of tweets posted in August between 2014 and 2022. Two search queries were used in this analysis: one specifically targeting tweets related to Neurosurgery Awareness Month and the other isolating all neurosurgery-related posts. Total impressions and top influencers for \#neurosurgery were calculated using Symplur's machine learning algorithm. To study the context of the tweets, we used SocioViz to isolate the top 100 popular hashtags, keywords, and collaborations between influencers. Network analysis was performed to illustrate the interactions and connections within the digital media environment using  ForceAtlas2 model. Sentiment analysis was done to study the underlying emotion of the tweets. Google Trends was used to study the global search interest by studying relative search volume data. Results: A total of 10,007 users were identified as tweeting about neurosurgery during Neurosurgery Awareness Month using the ``\#neurosurgery'' hashtag. These tweets generated over 29.14 million impressions globally. Of the top 10 most influential users, 5 were faculty neurosurgeons at US university hospitals. Other influential users included notable organizations and journals in the field of neurosurgery. The network analysis of the top 100 influencers showed a collaboration rate of 81\%. However, only 1.6\% of the total neurosurgery tweets were advocating about neurosurgery awareness during Neurosurgery Awareness Month, and only 13 tweets were posted by verified users using the \#neurosurgeryawarenessmonth hashtag. The sentiment analysis revealed that the majority of the tweets about Neurosurgery Awareness Month were pleasant with subdued emotion. Conclusions: The global digital impact of Neurosurgery Awareness Month is nascent, and support from other international organizations and neurosurgical influencers is needed to yield a significant digital reach. Increasing collaboration and involvement from underrepresented communities may help to increase the global reach. By better understanding the digital impact of Neurosurgery Awareness Month, future health care awareness campaigns can be optimized to increase global awareness of neurosurgery and the challenges facing the field. ",
doi="10.2196/44754",
url="https://formative.jmir.org/2023/1/e44754",
url="http://www.ncbi.nlm.nih.gov/pubmed/37155226"
}


@Article{info:doi/10.2196/40461,
author="Goadsby, Peter
and Ruiz de la Torre, Elena
and Constantin, Luminita
and Amand, Caroline",
title="Social Media Listening and Digital Profiling Study of People With Headache and Migraine: Retrospective Infodemiology Study",
journal="J Med Internet Res",
year="2023",
month="May",
day="5",
volume="25",
pages="e40461",
keywords="brand, headache",
keywords="internet",
keywords="migraine",
keywords="social media",
keywords="social support",
keywords="self-management",
keywords="management",
keywords="digital",
keywords="technology",
keywords="symptoms",
keywords="medicinal treatment",
keywords="treatment",
keywords="Twitter",
keywords="blog",
keywords="Youtube",
keywords="drugs",
keywords="ibuprofen",
keywords="hydration",
keywords="relaxation",
abstract="Background: There is an unmet need for a better understanding and management of headache, particularly migraine, beyond specialist centers, which may be facilitated using digital technology. Objective: The objective of this study was to identify where, when, and how people with headache and migraine describe their symptoms and the nonpharmaceutical and medicinal treatments used as indicated on social media. Methods: Social media sources, including Twitter, web-based forums, blogs, YouTube, and review sites, were searched using a predefined search string related to headache and migraine. The real-time data from social media posts were collected retrospectively for a 1-year period from January 1, 2018, to December 31, 2018 (Japan), or a 2-year period from January 1, 2017, to December 31, 2018 (Germany and France). The data were analyzed after collection, using content analysis and audience profiling. Results: A total of 3,509,828 social media posts related to headache and migraine were obtained from Japan in 1 year and 146,257 and 306,787 posts from Germany and France, respectively, in 2 years. Among social media sites, Twitter was the most used platform across these countries. Japanese sufferers used specific terminology, such as ``tension headaches'' or ``cluster headaches'' (36\%), whereas French sufferers even mentioned specific migraine types, such as ocular (7\%) and aura (2\%). The most detailed posts on headache or migraine were from Germany. The French sufferers explicitly mentioned ``headache or migraine attacks'' in the ``evening (41\%) or morning (38\%),'' whereas Japanese mentioned ``morning (48\%) or night (27\%)'' and German sufferers mentioned ``evening (22\%) or night (41\%).'' The use of ``generic terms'' such as medicine, tablet, and pill were prevalent. The most discussed drugs were ibuprofen and naproxen combination (43\%) in Japan; ibuprofen (29\%) in Germany; and acetylsalicylic acid, paracetamol, and caffeine combination (75\%) in France. The top 3 nonpharmaceutical treatments are hydration, caffeinated beverages, and relaxation methods. Of the sufferers, 44\% were between 18 and 24 years of age. Conclusions: In this digital era, social media listening studies present an opportunity to provide unguided, self-reported, sufferers' perceptions in the real world. The generation of social media evidence requires appropriate methodology to translate data into scientific information and relevant medical insights. This social media listening study showed country-specific differences in headache and migraine symptoms experienced and in the times of the day and treatments used. Furthermore, this study highlighted the prevalence of social media usage by younger sufferers compared to that by older sufferers. ",
doi="10.2196/40461",
url="https://www.jmir.org/2023/1/e40461",
url="http://www.ncbi.nlm.nih.gov/pubmed/37145844"
}


@Article{info:doi/10.2196/38245,
author="Eaton, C. Melissa
and Probst, C. Yasmine
and Smith, A. Marc",
title="Characterizing the Discourse of Popular Diets to Describe Information Dispersal and Identify Leading Voices, Interaction, and Themes of Mental Health: Social Network Analysis",
journal="JMIR Infodemiology",
year="2023",
month="May",
day="5",
volume="3",
pages="e38245",
keywords="social media",
keywords="popular diets",
keywords="nutrition",
keywords="public health",
keywords="social network analysis",
abstract="Background: Social media has transformed the way health messages are communicated. This has created new challenges and ethical considerations while providing a platform to share nutrition information for communities to connect and for information to spread. However, research exploring the web-based diet communities of popular diets is limited. Objective: This study aims to characterize the web-based discourse of popular diets, describe information dissemination, identify influential voices, and explore interactions between community networks and themes of mental health. Methods: This exploratory study used Twitter social media posts for an online social network analysis. Popular diet keywords were systematically developed, and data were collected and analyzed using the NodeXL metrics tool (Social Media Research Foundation) to determine the key network metrics (vertices, edges, cluster algorithms, graph visualization, centrality measures, text analysis, and time-series analytics). Results: The vegan and ketogenic diets had the largest networks, whereas the zone diet had the smallest network. In total, 31.2\% (54/173) of the top users endorsed the corresponding diet, and 11\% (19/173) claimed a health or science education, which included 1.2\% (2/173) of dietitians. Complete fragmentation and hub and spoke messaging were the dominant network structures. In total, 69\% (11/16) of the networks interacted, where the ketogenic diet was mentioned most, with depression and anxiety and eating disorder words most prominent in the ``zone diet'' network and the least prominent in the ``soy-free,'' ``vegan,'' ``dairy-free,'' and ``gluten-free'' diet networks. Conclusions: Social media activity reflects diet trends and provides a platform for nutrition information to spread through resharing. A longitudinal exploration of popular diet networks is needed to further understand the impact social media can have on dietary choices. Social media training is vital, and nutrition professionals must work together as a community to actively reshare evidence-based posts on the web. ",
doi="10.2196/38245",
url="https://infodemiology.jmir.org/2023/1/e38245",
url="http://www.ncbi.nlm.nih.gov/pubmed/37159259"
}


@Article{info:doi/10.2196/44870,
author="Nishiyama, Tomohiro
and Yada, Shuntaro
and Wakamiya, Shoko
and Hori, Satoko
and Aramaki, Eiji",
title="Transferability Based on Drug Structure Similarity in the Automatic Classification of Noncompliant Drug Use on Social Media: Natural Language Processing Approach",
journal="J Med Internet Res",
year="2023",
month="May",
day="3",
volume="25",
pages="e44870",
keywords="data mining",
keywords="machine learning",
keywords="medication noncompliance",
keywords="natural language processing",
keywords="pharmacovigilance",
keywords="transfer learning",
keywords="text classification",
abstract="Background: Medication noncompliance is a critical issue because of the increased number of drugs sold on the web. Web-based drug distribution is difficult to control, causing problems such as drug noncompliance and abuse. The existing medication compliance surveys lack completeness because it is impossible to cover patients who do not go to the hospital or provide accurate information to their doctors, so a social media--based approach is being explored to collect information about drug use. Social media data, which includes information on drug usage by users, can be used to detect drug abuse and medication compliance in patients. Objective: This study aimed to assess how the structural similarity of drugs affects the efficiency of machine learning models for text classification of drug noncompliance. Methods: This study analyzed 22,022 tweets about 20 different drugs. The tweets were labeled as either noncompliant use or mention, noncompliant sales, general use, or general mention. The study compares 2 methods for training machine learning models for text classification: single-sub-corpus transfer learning, in which a model is trained on tweets about a single drug and then tested on tweets about other drugs, and multi-sub-corpus incremental learning, in which models are trained on tweets about drugs in order of their structural similarity. The performance of a machine learning model trained on a single subcorpus (a data set of tweets about a specific category of drugs) was compared to the performance of a model trained on multiple subcorpora (data sets of tweets about multiple categories of drugs). Results: The results showed that the performance of the model trained on a single subcorpus varied depending on the specific drug used for training. The Tanimoto similarity (a measure of the structural similarity between compounds) was weakly correlated with the classification results. The model trained by transfer learning a corpus of drugs with close structural similarity performed better than the model trained by randomly adding a subcorpus when the number of subcorpora was small. Conclusions: The results suggest that structural similarity improves the classification performance of messages about unknown drugs if the drugs in the training corpus are few. On the other hand, this indicates that there is little need to consider the influence of the Tanimoto structural similarity if a sufficient variety of drugs are ensured. ",
doi="10.2196/44870",
url="https://www.jmir.org/2023/1/e44870",
url="http://www.ncbi.nlm.nih.gov/pubmed/37133915"
}


@Article{info:doi/10.2196/34315,
author="Chopra, Harshita
and Vashishtha, Aniket
and Pal, Ridam
and 
and Tyagi, Ananya
and Sethi, Tavpritesh",
title="Mining Trends of COVID-19 Vaccine Beliefs on Twitter With Lexical Embeddings: Longitudinal Observational Study",
journal="JMIR Infodemiology",
year="2023",
month="May",
day="2",
volume="3",
pages="e34315",
keywords="COVID-19",
keywords="COVID-19 vaccination",
keywords="vaccine hesitancy",
keywords="public health",
keywords="unsupervised word embeddings",
keywords="natural language preprocessing",
keywords="social media",
keywords="Twitter",
abstract="Background: Social media plays a pivotal role in disseminating news globally and acts as a platform for people to express their opinions on various topics. A wide variety of views accompany COVID-19 vaccination drives across the globe, often colored by emotions that change along with rising cases, approval of vaccines, and multiple factors discussed online. Objective: This study aims to analyze the temporal evolution of different emotions and the related influencing factors in tweets belonging to 5 countries with vital vaccine rollout programs, namely India, the United States, Brazil, the United Kingdom, and Australia. Methods: We extracted a corpus of nearly 1.8 million Twitter posts related to COVID-19 vaccination and created 2 classes of lexical categories---emotions and influencing factors. Using cosine distance from selected seed words' embeddings, we expanded the vocabulary of each category and tracked the longitudinal change in their strength from June 2020 to April 2021 in each country. Community detection algorithms were used to find modules in positive correlation networks. Results: Our findings indicated the varying relationship among emotions and influencing factors across countries. Tweets expressing hesitancy toward vaccines represented the highest mentions of health-related effects in all countries, which reduced from 41\% to 39\% in India. We also observed a significant change (P<.001) in the linear trends of categories like hesitation and contentment before and after approval of vaccines. After the vaccine approval, 42\% of tweets coming from India and 45\% of tweets from the United States represented the ``vaccine\_rollout'' category. Negative emotions like rage and sorrow gained the highest importance in the alluvial diagram and formed a significant module with all the influencing factors in April 2021, when India observed the second wave of COVID-19 cases. Conclusions: By extracting and visualizing these tweets, we propose that such a framework may help guide the design of effective vaccine campaigns and be used by policy makers to model vaccine uptake and targeted interventions. ",
doi="10.2196/34315",
url="https://infodemiology.jmir.org/2023/1/e34315",
url="http://www.ncbi.nlm.nih.gov/pubmed/37192952"
}


@Article{info:doi/10.2196/45108,
author="Movahedi Nia, Zahra
and Bragazzi, Nicola
and Asgary, Ali
and Orbinski, James
and Wu, Jianhong
and Kong, Jude",
title="Mpox Panic, Infodemic, and Stigmatization of the Two-Spirit, Lesbian, Gay, Bisexual, Transgender, Queer or Questioning, Intersex, Asexual Community: Geospatial Analysis, Topic Modeling, and Sentiment Analysis of a Large, Multilingual Social Media Database",
journal="J Med Internet Res",
year="2023",
month="May",
day="1",
volume="25",
pages="e45108",
keywords="monkeypox",
keywords="infectious outbreak",
keywords="infodemic",
keywords="stigma",
keywords="natural language processing",
keywords="sentiment analysis",
keywords="Twitter",
keywords="community",
keywords="discrimination",
keywords="social media",
keywords="virus",
abstract="Background: The global Mpox (formerly, Monkeypox) outbreak is disproportionately affecting the gay and bisexual men having sex with men community. Objective: The aim of this study is to use social media to study country-level variations in topics and sentiments toward Mpox and Two-Spirit, Lesbian, Gay, Bisexual, Transgender, Queer or Questioning, Intersex, Asexual (2SLGBTQIAP+)--related topics. Previous infectious outbreaks have shown that stigma intensifies an outbreak. This work helps health officials control fear and stop discrimination. Methods: In total, 125,424 Twitter and Facebook posts related to Mpox and the 2SLGBTQIAP+ community were extracted from May 1 to December 25, 2022, using Twitter application programming interface academic accounts and Facebook-scraper tools. The tweets' main topics were discovered using Latent Dirichlet Allocation in the sklearn library. The pysentimiento package was used to find the sentiments of English and Spanish posts, and the CamemBERT package was used to recognize the sentiments of French posts. The tweets' and Facebook posts' languages were understood using the Twitter application programming interface platform and pycld3 library, respectively. Using ArcGis Online, the hot spots of the geotagged tweets were identified. Mann-Whitney U, ANOVA, and Dunn tests were used to compare the sentiment polarity of different topics and countries. Results: The number of Mpox posts and the number of posts with Mpox and 2SLGBTQIAP+ keywords were 85\% correlated (P<.001). Interestingly, the number of posts with Mpox and 2SLGBTQIAP+ keywords had a higher correlation with the number of Mpox cases (correlation=0.36, P<.001) than the number of posts on Mpox (correlation=0.24, P<.001). Of the 10 topics, 8 were aimed at stigmatizing the 2SLGBTQIAP+ community, 3 of which had a significantly lower sentiment score than other topics (ANOVA P<.001). The Mann-Whitney U test shows that negative sentiments have a lower intensity than neutral and positive sentiments (P<.001) and neutral sentiments have a lower intensity than positive sentiments (P<.001). In addition, English sentiments have a higher negative and lower neutral and positive intensities than Spanish and French sentiments (P<.001), and Spanish sentiments have a higher negative and lower positive intensities than French sentiments (P<.001). The hot spots of the tweets with Mpox and 2SLGBTQIAP+ keywords were recognized as the United States, the United Kingdom, Canada, Spain, Portugal, India, Ireland, and Italy. Canada was identified as having more tweets with negative polarity and a lower sentiment score (P<.04). Conclusions: The 2SLGBTQIAP+ community is being widely stigmatized for spreading the Mpox virus on social media. This turns the community into a highly vulnerable population, widens the disparities, increases discrimination, and accelerates the spread of the virus. By identifying the hot spots and key topics of the related tweets, this work helps decision makers and health officials inform more targeted policies. ",
doi="10.2196/45108",
url="https://www.jmir.org/2023/1/e45108",
url="http://www.ncbi.nlm.nih.gov/pubmed/37126377"
}


@Article{info:doi/10.2196/39852,
author="Crawford, Rebecca
and Sikirica, Slaven
and Morrison, Ross
and Cappelleri, C. Joseph
and Russell-Smith, Alexander
and Shah, Richa
and Chadwick, Helen
and Doward, Lynda",
title="The Patient Experience of Acute Lymphoblastic Leukemia and Its Treatment: Social Media Review",
journal="JMIR Cancer",
year="2023",
month="May",
day="1",
volume="9",
pages="e39852",
keywords="acute lymphoblastic leukemia",
keywords="health-related quality of life",
keywords="qualitative research",
keywords="social media",
keywords="leukemia",
keywords="lymphoblastic",
keywords="adult",
keywords="disease",
keywords="treatment",
keywords="therapy",
keywords="symptoms",
keywords="independence",
keywords="functioning",
keywords="social",
keywords="well-being",
keywords="emotional",
abstract="Background: Adult patients with acute lymphoblastic leukemia (ALL) report substantial disease- and treatment-related impacts on their health-related quality of life (HRQOL). Patient-reported information (PRI) shared on social media may provide a distinct opportunity to understand the patient experience outside of formal research contexts and help inform the development of novel therapies. Objective: This qualitative social media review aimed to assess PRI shared on social media websites to gain a better understanding of the symptom, HRQOL, and treatment impacts on individuals with ALL. Methods: We identified English-language posts on 3 patient advocacy websites (Patient Power, The Patient Story, and Leukaemia Care) and YouTube that included PRI about experiences with ALL or ALL treatments shared by adults (aged ?18 years) with a self-reported ALL diagnosis. Patients' demographic and disease characteristics were extracted from posts (where available), and the posts were analyzed thematically. A network analysis was conducted to delineate possible associations among ALL symptoms, HRQOL impacts, and treatment-related symptoms and impacts. Results: Of the 935 social media posts identified, 63 (7\%) met the review criteria, including 40 (63\%) videos, 5 (8\%) comments posted in response to videos, and 18 (29\%) blog posts. The 63 posts were contributed by 41 patients comprised of 21 (51\%) males, 18 females (44\%), and 2 (5\%) whose gender was not reported. Among the patients, 13 (32\%) contributed >1 source of data. Fatigue (n=20, 49\%), shortness of breath (n=13, 32\%), and bruising (n=12, 29\%) were the symptoms prior to treatment most frequently discussed by patients. Patients also reported impacts on personal relationships (n=26, 63\%), psychological and emotional well-being (n=25, 61\%), and work (n=16, 39\%). Although inpatient treatment reportedly restricted patients' independence and social functioning, it also provided a few patients with a sense of safety. Patients frequently relied on their doctors to drive their treatment decisions but were also influenced by family members. The network analysis indicated that disease-related symptoms were primarily associated with patients' physical functioning, activities of daily living, and ability to work, while treatment-related symptoms were primarily associated with emotional well-being. Conclusions: This social media review explored PRI through a thematic analysis of patient-contributed content on patient advocacy websites and YouTube to identify and contextualize emergent themes in patient experiences with ALL and its treatments. To our knowledge, this is the first study to leverage this novel tool to generate new insights into patients' experiences with ALL. Patients' social media posts suggest that inpatient care for ALL is associated with restricted independence and social functioning. However, inpatient care also provided a sense of safety for some patients. Studies such as this one that capture patients' experiences in their own words are valuable tools to further our knowledge of patient outcomes with ALL. ",
doi="10.2196/39852",
url="https://cancer.jmir.org/2023/1/e39852",
url="http://www.ncbi.nlm.nih.gov/pubmed/37126376"
}


@Article{info:doi/10.2196/44990,
author="Nguyen, T. Thu
and Merchant, S. Junaid
and Criss, Shaniece
and Makres, Katrina
and Gowda, N. Krishik
and Mane, Heran
and Yue, Xiaohe
and Hswen, Yulin
and Glymour, Maria M.
and Nguyen, C. Quynh
and Allen, M. Amani",
title="Examining Twitter-Derived Negative Racial Sentiment as Indicators of Cultural Racism: Observational Associations With Preterm Birth and Low Birth Weight Among a Multiracial Sample of Mothers, 2011-2021",
journal="J Med Internet Res",
year="2023",
month="Apr",
day="28",
volume="25",
pages="e44990",
keywords="birth outcomes",
keywords="health disparities",
keywords="machine learning, racial sentiment",
keywords="social media",
abstract="Background: Large racial and ethnic disparities in adverse birth outcomes persist. Increasing evidence points to the potential role of racism in creating and perpetuating these disparities. Valid measures of area-level racial attitudes and bias remain elusive, but capture an important and underexplored form of racism that may help explain these disparities. Cultural values and attitudes expressed through social media reflect and shape public norms and subsequent behaviors. Few studies have quantified attitudes toward different racial groups using social media with the aim of examining associations with birth outcomes. Objective: We used Twitter data to measure state-level racial sentiments and investigate associations with preterm birth (PTB) and low birth weight (LBW) in a multiracial or ethnic sample of mothers in the United States. Methods: A random 1\% sample of publicly available tweets from January 1, 2011, to December 31, 2021, was collected using Twitter's Academic Application Programming Interface (N=56,400,097). Analyses were on English-language tweets from the United States that used one or more race-related keywords. We assessed the sentiment of each tweet using support vector machine, a supervised machine learning model. We used 5-fold cross-validation to assess model performance and achieved high accuracy for negative sentiment classification (91\%) and a high F1 score (84\%). For each year, the state-level racial sentiment was merged with birth data during that year ({\textasciitilde}3 million births per year). We estimated incidence ratios for LBW and PTB using log binomial regression models, among all mothers, Black mothers, racially minoritized mothers (Asian, Black, or Latina mothers), and White mothers. Models were controlled for individual-level maternal characteristics and state-level demographics. Results: Mothers living in states in the highest tertile of negative racial sentiment for tweets referencing racial and ethnic minoritized groups had an 8\% higher (95\% CI 3\%-13\%) incidence of LBW and 5\% higher (95\% CI 0\%-11\%) incidence of PTB compared to mothers living in the lowest tertile. Negative racial sentiment referencing racially minoritized groups was associated with adverse birth outcomes in the total population, among minoritized mothers, and White mothers. Black mothers living in states in the highest tertile of negative Black sentiment had 6\% (95\% CI 1\%-11\%) and 7\% (95\% CI 2\%-13\%) higher incidence of LBW and PTB, respectively, compared to mothers living in the lowest tertile. Negative Latinx sentiment was associated with a 6\% (95\% CI 1\%-11\%) and 3\% (95\% CI 0\%-6\%) higher incidence of LBW and PTB among Latina mothers, respectively. Conclusions: Twitter-derived negative state-level racial sentiment toward racially minoritized groups was associated with a higher risk of adverse birth outcomes among the total population and racially minoritized groups. Policies and supports establishing an inclusive environment accepting of all races and cultures may decrease the overall risk of adverse birth outcomes and reduce racial birth outcome disparities. ",
doi="10.2196/44990",
url="https://www.jmir.org/2023/1/e44990",
url="http://www.ncbi.nlm.nih.gov/pubmed/37115602"
}


@Article{info:doi/10.2196/42024,
author="Andrade, C. Fernanda
and Erwin, Savannah
and Burnell, Kaitlyn
and Jackson, Jalisa
and Storch, Marley
and Nicholas, Julia
and Zucker, Nancy",
title="Intervening on Social Comparisons on Social Media: Electronic Daily Diary Pilot Study",
journal="JMIR Ment Health",
year="2023",
month="Apr",
day="28",
volume="10",
pages="e42024",
keywords="social media",
keywords="social comparison",
keywords="young adults",
keywords="social savoring",
keywords="intervention",
keywords="self-esteem",
keywords="depression",
abstract="Background: Literature has underscored the dark aspects of social media use, including associations with depressive symptoms, feelings of social isolation, and diminished self-esteem. Social comparison, the process of evaluating oneself relative to another person, is thought to contribute to these negative experiences such that people with a stronger tendency to compare themselves with others are particularly susceptible to the detrimental effects of social media. Social media as a form of social connection and communication is nevertheless an inevitable---and arguably integral---part of life, particularly for young adults. Therefore, there is a need to investigate strategies that could alter the manner in which people interact with social media to minimize its detrimental effects and maximize the feelings of affiliation and connection. Objective: This pilot study examined the feasibility, acceptability, and effectiveness of a brief web-based intervention designed to alter engagement with social media and promote psychological well-being by encouraging social savoring as an alternative to social comparison. Social savoring was operationalized as experiencing joyful emotions related to the happiness of someone else's experiences (ie, feeling happy for someone else). Methods: Following an intensive longitudinal design, 55 college students (mean age 19.29, SD 0.93 years; n=43, 78\% women and n=23, 42\% White) completed baseline measures (individual differences, psychological well-being, connectedness, and social media use) and then 14 days of daily surveys on their social media activity and well-being. On day 8, the group that was randomized to receive the intervention watched a video instructing them on the skill of social savoring and was asked to practice this skill during days 8 to 14. Results: Overall, participants reported positive perceptions of the intervention. Participants who watched the intervention video reported significantly higher performance self-esteem (P=.02) at posttest than those in the control condition, after controlling for baseline levels. Participants also reported significantly higher state self-esteem (P=.01) on days in which they engaged in more social savoring while using social media, and the use of social savoring increased significantly (P=.01) over time, suggesting that participants found it helpful. Participants in both conditions reported significantly lower levels of social comparison (control: P=.01; intervention: P=.002) and higher levels of connectedness (control: P<.001; intervention: P=.001) at posttest than at baseline. Conclusions: Initial evidence from this pilot study suggests that a web-based social savoring intervention may help minimize the potentially harmful consequences of social media use, at least in some domains. Future work is needed to examine the effectiveness and acceptance of this intervention in different age groups and in clinical samples that are in part characterized by higher levels of comparison with others (eg, people with eating disorders). ",
doi="10.2196/42024",
url="https://mental.jmir.org/2023/1/e42024",
url="http://www.ncbi.nlm.nih.gov/pubmed/37115607"
}


@Article{info:doi/10.2196/41545,
author="Waring, E. Molly
and Pagoto, L. Sherry
and Moore Simas, A. Tiffany
and Blackman Carr, T. Loneke
and Eamiello, L. Madison
and Libby, A. Brooke
and Rudin, R. Lauren
and Heersping, E. Grace",
title="Delivering a Postpartum Weight Loss Intervention via Facebook or In-Person Groups: Results From a Randomized Pilot Feasibility Trial",
journal="JMIR Mhealth Uhealth",
year="2023",
month="Apr",
day="27",
volume="11",
pages="e41545",
keywords="postpartum weight loss",
keywords="Facebook",
keywords="social media",
keywords="pilot study",
keywords="feasibility",
keywords="mobile phone",
abstract="Background: Postpartum weight retention contributes to weight gain and obesity. Remotely delivered lifestyle interventions may be able to overcome barriers to attending in-person programs during this life phase. Objective: This study aimed to conduct a randomized feasibility pilot trial of a 6-month postpartum weight loss intervention delivered via Facebook or in-person groups. Feasibility outcomes were recruitment, sustained participation, contamination, retention, and feasibility of study procedures. Percent weight loss at 6 and 12 months were exploratory outcomes. Methods: Women with overweight or obesity who were 8 weeks to 12 months post partum were randomized to receive a 6-month behavioral weight loss intervention based on the Diabetes Prevention Program lifestyle intervention via Facebook or in-person groups. Participants completed assessments at baseline, 6 months, and 12 months. Sustained participation was defined by intervention meeting attendance or visible engagement in the Facebook group. We calculated percent weight change for participants who provided weight at each follow-up. Results: Among individuals not interested in the study, 68.6\% (72/105) were not interested in or could not attend in-person meetings and 2.9\% (3/105) were not interested in the Facebook condition. Among individuals excluded at screening, 18.5\% (36/195) were ineligible owing to reasons related to the in-person condition, 12.3\% (24/195) related to the Facebook condition, and 2.6\% (5/195) were unwilling to be randomized. Randomized participants (n=62) were a median of 6.1 (IQR 3.1-8.3) months post partum, with a median BMI of 31.7 (IQR 28.2-37.4) kg/m2. Retention was 92\% (57/62) at 6 months and 94\% (58/62) at 12 months. The majority (21/30, 70\%) of Facebook and 31\% (10/32) of in-person participants participated in the last intervention module. Half (13/26, 50\%) of Facebook and 58\% (15/26) of in-person participants would be likely or very likely to participate again if they had another baby, and 54\% (14/26) and 70\% (19/27), respectively, would be likely or very likely to recommend the program to a friend. In total, 96\% (25/26) of Facebook participants reported that it was convenient or very convenient to log into the Facebook group daily compared with 7\% (2/27) of in-person participants who said it was convenient or very convenient to attend group meetings each week. Average weight loss was 3.0\% (SD 7.2\%) in the Facebook condition and 5.4\% (SD 6.8\%) in the in-person condition at 6 months, and 2.8\% (SD 7.4\%) in the Facebook condition and 4.8\% (SD 7.6\%) in the in-person condition at 12 months. Conclusions: Barriers to attending in-person meetings hampered recruitment efforts and intervention participation. Although women found the Facebook group convenient and stayed engaged in the group, weight loss appeared lower. Research is needed to further develop care models for postpartum weight loss that balance accessibility with efficacy. Trial Registration: ClinicalTrials.gov, NCT03700736; https://clinicaltrials.gov/ct2/show/NCT03700736 ",
doi="10.2196/41545",
url="https://mhealth.jmir.org/2023/1/e41545",
url="http://www.ncbi.nlm.nih.gov/pubmed/37103991"
}


@Article{info:doi/10.2196/43849,
author="Jones, M. Lenette
and de Marco, Kayla
and Keener, Katharine
and Monroe, E. Korrey",
title="Blood Pressure and Self-management in Black Women With Hypertension: Protocol Revisions to the Brain Relationships Among Information, Neuroprocessing, and Self-Management Study Due to the COVID-19 Pandemic",
journal="JMIR Res Protoc",
year="2023",
month="Apr",
day="27",
volume="12",
pages="e43849",
keywords="Black",
keywords="BRAINS",
keywords="COVID-19 pandemic",
keywords="eHealth",
keywords="Facebook",
keywords="hypertension",
keywords="protocol",
keywords="videoconferencing",
keywords="web-based",
keywords="women",
abstract="Background: The COVID-19 pandemic and the halt to in-person research activities beginning in March 2020 brought new challenges to protocol development and implementation. Due to the pandemic, we had to revise our protocol for the Brain Relationships Among Information, Neuroprocessing, and Self-Management (BRAINS) study, which was designed to examine health information behavior, brain activity, diabetes status, and self-management behavior among Black women with hypertension. Objective: This report outlines 7 steps describing how our research team (1) revised the BRAINS study protocol, (2) implemented a remote method of data collection, and (3) mitigated the challenges we faced. Methods: Prior to March 2020, Black women with hypertension were invited to participate in the BRAINS study to undergo a functional magnetic resonance imaging scan, complete surveys, have their blood pressure measured, and have their blood drawn. After these measures were collected, participants would receive phone calls from a dietician to complete two 24-hour dietary recalls using the Nutrition Data System for Research. Our revised protocol relied on a web-based, interactive approach. Participants received a study kit that included an Omron automatic home blood pressure monitor and a hemoglobin A1c kit from the DTIL laboratory. In a Zoom meeting with each participant, our team played an introductory video, administered surveys (via Qualtrics), and guided participants through measuring their blood pressure and performing a finger stick to collect a blood sample for hemoglobin A1c testing. We examined cognitive function using the TestMyBrain Digital Neuropsychology Toolkit, as we were unable to access the functional magnetic resonance imaging laboratory to assess brain activity. The 7 steps in revising our protocol were as follows: conceptualizing the move from in-person to remote study activities (step 1); contacting the funders (step 2); submitting changes for Institutional Review Board approval (step 3); preparing to implement the revised protocol (step 4); implementing the study changes (step 5); mitigating challenges (step 6); and evaluating protocol implementation (step 7). Results: Approximately 1700 individuals responded to web-based advertisements about the BRAINS study. A total of 131 individuals completed our eligibility screener. We conducted our first Zoom appointment in July 2020 and our last Zoom appointment in September 2020. Using our revised strategies, a total of 99 participants completed all study measures within a 3-month period. Conclusions: In this report, we discuss successes and challenges in revising our protocol and reaching our population of interest remotely, safely, and effectively. The information we have outlined can help researchers create similar protocols to reach and conduct research remotely with diverse populations, such as individuals who are unable to participate in studies in person. International Registered Report Identifier (IRRID): DERR1-10.2196/43849 ",
doi="10.2196/43849",
url="https://www.researchprotocols.org/2023/1/e43849",
url="http://www.ncbi.nlm.nih.gov/pubmed/37104029"
}


@Article{info:doi/10.2196/37237,
author="Dupuy-Zini, Alexandre
and Audeh, Bissan
and G{\'e}rardin, Christel
and Duclos, Catherine
and Gagneux-Brunon, Amandine
and Bousquet, Cedric",
title="Users' Reactions to Announced Vaccines Against COVID-19 Before Marketing in France: Analysis of Twitter Posts",
journal="J Med Internet Res",
year="2023",
month="Apr",
day="24",
volume="25",
pages="e37237",
keywords="COVID-19 Vaccines",
keywords="Social Media",
keywords="Deep Learning",
keywords="France",
keywords="Sentiment Analysis",
abstract="Background: Within a few months, the COVID-19 pandemic had spread to many countries and had been a real challenge for health systems all around the world. This unprecedented crisis has led to a surge of online discussions about potential cures for the disease. Among them, vaccines have been at the heart of the debates and have faced lack of confidence before marketing in France. Objective: This study aims to identify and investigate the opinions of French Twitter users on the announced vaccines against COVID-19 through sentiment analysis. Methods: This study was conducted in 2 phases. First, we filtered a collection of tweets related to COVID-19 available on Twitter from February 2020 to August 2020 with a set of keywords associated with vaccine mistrust using word embeddings. Second, we performed sentiment analysis using deep learning to identify the characteristics of vaccine mistrust. The model was trained on a hand-labeled subset of 4548 tweets. Results: A set of 69 relevant keywords were identified as the semantic concept of the word ``vaccin'' (vaccine in French) and focused mainly on conspiracies, pharmaceutical companies, and alternative treatments. Those keywords enabled us to extract nearly 350,000 tweets in French. The sentiment analysis model achieved 0.75 accuracy. The model then predicted 16\% of positive tweets, 41\% of negative tweets, and 43\% of neutral tweets. This allowed us to explore the semantic concepts of positive and negative tweets and to plot the trends of each sentiment. The main negative rhetoric identified from users' tweets was that vaccines are perceived as having a political purpose and that COVID-19 is a commercial argument for the pharmaceutical companies. Conclusions: Twitter might be a useful tool to investigate the arguments for vaccine mistrust because it unveils political criticism contrasting with the usual concerns on adverse drug reactions. As the opposition rhetoric is more consistent and more widely spread than the positive rhetoric, we believe that this research provides effective tools to help health authorities better characterize the risk of vaccine mistrust. ",
doi="10.2196/37237",
url="https://www.jmir.org/2023/1/e37237",
url="http://www.ncbi.nlm.nih.gov/pubmed/36596215"
}


@Article{info:doi/10.2196/45408,
author="Lam, Sing Chun
and Zhou, Keary
and Loong, Ho-Fung Herbert
and Chung, Chi-Ho Vincent
and Ngan, Chun-Kit
and Cheung, Ting Yin",
title="The Use of Traditional, Complementary, and Integrative Medicine in Cancer: Data-Mining Study of 1 Million Web-Based Posts From Health Forums and Social Media Platforms",
journal="J Med Internet Res",
year="2023",
month="Apr",
day="21",
volume="25",
pages="e45408",
keywords="traditional",
keywords="complementary",
keywords="integrative",
keywords="social media",
keywords="cancer",
keywords="forums, digital health",
keywords="traditional, complementary, and integrative medicine",
keywords="TCIM",
keywords="perceptions",
keywords="machine learning",
keywords="cancer care",
abstract="Background: Patients with cancer are increasingly using forums and social media platforms to access health information and share their experiences, particularly in the use of traditional, complementary, and integrative medicine (TCIM). Despite the popularity of TCIM among patients with cancer, few related studies have used data from these web-based sources to explore the use of TCIM among patients with cancer. Objective: This study leveraged multiple forums and social media platforms to explore patients' use, interest, and perception of TCIM for cancer care. Methods: Posts (in English) related to TCIM were collected from Facebook, Twitter, Reddit, and 16 health forums from inception until February 2022. Both manual assessments and natural language processing were performed. Descriptive analyses were performed to explore the most commonly discussed TCIM modalities for each symptom and cancer type. Sentiment analyses were performed to measure the polarity of each post or comment, and themes were identified from posts with positive and negative sentiments. TCIM modalities that are emerging or recommended in the guidelines were identified a priori. Exploratory topic-modeling analyses with latent Dirichlet allocation were conducted to investigate the patients' perceptions of these modalities. Results: Among the 1,620,755 posts available, cancer-related symptoms, such as pain (10/10, 100\% cancer types), anxiety and depression (9/10, 90\%), and poor sleep (9/10, 90\%), were commonly discussed. Cannabis was among the most frequently discussed TCIM modalities for pain in 7 (70\%) out of 10 cancer types, as well as nausea and vomiting, loss of appetite, anxiety and depression, and poor sleep. A total of 7 positive and 7 negative themes were also identified. The positive themes included TCIM, making symptoms manageable, and reducing the need for medication and their side effects. The belief that TCIM and conventional treatments were not mutually exclusive and intolerance to conventional treatment may facilitate TCIM use. Conversely, TCIM was viewed as leading to patients' refusal of conventional treatment or delays in diagnosis and treatment. Doctors' ignorance regarding TCIM and the lack of information provided about TCIM may be barriers to its use. Exploratory analyses showed that TCIM recommendations were well discussed among patients; however, these modalities were also used for many other indications. Other notable topics included concerns about the legalization of cannabis, acupressure techniques, and positive experiences of meditation. Conclusions: Using machine learning techniques, social media and health forums provide a valuable resource for patient-generated data regarding the pattern of use and patients' perceptions of TCIM. Such information will help clarify patients' needs and concerns and provide directions for research on integrating TCIM into cancer care. Our results also suggest that effective communication about TCIM should be achieved and that doctors should be more open-minded to actively discuss TCIM use with their patients. ",
doi="10.2196/45408",
url="https://www.jmir.org/2023/1/e45408",
url="http://www.ncbi.nlm.nih.gov/pubmed/37083752"
}


@Article{info:doi/10.2196/44413,
author="Porras Fimbres, Cristina Denisse
and Quinn, P. Alyssa
and Cooper, R. Benjamin
and Presley, L. Colby
and Jacobs, Jennifer
and Rundle, W. Chandler
and Dellavalle, P. Robert",
title="Cross-sectional Analysis of Dermatologists and Sponsored Content on TikTok",
journal="JMIR Dermatol",
year="2023",
month="Apr",
day="21",
volume="6",
pages="e44413",
keywords="social media",
keywords="TikTok",
keywords="sponsorship",
keywords="stewardship",
keywords="ethics",
keywords="dermatology",
keywords="dermatologist",
keywords="content analysis",
doi="10.2196/44413",
url="https://derma.jmir.org/2023/1/e44413",
url="http://www.ncbi.nlm.nih.gov/pubmed/37632930"
}


@Article{info:doi/10.2196/46254,
author="Choi, Won-Seok
and Han, Junhee
and Hong, Ju Hyun",
title="Association Between Internet Searches Related to Suicide/Self-harm and Adolescent Suicide Death in South Korea in 2016-2020: Secondary Data Analysis",
journal="J Med Internet Res",
year="2023",
month="Apr",
day="20",
volume="25",
pages="e46254",
keywords="adolescent",
keywords="suicide",
keywords="self-mutilation",
keywords="internet",
keywords="search engine",
keywords="Korea",
keywords="suicide death",
keywords="surveillance",
keywords="monitoring",
keywords="internet search",
abstract="Background: Previous studies have investigated the association between suicide and internet search volumes of terms related to suicide or self-harm. However, the results varied by people's age, period, and country, and no study has exclusively investigated suicide or self-harm rates among adolescents. Objective: This study aims to determine the association between the internet search volumes of terms related to suicide/self-harm and the number of suicides among South Korean adolescents. We investigated gender differences in this association and the time lag between the internet search volumes of the terms and the connected suicide deaths. Methods: We selected 26 search terms related to suicide and self-harm among South Korean adolescents, and the search volumes of these terms for adolescents aged 13-18 years were obtained from the leading internet search engine in South Korea (Naver Datalab). A data set was constructed by combining data from Naver Datalab and the number of suicide deaths of adolescents on a daily basis from January 1, 2016, to December 31, 2020. Spearman rank correlation and multivariate Poisson regression analyses were performed to identify the association between the search volumes of the terms and the suicide deaths during that period. The time lag between suicide death and the increasing trend in the search volumes of the related terms was estimated from the cross-correlation coefficients. Results: Significant correlations were observed within the search volumes of the 26 terms related to suicide/self-harm. The internet search volumes of several terms were associated with the number of suicide deaths among South Korean adolescents, and this association differed by gender. The search volume for ``dropout'' showed a statistically significant correlation with the number of suicides in all adolescent population groups. The correlation between the internet search volume for ``dropout'' and the connected suicide deaths was the strongest for a time lag of 0 days. In females, self-harm and academic score showed significant associations with suicide deaths, but academic score showed a negative correlation, and the time lags with the strongest correlations were 0 and --11 days, respectively. In the total population, self-harm and suicide method were associated with the number of suicides, and the time lags with the strongest correlations were +7 and 0 days, respectively. Conclusions: This study identifies a correlation between suicides and internet search volumes related to suicide/self-harm among South Korean adolescents, but the relatively weak correlation (incidence rate ratio 0.990-1.068) should be interpreted with caution. ",
doi="10.2196/46254",
url="https://www.jmir.org/2023/1/e46254",
url="http://www.ncbi.nlm.nih.gov/pubmed/37079349"
}


@Article{info:doi/10.2196/45249,
author="Yao, Franzl Lean
and Ferawati, Kiki
and Liew, Kongmeng
and Wakamiya, Shoko
and Aramaki, Eiji",
title="Disruptions in the Cystic Fibrosis Community's Experiences and Concerns During the COVID-19 Pandemic: Topic Modeling and Time Series Analysis of Reddit Comments",
journal="J Med Internet Res",
year="2023",
month="Apr",
day="20",
volume="25",
pages="e45249",
keywords="COVID-19",
keywords="Reddit",
keywords="time series analysis",
keywords="BERTopic",
keywords="topic modeling",
keywords="cystic fibrosis",
abstract="Background: The COVID-19 pandemic disrupted the needs and concerns of the cystic fibrosis community. Patients with cystic fibrosis were particularly vulnerable during the pandemic due to overlapping symptoms in addition to the challenges patients with rare diseases face, such as the need for constant medical aid and limited information regarding their disease or treatments. Even before the pandemic, patients vocalized these concerns on social media platforms like Reddit and formed communities and networks to share insight and information. This data can be used as a quick and efficient source of information about the experiences and concerns of patients with cystic fibrosis in contrast to traditional survey- or clinical-based methods. Objective: This study applies topic modeling and time series analysis to identify the disruption caused by the COVID-19 pandemic and its impact on the cystic fibrosis community's experiences and concerns. This study illustrates the utility of social media data in gaining insight into the experiences and concerns of patients with rare diseases. Methods: We collected comments from the subreddit r/CysticFibrosis to represent the experiences and concerns of the cystic fibrosis community. The comments were preprocessed before being used to train the BERTopic model to assign each comment to a topic. The number of comments and active users for each data set was aggregated monthly per topic and then fitted with an autoregressive integrated moving average (ARIMA) model to study the trends in activity. To verify the disruption in trends during the COVID-19 pandemic, we assigned a dummy variable in the model where a value of ``1'' was assigned to months in 2020 and ``0'' otherwise and tested for its statistical significance. Results: A total of 120,738 comments from 5827 users were collected from March 24, 2011, until August 31, 2022. We found 22 topics representing the cystic fibrosis community's experiences and concerns. Our time series analysis showed that for 9 topics, the COVID-19 pandemic was a statistically significant event that disrupted the trends in user activity. Of the 9 topics, only 1 showed significantly increased activity during this period, while the other 8 showed decreased activity. This mixture of increased and decreased activity for these topics indicates a shift in attention or focus on discussion topics during this period. Conclusions: There was a disruption in the experiences and concerns the cystic fibrosis community faced during the COVID-19 pandemic. By studying social media data, we were able to quickly and efficiently study the impact on the lived experiences and daily struggles of patients with cystic fibrosis. This study shows how social media data can be used as an alternative source of information to gain insight into the needs of patients with rare diseases and how external factors disrupt them. ",
doi="10.2196/45249",
url="https://www.jmir.org/2023/1/e45249",
url="http://www.ncbi.nlm.nih.gov/pubmed/37079359"
}


@Article{info:doi/10.2196/40913,
author="Zheng, Zihe
and Xie, Zidian
and Goniewicz, Maciej
and Rahman, Irfan
and Li, Dongmei",
title="Potential Impact of the COVID-19 Pandemic on Public Perception of Water Pipes on Reddit: Observational Study",
journal="JMIR Infodemiology",
year="2023",
month="Apr",
day="20",
volume="3",
pages="e40913",
keywords="water pipes",
keywords="Reddit",
keywords="COVID-19",
keywords="COVID-19 pandemic",
keywords="public perception",
abstract="Background: Socializing is one of the main motivations for water pipe smoking. Restrictions on social gatherings during the COVID-19 pandemic might have influenced water pipe smokers' behaviors. As one of the most popular social media platforms, Reddit has been used to study public opinions and user experiences. Objective: In this study, we aimed to examine the influence of the COVID-19 pandemic on public perception and discussion of water pipe tobacco smoking using Reddit data. Methods: We collected Reddit posts between December 1, 2018, and June 30, 2021, from a Reddit archive (PushShift) using keywords such as ``waterpipe,'' ``hookah,'' and ``shisha.'' We examined the temporal trend in Reddit posts mentioning water pipes and different locations (such as homes and lounges or bars). The temporal trend was further tested using interrupted time series analysis. Sentiment analysis was performed to study the change in sentiment of water pipe--related posts before and during the pandemic. Topic modeling using latent Dirichlet allocation (LDA) was used to examine major topics discussed in water pipe--related posts before and during the pandemic. Results: A total of 45,765 nonpromotion water pipe--related Reddit posts were collected and used for data analysis. We found that the weekly number of Reddit posts mentioning water pipes significantly increased at the beginning of the COVID-19 pandemic (P<.001), and gradually decreased afterward (P<.001). In contrast, Reddit posts mentioning water pipes and lounges or bars showed an opposite trend. Compared to the period before the COVID-19 pandemic, the average number of Reddit posts mentioning lounges or bars was lower at the beginning of the pandemic but gradually increased afterward, while the average number of Reddit posts mentioning the word ``home'' remained similar during the COVID-19 pandemic (P=.29). While water pipe--related posts with a positive sentiment were dominant (12,526/21,182, 59.14\% before the pandemic; 14,686/24,583, 59.74\% after the pandemic), there was no change in the proportion of water pipe--related posts with different sentiments before and during the pandemic (P=.19, P=.26, and P=.65 for positive, negative, and neutral posts, respectively). Most topics related to water pipes on Reddit were similar before and during the pandemic. There were more discussions about the opening and closing of hookah lounges or bars during the pandemic. Conclusions: This study provides a first evaluation of the possible impact of the COVID-19 pandemic on public perceptions of and discussions about water pipes on Reddit. ",
doi="10.2196/40913",
url="https://infodemiology.jmir.org/2023/1/e40913",
url="http://www.ncbi.nlm.nih.gov/pubmed/37124245"
}


@Article{info:doi/10.2196/42297,
author="Cheng, Quan
and Lin, Yingru",
title="Multilevel Classification of Users' Needs in Chinese Online Medical and Health Communities: Model Development and Evaluation Based on Graph Convolutional Network",
journal="JMIR Form Res",
year="2023",
month="Apr",
day="20",
volume="7",
pages="e42297",
keywords="online medical health community",
keywords="multilevel classification",
keywords="graph convolutional network",
keywords="cardiovascular disease",
keywords="cardiovascular",
keywords="China",
keywords="online",
keywords="medical",
keywords="community",
keywords="behavior",
abstract="Background: Online medical and health communities provide a platform for internet users to share experiences and ask questions about medical and health issues. However, there are problems in these communities, such as the low accuracy of the classification of users' questions and the uneven health literacy of users, which affect the accuracy of user retrieval and the professionalism of the medical personnel answering the question. In this context, it is essential to study more effective classification methods of users' information needs. Objective: Most online medical and health communities tend to provide only disease-type labels, which do not give a comprehensive summary of users' needs. The study aims to construct a multilevel classification framework based on the graph convolutional network (GCN) model for users' needs in online medical and health communities so that users can perform more targeted information retrieval. Methods: Using the Chinese online medical and health community ``Qiuyi'' as an example, we crawled questions posted by users in the ``Cardiovascular Disease'' section as the data source. First, the disease types involved in the problem data were segmented by manual coding to generate the first-level label. Second, the needs were identified by K-means clustering to generate the users' information needs label as the second-level label. Finally, by constructing a GCN model, users' questions were automatically classified, thus realizing the multilevel classification of users' needs. Results: Based on the empirical research of questions posted by users in the ``Cardiovascular Disease'' section of Qiuyi, the hierarchical classification of users' questions (data) was realized. The classification models designed in the study achieved accuracy, precision, recall, and F1-score of 0.6265, 0.6328, 0.5788, and 0.5912, respectively. Compared with the traditional machine learning method na{\"i}ve Bayes and the deep learning method hierarchical text classification convolutional neural network, our classification model showed better performance. At the same time, we also performed a single-level classification experiment on users' needs, which in comparison with the multilevel classification model exhibited a great improvement. Conclusions: A multilevel classification framework has been designed based on the GCN model. The results demonstrated that the method is effective in classifying users' information needs in online medical and health communities. At the same time, users with different diseases have different directions for information needs, which plays an important role in providing diversified and targeted services to the online medical and health community. Our method is also applicable to other similar disease classifications. ",
doi="10.2196/42297",
url="https://formative.jmir.org/2023/1/e42297",
url="http://www.ncbi.nlm.nih.gov/pubmed/37079346"
}


@Article{info:doi/10.2196/43609,
author="Bui, Tam Kim
and Li, Zoe
and Dhillon, M. Haryana
and Kiely, E. Belinda
and Blinman, Prunella",
title="Scanxiety Conversations on Twitter: Observational Study",
journal="JMIR Cancer",
year="2023",
month="Apr",
day="19",
volume="9",
pages="e43609",
keywords="anxiety",
keywords="cancer",
keywords="medical imaging",
keywords="oncology",
keywords="psycho-oncology",
keywords="social media",
keywords="twitter",
keywords="tweet",
keywords="scanxiety",
keywords="mental health",
keywords="sentiment analysis",
keywords="thematic analysis",
keywords="screen time",
keywords="scan",
keywords="hyperawareness",
keywords="radiology",
abstract="Background: Scan-associated anxiety (or ``scanxiety'') is commonly experienced by people having cancer-related scans. Social media platforms such as Twitter provide a novel source of data for observational research. Objective: We aimed to identify posts on Twitter (or ``tweets'') related to scanxiety, describe the volume and content of these tweets, and describe the demographics of users posting about scanxiety. Methods: We manually searched for ``scanxiety'' and associated keywords in cancer-related, publicly available, English-language tweets posted between January 2018 and December 2020. We defined ``conversations'' as a primary tweet (the first tweet about scanxiety) and subsequent tweets (interactions stemming from the primary tweet). User demographics and the volume of primary tweets were assessed. Conversations underwent inductive thematic and content analysis. Results: A total of 2031 unique Twitter users initiated a conversation about scanxiety from cancer-related scans. Most were patients (n=1306, 64\%), female (n=1343, 66\%), from North America (n=1130, 56\%), and had breast cancer (449/1306, 34\%). There were 3623 Twitter conversations, with a mean of 101 per month (range 40-180). Five themes were identified. The first theme was experiences of scanxiety, identified in 60\% (2184/3623) of primary tweets, which captured the personal account of scanxiety by patients or their support person. Scanxiety was often described with negative adjectives or similes, despite being experienced differently by users. Scanxiety had psychological, physical, and functional impacts. Contributing factors to scanxiety included the presence and duration of uncertainty, which was exacerbated during the COVID-19 pandemic. The second theme (643/3623, 18\%) was the acknowledgment of scanxiety, where users summarized or labeled an experience as scanxiety without providing emotive clarification, and advocacy of scanxiety, where users raised awareness of scanxiety without describing personal experiences. The third theme was messages of support (427/3623, 12\%), where users expressed well wishes and encouraged positivity for people experiencing scanxiety. The fourth theme was strategies to reduce scanxiety (319/3623, 9\%), which included general and specific strategies for patients and strategies that required improvements in clinical practice by clinicians or health care systems. The final theme was research about scanxiety (50/3623, 1\%), which included tweets about the epidemiology, impact, and contributing factors of scanxiety as well as novel strategies to reduce scanxiety. Conclusions: Scanxiety was often a negative experience described by patients having cancer-related scans. Social media platforms like Twitter enable individuals to share their experiences and offer support while providing researchers with unique data to improve their understanding of a problem. Acknowledging scanxiety as a term and increasing awareness of scanxiety is an important first step in reducing scanxiety. Research is needed to guide evidence-based approaches to reduce scanxiety, though some low-cost, low-resource practical strategies identified in this study could be rapidly introduced into clinical care. ",
doi="10.2196/43609",
url="https://cancer.jmir.org/2023/1/e43609",
url="http://www.ncbi.nlm.nih.gov/pubmed/37074770"
}


@Article{info:doi/10.2196/38377,
author="Moretti, Valentina
and Brunelli, Laura
and Conte, Alessandro
and Valdi, Giulia
and Guelfi, Renza Maria
and Masoni, Marco
and Anelli, Filippo
and Arnoldo, Luca",
title="A Web Tool to Help Counter the Spread of Misinformation and Fake News: Pre-Post Study Among Medical Students to Increase Digital Health Literacy",
journal="JMIR Med Educ",
year="2023",
month="Apr",
day="18",
volume="9",
pages="e38377",
keywords="infodemic",
keywords="fake news",
keywords="education",
keywords="digital health literacy",
keywords="medical education",
keywords="medical student",
keywords="health information",
keywords="social media",
keywords="health literacy",
keywords="online learning",
keywords="digital education",
keywords="COVID-19",
abstract="Background: The COVID-19 pandemic was accompanied by the spread of uncontrolled health information and fake news, which also quickly became an infodemic. Emergency communication is a challenge for public health institutions to engage the public during disease outbreaks. Health professionals need a high level of digital health literacy (DHL) to cope with difficulties; therefore, efforts should be made to address this issue starting from undergraduate medical students. Objective: The aim of this study was to investigate the DHL skills of Italian medical students and the effectiveness of an informatics course offered by the University of Florence (Italy). This course focuses on assessing the quality of medical information using the ``dottoremaeveroche'' (DMEVC) web resource offered by the Italian National Federation of Orders of Surgeons and Dentists, and on health information management. Methods: A pre-post study was conducted at the University of Florence between November and December 2020. First-year medical students participated in a web-based survey before and after attending the informatics course. The DHL level was self-assessed using the eHealth Literacy Scale for Italy (IT-eHEALS) tool and questions about the features and quality of the resources. All responses were rated on a 5-point Likert scale. Change in the perception of skills was assessed using the Wilcoxon test. Results: A total of 341 students participated in the survey at the beginning of the informatics course (women: n=211, 61.9\%; mean age 19.8, SD 2.0) and 217 of them (64.2\%) completed the survey at the end of the course. At the first assessment, the DHL level was moderate, with a mean total score of the IT-eHEALS of 2.9 (SD 0.9). Students felt confident about finding health-related information on the internet (mean score of 3.4, SD 1.1), whereas they doubted the usefulness of the information they received (mean score of 2.0, SD 1.0). All scores improved significantly in the second assessment. The overall mean score of the IT-eHEALS significantly increased (P<.001) to 4.2 (SD 0.6). The item with the highest score related to recognizing the quality of health information (mean score of 4.5, SD 0.7), whereas confidence in the practical application of the information received remained the lowest (mean of 3.7, SD 1.1) despite improvement. Almost all students (94.5\%) valued the DMEVC as an educational tool. Conclusions: The DMEVC tool was effective in improving medical students' DHL skills. Effective tools and resources such as the DMEVC website should be used in public health communication to facilitate access to validated evidence and understanding of health recommendations. ",
doi="10.2196/38377",
url="https://mededu.jmir.org/2023/1/e38377",
url="http://www.ncbi.nlm.nih.gov/pubmed/36996010"
}


@Article{info:doi/10.2196/41156,
author="Kj{\ae}rulff, M{\o}lholm Emilie
and Andersen, Helms Tue
and Kingod, Natasja
and Nex{\o}, Andersen Mette",
title="When People With Chronic Conditions Turn to Peers on Social Media to Obtain and Share Information: Systematic Review of the Implications for Relationships With Health Care Professionals",
journal="J Med Internet Res",
year="2023",
month="Apr",
day="17",
volume="25",
pages="e41156",
keywords="patient-physician relationship",
keywords="social media",
keywords="internet",
keywords="health information",
keywords="diabetes",
keywords="chronic diseases",
keywords="systematic review",
keywords="information-seeking behavior",
keywords="retrieval",
keywords="sharing",
abstract="Background: People living with chronic conditions such as diabetes turn to peers on social media to obtain and share information. Although social media use has grown dramatically in the past decade, little is known about its implications for the relationships between people with chronic conditions and health care professionals (HCPs). Objective: We aimed to systematically review the content and quality of studies examining what the retrieval and sharing of information by people with chronic conditions on social media implies for their relationships with HCPs. Methods: We conducted a search of studies in MEDLINE (Ovid), Embase (Ovid), PsycINFO (Ovid), and CINAHL (EBSCO). Eligible studies were primary studies; examined social media use; included adults with any type of diabetes, cardiovascular diseases that are closely linked with diabetes, obesity, hypertension, or dyslipidemia; and reported on the implications for people with chronic conditions--HCP relationships when people with chronic conditions access and share information on social media. We used the Mixed Methods Appraisal Tool version 2018 to assess the quality of the studies, and the included studies were narratively synthesized. Results: Of the 3111 screened studies, 17 (0.55\%) were included. Most studies (13/17, 76\%) were of low quality. The narrative synthesis identified implications for people with chronic conditions--HCP relationships when people with chronic conditions access and share information on social media, divided into 3 main categories with 7 subcategories. These categories of implications address how the peer interactions of people with chronic conditions on social media can influence their communication with HCPs, how people with chronic conditions discuss advice and medical information from HCPs on social media, and how relationships with HCPs are discussed by people with chronic conditions on social media. The implications are illustrated collectively in a conceptual model. Conclusions: More evidence is needed to draw conclusions, but the findings indicate that the peer interactions of people with chronic conditions on social media are implicated in the ways in which people with chronic conditions equip themselves for clinical consultations, evaluate the information and advice provided by HCPs, and manage their relationships with HCPs. Future populations with chronic conditions will be raised in a digital world, and social media will likely remain a strategy for obtaining support and information. However, the generally low quality of the studies included in this review points to the relatively immature state of research exploring social media and its implications for people with chronic conditions--HCP relationships. Better study designs and methods for conducting research on social media are needed to generate robust evidence. ",
doi="10.2196/41156",
url="https://www.jmir.org/2023/1/e41156",
url="http://www.ncbi.nlm.nih.gov/pubmed/37067874"
}


@Article{info:doi/10.2196/45051,
author="Wu, Xiaoqian
and Li, Ziyu
and Xu, Lin
and Li, Pengfei
and Liu, Ming
and Huang, Cheng",
title="COVID-19 Vaccine--Related Information on the WeChat Public Platform: Topic Modeling and Content Analysis",
journal="J Med Internet Res",
year="2023",
month="Apr",
day="14",
volume="25",
pages="e45051",
keywords="health belief model",
keywords="COVID-19 vaccines",
keywords="WeChat",
keywords="content analysis",
keywords="topic modeling",
keywords="public health",
keywords="COVID-19",
abstract="Background: The COVID-19 vaccine is an effective tool in the fight against the COVID-19 outbreak. As the main channel of information dissemination in the context of the epidemic, social media influences public trust and acceptance of the vaccine. The rational application of health behavior theory is a guarantee of effective public health information dissemination. However, little is known about the application of health behavior theory in web-based COVID-19 vaccine messages, especially from Chinese social media posts. Objective: This study aimed to understand the main topics and communication characteristics of hot papers related to COVID-19 vaccine on the WeChat platform and assess the health behavior theory application with the aid of health belief model (HBM). Methods: A systematic search was conducted on the Chinese social media platform WeChat to identify COVID-19 vaccine--related papers. A coding scheme was established based on the HBM, and the sample was managed and coded using NVivo 12 (QSR International) to assess the application of health behavior theory. The main topics of the papers were extracted through the Latent Dirichlet Allocation algorithm. Finally, temporal analysis was used to explore trends in the evolution of themes and health belief structures in the papers. Results: A total of 757 papers were analyzed. Almost all (671/757, 89\%) of the papers did not have an original logo. By topic modeling, 5 topics were identified, which were vaccine development and effectiveness (267/757, 35\%), disease infection and protection (197/757, 26\%), vaccine safety and adverse reactions (52/757, 7\%), vaccine access (136/757, 18\%), and vaccination science popularization (105/757, 14\%). All papers identified at least one structure in the extended HBM, but only 29 papers included all of the structures. Descriptions of solutions to obstacles (585/757, 77\%) and benefit (468/757, 62\%) were the most emphasized components in all samples. Relatively few elements of susceptibility (208/757, 27\%) and the least were descriptions of severity (135/757, 18\%). Heat map visualization revealed the change in health belief structure before and after vaccine entry into the market. Conclusions: To the best of our knowledge, this is the first study to assess the structural expression of health beliefs in information related to the COVID-19 vaccine on the WeChat public platform based on an HBM. The study also identified topics and communication characteristics before and after the market entry of vaccines. Our findings can inform customized education and communication strategies to promote vaccination not only in this pandemic but also in future pandemics. ",
doi="10.2196/45051",
url="https://www.jmir.org/2023/1/e45051",
url="http://www.ncbi.nlm.nih.gov/pubmed/37058349"
}


@Article{info:doi/10.2196/42609,
author="Wojtara, Sara Magda",
title="Use of Social Media for Patient Education in Dermatology: Narrative Review",
journal="JMIR Dermatol",
year="2023",
month="Apr",
day="14",
volume="6",
pages="e42609",
keywords="dermatology",
keywords="health literacy",
keywords="innovation",
keywords="patient education",
keywords="social media",
abstract="Background: Social media has rapidly become one of the main avenues for news and communication among those with access to technology. Nearly 60\% or 4.7 billion people worldwide use social media. Different social media networks provide users with a barrage of posts, opinions, and transformations. With this noticeable uptick in physician and patient education usage of social media, exploration of the impacts of social media on patient education in dermatology is crucial. Objective: The goal of this narrative review was to evaluate existing peer-reviewed literature examining the use of social media for patient education in dermatology and to establish trends and implications. Additional attention was given to different social media sites, and potential differences in modalities of posts such as short-form videos on TikTok and Instagram Reels, long-form videos on YouTube, and infographics on Twitter, Instagram, and Facebook. Methods: PubMed, Access DermatologyDxRx, and Scopus searches of peer-reviewed publications were performed to discover articles with social media and patient education keywords in combination with other health care--relevant or dermatology-relevant keywords. Subsequently, the screening of these studies was performed by the author who has experience with education and research experience in health care, dermatology, social media, and telehealth. Ultimately, the selected articles were summarized through qualitative analysis of key points and presented for further discussion. Results: Through this narrative review, the researcher was able to identify several publications focusing on dermatology and social media. Some common subject areas included the use of social media for the promotion of private dermatology practices, residency programs, and research journals. So long as providers, such as dermatologists, take ethical considerations into account, these platforms can provide patients with curated educational content. In addition, several publications emphasized the use of social media as a form of patient education on dermatologic conditions but also as a source of misinformation. Conclusions: This narrative review illuminated the use of social media as a form of patient education for dermatology, with its applications addressed across many demographics and situations. As social media platforms continue to update their algorithms, content filters, and posts, social media may become a reputable form of patient education in dermatology. Future studies and innovations should continue to explore innovations in this space, the efficacy of different modalities of posts, and longitudinal differences in patient outcomes and health literacy. ",
doi="10.2196/42609",
url="https://derma.jmir.org/2023/1/e42609",
url="http://www.ncbi.nlm.nih.gov/pubmed/37632938"
}


@Article{info:doi/10.2196/46661,
author="Handayani, Wuri Putu
and Zagatti, Augusto Guilherme
and Kefi, Hajer
and Bressan, St{\'e}phane",
title="Impact of Social Media Usage on Users' COVID-19 Protective Behavior: Survey Study in Indonesia",
journal="JMIR Form Res",
year="2023",
month="Apr",
day="13",
volume="7",
pages="e46661",
keywords="COVID-19",
keywords="pandemic",
keywords="infectious diseases",
keywords="social media",
keywords="trust",
keywords="behavior",
keywords="Indonesia",
abstract="Background: Social media have become the source of choice for many users to search for health information on COVID-19 despite possible detrimental consequences. Several studies have analyzed the association between health information--searching behavior and mental health. Some of these studies examined users' intentions in searching health information on social media and the impact of social media use on mental health in Indonesia. Objective: This study investigates both active and passive participation in social media, shedding light on cofounding effects from these different forms of engagement. In addition, this study analyses the role of trust in social media platforms and its effect on public health outcomes. Thus, the purpose of this study is to analyze the impact of social media usage on COVID-19 protective behavior in Indonesia. The most commonly used social media platforms are Instagram, Facebook, YouTube, TikTok, and Twitter. Methods: We used primary data from an online survey. We processed 414 answers to a structured questionnaire to evaluate the relationship between these users' active and passive participation in social media, trust in social media, anxiety, self-efficacy, and protective behavior to COVID-19. We modeled the data using partial least square structural equation modeling. Results: This study reveals that social media trust is a crucial antecedent, where trust in social media is positively associated with active contribution and passive consumption of COVID-19 content in social media, users' anxiety, self-efficacy, and protective behavior. This study found that active contribution of content related to COVID-19 on social media is positively correlated with anxiety, while passive participation increases self-efficacy and, in turn, protective behavior. This study also found that active participation is associated with negative health outcomes, while passive participation has the opposite effects. The results of this study can potentially be used for other infectious diseases, for example, dengue fever and diseases that can be transmitted through the air and have handling protocols similar to that of COVID-19. Conclusions: Public health campaigns can use social media for health promotion. Public health campaigns should post positive messages and distil the received information parsimoniously to avoid unnecessary and possibly counterproductive increased anxiety of the users. ",
doi="10.2196/46661",
url="https://formative.jmir.org/2023/1/e46661",
url="http://www.ncbi.nlm.nih.gov/pubmed/37052987"
}


@Article{info:doi/10.2196/41319,
author="Lindel{\"o}f, Gabriel
and Aledavood, Talayeh
and Keller, Barbara",
title="Dynamics of the Negative Discourse Toward COVID-19 Vaccines: Topic Modeling Study and an Annotated Data Set of Twitter Posts",
journal="J Med Internet Res",
year="2023",
month="Apr",
day="12",
volume="25",
pages="e41319",
keywords="COVID-19 vaccines",
keywords="SARS-CoV-2",
keywords="vaccine hesitancy",
keywords="social media",
keywords="Twitter",
keywords="natural language processing",
keywords="machine learning",
keywords="stance detection",
keywords="topic modeling",
abstract="Background: Since the onset of the COVID-19 pandemic, vaccines have been an important topic in public discourse. The discussions around vaccines are polarized, as some see them as an important measure to end the pandemic, and others are hesitant or find them harmful. A substantial portion of these discussions occurs openly on social media platforms. This allows us to closely monitor the opinions of different groups and their changes over time. Objective: This study investigated posts related to COVID-19 vaccines on Twitter (Twitter Inc) and focused on those that had a negative stance toward vaccines. It examined the evolution of the percentage of negative tweets over time. It also examined the different topics discussed in these tweets to understand the concerns and discussion points of those holding a negative stance toward the vaccines. Methods: A data set of 16,713,238 English tweets related to COVID-19 vaccines was collected, covering the period from March 1, 2020, to July 31, 2021. We used the scikit-learn Python library to apply a support vector machine classifier to identify the tweets with a negative stance toward COVID-19 vaccines. A total of 5163 tweets were used to train the classifier, of which a subset of 2484 tweets was manually annotated by us and made publicly available along with this paper. We used the BERTopic model to extract the topics discussed within the negative tweets and investigate them, including how they changed over time. Results: We showed that the negativity with respect to COVID-19 vaccines has decreased over time along with the vaccine rollouts. We identified 37 topics of discussion and presented their respective importance over time. We showed that popular topics not only consisted of conspiratorial discussions, such as 5G towers and microchips, but also contained legitimate concerns around vaccination safety and side effects as well as concerns about policies. The most prevalent topic among vaccine-hesitant tweets was related to the use of messenger RNA and fears about its speculated negative effects on our DNA. Conclusions: Hesitancy toward vaccines existed before the COVID-19 pandemic. However, given the dimension of and circumstances surrounding the COVID-19 pandemic, some new areas of hesitancy and negativity toward COVID-19 vaccines have arisen, for example, whether there has been enough time for them to be properly tested. There is also an unprecedented number of conspiracy theories associated with them. Our study shows that even unpopular opinions or conspiracy theories can become widespread when paired with a widely popular discussion topic such as COVID-19 vaccines. Understanding the concerns, the discussed topics, and how they change over time is essential for policy makers and public health authorities to provide better in-time information and policies to facilitate the vaccination of the population in future similar crises. ",
doi="10.2196/41319",
url="https://www.jmir.org/2023/1/e41319",
url="http://www.ncbi.nlm.nih.gov/pubmed/36877804"
}


@Article{info:doi/10.2196/42218,
author="Murthy, Dhiraj
and Lee, Juhan
and Dashtian, Hassan
and Kong, Grace",
title="Influence of User Profile Attributes on e-Cigarette--Related Searches on YouTube: Machine Learning Clustering and Classification",
journal="JMIR Infodemiology",
year="2023",
month="Apr",
day="12",
volume="3",
pages="e42218",
keywords="electronic cigarettes",
keywords="electronic nicotine delivery systems",
keywords="ENDS",
keywords="tobacco products",
keywords="YouTube",
keywords="social media",
keywords="minority groups",
keywords="exposure",
keywords="youth",
keywords="behavior",
keywords="user",
keywords="machine learning",
keywords="policy",
abstract="Background: The proliferation of e-cigarette content on YouTube is concerning because of its possible effect on youth use behaviors. YouTube has a personalized search and recommendation algorithm that derives attributes from a user's profile, such as age and sex. However, little is known about whether e-cigarette content is shown differently based on user characteristics. Objective: The aim of this study was to understand the influence of age and sex attributes of user profiles on e-cigarette--related YouTube search results. Methods: We created 16 fictitious YouTube profiles with ages of 16 and 24 years, sex (female and male), and ethnicity/race to search for 18 e-cigarette--related search terms. We used unsupervised (k-means clustering and classification) and supervised (graph convolutional network) machine learning and network analysis to characterize the variation in the search results of each profile. We further examined whether user attributes may play a role in e-cigarette--related content exposure by using networks and degree centrality. Results: We analyzed 4201 nonduplicate videos. Our k-means clustering suggested that the videos could be clustered into 3 categories. The graph convolutional network achieved high accuracy (0.72). Videos were classified based on content into 4 categories: product review (49.3\%), health information (15.1\%), instruction (26.9\%), and other (8.5\%). Underage users were exposed mostly to instructional videos (37.5\%), with some indication that more female 16-year-old profiles were exposed to this content, while young adult age groups (24 years) were exposed mostly to product review videos (39.2\%). Conclusions: Our results indicate that demographic attributes factor into YouTube's algorithmic systems in the context of e-cigarette--related queries on YouTube. Specifically, differences in the age and sex attributes of user profiles do result in variance in both the videos presented in YouTube search results as well as in the types of these videos. We find that underage profiles were exposed to e-cigarette content despite YouTube's age-restriction policy that ostensibly prohibits certain e-cigarette content. Greater enforcement of policies to restrict youth access to e-cigarette content is needed. ",
doi="10.2196/42218",
url="https://infodemiology.jmir.org/2023/1/e42218",
url="http://www.ncbi.nlm.nih.gov/pubmed/37124246"
}


@Article{info:doi/10.2196/45368,
author="Adkins, Kate
and Overton, G. Paul
and Moses, Julia
and Thompson, Andrew",
title="Investigating the Role of Upward Comparisons and Self-compassion on Stigma in People With Acne: Cross-sectional Study",
journal="JMIR Dermatol",
year="2023",
month="Apr",
day="12",
volume="6",
pages="e45368",
keywords="acne",
keywords="stigma",
keywords="appearance comparisons",
keywords="self-compassion",
keywords="social media",
keywords="psychological distress",
keywords="stigmatization",
keywords="acne symptoms",
keywords="symptoms",
keywords="Facebook",
keywords="Instagram",
keywords="skin",
keywords="engagement",
keywords="appearance",
keywords="distress",
abstract="Background: The use of image-laden social media is hypothesized as being implicated in psychological distress in individuals with conditions affecting their appearance. However, relatively little is known about the mechanisms involved in this relationship. Objective: This cross-sectional study examined the relationship between photo-orientated social media use and feelings of stigmatization in adults with acne, and tested whether upward skin comparisons mediate and self-compassion moderates this relationship. Methods: Adults (N=650) with acne symptoms completed web-based measures of social media use (daily Facebook or Instagram use, Facebook function use), self-compassion, skin appearance comparisons, and internalized stigmatization. Results: Moderated-mediation and mediation analyses indicated that there was a significant indirect effect of Facebook photo use on stigmatization, mediated by upward appearance comparisons (estimation of indirect effect 11.03, SE 5.11, 95\% CI 1.19-21.12). There was no significant relationship between Instagram use and feelings of stigmatization (estimation of indirect effect 0.0002, SE 0.005, 95\% CI ?0.011 to 0.009), yet upward appearance comparisons predicted feelings of stigmatization (B=0.99, P<.001). Self-compassion did not moderate the indirect or direct relationships between photo-orientated social media use and stigma. However, self-compassion was negatively correlated with upward appearance comparisons and feelings of stigmatization in both Facebook and Instagram users. Conclusions: The way that individuals engage with social media, and in particular make appearance comparisons, should be considered when working with individuals with skin-related distress. Interventions aimed at boosting self-compassion and reducing appearance comparisons may provide avenues for protecting against feelings of stigma. ",
doi="10.2196/45368",
url="https://derma.jmir.org/2023/1/e45368",
url="http://www.ncbi.nlm.nih.gov/pubmed/37632940"
}


@Article{info:doi/10.2196/43115,
author="Derges, Jane
and Bould, Helen
and Gooberman-Hill, Rachael
and Moran, Paul
and Linton, Myles-Jay
and Rifkin-Zybutz, Raphael
and Biddle, Lucy",
title="Mental Health Practitioners' and Young People's Experiences of Talking About Social Media During Mental Health Consultations: Qualitative Focus Group and Interview Study",
journal="JMIR Form Res",
year="2023",
month="Apr",
day="7",
volume="7",
pages="e43115",
keywords="young people",
keywords="digital technology and social media",
keywords="mental health consultations",
keywords="clinician and young people's experiences",
abstract="Background: Increasing concerns among mental health care professionals have focused on the impact of young people's use of digital technology and social media on their mental well-being. It has been recommended that the use of digital technology and social media be routinely explored during mental health clinical consultations with young people. Whether these conversations occur and how they are experienced by both clinicians and young people are currently unknown. Objective: This study aimed to explore mental health practitioners' and young people's experiences of talking about young people's web-based activities related to their mental health during clinical consultations. Web-based activities include use of social media, websites, and messaging. Our aim was to identify barriers to effective communication and examples of good practice. In particular, we wanted to obtain the views of young people, who are underrepresented in studies, on their social media and digital technology use related to mental health. Methods: A qualitative study was conducted using focus groups (11 participants across 3 groups) with young people aged 16 to 24 years and interviews (n=8) and focus groups (7 participants across 2 groups) with mental health practitioners in the United Kingdom. Young people had experience of mental health problems and support provided by statutory mental health services or third-sector organizations. Practitioners worked in children and young people's mental health services, statutory services, or third-sector organizations such as a university counseling service. Thematic analysis was used to analyze the data. Results: Practitioners and young people agreed that talking about young people's web-based activities and their impact on mental health is important. Mental health practitioners varied in their confidence in doing this and were keen to have more guidance. Young people said that practitioners seldom asked about their web-based activities, but when asked, they often felt judged or misunderstood. This stopped them from disclosing difficult web-based experiences and precluded useful conversations about web-based safety and how to access appropriate web-based support. Young people supported the idea of guidance or training for practitioners and were enthusiastic about sharing their experiences and being involved in the training or guidance provided to practitioners. Conclusions: Practitioners would benefit from structured guidance and professional development to enable them to support young people in feeling more willing to disclose and talk about their web-based experiences and their impact on their mental health. This is reflected in practitioners' desire for guidance to improve their confidence and skills to safely support young people in navigating the challenges of the web-based world. Young people want to feel comfortable discussing their web-based activities during their consultations with mental health practitioners, both in tackling the challenges and using the opportunity to discuss their experiences, gain support, and develop coping strategies related to web-based safety. ",
doi="10.2196/43115",
url="https://formative.jmir.org/2023/1/e43115",
url="http://www.ncbi.nlm.nih.gov/pubmed/37027182"
}


@Article{info:doi/10.2196/42207,
author="Alfonso-Fuertes, Isabel
and Alvarez-Mon, Angel Miguel
and Sanchez del Hoyo, Rafael
and Ortega, A. Miguel
and Alvarez-Mon, Melchor
and Molina-Ruiz, M. Rosa",
title="Time Spent on Instagram and Body Image, Self-esteem, and Physical Comparison Among Young Adults in Spain: Observational Study",
journal="JMIR Form Res",
year="2023",
month="Apr",
day="7",
volume="7",
pages="e42207",
keywords="Instagram",
keywords="self-esteem",
keywords="body image",
keywords="physical comparison",
keywords="young adults",
keywords="social media",
keywords="assessment",
keywords="tool",
keywords="questionnaire",
keywords="satisfaction",
keywords="physical appearance",
keywords="usage",
abstract="Background: Instagram is a social media platform based on photos and videos that encourages interaction and comparison between users. Its growing popularity, especially among young people, has generated interest in the impact its use can have on users{\textasciiacute} mental health, specifically on their self-esteem and degree of satisfaction with their own body image. Objective: We aimed to analyze the relationships between the use of Instagram, both the hours of daily use and the type of content viewed, and self-esteem, tendency to make physical comparisons, and satisfaction with body image. Methods: In this cross-sectional study, we recruited 585 participants aged between 18 years and 40 years. Individuals who were interested in participating but had a personal history of eating disorders or had previously been diagnosed with a psychiatric disorder were excluded. The assessment tools consisted of (1) a questionnaire that collected sociodemographic data and Instagram use variables and was created by the research team specifically for this study; (2) the self-esteem scale by Rosenberg; (3) Physical Appearance Comparison Scale-Revised (PACS-R); and (4) Body Shape Questionnaire (BSQ). The recruitment and evaluation processes were carried out in January 2021. Results: Of the participants, 234 (234/585, 40\%) used Instagram less than 1 hour a day, 303 (303/585, 51.8\%) used Instagram between 1 hour and 3 hours a day, and 48 participants (48/585, 8.2\%) used it more than 3 hours per day. We found statistically significant differences (P<.05) between the 3 groups in the scores obtained on the self-esteem test by Rosenberg, PACS-R, and BSQ. Participants who spent more time on Instagram had higher levels of body dissatisfaction, greater comparisons of physical appearance, and lower self-esteem. Moreover, we analyzed the relationship between the score obtained on the different scales and the types of content viewed, with no differences between those who mainly viewed professional content and those who primarily consumed fashion and beauty or sport and nutrition content. Conclusions: The results of this study indicate that the use of Instagram is associated with poorer body image satisfaction and self-esteem, mediated by the tendency to compare physical appearance in relation to the daily duration of Instagram use. ",
doi="10.2196/42207",
url="https://formative.jmir.org/2023/1/e42207",
url="http://www.ncbi.nlm.nih.gov/pubmed/37027197"
}


@Article{info:doi/10.2196/42346,
author="Xie, Zidian
and Xue, Siyu
and Gao, Yankun
and Li, Dongmei",
title="Characterizing e-Cigarette--Related Videos on TikTok: Observational Study",
journal="JMIR Form Res",
year="2023",
month="Apr",
day="5",
volume="7",
pages="e42346",
keywords="e-cigarette",
keywords="TikTok",
keywords="video",
keywords="provaping",
keywords="antivaping",
abstract="Background: As a popular social networking platform for sharing short videos, TikTok has been widely used for sharing e-cigarettes or vaping-related videos, especially among the youth. Objective: This study aims to characterize e-cigarette or vaping-related videos and their user engagement on TikTok through descriptive analysis. Methods: From TikTok, a total of 417 short videos, posted between October 4, 2018, and February 27, 2021, were collected using e-cigarette or vaping-related hashtags. Two human coders independently hand-coded the video category and the attitude toward vaping (provaping or antivaping) for each vaping-related video. The social media user engagement measures (eg, the comment count, like count, and share count) for each video category were compared within provaping and antivaping groups. The user accounts posting these videos were also characterized. Results: Among 417 vaping-related TikTok videos, 387 (92.8\%) were provaping, and 30 (7.2\%) were antivaping videos. Among provaping TikTok videos, the most popular category is vaping tricks (n=107, 27.65\%), followed by advertisement (n=85, 21.95\%), customization (n=75, 19.38\%), TikTok trend (n=70, 18.09\%), others (n=44, 11.37\%), and education (n=6, 1.55\%). By comparison, videos showing the TikTok trend had significantly higher user engagement (like count per video) than other provaping videos. Antivaping videos included 15 (50\%) videos with the TikTok trend, 10 (33.33\%) videos on education, and 5 (16.67\%) videos about others. Videos with education have a significantly lower number of likes than other antivaping videos. Most TikTok users posting vaping-related videos are personal accounts (119/203, 58.62\%). Conclusions: Vaping-related TikTok videos are dominated by provaping videos focusing on vaping tricks, advertisement, customization, and TikTok trend. Videos with the TikTok trend have higher user engagement than other video categories. Our findings provide important information on vaping-related videos shared on TikTok and their user engagement levels, which might provide valuable guidance on future policy making, such as possible restrictions on provaping videos posted on TikTok, as well as how to effectively communicate with the public about the potential health risks of vaping. ",
doi="10.2196/42346",
url="https://formative.jmir.org/2023/1/e42346",
url="http://www.ncbi.nlm.nih.gov/pubmed/37018026"
}


@Article{info:doi/10.2196/45777,
author="Zhu, Jianghong
and Li, Zepeng
and Zhang, Xiu
and Zhang, Zhenwen
and Hu, Bin",
title="Public Attitudes Toward Anxiety Disorder on Sina Weibo: Content Analysis",
journal="J Med Internet Res",
year="2023",
month="Apr",
day="4",
volume="25",
pages="e45777",
keywords="anxiety disorder",
keywords="linguistic feature",
keywords="topic model",
keywords="public attitude",
keywords="social media",
abstract="Background: Anxiety disorder has become a major clinical and public health problem, causing a significant economic burden worldwide. Public attitudes toward anxiety can impact the psychological state, help-seeking behavior, and social activities of people with anxiety disorder. Objective: The purpose of this study was to explore public attitudes toward anxiety disorders and the changing trends of these attitudes by analyzing the posts related to anxiety disorders on Sina Weibo, a Chinese social media platform that has about 582 million users, as well as the psycholinguistic and topical features in the text content of the posts. Methods: From April 2018 to March 2022, 325,807 Sina Weibo posts with the keyword ``anxiety disorder'' were collected and analyzed. First, we analyzed the changing trends in the number and total length of posts every month. Second, a Chinese Linguistic Psychological Text Analysis System (TextMind) was used to analyze the changing trends in the language features of the posts, in which 20 linguistic features were selected and presented. Third, a topic model (biterm topic model) was used for semantic content analysis to identify specific themes in Weibo users' attitudes toward anxiety. Results: The changing trends in the number and the total length of posts indicated that anxiety-related posts significantly increased from April 2018 to March 2022 (R2=0.6512; P<.001 to R2=0.8133; P<.001, respectively) and were greatly impacted by the beginning of a new semester (spring/fall). The analysis of linguistic features showed that the frequency of the cognitive process (R2=0.1782; P=.003), perceptual process (R2=0.1435; P=.008), biological process (R2=0.3225; P<.001), and assent words (R2=0.4412; P<.001) increased significantly over time, while the frequency of the social process words (R2=0.2889; P<.001) decreased significantly, and public anxiety was greatly impacted by the COVID-19 pandemic. Feature correlation analysis showed that the frequencies of words related to work and family are almost negatively correlated with those of other psychological words. Semantic content analysis identified 5 common topical areas: discrimination and stigma, symptoms and physical health, treatment and support, work and social, and family and life. Our results showed that the occurrence probability of the topical area ``discrimination and stigma'' reached the highest value and averagely accounted for 26.66\% in the 4-year period. The occurrence probability of the topical area ``family and life'' (R2=0.1888; P=.09) decreased over time, while that of the other 4 topical areas increased. Conclusions: The findings of our study indicate that public discrimination and stigma against anxiety disorder remain high, particularly in the aspects of self-denial and negative emotions. People with anxiety disorders should receive more social support to reduce the impact of discrimination and stigma. ",
doi="10.2196/45777",
url="https://www.jmir.org/2023/1/e45777",
url="http://www.ncbi.nlm.nih.gov/pubmed/37014691"
}


@Article{info:doi/10.2196/43497,
author="Ahmed, Wasim
and Das, Ronnie
and Vidal-Alaball, Josep
and Hardey, Mariann
and Fuster-Casanovas, A{\"i}na",
title="Twitter's Role in Combating the Magnetic Vaccine Conspiracy Theory: Social Network Analysis of Tweets",
journal="J Med Internet Res",
year="2023",
month="Mar",
day="31",
volume="25",
pages="e43497",
keywords="COVID-19",
keywords="coronavirus",
keywords="Twitter",
keywords="social network analysis",
keywords="misinformation",
keywords="online social capital",
abstract="Background: The popularity of the magnetic vaccine conspiracy theory and other conspiracy theories of a similar nature creates challenges to promoting vaccines and disseminating accurate health information. Objective: Health conspiracy theories are gaining in popularity. This study's objective was to evaluate the Twitter social media network related to the magnetic vaccine conspiracy theory and apply social capital theory to analyze the unique social structures of influential users. As a strategy for web-based public health surveillance, we conducted a social network analysis to identify the important opinion leaders sharing the conspiracy, the key websites, and the narratives. Methods: A total of 18,706 tweets were retrieved and analyzed by using social network analysis. Data were retrieved from June 1 to June 13, 2021, using the keyword vaccine magnetic. Tweets were retrieved via a dedicated Twitter application programming interface. More specifically, the Academic Track application programming interface was used, and the data were analyzed by using NodeXL Pro (Social Media Research Foundation) and Gephi. Results: There were a total of 22,762 connections between Twitter users within the data set. This study found that the most influential user within the network consisted of a news account that was reporting on the magnetic vaccine conspiracy. There were also several other users that became influential, such as an epidemiologist, a health economist, and a retired sports athlete who exerted their social capital within the network. Conclusions: Our study found that influential users were effective broadcasters against the conspiracy, and their reach extended beyond their own networks of Twitter followers. We emphasize the need for trust in influential users with regard to health information, particularly in the context of the widespread social uncertainty resulting from the COVID-19 pandemic, when public sentiment on social media may be unpredictable. This study highlights the potential of influential users to disrupt information flows of conspiracy theories via their unique social capital. ",
doi="10.2196/43497",
url="https://www.jmir.org/2023/1/e43497",
url="http://www.ncbi.nlm.nih.gov/pubmed/36927550"
}


@Article{info:doi/10.2196/44660,
author="Blackie, A. Caroline
and Gualtieri, Lisa
and Kasturi, Shanthini",
title="Listening to Patients With Lupus: Why Not Proactively Integrate the Internet as a Resource to Drive Improved Care?",
journal="J Med Internet Res",
year="2023",
month="Mar",
day="29",
volume="25",
pages="e44660",
keywords="lupus",
keywords="patient symptom",
keywords="patient journey",
keywords="chronic disease",
keywords="lived experience",
keywords="patient experience",
keywords="patient need",
keywords="digital health intervention",
keywords="autoimmune disease",
keywords="clinical care",
keywords="digital voice",
keywords="social media",
keywords="patient care",
keywords="online community",
keywords="social listening",
keywords="autoimmune",
keywords="experience",
keywords="perspective",
doi="10.2196/44660",
url="https://www.jmir.org/2023/1/e44660",
url="http://www.ncbi.nlm.nih.gov/pubmed/36989021"
}


@Article{info:doi/10.2196/38404,
author="Jones, Ffion Leah
and Bonfield, Stefanie
and Farrell, Jade
and Weston, Dale",
title="Understanding the Public's Attitudes Toward COVID-19 Vaccines in Nottinghamshire, United Kingdom: Qualitative Social Media Analysis",
journal="J Med Internet Res",
year="2023",
month="Mar",
day="29",
volume="25",
pages="e38404",
keywords="COVID-19",
keywords="vaccine",
keywords="social media",
keywords="qualitative",
keywords="vaccine hesitancy",
keywords="infodemic",
keywords="misinformation",
keywords="infodemiology",
keywords="online health information",
keywords="content analysis",
keywords="Facebook",
keywords="Twitter",
keywords="transmission",
abstract="Background: COVID-19 vaccines remain central to the UK government's plan for tackling the COVID-19 pandemic. Average uptake of 3 doses in the United Kingdom stood at 66.7\% as of March 2022; however, this rate varies across localities. Understanding the views of groups who have low vaccine uptake is crucial to guide efforts to improve vaccine uptake. Objective: This study aims to understand the public's attitudes toward COVID-19 vaccines in Nottinghamshire, United Kingdom. Methods: A qualitative thematic analysis of social media posts from Nottinghamshire-based profiles and data sources was conducted. A manual search strategy was used to search the Nottingham Post website and local Facebook and Twitter accounts from September 2021 to October 2021. Only comments in the public domain and in English were included in the analysis. Results: A total of 3508 comments from 1238 users on COVID-19 vaccine posts by 10 different local organizations were analyzed, and 6 overarching themes were identified: trust in the vaccines, often characterized by a lack of trust in vaccine information, information sources including the media, and the government; beliefs about safety including doubts about the speed of development and approval process, the severity of side effects, and belief that the ingredients are harmful; belief that the vaccines are not effective as people can still become infected and spread the virus and that the vaccines may increase transmission through shedding; belief that the vaccines are not necessary due to low perceived risk of death and severe outcomes and use of other protective measures such as natural immunity, ventilation, testing, face coverings, and self-isolation; individual rights and freedoms to be able to choose to be vaccinated or not without judgement or discrimination; and barriers to physical access. Conclusions: The findings revealed a wide range of beliefs and attitudes toward COVID-19 vaccination. Implications for the vaccine program in Nottinghamshire include communication strategies delivered by trusted sources to address the gaps in knowledge identified while acknowledging some negatives such as side effects alongside emphasizing the benefits. These strategies should avoid perpetuating myths and avoid using scare tactics when addressing risk perceptions. Accessibility should also be considered with a review of current vaccination site locations, opening hours, and transport links. Additional research may benefit from using qualitative interviews or focus groups to further probe on the themes identified and explore the acceptability of the recommended interventions. ",
doi="10.2196/38404",
url="https://www.jmir.org/2023/1/e38404",
url="http://www.ncbi.nlm.nih.gov/pubmed/36812390"
}


@Article{info:doi/10.2196/43623,
author="Beauchamp, M. Alaina
and Lehmann, U. Christoph
and Medford, J. Richard
and Hughes, E. Amy",
title="The Association of a Geographically Wide Social Media Network on Depression: County-Level Ecological Analysis",
journal="J Med Internet Res",
year="2023",
month="Mar",
day="27",
volume="25",
pages="e43623",
keywords="Facebook",
keywords="social connectedness",
keywords="depression",
keywords="county-level analysis",
keywords="social media",
keywords="mental health",
keywords="research",
keywords="ecological",
keywords="geography",
keywords="GIS",
abstract="Background: Social connectedness decreases human mortality, improves cancer survival, cardiovascular health, and body mass, results in better-controlled glucose levels, and strengthens mental health. However, few public health studies have leveraged large social media data sets to classify user network structure and geographic reach rather than the sole use of social media platforms. Objective: The objective of this study was to determine the association between population-level digital social connectedness and reach and depression in the population across geographies of the United States. Methods: Our study used an ecological assessment of aggregated, cross-sectional population measures of social connectedness, and self-reported depression across all counties in the United States. This study included all 3142 counties in the contiguous United States. We used measures obtained between 2018 and 2020 for adult residents in the study area. The study's main exposure of interest is the Social Connectedness Index (SCI), a pair-wise composite index describing the ``strength of connectedness between 2 geographic areas as represented by Facebook friendship ties.'' This measure describes the density and geographical reach of average county residents' social network using Facebook friendships and can differentiate between local and long-distance Facebook connections. The study's outcome of interest is self-reported depressive disorder as published by the Centers for Disease Control and Prevention. Results: On average, 21\% (21/100) of all adult residents in the United States reported a depressive disorder. Depression frequency was the lowest for counties in the Northeast (18.6\%) and was highest for southern counties (22.4\%). Social networks in northeastern counties involved moderately local connections (SCI 5-10 the 20th percentile for n=70, 36\% of counties), whereas social networks in Midwest, southern, and western counties contained mostly local connections (SCI 1-2 the 20th percentile for n=598, 56.7\%, n=401, 28.2\%, and n=159, 38.4\%, respectively). As the quantity and distance that social connections span (ie, SCI) increased, the prevalence of depressive disorders decreased by 0.3\% (SE 0.1\%) per rank. Conclusions: Social connectedness and depression showed, after adjusting for confounding factors such as income, education, cohabitation, natural resources, employment categories, accessibility, and urbanicity, that a greater social connectedness score is associated with a decreased prevalence of depression. ",
doi="10.2196/43623",
url="https://www.jmir.org/2023/1/e43623",
url="http://www.ncbi.nlm.nih.gov/pubmed/36972109"
}


@Article{info:doi/10.2196/45011,
author="Renner, Simon
and Loussikian, Paul
and Foulqui{\'e}, Pierre
and Marrel, Alexia
and Barbier, Valentin
and Mebarki, Adel
and Sch{\"u}ck, St{\'e}phane
and Bharmal, Murtuza",
title="Patient and Caregiver Perceptions of Advanced Bladder Cancer Systemic Treatments: Infodemiology Study Based on Social Media Data",
journal="JMIR Cancer",
year="2023",
month="Mar",
day="27",
volume="9",
pages="e45011",
keywords="bladder cancer",
keywords="social media",
keywords="patient",
keywords="caregiver",
keywords="chemotherapy",
keywords="immunotherapy",
keywords="qualitative research",
keywords="cancer treatment",
keywords="first-line therapy",
keywords="patient support",
keywords="adverse event",
keywords="peer support",
keywords="cancer",
keywords="oncology",
keywords="perception",
keywords="pharmacotherapy",
keywords="opinion",
keywords="attitude",
abstract="Background: In 2022, it was estimated that more than 80,000 new cases of bladder cancer (BC) were diagnosed in the United States, 12\% of which were locally advanced or metastatic BC (advanced BC). These forms of cancer are aggressive and have a poor prognosis, with a 5-year survival rate of 7.7\% for metastatic BC. Despite recent therapeutic advances for advanced BC, little is known about patient and caregiver perceptions of different systemic treatments. To further explore this topic, social media can be used to collect the perceptions of patients and caregivers when they discuss their experiences on forums and online communities. Objective: The aim of this study was to assess patient and caregiver perceptions of chemotherapy and immunotherapy for treating advanced BC from social media--posted data. Methods: Public posts on social media in the United States between January 2015 and April 2021 from patients with advanced BC and their caregivers were collected. The posts included in this analysis were geolocalized to the United States; collected from publicly available domains and sites, including social media sites such as Twitter and forums such as patient association forums; and were written in English. Posts mentioning any line of chemotherapy or immunotherapy were qualitatively analyzed by two researchers to classify perceptions of treatments (positive, negative, mixed, or without perception). Results: A total of 80 posts by 69 patients and 142 posts by 127 caregivers mentioning chemotherapy, and 42 posts by 31 patients and 35 posts by 32 caregivers mentioning immunotherapy were included for analysis. These posts were retrieved from 39 public social media sites. Among patients with advanced BC and their caregivers, treatment perceptions of chemotherapy were more negative (36\%) than positive (7\%). Most of the patients' posts (71\%) mentioned chemotherapy factually without expressing a perception of the treatment. The caregivers' perceptions of treatment were negative in 44\%, mixed in 8\%, and positive in 7\% of posts. In combined patient and caregiver posts, immunotherapy was perceived positively in 47\% of posts and negatively in 22\% of posts. Caregivers also posted more negative perceptions (37\%) of immunotherapy than patients (9\%). Negative perceptions of both chemotherapy and immunotherapy were mainly due to side effects and perceived lack of effectiveness. Conclusions: Despite chemotherapy being standard first-line therapy for advanced BC, negative perceptions were identified on social media, particularly among caregivers. Addressing these negative perceptions of treatment may improve treatment adoption. Strengthening support for patients receiving chemotherapy and their caregivers to help them manage side effects and understand the role of chemotherapy in the treatment of advanced BC would potentially enable a more positive experience. ",
doi="10.2196/45011",
url="https://cancer.jmir.org/2023/1/e45011",
url="http://www.ncbi.nlm.nih.gov/pubmed/36972135"
}


@Article{info:doi/10.2196/43213,
author="Plackett, Ruth
and Sheringham, Jessica
and Dykxhoorn, Jennifer",
title="The Longitudinal Impact of Social Media Use on UK Adolescents' Mental Health: Longitudinal Observational Study",
journal="J Med Internet Res",
year="2023",
month="Mar",
day="24",
volume="25",
pages="e43213",
keywords="social media",
keywords="mental health",
keywords="depression",
keywords="depressive",
keywords="anxiety",
keywords="adolescent",
keywords="adolescence",
keywords="mediation analysis",
keywords="cohort study",
keywords="youth",
keywords="young people",
keywords="self-esteem",
keywords="national survey",
keywords="household survey",
keywords="computer use",
keywords="technology use",
keywords="screen time",
abstract="Background: Cross-sectional studies have found a relationship between social media use and depression and anxiety in young people. However, few longitudinal studies using representative data and mediation analysis have been conducted to understand the causal pathways of this relationship. Objective: This study aims to examine the longitudinal relationship between social media use and young people's mental health and the role of self-esteem and social connectedness as potential mediators. Methods: The sample included 3228 participants who were 10- to 15-year-olds from Understanding Society (2009-2019), a UK longitudinal household survey. The number of hours spent on social media was measured on a 5-point scale from ``none'' to ``7 or more hours'' at the ages of 12-13 years. Self-esteem and social connectedness (number of friends and happiness with friendships) were measured at the ages of 13-14 years. Mental health problems measured by the Strengths and Difficulties Questionnaire were assessed at the ages of 14-15 years. Covariates included demographic and household variables. Unadjusted and adjusted multilevel linear regression models were used to estimate the association between social media use and mental health. We used path analysis with structural equation modeling to investigate the mediation pathways. Results: In adjusted analysis, there was a nonsignificant linear trend showing that more time spent on social media was related to poorer mental health 2 years later (n=2603, $\beta$=.21, 95\% CI ?0.43 to 0.84; P=.52). In an unadjusted path analysis, 68\% of the effect of social media use on mental health was mediated by self-esteem (indirect effect, n=2569, $\beta$=.70, 95\% CI 0.15-1.30; P=.02). This effect was attenuated in the adjusted analysis, and it was found that self-esteem was no longer a significant mediator (indirect effect, n=2316, $\beta$=.24, 95\% CI ?0.12 to 0.66; P=.22). We did not find evidence that the association between social media and mental health was mediated by social connectedness. Similar results were found in imputed data. Conclusions: There was little evidence to suggest that more time spent on social media was associated with later mental health problems in UK adolescents. This study shows the importance of longitudinal studies to examine this relationship and suggests that prevention strategies and interventions to improve mental health associated with social media use could consider the role of factors like self-esteem. ",
doi="10.2196/43213",
url="https://www.jmir.org/2023/1/e43213",
url="http://www.ncbi.nlm.nih.gov/pubmed/36961482"
}


@Article{info:doi/10.2196/41882,
author="Li, Yue
and Gee, William
and Jin, Kun
and Bond, Robert",
title="Examining Homophily, Language Coordination, and Analytical Thinking in Web-Based Conversations About Vaccines on Reddit: Study Using Deep Neural Network Language Models and Computer-Assisted Conversational Analyses",
journal="J Med Internet Res",
year="2023",
month="Mar",
day="23",
volume="25",
pages="e41882",
keywords="vaccine hesitancy",
keywords="social media",
keywords="web-based conversations",
keywords="neural network language models",
keywords="computer-assisted conversational analyses",
abstract="Background: Vaccine hesitancy has been deemed one of the top 10 threats to global health. Antivaccine information on social media is a major barrier to addressing vaccine hesitancy. Understanding how vaccine proponents and opponents interact with each other on social media may help address vaccine hesitancy. Objective: We aimed to examine conversations between vaccine proponents and opponents on Reddit to understand whether homophily in web-based conversations impedes opinion exchange, whether people are able to accommodate their languages to each other in web-based conversations, and whether engaging with opposing viewpoints stimulates higher levels of analytical thinking. Methods: We analyzed large-scale conversational text data about human vaccines on Reddit from 2016 to 2018. Using deep neural network language models and computer-assisted conversational analyses, we obtained each Redditor's stance on vaccines, each post's stance on vaccines, each Redditor's language coordination score, and each post or comment's analytical thinking score. We then performed chi-square tests, 2-tailed t tests, and multilevel modeling to test 3 questions of interest. Results: The results show that both provaccine and antivaccine Redditors are more likely to selectively respond to Redditors who indicate similar views on vaccines (P<.001). When Redditors interact with others who hold opposing views on vaccines, both provaccine and antivaccine Redditors accommodate their language to out-group members (provaccine Redditors: P=.044; antivaccine Redditors: P=.047) and show no difference in analytical thinking compared with interacting with congruent views (P=.63), suggesting that Redditors do not engage in motivated reasoning. Antivaccine Redditors, on average, showed higher analytical thinking in their posts and comments than provaccine Redditors (P<.001). Conclusions: This study shows that although vaccine proponents and opponents selectively communicate with their in-group members on Reddit, they accommodate their language and do not engage in motivated reasoning when communicating with out-group members. These findings may have implications for the design of provaccine campaigns on social media. ",
doi="10.2196/41882",
url="https://www.jmir.org/2023/1/e41882",
url="http://www.ncbi.nlm.nih.gov/pubmed/36951921"
}


@Article{info:doi/10.2196/42042,
author="Plack, L. Daniel
and Abcejo, S. Arnoley
and Kraus, B. Molly
and Renew, Ross J.
and Long, R. Timothy
and Sharpe, E. Emily",
title="Postgraduate-Year-1 Residents' Perceptions of Social Media and Virtual Applicant Recruitment: Cross-sectional Survey Study",
journal="Interact J Med Res",
year="2023",
month="Mar",
day="21",
volume="12",
pages="e42042",
keywords="COVID-19",
keywords="resident match",
keywords="social media",
keywords="Twitter",
keywords="Instagram",
keywords="virtual interview",
keywords="residency",
keywords="medical education",
keywords="dissemination",
keywords="residency program",
keywords="residency recruitment",
abstract="Background: The dissemination of information about residency programs is a vital step in residency recruitment. Traditional methods of distributing information have been printed brochures, websites, in-person interviews, and increasingly, social media. Away rotations and in-person interviews were cancelled, and interviews were virtual for the first time during the COVID-19 pandemic. Objective: The purpose of our study was to describe postgraduate-year-1 (PGY1) residents' social media habits in regard to residency recruitment and their perceptions of the residency programs' social media accounts in light of the transition to virtual interviews. Methods: A web-based 33-question survey was developed to evaluate personal social media use, perceptions of social media use by residency programs, and perceptions of the residency program content. Surveys were sent in 2021 to PGY1 residents at Mayo Clinic in Arizona, Florida, and Minnesota who participated in the 2020-2021 interview cycle. Results: Of the 31 program directors contacted, 22 (71\%) provided permission for their residents to complete the survey. Of 219 residents who received the survey, 67 (30\%) completed the survey. Most respondents applied to a single specialty, and greater than 61\% (41/67) of respondents applied to more than 30 programs. The social media platforms used most regularly by the respondents were Instagram (42/67, 63\%), Facebook (36/67, 54\%), and Twitter (22/67, 33\%). Respondents used the program website (66/67, 99\%), residents (47/67, 70\%), and social media (43/67, 64\%) as the most frequent resources to research programs. The most commonly used social media platforms to research programs were Instagram (38/66, 58\%), Twitter (22/66, 33\%), and Doximity (20/66, 30\%). The type of social media post ranked as most interesting by the respondents was ``resident life outside of the hospital.'' In addition, 68\% (39/57) of the respondents agreed or strongly agreed that their perception of a program was positively influenced by the residency program's social media account. Conclusions: In this multispecialty survey of PGY1 residents participating in the 2020-2021 virtual interview season, respondents preferred Instagram to Twitter or Facebook for gathering information on prospective residency programs. In addition, the program website, current residents, and social media platforms were the top-ranked resources used by prospective applicants. Having an up-to-date website and robust social media presence, particularly on Instagram, may become increasingly important in the virtual interview environment. ",
doi="10.2196/42042",
url="https://www.i-jmr.org/2023/1/e42042",
url="http://www.ncbi.nlm.nih.gov/pubmed/36943340"
}


@Article{info:doi/10.2196/39061,
author="Roe, L. Kyle
and Giordano, R. Katherine
and Ezzell, A. Gary
and Lifshitz, Jonathan",
title="Public Awareness of the Fencing Response as an Indicator of Traumatic Brain Injury: Quantitative Study of Twitter and Wikipedia Data",
journal="JMIR Form Res",
year="2023",
month="Mar",
day="17",
volume="7",
pages="e39061",
keywords="athlete",
keywords="brain",
keywords="concussion",
keywords="fencing response",
keywords="health communication",
keywords="health information",
keywords="injury pattern",
keywords="posture",
keywords="public education",
keywords="science communication",
keywords="social media",
keywords="sport",
keywords="trauma",
keywords="traumatic brain injury",
abstract="Background: Traumatic brain injury (TBI) is a disruption in normal brain function caused by an impact of external forces on the head. TBI affects millions of individuals per year, many potentially experiencing chronic symptoms and long-term disability, creating a public health crisis and an economic burden on society. The public discourse around sport-related TBIs has increased in recent decades; however, recognition of a possible TBI remains a challenge. The fencing response is an immediate posturing of the limbs, which can occur in individuals who sustain a TBI and can be used as an overt indicator of TBI. Typically, an individual demonstrating the fencing response exhibits extension in 1 arm and flexion in the contralateral arm immediately upon impact to the head; variations of forearm posturing among each limb have been observed. The tonic posturing is retained for several seconds, sufficient for observation and recognition of a TBI. Since the publication of the original peer-reviewed article on the fencing response, there have been efforts to raise awareness of the fencing response as a visible sign of TBI through publicly available web-based platforms, such as Twitter and Wikipedia. Objective: We aimed to quantify trends that demonstrate levels of public discussion and awareness of the fencing response over time using data from Twitter and Wikipedia. Methods: Raw Twitter data from January 1, 2010, to December 31, 2019, were accessed using the RStudio package academictwitteR and queried for the text ``fencing response.'' Data for page views of the Fencing Response Wikipedia article from January 1, 2010, to December 31, 2019, were accessed using the RStudio packages wikipediatrend and pageviews. Data were clustered by weekday, month, half-year (to represent the American football season vs off-season), and year to identify trends over time. Seasonal regression analysis was used to analyze the relationship between the number of fencing response tweets and page views and month of the year. Results: Twitter mentions of the fencing response and Wikipedia page views increased overall from 2010 to 2019, with hundreds of tweets and hundreds of thousands of Wikipedia page views per year. Twitter mentions peaked during the American football season, especially on and following game days. Wikipedia page views did not demonstrate a clear weekday or seasonal pattern, but instead had multiple peaks across various months and years, with January having more page views than May. Conclusions: Here, we demonstrated increased awareness of the fencing response over time using public data from Twitter and Wikipedia. Effective scientific communication through free public platforms can help spread awareness of clinical indicators of TBI, such as the fencing response. Greater awareness of the fencing response as a ``red-flag'' sign of TBI among coaches, athletic trainers, and sports organizations can help with medical care and return-to-play decisions. ",
doi="10.2196/39061",
url="https://formative.jmir.org/2023/1/e39061",
url="http://www.ncbi.nlm.nih.gov/pubmed/36930198"
}


@Article{info:doi/10.2196/44965,
author="Ueda, Michiko
and Watanabe, Kohei
and Sueki, Hajime",
title="Emotional Distress During COVID-19 by Mental Health Conditions and Economic Vulnerability: Retrospective Analysis of Survey-Linked Twitter Data With a Semisupervised Machine Learning Algorithm",
journal="J Med Internet Res",
year="2023",
month="Mar",
day="16",
volume="25",
pages="e44965",
keywords="mental health",
keywords="COVID-19",
keywords="Twitter",
keywords="social media",
keywords="depression",
keywords="suicidal ideation",
keywords="loneliness",
keywords="public health crisis",
keywords="psychological well-being",
keywords="infodemiology",
keywords="machine learning framework",
keywords="digital surveillance",
keywords="emotional distress",
keywords="online survey",
abstract="Background: Monitoring the psychological conditions of social media users during rapidly developing public health crises, such as the COVID-19 pandemic, using their posts on social media has rapidly gained popularity as a relatively easy and cost-effective method. However, the characteristics of individuals who created these posts are largely unknown, making it difficult to identify groups of individuals most affected by such crises. In addition, large annotated data sets for mental health conditions are not easily available, and thus, supervised machine learning algorithms can be infeasible or too costly. Objective: This study proposes a machine learning framework for the real-time surveillance of mental health conditions that does not require extensive training data. Using survey-linked tweets, we tracked the level of emotional distress during the COVID-19 pandemic by the attributes and psychological conditions of social media users in Japan. Methods: We conducted online surveys of adults residing in Japan in May 2022 and collected their basic demographic information, socioeconomic status, and mental health conditions, along with their Twitter handles (N=2432). We computed emotional distress scores for all the tweets posted by the study participants between January 1, 2019, and May 30, 2022 (N=2,493,682) using a semisupervised algorithm called latent semantic scaling (LSS), with higher values indicating higher levels of emotional distress. After excluding users by age and other criteria, we examined 495,021 (19.85\%) tweets generated by 560 (23.03\%) individuals (age 18-49 years) in 2019 and 2020. We estimated fixed-effect regression models to examine their emotional distress levels in 2020 relative to the corresponding weeks in 2019 by the mental health conditions and characteristics of social media users. Results: The estimated level of emotional distress of our study participants increased in the week when school closure started (March 2020), and it peaked at the beginning of the state of emergency (estimated coefficient=0.219, 95\% CI 0.162-0.276) in early April 2020. Their level of emotional distress was unrelated to the number of COVID-19 cases. We found that the government-induced restrictions disproportionately affected the psychological conditions of vulnerable individuals, including those with low income, precarious employment, depressive symptoms, and suicidal ideation. Conclusions: This study establishes a framework to implement near-real-time monitoring of the emotional distress level of social media users, highlighting a great potential to continuously monitor their well-being using survey-linked social media posts as a complement to administrative and large-scale survey data. Given its flexibility and adaptability, the proposed framework is easily extendable for other purposes, such as detecting suicidality among social media users, and can be used on streaming data for continuous measurement of the conditions and sentiment of any group of interest. ",
doi="10.2196/44965",
url="https://www.jmir.org/2023/1/e44965",
url="http://www.ncbi.nlm.nih.gov/pubmed/36809798"
}


@Article{info:doi/10.2196/38429,
author="Shiyab, Wa'ed
and Halcomb, Elizabeth
and Rolls, Kaye
and Ferguson, Caleb",
title="The Impact of Social Media Interventions on Weight Reduction and Physical Activity Improvement Among Healthy Adults: Systematic Review",
journal="J Med Internet Res",
year="2023",
month="Mar",
day="16",
volume="25",
pages="e38429",
keywords="social media",
keywords="physical activity",
keywords="overweight",
keywords="lifestyle risk factors",
abstract="Background: A sedentary lifestyle and being overweight or obese are well-established cardiovascular risk factors and contribute substantially to the global burden of disease. Changing such behavior is complex and requires support. Social media interventions show promise in supporting health behavior change, but their impact is unclear. Moreover, previous reviews have reported contradictory evidence regarding the relationship between engagement with social media interventions and the efficacy of these interventions. Objective: This review aimed to critically synthesize available evidence regarding the impact of social media interventions on physical activity and weight among healthy adults. In addition, this review examined the effect of engagement with social media interventions on their efficacy. Methods: CINAHL and MEDLINE were searched for relevant randomized trials that were conducted to investigate the impact of social media interventions on weight and physical activity and were published between 2011 and 2021 in the English language. Studies were included if the intervention used social media tools that provided explicit interactions between the participants. Studies were excluded if the intervention was passively delivered through an app website or if the participants had a known chronic disease. Eligible studies were appraised for quality and synthesized using narrative synthesis. Results: A total of 17 papers reporting 16 studies from 4 countries, with 7372 participants, were identified. Overall, 56\% (9/16) of studies explored the effect of social media interventions on physical activity; 38\% (6/16) of studies investigated weight reduction; and 6\% (1/16) of studies assessed the effect on both physical activity and weight reduction. Evidence of the effects of social media interventions on physical activity and weight loss was mixed across the included studies. There were no standard metrics for measuring engagement with social media, and the relationship between participant engagement with the intervention and subsequent behavior change was also mixed. Although 35\% (6/16) of studies reported that engagement was not a predictor of behavior change, engagement with social media interventions was found to be related to behavior change in 29\% (5/16) of studies. Conclusions: Despite the promise of social media interventions, evidence regarding their effectiveness is mixed. Further robust studies are needed to elucidate the components of social media interventions that lead to successful behavior change. Furthermore, the effect of engagement with social media interventions on behavior change needs to be clearly understood. Trial Registration: PROSPERO International Prospective Register of Systematic Reviews CRD42022311430; https://www.crd.york.ac.uk/prospero/display\_record.php?RecordID=311430 ",
doi="10.2196/38429",
url="https://www.jmir.org/2023/1/e38429",
url="http://www.ncbi.nlm.nih.gov/pubmed/36927627"
}


@Article{info:doi/10.2196/42927,
author="Dadich, Ann
and Wells, Rebecca
and Williams, J. Sharon
and Taskin, Nazim
and Coskun, Mustafa
and Grenier, Corinne
and Ponsignon, Frederic
and Scahill, Shane
and Best, Stephanie",
title="Cues Disseminated by Professional Associations That Represent 5 Health Care Professions Across 5 Nations: Lexical Analysis of Tweets",
journal="J Med Internet Res",
year="2023",
month="Mar",
day="15",
volume="25",
pages="e42927",
keywords="professional associations",
keywords="social media",
keywords="professional identity",
keywords="collaboration",
keywords="knowledge translation",
abstract="Background: Collaboration across health care professions is critical in efficiently and effectively managing complex and chronic health conditions, yet interprofessional care does not happen automatically. Professional associations have a key role in setting a profession's agenda, maintaining professional identity, and establishing priorities. The associations' external communication is commonly undertaken through social media platforms, such as Twitter. Despite the valuable insights potentially available into professional associations through such communication, to date, their messaging has not been examined. Objective: This study aimed to identify the cues disseminated by professional associations that represent 5 health care professions spanning 5 nations. Methods: Using a back-iterative application programming interface methodology, public tweets were sourced from professional associations that represent 5 health care professions that have key roles in community-based health care: general practice, nursing, pharmacy, physiotherapy, and social work. Furthermore, the professional associations spanned Australia, Canada, New Zealand, the United Kingdom, and the United States. A lexical analysis was conducted of the tweets using Leximancer (Leximancer Pty Ltd) to clarify relationships within the discourse. Results: After completing a lexical analysis of 50,638 tweets, 7 key findings were identified. First, the discourse was largely devoid of references to interprofessional care. Second, there was no explicit discourse pertaining to physiotherapists. Third, although all the professions represented in this study support patients, discourse pertaining to general practitioners was most likely to be connected with that pertaining to patients. Fourth, tweets pertaining to pharmacists were most likely to be connected with discourse pertaining to latest and research. Fifth, tweets about social workers were unlikely to be connected with discourse pertaining to health or care. Sixth, notwithstanding a few exceptions, the findings across the different nations were generally similar, suggesting their generality. Seventh and last, tweets pertaining to physiotherapists were most likely to refer to discourse pertaining to profession. Conclusions: The findings indicate that health care professional associations do not use Twitter to disseminate cues that reinforce the importance of interprofessional care. Instead, they largely use this platform to emphasize what they individually deem to be important and advance the interests of their respective professions. Therefore, there is considerable opportunity for professional associations to assert how the profession they represent complements other health care professions and how the professionals they represent can enact interprofessional care for the benefit of patients and carers. ",
doi="10.2196/42927",
url="https://www.jmir.org/2023/1/e42927",
url="http://www.ncbi.nlm.nih.gov/pubmed/36920443"
}


@Article{info:doi/10.2196/41793,
author="Wang, Rui
and Cong, Shengnan
and Sha, Lijuan
and Sun, Xiaoqing
and Zhu, Rong
and Feng, Jingyi
and Wang, Jianfang
and Tang, Xiaomei
and Zhao, Dan
and Zhu, Qing
and Fan, Xuemei
and Ren, Ziqi
and Zhang, Aixia",
title="Association Between Social Networking Site Use Intensity and Depression Among Chinese Pregnant Women: Cross-sectional Study",
journal="J Med Internet Res",
year="2023",
month="Mar",
day="15",
volume="25",
pages="e41793",
keywords="antenatal depression",
keywords="social network site",
keywords="social media",
keywords="WeChat",
keywords="upward social  comparison",
keywords="rumination",
abstract="Background: Despite extensive debates about the mental health impacts of the use of social networking sites (SNSs), including WeChat, the association and mechanisms between social interaction of WeChat use intensity and antenatal depression are unclear. Objective: We aimed to test the mediating roles of upward social comparison on social interaction of WeChat and rumination in the association between social interaction of WeChat use intensity and antenatal depression. Methods: A cross-sectional survey was conducted in four hospitals with the self-reported measures of social interaction of WeChat use intensity, upward social comparison on social interaction of WeChat, rumination, antenatal depression, and control variables. The mediation analysis was performed through Model 6 from the PROCESS macro 4.0 in SPSS 26. Results: Results from 2661 participants showed that antenatal depression was unrelated to social interaction of WeChat use intensity (P=.54), but was significantly positively related to the attitude toward social interaction of WeChat (P=.01). The direct effect of attitude toward social interaction of WeChat use on antenatal depression was not statistically significant ($\beta$=--.03, P=.05). The results supported an indirect relationship between attitude toward social interaction of WeChat use and antenatal depression via (1) upward social comparison on social interaction of WeChat (indirect effect value=0.04, 95\% CI 0.03 to 0.06); (2) rumination (indirect effect value=--0.02, 95\% CI --0.04 to --0.01); and (3) upward social comparison on social interaction of WeChat and rumination in sequence (indirect effect value=0.07, 95\% CI 0.06 to 0.08). Conclusions: Our findings highlight the necessity of focusing on attitudes toward SNS use, and the importance of upward social comparison and rumination in understanding the effect of SNS use on antenatal depression. ",
doi="10.2196/41793",
url="https://www.jmir.org/2023/1/e41793",
url="http://www.ncbi.nlm.nih.gov/pubmed/36920458"
}


@Article{info:doi/10.2196/43334,
author="Chen, Jiarui
and Xue, Siyu
and Xie, Zidian
and Li, Dongmei",
title="Characterizing Heated Tobacco Products Marketing on Instagram: Observational Study",
journal="JMIR Form Res",
year="2023",
month="Mar",
day="15",
volume="7",
pages="e43334",
keywords="IQOS",
keywords="Instagram",
keywords="heated tobacco products",
keywords="web-based tobacco marketing",
abstract="Background: Heated tobacco products (HTPs), including I Quit Ordinary Smoking (IQOS), are new tobacco products that use an electronic device to heat compressed tobacco leaves to generate an aerosol for consumers to inhale. Marketing of HTPs is prevalent on Instagram, a popular social media platform. Objective: This study aims to characterize posts related to HTPs on Instagram and their associations with user engagement. Methods: Through the Instagram application programming interface, 979 Instagram posts were collected using keywords related to HTPs, such as ``IQOS'' and ``heat-not-burn.'' Among them, 596 posts were related to IQOS and other HTP marketing. The codebook was developed from a randomly selected 200 posts on the post content by hand coding, which was applied to the remaining 396 Instagram posts. Summary statistics were calculated, and statistical hypothesis testing was conducted to understand the popularity of Instagram posts on HTPs. Negative binomial regression models were applied to identify Instagram post characteristics associated with user engagement (eg, count). Results: Among Instagram posts related to HTP marketing (N=596), ``product display'' was dominant (n=550, 92.28\%), followed by ``brand promotion'' (n=41, 6.88\%), and ``others'' (n=5, 0.84\%). Among posts within ``product display,'' ``device only'' was the most popular (n=338, 61.45\%), followed by ``heatstick only'' (n=80, 14.55\%), ``accessory'' (n=66, 12\%), ``device and heatstick'' (n=56, 10.18\%), and ``capsule'' (n=10, 1.82\%). A univariate negative binomial regression model with pairwise comparisons across ``product display'' types showed that the number of likes for posts with HTP heatsticks was significantly lower compared to posts with HTP devices, accessories, and device-heatstick sets. Multivariate negative binomial regression models showed that HTP-related Instagram posts with a model or lifestyle elements (;=.60, 95\% CI 0.36-0.84) or without obvious product advertising information (=.69, 95\% CI 0.49-0.89) received more likes. Conclusions: It is shown that posts with product displays were dominant among HTP-related posts on Instagram. Posts with model or lifestyle elements are associated with high user engagement, which might be one of the web-based marketing strategies of HTPs. ",
doi="10.2196/43334",
url="https://formative.jmir.org/2023/1/e43334",
url="http://www.ncbi.nlm.nih.gov/pubmed/36920463"
}


@Article{info:doi/10.2196/45419,
author="Wu, Jiageng
and Wang, Lumin
and Hua, Yining
and Li, Minghui
and Zhou, Li
and Bates, W. David
and Yang, Jie",
title="Trend and Co-occurrence Network of COVID-19 Symptoms From Large-Scale Social Media Data: Infoveillance Study",
journal="J Med Internet Res",
year="2023",
month="Mar",
day="14",
volume="25",
pages="e45419",
keywords="social media",
keywords="network analysis",
keywords="public health",
keywords="data mining",
keywords="COVID-19",
abstract="Background: For an emergent pandemic, such as COVID-19, the statistics of symptoms based on hospital data may be biased or delayed due to the high proportion of asymptomatic or mild-symptom infections that are not recorded in hospitals. Meanwhile, the difficulty in accessing large-scale clinical data also limits many researchers from conducting timely research. Objective: Given the wide coverage and promptness of social media, this study aimed to present an efficient workflow to track and visualize the dynamic characteristics and co-occurrence of symptoms for the COVID-19 pandemic from large-scale and long-term social media data. Methods: This retrospective study included 471,553,966 COVID-19--related tweets from February 1, 2020, to April 30, 2022. We curated a hierarchical symptom lexicon for social media containing 10 affected organs/systems, 257 symptoms, and 1808 synonyms. The dynamic characteristics of COVID-19 symptoms over time were analyzed from the perspectives of weekly new cases, overall distribution, and temporal prevalence of reported symptoms. The symptom evolutions between virus strains (Delta and Omicron) were investigated by comparing the symptom prevalence during their dominant periods. A co-occurrence symptom network was developed and visualized to investigate inner relationships among symptoms and affected body systems. Results: This study identified 201 COVID-19 symptoms and grouped them into 10 affected body systems. There was a significant correlation between the weekly quantity of self-reported symptoms and new COVID-19 infections (Pearson correlation coefficient=0.8528; P<.001). We also observed a 1-week leading trend (Pearson correlation coefficient=0.8802; P<.001) between them. The frequency of symptoms showed dynamic changes as the pandemic progressed, from typical respiratory symptoms in the early stage to more musculoskeletal and nervous symptoms in the later stages. We identified the difference in symptoms between the Delta and Omicron periods. There were fewer severe symptoms (coma and dyspnea), more flu-like symptoms (throat pain and nasal congestion), and fewer typical COVID symptoms (anosmia and taste altered) in the Omicron period than in the Delta period (all P<.001). Network analysis revealed co-occurrences among symptoms and systems corresponding to specific disease progressions, including palpitations (cardiovascular) and dyspnea (respiratory), and alopecia (musculoskeletal) and impotence (reproductive). Conclusions: This study identified more and milder COVID-19 symptoms than clinical research and characterized the dynamic symptom evolution based on 400 million tweets over 27 months. The symptom network revealed potential comorbidity risk and prognostic disease progression. These findings demonstrate that the cooperation of social media and a well-designed workflow can depict a holistic picture of pandemic symptoms to complement clinical studies. ",
doi="10.2196/45419",
url="https://www.jmir.org/2023/1/e45419",
url="http://www.ncbi.nlm.nih.gov/pubmed/36812402"
}


@Article{info:doi/10.2196/39262,
author="Applequist, Janelle
and Burroughs, Cristina
and Merkel, A. Peter
and Rothenberg, Marc
and Trapnell, Bruce
and Desnick, Robert
and Sahin, Mustafa
and Krischer, Jeffrey",
title="Direct-to-Consumer Recruitment Methods via Traditional and Social Media to Aid in Research Accrual for Clinical Trials for Rare Diseases: Comparative Analysis Study",
journal="J Med Internet Res",
year="2023",
month="Mar",
day="14",
volume="25",
pages="e39262",
keywords="direct-to-consumer advertising",
keywords="clinical trial recruitment",
keywords="clinical trial accrual",
keywords="research recruitment",
keywords="research participant recruitment",
keywords="social media recruitment",
keywords="web-based recruitment",
keywords="patient-centered research",
keywords="rare diseases",
keywords="clinical trial",
abstract="Background: Recruitment into clinical trials is a challenging process, with as many as 40\% of studies failing to meet their target sample sizes. The principles of direct-to-consumer (DTC) advertising rely upon novel marketing strategies. The ability to reach expansive audiences in the web-based realm presents a unique opportunity for researchers to overcome various barriers to enrollment in clinical trials. Research has investigated the use of individual web-based platforms to aid in recruitment and accrual into trials; however, a gap in the literature exists, whereby multiple mass communication platforms have yet to be investigated across a range of clinical trials. Objective: There is a need to better understand how individual factors combine to collectively influence trial recruitment. We aimed to test whether DTC recruitment of potentially eligible study participants via social media platforms (eg, Facebook [Meta Platforms Inc] and Twitter [Twitter Inc]) was an effective strategy or whether this acted as an enhancement to traditional (eg, email via contact registries) recruitment strategies through established clinical research sites. Methods: This study tested multiple DTC web-based recruitment efforts (Facebook, Twitter, email, and patient advocacy group [PAG] involvement) across 6 national and international research studies from 5 rare disease consortia. Targeted social media messaging, social media management software, and individual study websites with prescreening questions were used in the Protocol for Increasing Accrual Using Social Media (PRISM). Results: In total, 1465 PRISM website referrals occurred across all 6 studies. Organic (unpaid) Facebook posts (676/1465, 46.14\%) and Rare Diseases Clinical Research Network patient contact registry emails (461/1465, 31.47\%) represented the most successful forms of engagement. PRISM was successful in accumulating a 40.1\% (136/339) lead generation (those who screened positive and consented to share their contact information to be contacted by a clinical site coordinator). Despite the large number of leads generated from PRISM recruitment efforts, the number of patients who were subsequently enrolled in studies was low. Across 6 studies, 3 participants were ultimately enrolled, meaning that 97.8\% (133/136) of leads dropped off. Conclusions: The results indicate that although accrual results were low, this is consistent with previously documented challenges of studying populations with rare diseases. Targeted messaging integrated throughout the recruitment process (eg, referral, lead, and accrual) remains an area for further research. Key elements to consider include structuring the communicative workflow in such a way that PAG involvement is central to the process, with clinical site coordinators actively involved after an individual consents to share their contact information. Customized approaches are needed for each population and research study, with observational studies best suited for social media recruitment. As evidenced by lead generation, results suggest that web-based recruitment efforts, coupled with targeted messaging and PAG partnerships, have the potential to supplement clinical trial accrual. ",
doi="10.2196/39262",
url="https://www.jmir.org/2023/1/e39262",
url="http://www.ncbi.nlm.nih.gov/pubmed/36917158"
}


@Article{info:doi/10.2196/41969,
author="Wu, Jiaxi
and Origgi, Manuel Juan
and Ranker, R. Lynsie
and Bhatnagar, Aruni
and Robertson, Marie Rose
and Xuan, Ziming
and Wijaya, Derry
and Hong, Traci
and Fetterman, L. Jessica",
title="Compliance With the US Food and Drug Administration's Guidelines for Health Warning Labels and Engagement in Little Cigar and Cigarillo Content: Computer Vision Analysis of Instagram Posts",
journal="JMIR Infodemiology",
year="2023",
month="Mar",
day="14",
volume="3",
pages="e41969",
keywords="tobacco",
keywords="cigar",
keywords="little cigar",
keywords="cigarillo",
keywords="Instagram",
keywords="social media",
keywords="influencer promotion",
keywords="tobacco advertising",
keywords="health warning",
keywords="machine learning",
keywords="computer vision",
keywords="warning label",
keywords="health label",
keywords="health promotion",
keywords="advertising",
keywords="advertise",
keywords="smoking",
keywords="smoker",
keywords="algorithm",
keywords="visualization",
abstract="Background: Health warnings in tobacco advertisements provide health information while also increasing the perceived risks of tobacco use. However, existing federal laws requiring warnings on advertisements for tobacco products do not specify whether the rules apply to social media promotions. Objective: This study aims to examine the current state of influencer promotions of little cigars and cigarillos (LCCs) on Instagram and the use of health warnings in influencer promotions. Methods: Instagram influencers were identified as those who were tagged by any of the 3 leading LCC brand Instagram pages between 2018 and 2021. Posts from identified influencers, which mentioned one of the three brands were considered LCC influencer promotions. A novel Warning Label Multi-Layer Image Identification computer vision algorithm was developed to measure the presence and properties of health warnings in a sample of 889 influencer posts. Negative binomial regressions were performed to examine the associations of health warning properties with post engagement (number of likes and comments). Results: The Warning Label Multi-Layer Image Identification algorithm was 99.3\% accurate in detecting the presence of health warnings. Only 8.2\% (n=73) of LCC influencer posts included a health warning. Influencer posts that contained health warnings received fewer likes (incidence rate ratio 0.59, P<.001, 95\% CI 0.48-0.71) and fewer comments (incidence rate ratio 0.46, P<.001, 95\% CI 0.31-0.67). Conclusions: Health warnings are rarely used by influencers tagged by LCC brands' Instagram accounts. Very few influencer posts met the US Food and Drug Administration's health warning requirement of size and placement for tobacco advertising. The presence of a health warning was associated with lower social media engagement. Our study provides support for the implementation of comparable health warning requirements to social media tobacco promotions. Using an innovative computer vision approach to detect health warning labels in influencer promotions on social media is a novel strategy for monitoring health warning compliance in social media tobacco promotions. ",
doi="10.2196/41969",
url="https://infodemiology.jmir.org/2023/1/e41969",
url="http://www.ncbi.nlm.nih.gov/pubmed/37113379"
}


@Article{info:doi/10.2196/38491,
author="Chen, Emily
and Hollowell, Adam
and Truong, Tracy
and Bentley-Edwards, Keisha
and Myers, Evan
and Erkanli, Alaattin
and Holt, Lauren
and Swartz, J. Jonas",
title="Contraceptive Access and Use Among Undergraduate and Graduate Students During COVID-19: Online Survey Study",
journal="JMIR Form Res",
year="2023",
month="Mar",
day="14",
volume="7",
pages="e38491",
keywords="COVID-19",
keywords="contraception",
keywords="college",
keywords="disparities",
keywords="LARC",
keywords="sexual health",
keywords="social media",
keywords="health promotion",
keywords="telehealth",
keywords="health messaging",
keywords="health resource",
keywords="health disparity",
keywords="risk factor",
keywords="healthcare access",
abstract="Background: The COVID-19 pandemic led to widespread college campus closures in the months of March to June 2020, endangering students' access to on-campus health resources, including reproductive health services. Objective: To assess contraceptive access and use among undergraduate and graduate students in North Carolina during the COVID-19 pandemic. Methods: We conducted a cross-sectional web-based survey of undergraduate and graduate students enrolled at degree-granting institutions in North Carolina. Participants were recruited using targeted Instagram advertisements. The survey queried several aspects of participants' sexual behavior, including sex drive, level of sexual experience, number of sexual partners, digital sexual experience, dating patterns, and types of contraception used. Participants were asked to compare many of these behaviors before and after the pandemic. The survey also assessed several sociodemographic factors that we hypothesized would be associated with contraceptive use based on prior data, including educational background, sexual orientation and gender minority status (ie, lesbian, gay, bisexual, transgender, queer), health insurance status, race, ethnicity, degree of sensation seeking, religiosity, and desire to become pregnant. Results: Over 10 days, 2035 Instagram users began our survey, of whom 1002 met eligibility criteria. Of these 1002 eligible participants, 934 completed the survey, for a 93\% completion rate. Our respondents were mostly female (665/934, 71\%), cisgender (877/934, 94\%), heterosexual (592/934, 64\%), white (695/934 75\%), not Hispanic (835/934, 89\%), and enrolled at a 4-year college (618/934, 66\%). Over 95\% (895/934) of respondents reported that they maintained access to their preferred contraception during the COVID-19 pandemic. In a multivariable analysis, participants who were enrolled in a 4-year college or graduate program were less likely to lose contraceptive access when compared to participants enrolled in a 2-year college (risk ratio [RR] 0.34, 95\% CI 0.16-0.71); in addition, when compared to cisgender participants, nonbinary and transgender participants were more likely to lose contraceptive access (RR 2.43, 95\% CI 1.01-5.87). Respondents reported that they were more interested in using telehealth to access contraception during the pandemic. The contraceptive methods most commonly used by our participants were, in order, condoms (331/934, 35.4\%), oral contraception (303/934, 32.4\%), and long-acting reversible contraception (LARC; 221/934, 23.7\%). The rate of LARC use among our participants was higher than the national average for this age group (14\%). Emergency contraception was uncommonly used (25/934, 2.7\%). Conclusions: Undergraduate and graduate students in North Carolina overwhelmingly reported that they maintained access to their preferred contraceptive methods during the COVID-19 pandemic and through changing patterns of health care access, including telehealth. Gender nonbinary and transgender students and 2-year college students may have been at greater risk of losing access to contraception during the first year of the COVID-19 pandemic. ",
doi="10.2196/38491",
url="https://formative.jmir.org/2023/1/e38491",
url="http://www.ncbi.nlm.nih.gov/pubmed/36827491"
}


@Article{info:doi/10.2196/45571,
author="Lorenzo-Luaces, Lorenzo
and Dierckman, Clare
and Adams, Sydney",
title="Attitudes and (Mis)information About Cognitive Behavioral Therapy on TikTok: An Analysis of Video Content",
journal="J Med Internet Res",
year="2023",
month="Mar",
day="13",
volume="25",
pages="e45571",
keywords="social media",
keywords="cognitive behavioral therapy",
keywords="misinformation",
keywords="public health",
keywords="mental health",
keywords="TikTok",
keywords="psychotherapy",
keywords="content analysis",
keywords="therapist",
keywords="online health information",
doi="10.2196/45571",
url="https://www.jmir.org/2023/1/e45571",
url="http://www.ncbi.nlm.nih.gov/pubmed/36912883"
}


@Article{info:doi/10.2196/41867,
author="Willis, Erin
and Friedel, Kate
and Heisten, Mark
and Pickett, Melissa
and Bhowmick, Amrita",
title="Communicating Health Literacy on Prescription Medications on Social Media: In-depth Interviews With ``Patient Influencers''",
journal="J Med Internet Res",
year="2023",
month="Mar",
day="13",
volume="25",
pages="e41867",
keywords="social media",
keywords="social media influencer",
keywords="pharmaceutical advertising",
keywords="health literacy",
abstract="Background: Historically, pharmaceutical companies have struggled with trust and brand reputation among key stakeholders and have adopted innovative marketing strategies to reach patients directly and rebuild those relationships. Social media influencers are a popular strategy to influence younger demographics, including Generation Z and millennials. It is common for social media influencers to work in paid partnerships with brands; this is a multibillion-dollar industry. Long have patients been active in online health communities and social media platforms such as Twitter and Instagram, but in recent years, pharmaceutical marketers have noticed the power of patient persuasion and begun to leverage ``patient influencers'' in brand campaigns. Objective: This study aimed to explore how patient influencers communicate health literacy on pharmaceutical medications on social media to their communities of followers. Methods: A total of 26 in-depth interviews were conducted with patient influencers using a snowball sampling technique. This study is part of a larger project using an interview guide that included a range of topics such as social media practices, logistics of being an influencer, considerations for brand partnerships, and views on the ethical nature of patient influencers. The constructs of the Health Belief Model were used in this study's data analysis: perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy. This study was approved by the institutional review board of the University of Colorado and adhered to ethical standards in interview practice. Results: As patient influencers are a new phenomenon, it was our goal to identify how health literacy on prescription medications and pharmaceuticals is being communicated on social media. Using the constructs of the Health Belief Model to guide the analysis, 3 themes were identified: understanding disease through experience, staying informed on the science or field, and suggesting that physicians know best. Conclusions: Patients are actively exchanging health information on social media channels and connecting with other patients who share similar diagnoses. Patient influencers share their knowledge and experience in efforts to help other patients learn about disease self-management and improve their quality of life. Similar to traditional direct-to-consumer advertising, the phenomenon of patient influencers raises ethical questions that need more investigation. In a way, patient influencers are health education agents who may also share prescription medication or pharmaceutical information. They can break down complex health information based on expertise and experience and mitigate the loneliness and isolation that other patients may feel without the support of a community. ",
doi="10.2196/41867",
url="https://www.jmir.org/2023/1/e41867",
url="http://www.ncbi.nlm.nih.gov/pubmed/36912881"
}


@Article{info:doi/10.2196/40575,
author="Honcharov, Vlad
and Li, Jiawei
and Sierra, Maribel
and Rivadeneira, A. Natalie
and Olazo, Kristan
and Nguyen, T. Thu
and Mackey, K. Tim
and Sarkar, Urmimala",
title="Public Figure Vaccination Rhetoric and Vaccine Hesitancy: Retrospective Twitter Analysis",
journal="JMIR Infodemiology",
year="2023",
month="Mar",
day="10",
volume="3",
pages="e40575",
keywords="Twitter",
keywords="anti-vaccination",
keywords="Biterm Topic modeling",
keywords="inductive content analysis",
keywords="COVID-19",
keywords="social media",
keywords="health information",
keywords="vaccination",
keywords="vaccine hesitancy",
keywords="infodemiology",
keywords="misinformation",
abstract="Background: Social media has emerged as a critical mass communication tool, with both health information and misinformation now spread widely on the web. Prior to the COVID-19 pandemic, some public figures promulgated anti-vaccine attitudes, which spread widely on social media platforms. Although anti-vaccine sentiment has pervaded social media throughout the COVID-19 pandemic, it is unclear to what extent interest in public figures is generating anti-vaccine discourse. Objective: We examined Twitter messages that included anti-vaccination hashtags and mentions of public figures to assess the connection between interest in these individuals and the possible spread of anti-vaccine messages. Methods: We used a data set of COVID-19--related Twitter posts collected from the public streaming application programming interface from March to October 2020 and filtered it for anti-vaccination hashtags ``antivaxxing,'' ``antivaxx,'' ``antivaxxers,'' ``antivax,'' ``anti-vaxxer,'' ``discredit,'' ``undermine,'' ``confidence,'' and ``immune.'' Next, we applied the Biterm Topic model (BTM) to output topic clusters associated with the entire corpus. Topic clusters were manually screened by examining the top 10 posts most highly correlated in each of the 20 clusters, from which we identified 5 clusters most relevant to public figures and vaccination attitudes. We extracted all messages from these clusters and conducted inductive content analysis to characterize the discourse. Results: Our keyword search yielded 118,971 Twitter posts after duplicates were removed, and subsequently, we applied BTM to parse these data into 20 clusters. After removing retweets, we manually screened the top 10 tweets associated with each cluster (200 messages) to identify clusters associated with public figures. Extraction of these clusters yielded 768 posts for inductive analysis. Most messages were either pro-vaccination (n=329, 43\%) or neutral about vaccination (n=425, 55\%), with only 2\% (14/768) including anti-vaccination messages. Three main themes emerged: (1) anti-vaccination accusation, in which the message accused the public figure of holding anti-vaccination beliefs; (2) using ``anti-vax'' as an epithet; and (3) stating or implying the negative public health impact of anti-vaccination discourse. Conclusions: Most discussions surrounding public figures in common hashtags labelled as ``anti-vax'' did not reflect anti-vaccination beliefs. We observed that public figures with known anti-vaccination beliefs face scorn and ridicule on Twitter. Accusing public figures of anti-vaccination attitudes is a means of insulting and discrediting the public figure rather than discrediting vaccines. The majority of posts in our sample condemned public figures expressing anti-vax beliefs by undermining their influence, insulting them, or expressing concerns over public health ramifications. This points to a complex information ecosystem, where anti-vax sentiment may not reside in common anti-vax--related keywords or hashtags, necessitating further assessment of the influence that public figures have on this discourse. ",
doi="10.2196/40575",
url="https://infodemiology.jmir.org/2023/1/e40575",
url="http://www.ncbi.nlm.nih.gov/pubmed/37113377"
}


@Article{info:doi/10.2196/39209,
author="Ahmed, Wasim
and Vidal-Alaball, Josep
and Vilaseca Llobet, Maria Josep",
title="Analyzing Discussions Around Rural Health on Twitter During the COVID-19 Pandemic: Social Network Analysis of Twitter Data",
journal="JMIR Infodemiology",
year="2023",
month="Mar",
day="8",
volume="3",
pages="e39209",
keywords="rural health",
keywords="Twitter messaging",
keywords="social media",
keywords="COVID-19",
keywords="SARS-CoV-2",
keywords="coronavirus",
keywords="social network analysis",
abstract="Background: Individuals from rural areas are increasingly using social media as a means of communication, receiving information, or actively complaining of inequalities and injustices. Objective: The aim of our study is to analyze conversations about rural health taking place on Twitter during a particular phase of the COVID-19 pandemic. Methods: This study captured 57 days' worth of Twitter data related to rural health from June to August 2021, using English-language keywords. The study used social network analysis and natural language processing to analyze the data. Results: It was found that Twitter served as a fruitful platform to raise awareness of problems faced by users living in rural areas. Overall, Twitter was used in rural areas to express complaints, debate, and share information. Conclusions: Twitter could be leveraged as a powerful social listening tool for individuals and organizations that want to gain insight into popular narratives around rural health. ",
doi="10.2196/39209",
url="https://infodemiology.jmir.org/2023/1/e39209",
url="http://www.ncbi.nlm.nih.gov/pubmed/36936067"
}


@Article{info:doi/10.2196/44741,
author="Mitsutake, Seigo
and Takahashi, Yoshimitsu
and Otsuki, Aki
and Umezawa, Jun
and Yaguchi-Saito, Akiko
and Saito, Junko
and Fujimori, Maiko
and Shimazu, Taichi
and ",
title="Chronic Diseases and Sociodemographic Characteristics Associated With Online Health Information Seeking and Using Social Networking Sites: Nationally Representative Cross-sectional Survey in Japan",
journal="J Med Internet Res",
year="2023",
month="Mar",
day="2",
volume="25",
pages="e44741",
keywords="chronic diseases",
keywords="cross-sectional study",
keywords="eHealth literacy, health communication",
keywords="internet, social networking",
abstract="Background: In an aging society, worsening chronic diseases increase the burden on patients and the health care system. Using online health information including health information via social networking sites (SNSs), such as Facebook and YouTube, may play an important role in the self-management of chronic diseases and health promotion for internet users. Objective: This study aims to improve strategies for promoting access to reliable information for the self-management of chronic diseases via the internet, and to identify populations facing barriers to using the internet for health, we examined chronic diseases and characteristics associated with online health information seeking and the use of SNSs. Methods: This study used data from the INFORM Study 2020, which was a nationally representative cross-sectional postal mail survey conducted using a self-administered questionnaire in 2020. The dependent variables were online health information seeking and SNS use. Online health information seeking was assessed using 1 question about whether respondents used the internet to find health or medical information. SNS use was assessed by inquiring about the following 4 aspects: visiting SNSs, sharing health information on SNSs, writing in an online diary or blog, and watching a health-related video on YouTube. The independent variables were 8 chronic diseases. Other independent variables were sex, age, education status, work, marital status, household income, health literacy, and self-reported health status. We conducted a multivariable logistic regression model adjusted for all independent variables to examine the associations of chronic diseases and other variables with online health information seeking and SNS use. Results: The final sample for analysis comprised 2481 internet users. Hypertension or high blood pressure, chronic lung diseases, depression or anxiety disorder, and cancer were reported by 24.5\%, 10.1\%, 7.7\%, and 7.2\% of respondents, respectively. The odds ratio of online health information seeking among respondents with cancer was 2.19 (95\% CI 1.47-3.27) compared with that among those without cancer, and the odds ratio among those with depression or anxiety disorder was 2.27 (95\% CI 1.46-3.53) compared with that among those without. Further, the odds ratio for watching a health-related YouTube video among those with chronic lung diseases was 1.42 (95\% CI 1.05-1.93) compared with that among those without these diseases. Women, younger age, higher level of education, and high health literacy were positively associated with online health information seeking and SNS use. Conclusions: For patients with cancer, strategies for promoting access to websites with reliable cancer-related information as well as access among patients with chronic lung diseases to YouTube videos providing reliable information may be beneficial for the management of these diseases. Moreover, it is important to improve the online environment to encourage men, older adults, internet users with lower education levels, and those with low health literacy to access online health information. ",
doi="10.2196/44741",
url="https://www.jmir.org/2023/1/e44741",
url="http://www.ncbi.nlm.nih.gov/pubmed/36862482"
}


@Article{info:doi/10.2196/42231,
author="Mali, Namrata
and Restrepo, Felipe
and Abrahams, Alan
and Sands, Laura
and Goldberg, M. David
and Gruss, Richard
and Zaman, Nohel
and Shields, Wendy
and Omaki, Elise
and Ehsani, Johnathon
and Ractham, Peter
and Kaewkitipong, Laddawan",
title="Safety Concerns in Mobility-Assistive Products for Older Adults: Content Analysis of Online Reviews",
journal="J Med Internet Res",
year="2023",
month="Mar",
day="2",
volume="25",
pages="e42231",
keywords="injury prevention",
keywords="consumer-reported injuries",
keywords="older adults",
keywords="online reviews",
keywords="mobility-assistive devices",
keywords="product failures",
abstract="Background: Older adults who have difficulty moving around are commonly advised to adopt mobility-assistive devices to prevent injuries. However, limited evidence exists on the safety of these devices. Existing data sources such as the National Electronic Injury Surveillance System tend to focus on injury description rather than the underlying context, thus providing little to no actionable information regarding the safety of these devices. Although online reviews are often used by consumers to assess the safety of products, prior studies have not explored consumer-reported injuries and safety concerns within online reviews of mobility-assistive devices. Objective: This study aimed to investigate injury types and contexts stemming from the use of mobility-assistive devices, as reported by older adults or their caregivers in online reviews. It not only identified injury severities and mobility-assistive device failure pathways but also shed light on the development of safety information and protocols for these products. Methods: Reviews concerning assistive devices were extracted from the ``assistive aid'' categories, which are typically intended for older adult use, on Amazon's US website. The extracted reviews were filtered so that only those pertaining to mobility-assistive devices (canes, gait or transfer belts, ramps, walkers or rollators, and wheelchairs or transport chairs) were retained. We conducted large-scale content analysis of these 48,886 retained reviews by coding them according to injury type (no injury, potential future injury, minor injury, and major injury) and injury pathway (device critical component breakage or decoupling; unintended movement; instability; poor, uneven surface handling; and trip hazards). Coding efforts were carried out across 2 separate phases in which the team manually verified all instances coded as minor injury, major injury, or potential future injury and established interrater reliability to validate coding efforts. Results: The content analysis provided a better understanding of the contexts and conditions leading to user injury, as well as the severity of injuries associated with these mobility-assistive devices. Injury pathways---device critical component failures; unintended device movement; poor, uneven surface handling; instability; and trip hazards---were identified for 5 product types (canes, gait and transfer belts, ramps, walkers and rollators, and wheelchairs and transport chairs). Outcomes were normalized per 10,000 posting counts (online reviews) mentioning minor injury, major injury, or potential future injury by product category. Overall, per 10,000 reviews, 240 (2.4\%) described mobility-assistive equipment--related user injuries, whereas 2318 (23.18\%) revealed potential future injuries. Conclusions: This study highlights mobility-assistive device injury contexts and severities, suggesting that consumers who posted online reviews attribute most serious injuries to a defective item, rather than user misuse. It implies that many mobility-assistive device injuries may be preventable through patient and caregiver education on how to evaluate new and existing equipment for risk of potential future injury. ",
doi="10.2196/42231",
url="https://www.jmir.org/2023/1/e42231",
url="http://www.ncbi.nlm.nih.gov/pubmed/36862459"
}


@Article{info:doi/10.2196/41855,
author="Rayland, Amy
and Andrews, Jacob",
title="From Social Network to Peer Support Network: Opportunities to Explore Mechanisms of Online Peer Support for Mental Health",
journal="JMIR Ment Health",
year="2023",
month="Feb",
day="28",
volume="10",
pages="e41855",
keywords="peer-to-peer support",
keywords="Facebook",
keywords="social networking sites",
keywords="mental health",
keywords="moderation",
doi="10.2196/41855",
url="https://mental.jmir.org/2023/1/e41855",
url="http://www.ncbi.nlm.nih.gov/pubmed/36853738"
}


@Article{info:doi/10.2196/40403,
author="Mokhberi, Maryam
and Biswas, Ahana
and Masud, Zarif
and Kteily-Hawa, Roula
and Goldstein, Abby
and Gillis, Roy Joseph
and Rayana, Shebuti
and Ahmed, Ishtiaque Syed",
title="Development of a COVID-19--Related Anti-Asian Tweet Data Set: Quantitative Study",
journal="JMIR Form Res",
year="2023",
month="Feb",
day="28",
volume="7",
pages="e40403",
keywords="COVID-19",
keywords="stigma",
keywords="hate speech",
keywords="classification",
keywords="annotation",
keywords="data set",
keywords="Sinophobia",
keywords="Twitter",
keywords="BERT",
keywords="pandemic",
keywords="data",
keywords="online",
keywords="community",
keywords="Asian",
keywords="research",
keywords="discrimination",
abstract="Background: Since the advent of the COVID-19 pandemic, individuals of Asian descent (colloquial usage prevalent in North America, where ``Asian'' is used to refer to people from East Asia, particularly China) have been the subject of stigma and hate speech in both offline and online communities. One of the major venues for encountering such unfair attacks is social networks, such as Twitter. As the research community seeks to understand, analyze, and implement detection techniques, high-quality data sets are becoming immensely important. Objective: In this study, we introduce a manually labeled data set of tweets containing anti-Asian stigmatizing content. Methods: We sampled over 668 million tweets posted on Twitter from January to July 2020 and used an iterative data construction approach that included 3 different stages of algorithm-driven data selection. Finally, we found volunteers who manually annotated the tweets by hand to arrive at a high-quality data set of tweets and a second, more sampled data set with higher-quality labels from multiple annotators. We presented this final high-quality Twitter data set on stigma toward Chinese people during the COVID-19 pandemic. The data set and instructions for labeling can be viewed in the Github repository. Furthermore, we implemented some state-of-the-art models to detect stigmatizing tweets to set initial benchmarks for our data set. Results: Our primary contributions are labeled data sets. Data Set v3.0 contained 11,263 tweets with primary labels (unknown/irrelevant, not-stigmatizing, stigmatizing-low, stigmatizing-medium, stigmatizing-high) and tweet subtopics (eg, wet market and eating habits, COVID-19 cases, bioweapon). Data Set v3.1 contained 4998 (44.4\%) tweets randomly sampled from Data Set v3.0, where a second annotator labeled them only on the primary labels and then a third annotator resolved conflicts between the first and second annotators. To demonstrate the usefulness of our data set, preliminary experiments on the data set showed that the Bidirectional Encoder Representations from Transformers (BERT) model achieved the highest accuracy of 79\% when detecting stigma on unseen data with traditional models, such as a support vector machine (SVM) performing at 73\% accuracy. Conclusions: Our data set can be used as a benchmark for further qualitative and quantitative research and analysis around the issue. It first reaffirms the existence and significance of widespread discrimination and stigma toward the Asian population worldwide. Moreover, our data set and subsequent arguments should assist other researchers from various domains, including psychologists, public policy authorities, and sociologists, to analyze the complex economic, political, historical, and cultural underlying roots of anti-Asian stigmatization and hateful behaviors. A manually annotated data set is of paramount importance for developing algorithms that can be used to detect stigma or problematic text, particularly on social media. We believe this contribution will help predict and subsequently design interventions that will significantly help reduce stigma, hate, and discrimination against marginalized populations during future crises like COVID-19. ",
doi="10.2196/40403",
url="https://formative.jmir.org/2023/1/e40403",
url="http://www.ncbi.nlm.nih.gov/pubmed/36693148"
}


@Article{info:doi/10.2196/40706,
author="Ramjee, Divya
and Pollack, C. Catherine
and Charpignon, Marie-Laure
and Gupta, Shagun
and Rivera, Malaty Jessica
and El Hayek, Ghinwa
and Dunn, G. Adam
and Desai, N. Angel
and Majumder, S. Maimuna",
title="Evolving Face Mask Guidance During a Pandemic and Potential Harm to Public Perception: Infodemiology Study of Sentiment and Emotion on Twitter",
journal="J Med Internet Res",
year="2023",
month="Feb",
day="27",
volume="25",
pages="e40706",
keywords="face masks",
keywords="COVID-19",
keywords="Twitter",
keywords="science communication",
keywords="political communication",
keywords="public policy",
keywords="public health",
keywords="sentiment analysis",
keywords="emotion analysis",
keywords="infodemiology",
keywords="infoveillance",
abstract="Background: Throughout the COVID-19 pandemic, US Centers for Disease Control and Prevention policies on face mask use fluctuated. Understanding how public health communications evolve around key policy decisions may inform future decisions on preventative measures by aiding the design of communication strategies (eg, wording, timing, and channel) that ensure rapid dissemination and maximize both widespread adoption and sustained adherence. Objective: We aimed to assess how sentiment on masks evolved surrounding 2 changes to mask guidelines: (1) the recommendation for mask use on April 3, 2020, and (2) the relaxation of mask use on May 13, 2021. Methods: We applied an interrupted time series method to US Twitter data surrounding each guideline change. Outcomes were changes in the (1) proportion of positive, negative, and neutral tweets and (2) number of words within a tweet tagged with a given emotion (eg, trust). Results were compared to COVID-19 Twitter data without mask keywords for the same period. Results: There were fewer neutral mask-related tweets in 2020 ($\beta$=--3.94 percentage points, 95\% CI --4.68 to --3.21; P<.001) and 2021 ($\beta$=--8.74, 95\% CI --9.31 to --8.17; P<.001). Following the April 3 recommendation ($\beta$=.51, 95\% CI .43-.59; P<.001) and May 13 relaxation ($\beta$=3.43, 95\% CI 1.61-5.26; P<.001), the percent of negative mask-related tweets increased. The quantity of trust-related terms decreased following the policy change on April 3 ($\beta$=--.004, 95\% CI --.004 to --.003; P<.001) and May 13 ($\beta$=--.001, 95\% CI --.002 to 0; P=.008). Conclusions: The US Twitter population responded negatively and with less trust following guideline shifts related to masking, regardless of whether the guidelines recommended or relaxed mask usage. Federal agencies should ensure that changes in public health recommendations are communicated concisely and rapidly. ",
doi="10.2196/40706",
url="https://www.jmir.org/2023/1/e40706",
url="http://www.ncbi.nlm.nih.gov/pubmed/36763687"
}


@Article{info:doi/10.2196/36667,
author="Khademi, Sedigh
and Hallinan, Mary Christine
and Conway, Mike
and Bonomo, Yvonne",
title="Using Social Media Data to Investigate Public Perceptions of Cannabis as a Medicine: Narrative Review",
journal="J Med Internet Res",
year="2023",
month="Feb",
day="27",
volume="25",
pages="e36667",
keywords="social media",
keywords="medicinal cannabis",
keywords="public health surveillance",
keywords="internet",
keywords="medical marijuana",
abstract="Background: The use and acceptance of medicinal cannabis is on the rise across the globe. To support the interests of public health, evidence relating to its use, effects, and safety is required to match this community demand. Web-based user-generated data are often used by researchers and public health organizations for the investigation of consumer perceptions, market forces, population behaviors, and for pharmacoepidemiology. Objective: In this review, we aimed to summarize the findings of studies that have used user-generated text as a data source to study medicinal cannabis or the use of cannabis as medicine. Our objectives were to categorize the insights provided by social media research on cannabis as medicine and describe the role of social media for consumers using medicinal cannabis. Methods: The inclusion criteria for this review were primary research studies and reviews that reported on the analysis of web-based user-generated content on cannabis as medicine. The MEDLINE, Scopus, Web of Science, and Embase databases were searched from January 1974 to April 2022. Results: We examined 42 studies published in English and found that consumers value their ability to exchange experiences on the web and tend to rely on web-based information sources. Cannabis discussions have portrayed the substance as a safe and natural medicine to help with many health conditions including cancer, sleep disorders, chronic pain, opioid use disorders, headaches, asthma, bowel disease, anxiety, depression, and posttraumatic stress disorder. These discussions provide a rich resource for researchers to investigate medicinal cannabis--related consumer sentiment and experiences, including the opportunity to monitor cannabis effects and adverse events, given the anecdotal and often biased nature of the information is properly accounted for. Conclusions: The extensive web-based presence of the cannabis industry coupled with the conversational nature of social media discourse results in rich but potentially biased information that is often not well-supported by scientific evidence. This review summarizes what social media is saying about the medicinal use of cannabis and discusses the challenges faced by health governance agencies and professionals to make use of web-based resources to both learn from medicinal cannabis users and provide factual, timely, and reliable evidence-based health information to consumers. ",
doi="10.2196/36667",
url="https://www.jmir.org/2023/1/e36667",
url="http://www.ncbi.nlm.nih.gov/pubmed/36848191"
}


@Article{info:doi/10.2196/42227,
author="Pierri, Francesco
and DeVerna, R. Matthew
and Yang, Kai-Cheng
and Axelrod, David
and Bryden, John
and Menczer, Filippo",
title="One Year of COVID-19 Vaccine Misinformation on Twitter: Longitudinal Study",
journal="J Med Internet Res",
year="2023",
month="Feb",
day="24",
volume="25",
pages="e42227",
keywords="content analysis",
keywords="COVID-19",
keywords="infodemiology",
keywords="misinformation",
keywords="online health information",
keywords="social media",
keywords="trend analysis",
keywords="Twitter",
keywords="vaccines",
keywords="vaccine hesitancy",
abstract="Background: Vaccinations play a critical role in mitigating the impact of COVID-19 and other diseases. Past research has linked misinformation to increased hesitancy and lower vaccination rates. Gaps remain in our knowledge about the main drivers of vaccine misinformation on social media and effective ways to intervene. Objective: Our longitudinal study had two primary objectives: (1) to investigate the patterns of prevalence and contagion of COVID-19 vaccine misinformation on Twitter in 2021, and (2) to identify the main spreaders of vaccine misinformation. Given our initial results, we further considered the likely drivers of misinformation and its spread, providing insights for potential interventions. Methods: We collected almost 300 million English-language tweets related to COVID-19 vaccines using a list of over 80 relevant keywords over a period of 12 months. We then extracted and labeled news articles at the source level based on third-party lists of low-credibility and mainstream news sources, and measured the prevalence of different kinds of information. We also considered suspicious YouTube videos shared on Twitter. We focused our analysis of vaccine misinformation spreaders on verified and automated Twitter accounts. Results: Our findings showed a relatively low prevalence of low-credibility information compared to the entirety of mainstream news. However, the most popular low-credibility sources had reshare volumes comparable to those of many mainstream sources, and had larger volumes than those of authoritative sources such as the US Centers for Disease Control and Prevention and the World Health Organization. Throughout the year, we observed an increasing trend in the prevalence of low-credibility news about vaccines. We also observed a considerable amount of suspicious YouTube videos shared on Twitter. Tweets by a small group of approximately 800 ``superspreaders'' verified by Twitter accounted for approximately 35\% of all reshares of misinformation on an average day, with the top superspreader (@RobertKennedyJr) responsible for over 13\% of retweets. Finally, low-credibility news and suspicious YouTube videos were more likely to be shared by automated accounts. Conclusions: The wide spread of misinformation around COVID-19 vaccines on Twitter during 2021 shows that there was an audience for this type of content. Our findings are also consistent with the hypothesis that superspreaders are driven by financial incentives that allow them to profit from health misinformation. Despite high-profile cases of deplatformed misinformation superspreaders, our results show that in 2021, a few individuals still played an outsized role in the spread of low-credibility vaccine content. As a result, social media moderation efforts would be better served by focusing on reducing the online visibility of repeat spreaders of harmful content, especially during public health crises. ",
doi="10.2196/42227",
url="https://www.jmir.org/2023/1/e42227",
url="http://www.ncbi.nlm.nih.gov/pubmed/36735835"
}


@Article{info:doi/10.2196/38676,
author="Abrams, P. Matthew
and Pelullo, P. Arthur
and Meisel, F. Zachary
and Merchant, M. Raina
and Purtle, Jonathan
and Agarwal, K. Anish",
title="State and Federal Legislators' Responses on Social Media to the Mental Health and Burnout of Health Care Workers Throughout the COVID-19 Pandemic: Natural Language Processing and Sentiment Analysis",
journal="JMIR Infodemiology",
year="2023",
month="Feb",
day="24",
volume="3",
pages="e38676",
keywords="burnout",
keywords="wellness",
keywords="mental health",
keywords="social media",
keywords="policy",
keywords="health care workforce",
keywords="COVID-19",
keywords="infodemiology",
keywords="healthcare worker",
keywords="mental well-being",
keywords="psychological distress",
keywords="Twitter",
keywords="content analysis",
keywords="thematic analysis",
keywords="policy maker",
keywords="healthcare workforce",
keywords="legislator",
abstract="Background: Burnout and the mental health burden of the COVID-19 pandemic have disproportionately impacted health care workers. The links between state policies, federal regulations, COVID-19 case counts, strains on health care systems, and the mental health of health care workers continue to evolve. The language used by state and federal legislators in public-facing venues such as social media is important, as it impacts public opinion and behavior, and it also reflects current policy-leader opinions and planned legislation. Objective: The objective of this study was to examine legislators' social media content on Twitter and Facebook throughout the COVID-19 pandemic to thematically characterize policy makers' attitudes and perspectives related to mental health and burnout in the health care workforce. Methods: Legislators' social media posts about mental health and burnout in the health care workforce were collected from January 2020 to November 2021 using Quorum, a digital database of policy-related documents. The total number of relevant social media posts per state legislator per calendar month was calculated and compared with COVID-19 case volume. Differences between themes expressed in Democratic and Republican posts were estimated using the Pearson chi-square test. Words within social media posts most associated with each political party were determined. Machine-learning was used to evaluate naturally occurring themes in the burnout- and mental health--related social media posts. Results: A total of 4165 social media posts (1400 tweets and 2765 Facebook posts) were generated by 2047 unique state and federal legislators and 38 government entities. The majority of posts (n=2319, 55.68\%) were generated by Democrats, followed by Republicans (n=1600, 40.34\%). Among both parties, the volume of burnout-related posts was greatest during the initial COVID-19 surge. However, there was significant variation in the themes expressed by the 2 major political parties. Themes most correlated with Democratic posts were (1) frontline care and burnout, (2) vaccines, (3) COVID-19 outbreaks, and (4) mental health services. Themes most correlated with Republican social media posts were (1) legislation, (2) call for local action, (3) government support, and (4) health care worker testing and mental health. Conclusions: State and federal legislators use social media to share opinions and thoughts on key topics, including burnout and mental health strain among health care workers. Variations in the volume of posts indicated that a focus on burnout and the mental health of the health care workforce existed early in the pandemic but has waned. Significant differences emerged in the content posted by the 2 major US political parties, underscoring how each prioritized different aspects of the crisis. ",
doi="10.2196/38676",
url="https://infodemiology.jmir.org/2023/1/e38676",
url="http://www.ncbi.nlm.nih.gov/pubmed/37013000"
}


@Article{info:doi/10.2196/37711,
author="Liang, Elisa
and Kutok, R. Emily
and Rosen, K. Rochelle
and Burke, A. Taylor
and Ranney, L. Megan",
title="Effects of Social Media Use on Connectivity and Emotions During Pandemic-Induced School Closures: Qualitative Interview Study Among Adolescents",
journal="JMIR Ment Health",
year="2023",
month="Feb",
day="23",
volume="10",
pages="e37711",
keywords="social media",
keywords="adolescents",
keywords="COVID-19",
keywords="emotions",
keywords="connectivity",
abstract="Background: The COVID-19 pandemic provided a unique opportunity to examine social media and technology use during a time in which technology served as adolescents' primary form of socialization. The literature is mixed regarding how increased screen time during this period affected adolescent mental health and well-being. The mechanisms by which screen time use affected adolescent psychosocial outcomes are also unknown. Objective: We aimed to deepen our understanding of how social media and technology use, social connectivity, and emotional well-being intersected during pandemic-related school closures. Methods: English-speaking adolescents aged 13 to 17 years were recruited on Instagram for a brief screening survey; 39 participants were purposefully selected to complete a semistructured interview regarding their social media and technology use during the pandemic. Interview summaries were abstracted from recordings, and deductive codes were created for the primary question stems. These codes were subsequently reviewed for the main themes. Results: The main themes were as follows: adolescent social media and technology use during school closures usually allowed for more and easier social connectivity, but the amount and relative ease of connectivity differed according to purpose and type of use. Emotions, particularly those of stress and happiness, were connected to whether adolescents actively or passively engaged with social media and technology. Conclusions: Our results suggest a nuanced relationship among social media and technology use, adolescent social support, and emotional well-being, including during the pandemic. Specifically, how adolescents use or engage with web-based platforms greatly influences their ability to connect with others and their feelings of stress and happiness. In the context of the COVID-19 pandemic and as technology in general remains at the core of the adolescent experience, future research should continue to examine how adolescents navigate and use web-based spaces in beneficial and harmful ways. This will inform education and interventions that foster healthy social media and technological habits. ",
doi="10.2196/37711",
url="https://mental.jmir.org/2023/1/e37711",
url="http://www.ncbi.nlm.nih.gov/pubmed/36054613"
}


@Article{info:doi/10.2196/42357,
author="Beirakdar, Safwat
and Klingborg, Leon
and Herzig van Wees, Sibylle",
title="Attitudes of Swedish Language Twitter Users Toward COVID-19 Vaccination: Exploratory Qualitative Study",
journal="JMIR Infodemiology",
year="2023",
month="Feb",
day="22",
volume="3",
pages="e42357",
keywords="COVID-19",
keywords="vaccine hesitancy",
keywords="COVID-19 vaccines",
keywords="social media",
keywords="Twitter",
keywords="qualitative analysis",
keywords="World Health Organization",
keywords="WHO's 3C model",
abstract="Background: Social media have played an important role in shaping COVID-19 vaccine choices during the pandemic. Understanding people's attitudes toward the vaccine as expressed on social media can help address the concerns of vaccine-hesitant individuals. Objective: The aim of this study was to understand the attitudes of Swedish-speaking Twitter users toward COVID-19 vaccines. Methods: This was an exploratory qualitative study that used a social media--listening approach. Between January and March 2022, a total of 2877 publicly available tweets in Swedish were systematically extracted from Twitter. A deductive thematic analysis was conducted using the World Health Organization's 3C model (confidence, complacency, and convenience). Results: Confidence in the safety and effectiveness of the COVID-19 vaccine appeared to be a major concern expressed on Twitter. Unclear governmental strategies in managing the pandemic in Sweden and the belief in conspiracy theories have further influenced negative attitudes toward vaccines. Complacency---the perceived risk of COVID-19 was low and booster vaccination was unnecessary; many expressed trust in natural immunity. Convenience---in terms of accessing the right information and the vaccine---highlighted a knowledge gap about the benefits and necessity of the vaccine, as well as complaints about the quality of vaccination services. Conclusions: Swedish-speaking Twitter users in this study had negative attitudes toward COVID-19 vaccines, particularly booster vaccines. We identified attitudes toward vaccines and misinformation, indicating that social media monitoring can help policy makers respond by developing proactive health communication interventions. ",
doi="10.2196/42357",
url="https://infodemiology.jmir.org/2023/1/e42357",
url="http://www.ncbi.nlm.nih.gov/pubmed/37012999"
}


@Article{info:doi/10.2196/42861,
author="Sui, Yufang
and Kor, Kin Patrick Pui
and Li, Mengli
and Wang, Jingjing",
title="Effects of a Social Media--Based Mind-Body Intervention Embedded With Acupressure and Mindfulness for Stress Reduction Among Family Caregivers of Frail Older Adults: Pilot Randomized Controlled Trial",
journal="JMIR Form Res",
year="2023",
month="Feb",
day="20",
volume="7",
pages="e42861",
keywords="mind-body intervention",
keywords="acupressure",
keywords="mindfulness meditation",
keywords="social media",
abstract="Background: Family caregivers of frail older adults experience high levels of stress. Mind-body interventions (MBIs) focused on caregiver stress are often limited in teaching approaches, difficult to practice, and costly. A social media--based MBI embedded with mindfulness meditation (MM) and self-administered acupressure (SA) may be effective for family caregivers, offer greater usability, and lead to greater adherence. Objective: The aim of this study was to test the feasibility and preliminary effects of a social media--based MBI embedded with MM and SA on family caregivers of frail older adults and to investigate the preliminary effects of the intervention using a pilot randomized controlled trial. Methods: A 2-arm randomized controlled trial design was adopted. Family caregivers of frail older adults (n=64) were randomized into either the intervention group (n=32), receiving 8 weeks of social media--based MM and SA, or the control group (n=32), receiving brief education on caregiving for people with frailty. The primary outcome (caregiver stress) and secondary outcomes (caregiver burden, sleep quality, and mindfulness awareness and attention) were measured using a web-based survey at baseline (T0), immediately after the intervention (T1), and at the 3-month follow-up (T2). Results: The feasibility of the intervention was established with a high attendance rate (87.5\%), high usability score (79), and low attrition rate (1.6\%). The generalized estimating equation results showed that participants in the intervention group at T1 and T2 experienced a significant improvement in stress reduction (P=.02 and P=.04, respectively), sleep quality (P=.004 and P=.01, respectively), and mindful awareness and attention (P=.006 and P=.02, respectively) compared with the control group. There were no substantial improvements in caregiver burden at T1 and T2 (P=.59 and P=.47, respectively). A focus group session conducted after the intervention had 5 themes: impact on the family caregivers, difficulty in practicing the intervention, the strength of the program, the limitations of the program, and perception of the intervention. Conclusions: The findings support the feasibility and preliminary effects of social media--based MBI embedded with acupressure and MM on reducing stress among family caregivers of frail older people and enhancing sleep quality and mindfulness levels. A future study with a larger and more diverse sample is proposed to evaluate the longer-term effects and generalizability of the intervention. Trial Registration: Chinese Clinical Trial Registry ChiCTR2100049507; http://www.chictr.org.cn/showproj.aspx?proj=128031 ",
doi="10.2196/42861",
url="https://formative.jmir.org/2023/1/e42861",
url="http://www.ncbi.nlm.nih.gov/pubmed/36804167"
}


@Article{info:doi/10.2196/44300,
author="Robinson, Jo
and La Sala, Louise
and Cooper, Charlie
and Spittal, Matthew
and Rice, Simon
and Lamblin, Michelle
and Brown, Ellie
and Nolan, Hayley
and Battersby-Coulter, Rikki
and Rajaram, Gowri
and Thorn, Pinar
and Pirkis, Jane
and May-Finlay, Summer
and Silenzio, Vincent
and Skehan, Jaelea
and Krysinska, Karolina
and Bellairs-Walsh, India",
title="Testing the Impact of the \#chatsafe Intervention on Young People's Ability to Communicate Safely About Suicide on Social Media: Protocol for a Randomized Controlled Trial",
journal="JMIR Res Protoc",
year="2023",
month="Feb",
day="17",
volume="12",
pages="e44300",
keywords="suicide",
keywords="young people",
keywords="social media",
keywords="intervention, sexual health, randomized-controlled trial",
abstract="Background: Suicide is the leading cause of death among Australians. One commonly cited explanation is the impact of social media, in particular, the ways in which young people use social media to communicate about their own experiences and their exposure to suicide-related content posted by others. Guidelines designed to assist mainstream media to safely report about suicide are widespread. Until recently, no guidelines existed that targeted social media or young people. In response, we developed the \#chatsafe guidelines and a supporting social media campaign, which together make up the \#chatsafe intervention. The intervention was tested in a pilot study with positive results. However, the study was limited by the lack of a control group. Objective: The aim of this study is to assess the impact of the \#chatsafe social media intervention on young people's safety and confidence when communicating on the web about suicide. Methods: The study employs a pragmatic, parallel, superiority randomized controlled design. It will be conducted in accordance with the Consolidated Standards of Reporting Trials statement over 18 months. Participants will be 400 young people aged 16-25 years (200 per arm). Participants will be recruited via social media advertising and assessed at 3 time points: time 1---baseline; time 2---8-week postintervention commencement; and time 3---4-week postintervention. They will be asked to complete a weekly survey to monitor safety and evaluate each piece of social media content. The intervention comprises an 8-week social media campaign including social media posts shared on public Instagram profiles. The intervention group will receive the \#chatsafe suicide prevention content and the control group will receive sexual health content. Both groups will receive 24 pieces of content delivered to their mobile phones via text message. The primary outcome is safety when communicating on the web about suicide, as measured via the purpose-designed \#chatsafe online safety questionnaire. Additional outcomes include willingness to intervene against suicide, internet self-efficacy, safety, and acceptability. Results: The study was funded in November 2020, approved by the University of Melbourne Human Research Ethics Committee on October 7, 2022, and prospectively registered with the Australian New Zealand Clinical Trials registry. Trial recruitment began in November 2022 and study completion is anticipated by June 2024. Conclusions: This will be the first randomized controlled trial internationally to test the impact of a social media intervention designed to equip young people to communicate safely on the web about suicide. Given the rising rates of youth suicide in Australia and the acceptability of social media among young people, incorporating social media--based interventions into the suicide prevention landscape is an obvious next step. This intervention, if effective, could also be extended internationally, thereby improving web-based safety for young people not just in Australia but globally. Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12622001397707; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=384318 International Registered Report Identifier (IRRID): DERR1-10.2196/44300 ",
doi="10.2196/44300",
url="https://www.researchprotocols.org/2023/1/e44300",
url="http://www.ncbi.nlm.nih.gov/pubmed/36800220"
}


@Article{info:doi/10.2196/42671,
author="Hong, Yimin
and Xie, Fang
and An, Xinyu
and Lan, Xue
and Liu, Chunhe
and Yan, Lei
and Zhang, Han",
title="Evolution of Public Attitudes and Opinions Regarding COVID-19 Vaccination During the Vaccine Campaign in China: Year-Long Infodemiology Study of Weibo Posts",
journal="J Med Internet Res",
year="2023",
month="Feb",
day="16",
volume="25",
pages="e42671",
keywords="COVID-19 vaccines",
keywords="social media",
keywords="infodemiology",
keywords="sentiment analysis",
keywords="opinion analysis",
keywords="monitoring public attitude",
keywords="gender differences",
keywords="LDA",
keywords="COVID-19",
abstract="Background: Monitoring people's perspectives on the COVID-19 vaccine is crucial for understanding public vaccination hesitancy and developing effective, targeted vaccine promotion strategies. Although this is widely recognized, studies on the evolution of public opinion over the course of an actual vaccination campaign are rare. Objective: We aimed to track the evolution of public opinion and sentiment toward COVID-19 vaccines in online discussions over an entire vaccination campaign. Moreover, we aimed to reveal the pattern of gender differences in attitudes and perceptions toward vaccination. Methods: We collected COVID-19 vaccine--related posts by the general public that appeared on Sina Weibo from January 1, 2021, to December 31, 2021; this period covered the entire vaccination process in China. We identified popular discussion topics using latent Dirichlet allocation. We further examined changes in public sentiment and topics during the 3 stages of the vaccination timeline. Gender differences in perceptions toward vaccination were also investigated. Results: Of 495,229 crawled posts, 96,145 original posts from individual accounts were included. Most posts presented positive sentiments (positive: 65,981/96,145, 68.63\%; negative: 23,184/96,145, 24.11\%; neutral: 6980/96,145, 7.26\%). The average sentiment scores were 0.75 (SD 0.35) for men and 0.67 (SD 0.37) for women. The overall trends in sentiment scores showed a mixed response to the number of new cases and significant events related to vaccine development and important holidays. The sentiment scores showed a weak correlation with new case numbers (R=0.296; P=.03). Significant sentiment score differences were observed between men and women (P<.001). Common and distinguishing characteristics were found among frequently discussed topics during the different stages, with significant differences in topic distribution between men and women (January 1, 2021, to March 31, 2021: $\chi$23=3030.9; April 1, 2021, to September 30, 2021: $\chi$24=8893.8; October 1, 2021, to December 31, 2021: $\chi$25=3019.5; P<.001). Women were more concerned with side effects and vaccine effectiveness. In contrast, men reported broader concerns around the global pandemic, the progress of vaccine development, and economics affected by the pandemic. Conclusions: Understanding public concerns regarding vaccination is essential for reaching vaccine-induced herd immunity. This study tracked the year-long evolution of attitudes and opinions on COVID-19 vaccines according to the different stages of vaccination in China. These findings provide timely information that will enable the government to understand the reasons for low vaccine uptake and promote COVID-19 vaccination nationwide. ",
doi="10.2196/42671",
url="https://www.jmir.org/2023/1/e42671",
url="http://www.ncbi.nlm.nih.gov/pubmed/36795467"
}


@Article{info:doi/10.2196/41716,
author="Diamond, Carrie
and Quinn, P. Alyssa
and Presley, L. Colby
and Jacobs, Jennifer
and Laughter, R. Melissa
and Anderson, Jaclyn
and Rundle, Chandler",
title="Telangiectasia-Related Social Media Posts: Cross-sectional Analysis of TikTok and Instagram",
journal="JMIR Dermatol",
year="2023",
month="Feb",
day="16",
volume="6",
pages="e41716",
keywords="social media",
keywords="telangiectasias",
keywords="varicose veins",
keywords="health information",
keywords="misinformation",
keywords="dermatology",
keywords="health education",
keywords="dermatologic information",
keywords="health content",
keywords="accuracy",
keywords="educational content",
doi="10.2196/41716",
url="https://derma.jmir.org/2023/1/e41716",
url="http://www.ncbi.nlm.nih.gov/pubmed/37632919"
}


@Article{info:doi/10.2196/42985,
author="Liu, Yongtai
and Yin, Zhijun
and Ni, Congning
and Yan, Chao
and Wan, Zhiyu
and Malin, Bradley",
title="Examining Rural and Urban Sentiment Difference in COVID-19--Related Topics on Twitter: Word Embedding--Based Retrospective Study",
journal="J Med Internet Res",
year="2023",
month="Feb",
day="15",
volume="25",
pages="e42985",
keywords="COVID-19",
keywords="social media",
keywords="word embedding",
keywords="topic analysis",
keywords="sentiment analysis",
keywords="Twitter",
keywords="data",
keywords="vaccination",
keywords="prevention",
keywords="urban",
keywords="rural",
keywords="epidemic",
keywords="management",
keywords="model",
keywords="training",
keywords="machine learning",
abstract="Background: By the end of 2022, more than 100 million people were infected with COVID-19 in the United States, and the cumulative death rate in rural areas (383.5/100,000) was much higher than in urban areas (280.1/100,000). As the pandemic spread, people used social media platforms to express their opinions and concerns about COVID-19--related topics. Objective: This study aimed to (1) identify the primary COVID-19--related topics in the contiguous United States communicated over Twitter and (2) compare the sentiments urban and rural users expressed about these topics. Methods: We collected tweets containing geolocation data from May 2020 to January 2022 in the contiguous United States. We relied on the tweets' geolocations to determine if their authors were in an urban or rural setting. We trained multiple word2vec models with several corpora of tweets based on geospatial and timing information. Using a word2vec model built on all tweets, we identified hashtags relevant to COVID-19 and performed hashtag clustering to obtain related topics. We then ran an inference analysis for urban and rural sentiments with respect to the topics based on the similarity between topic hashtags and opinion adjectives in the corresponding urban and rural word2vec models. Finally, we analyzed the temporal trend in sentiments using monthly word2vec models. Results: We created a corpus of 407 million tweets, 350 million (86\%) of which were posted by users in urban areas, while 18 million (4.4\%) were posted by users in rural areas. There were 2666 hashtags related to COVID-19, which clustered into 20 topics. Rural users expressed stronger negative sentiments than urban users about COVID-19 prevention strategies and vaccination (P<.001). Moreover, there was a clear political divide in the perception of politicians by urban and rural users; these users communicated stronger negative sentiments about Republican and Democratic politicians, respectively (P<.001). Regarding misinformation and conspiracy theories, urban users exhibited stronger negative sentiments about the ``covidiots'' and ``China virus'' topics, while rural users exhibited stronger negative sentiments about the ``Dr. Fauci'' and ``plandemic'' topics. Finally, we observed that urban users' sentiments about the economy appeared to transition from negative to positive in late 2021, which was in line with the US economic recovery. Conclusions: This study demonstrates there is a statistically significant difference in the sentiments of urban and rural Twitter users regarding a wide range of COVID-19--related topics. This suggests that social media can be relied upon to monitor public sentiment during pandemics in disparate types of regions. This may assist in the geographically targeted deployment of epidemic prevention and management efforts. ",
doi="10.2196/42985",
url="https://www.jmir.org/2023/1/e42985",
url="http://www.ncbi.nlm.nih.gov/pubmed/36790847"
}


@Article{info:doi/10.2196/39146,
author="Ling, M. Pamela
and Hrywna, Mary
and Talbot, M. Eugene
and Lewis, Jane M.",
title="Tobacco-Derived Nicotine Pouch Brands and Marketing Messages on Internet and Traditional Media: Content Analysis",
journal="JMIR Form Res",
year="2023",
month="Feb",
day="15",
volume="7",
pages="e39146",
keywords="nicotine pouch",
keywords="marketing",
keywords="tobacco industry",
keywords="web-based advertising",
keywords="advertising",
keywords="advertisement",
keywords="smoking",
keywords="tobacco",
keywords="nicotine",
keywords="smoker",
keywords="addiction",
keywords="industry",
keywords="industrial",
keywords="economic",
keywords="economy",
keywords="commercial",
keywords="commerce",
keywords="consumer",
abstract="Background: Nicotine pouches and lozenges are increasingly available in the United States, and sales are growing. The brands of nicotine pouch products with the largest market share are produced by tobacco companies. Objective: The aim of this study is to examine the marketing of 5 oral nicotine products sold by tobacco companies. Methods: Internet, radio, television, print, and web-based display advertisements between January 2019 and March 2020 for 6 brands of nicotine pouches and lozenges were identified through commercially available marketing surveillance systems supplemented by a manual search of trade press and a review of brand websites. A total of 711 advertisements (122 unique) were analyzed to identify characteristics, themes, marketing strategies, and target audiences, and qualitatively compared by brand. All 5 brand websites were also analyzed. Coders examined the entirety of each advertisement or website for products, marketing claims, and features and recorded the presence or absence of 27 marketing claims and lifestyle elements. Results: All 6 brands of nicotine pouch products spent a total of US \$11.2 million on advertising in 2019, with the most (US \$10.7 million) spent by the brand Velo, and 86.1\% (n=105) of the unique advertisements were web-based. Of the 711 total nicotine pouch advertisements run in 2019, the 2 brands Velo (n=407, 57\%) and ZYN (n=303, 42\%) dominated. These brands also made the greatest number of advertising claims in general. These claims focused on novelty, modernity, and use in a variety of contexts, including urban contexts, workplaces, transportation, and leisure activities. Of the 122 unique advertisements, ZYN's most common claims were to be ``tobacco-free,'' featuring many flavors or varieties, and modern. Velo was the only brand to include urban contexts (n=14, 38.9\% of advertisements) or freedom (n=8, 22.2\%); Velo advertisements portrayed use in the workplace (n=15, 41.7\%), bars or clubs (n=5, 13.9\%), leisure activities (n=4, 11.1\%), transportation (n=4, 11.1\%), sports (n=3, 8.3\%), cooking (n=2, 5.6\%), and with alcohol (n=1, 2.8\%). Velo and ZYN also included most of the images of people, including women and people of color. The 36 Velo ads included people in advertising in 77.8\% (n=28) of advertisements, and of those advertisements with identifiable people, 40\% (n=4) were young adults and 50\% (n=5) were middle-aged. About one-third (n=11, 35.5\%) of the 31 unique ZYN advertisements included people, and most identifiable models appeared to be young adults. Brands such as Rogue, Revel, Dryft, and on! focused mainly on product features. All nicotine pouch products made either tobacco-free, smoke-free, spit-free, or vape-free claims. The most common claim overall was ``tobacco-free,'' found in advertisements from Rogue (1/1, 100\%), ZYN (30/31, 96.8\%), Velo (19/36, 52.8\%), and Dryft (1/3, 33.3\%), but not Revel. Conclusions: Nicotine pouches and lozenges may expand the nicotine market as tobacco-free claims alleviate concerns about health harms and advertising features a greater diversity of people and contexts than typical smokeless tobacco advertising. The market leaders and highest-spending brands, ZYN and Velo, included more lifestyle claims. Surveillance of nicotine pouch marketing and uptake, including influence on tobacco use behaviors, is necessary. ",
doi="10.2196/39146",
url="https://formative.jmir.org/2023/1/e39146",
url="http://www.ncbi.nlm.nih.gov/pubmed/36790840"
}


@Article{info:doi/10.2196/35601,
author="Duong, Thien Huong
and Hopfer, Suellen",
title="Exploring Intergenerational Communication on Social Media Group Chats as a Cancer Prevention Intervention Opportunity Among Vietnamese American Families: Qualitative Study",
journal="JMIR Form Res",
year="2023",
month="Feb",
day="15",
volume="7",
pages="e35601",
keywords="cancer prevention",
keywords="Vietnamese",
keywords="family communication",
keywords="intervention",
keywords="colorectal cancer",
keywords="human papillomavirus vaccine",
keywords="HPV vaccine",
keywords="Papanicolaou test",
keywords="mobile phone",
abstract="Background: Families use social media group chats to connect with each other about daily life and to share information. Although cancer is not a frequent topic of conversation in family settings, the adoption of mobile technology in the family context presents a novel opportunity to promote cancer prevention information. To the best of our knowledge, few studies have used private social media group chats to promote cancer prevention information to family members. Objective: In this formative study, we investigated how family group chat platforms can be leveraged to encourage colorectal cancer screening, human papillomavirus vaccination, and cervical cancer screening among intergenerational Vietnamese American families. This study aimed to cocreate a family-based communication intervention for introducing cancer screening information in family group chats. We sought to understand family members' motivations for using group chats, family dynamics and conversation patterns, and group chat experiences and cultural norms for interacting with family members. Methods: Overall, 20 audio-recorded and semistructured interviews were conducted with young Vietnamese adults. The study was conducted between August and October 2018. Participants were Vietnamese Americans; aged between 18 and 44 years; living in Orange County, California; had an existing family group chat; and expressed an interest in becoming family health advocates. Data were analyzed using a framework analysis. Results: In total, 13 (65\%) of the 20 young adults reported having >1 group chat with their immediate and extended family. Preventive health was not a typical topic of family conversations, but food, family announcements, personal updates, humorous videos or photos, and current events were. Young adults expressed openness to initiating conversations with family members about cancer prevention; however, they also raised concerns that may influence family members' receptivity to the messages. Themes that could potentially impact family members' willingness to accept cancer prevention messages included family status and hierarchy, gender dynamics, relational closeness in the family, and source trust and credibility. These considerations may impact whether families will be open to receiving cancer screening information and acting on it. The participants also mentioned practical considerations for intervention and message design, which included the Vietnamese cultural conversation etiquette of h?i th?m, respect for a physician's recommendation, prevention versus symptom orientation, the family health advocate's bilingual capacity, and the busy lives of family members. In response to exemplar messages, participants mentioned that they preferred to personalize template messages to accommodate conversational norms in their family group chats. Conclusions: The findings of this study inform the development of a social media intervention for increasing preventive cancer screening in Vietnamese American families. ",
doi="10.2196/35601",
url="https://formative.jmir.org/2023/1/e35601",
url="http://www.ncbi.nlm.nih.gov/pubmed/36790844"
}


@Article{info:doi/10.2196/42863,
author="Lin, Shuo-Yu
and Cheng, Xiaolu
and Zhang, Jun
and Yannam, Sindhu Jaya
and Barnes, J. Andrew
and Koch, Randy J.
and Hayes, Rashelle
and Gimm, Gilbert
and Zhao, Xiaoquan
and Purohit, Hemant
and Xue, Hong",
title="Social Media Data Mining of Antitobacco Campaign Messages: Machine Learning Analysis of Facebook Posts",
journal="J Med Internet Res",
year="2023",
month="Feb",
day="13",
volume="25",
pages="e42863",
keywords="tobacco control",
keywords="social media campaign",
keywords="content analysis",
keywords="natural language processing",
keywords="topic modeling",
keywords="social media",
keywords="public health",
keywords="tobacco",
keywords="youth",
keywords="Facebook",
keywords="engagement",
keywords="use",
keywords="smoking",
abstract="Background: Social media platforms provide a valuable source of public health information, as one-third of US adults seek specific health information online. Many antitobacco campaigns have recognized such trends among youth and have shifted their advertising time and effort toward digital platforms. Timely evidence is needed to inform the adaptation of antitobacco campaigns to changing social media platforms. Objective: In this study, we conducted a content analysis of major antitobacco campaigns on Facebook using machine learning and natural language processing (NLP) methods, as well as a traditional approach, to investigate the factors that may influence effective antismoking information dissemination and user engagement. Methods: We collected 3515 posts and 28,125 associated comments from 7 large national and local antitobacco campaigns on Facebook between 2018 and 2021, including the Real Cost, Truth, CDC Tobacco Free (formally known as Tips from Former Smokers, where ``CDC'' refers to the Centers for Disease Control and Prevention), the Tobacco Prevention Toolkit, Behind the Haze VA, the Campaign for Tobacco-Free Kids, and Smoke Free US campaigns. NLP methods were used for content analysis, including parsimonious rule--based models for sentiment analysis and topic modeling. Logistic regression models were fitted to examine the relationship of antismoking message-framing strategies and viewer responses and engagement. Results: We found that large campaigns from government and nonprofit organizations had more user engagements compared to local and smaller campaigns. Facebook users were more likely to engage in negatively framed campaign posts. Negative posts tended to receive more negative comments (odds ratio [OR] 1.40, 95\% CI 1.20-1.65). Positively framed posts generated more negative comments (OR 1.41, 95\% CI 1.19-1.66) as well as positive comments (OR 1.29, 95\% CI 1.13-1.48). Our content analysis and topic modeling uncovered that the most popular campaign posts tended to be informational (ie, providing new information), where the key phrases included talking about harmful chemicals (n=43, 43\%) as well as the risk to pets (n=17, 17\%). Conclusions: Facebook users tend to engage more in antitobacco educational campaigns that are framed negatively. The most popular campaign posts are those providing new information, with key phrases and topics discussing harmful chemicals and risks of secondhand smoke for pets. Educational campaign designers can use such insights to increase the reach of antismoking campaigns and promote behavioral changes. ",
doi="10.2196/42863",
url="https://www.jmir.org/2023/1/e42863",
url="http://www.ncbi.nlm.nih.gov/pubmed/36780224"
}


@Article{info:doi/10.2196/40057,
author="Zang, Shujie
and Zhang, Xu
and Xing, Yuting
and Chen, Jiaxian
and Lin, Leesa
and Hou, Zhiyuan",
title="Applications of Social Media and Digital Technologies in COVID-19 Vaccination: Scoping Review",
journal="J Med Internet Res",
year="2023",
month="Feb",
day="10",
volume="25",
pages="e40057",
keywords="social media",
keywords="digital health",
keywords="COVID-19",
keywords="vaccination",
keywords="review",
abstract="Background: Social media and digital technologies have played essential roles in disseminating information and promoting vaccination during the COVID-19 pandemic. There is a need to summarize the applications and analytical techniques of social media and digital technologies in monitoring vaccine attitudes and administering COVID-19 vaccines. Objective: We aimed to synthesize the global evidence on the applications of social media and digital technologies in COVID-19 vaccination and to explore their avenues to promote COVID-19 vaccination. Methods: We searched 6 databases (PubMed, Scopus, Web of Science, Embase, EBSCO, and IEEE Xplore) for English-language articles from December 2019 to August 2022. The search terms covered keywords relating to social media, digital technology, and COVID-19 vaccines. Articles were included if they provided original descriptions of applications of social media or digital health technologies/solutions in COVID-19 vaccination. Conference abstracts, editorials, letters, commentaries, correspondence articles, study protocols, and reviews were excluded. A modified version of the Appraisal Tool for Cross-Sectional Studies (AXIS tool) was used to evaluate the quality of social media--related studies. The review was undertaken with the guidance of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. Results: A total of 178 articles were included in our review, including 114 social media articles and 64 digital technology articles. Social media has been applied for sentiment/emotion analysis, topic analysis, behavioral analysis, dissemination and engagement analysis, and information quality analysis around COVID-19 vaccination. Of these, sentiment analysis and topic analysis were the most common, with social media data being primarily analyzed by lexicon-based and machine learning techniques. The accuracy and reliability of information on social media can seriously affect public attitudes toward COVID-19 vaccines, and misinformation often leads to vaccine hesitancy. Digital technologies have been applied to determine the COVID-19 vaccination strategy, predict the vaccination process, optimize vaccine distribution and delivery, provide safe and transparent vaccination certificates, and perform postvaccination surveillance. The applied digital technologies included algorithms, blockchain, mobile health, the Internet of Things, and other technologies, although with some barriers to their popularization. Conclusions: The applications of social media and digital technologies in addressing COVID-19 vaccination--related issues represent an irreversible trend. Attention should be paid to the ethical issues and health inequities arising from the digital divide while applying and promoting these technologies. ",
doi="10.2196/40057",
url="https://www.jmir.org/2023/1/e40057",
url="http://www.ncbi.nlm.nih.gov/pubmed/36649235"
}


@Article{info:doi/10.2196/42706,
author="Zhou, Runtao
and Tang, Qihang
and Xie, Zidian
and Li, Dongmei",
title="Public Perceptions of the Food and Drug Administration's Proposed Rules Prohibiting Menthol Cigarettes on Twitter: Observational Study",
journal="JMIR Form Res",
year="2023",
month="Feb",
day="10",
volume="7",
pages="e42706",
keywords="menthol cigarettes",
keywords="Food and Drug Administration",
keywords="FDA",
keywords="FDA's proposed rules",
keywords="Twitter",
keywords="perception",
abstract="Background: On April 28, 2022, the Food and Drug Administration (FDA) proposed rules that prohibited all menthol-flavored cigarettes and other flavored cigars to prevent the initiation of tobacco use in youth and reduce tobacco-related diseases and death. Objective: The objective of this study was to investigate public perceptions of the FDA's proposed menthol cigarette rules on Twitter. Methods: Through the Twitter streaming application programming interface, tobacco-related tweets were collected between April 28, 2022, and May 27, 2022, using a set of keywords, such as smoking, cigarette, and nicotine. Furthermore, 1941 tweets related to the FDA's proposed menthol cigarette rules were extracted. Based on 300 randomly selected example tweets, the codebook for the attitudes toward the FDA's proposed rules and related topics was developed by 2 researchers and was used to label the rest of the tweets. Results: Among tweets related to the FDA's proposed menthol cigarette rules, 536 (27.61\%) showed a positive attitude, 443 (22.82\%) had a negative attitude, and 962 (49.56\%) had a neutral attitude toward the proposed rules. Social justice (210/536, 39\%) and health issues (117/536, 22\%) were two major topics in tweets with a positive attitude. For tweets with a negative attitude, alternative tobacco or nicotine products (127/443, 29\%) and racial discrimination (84/536, 16\%) were two of the most popular topics. Conclusions: In general, the public had a positive attitude toward the FDA's proposed menthol cigarette rules. Our study provides important information to the FDA on the public perceptions of the proposed menthol cigarette rules, which will be helpful for future FDA regulations on menthol cigarettes. ",
doi="10.2196/42706",
url="https://formative.jmir.org/2023/1/e42706",
url="http://www.ncbi.nlm.nih.gov/pubmed/36763414"
}


@Article{info:doi/10.2196/40569,
author="Klein, Z. Ari
and Kunatharaju, Shriya
and O'Connor, Karen
and Gonzalez-Hernandez, Graciela",
title="Pregex: Rule-Based Detection and Extraction of Twitter Data in Pregnancy",
journal="J Med Internet Res",
year="2023",
month="Feb",
day="9",
volume="25",
pages="e40569",
keywords="natural language processing",
keywords="data mining",
keywords="social media",
keywords="pregnancy",
doi="10.2196/40569",
url="https://www.jmir.org/2023/1/e40569",
url="http://www.ncbi.nlm.nih.gov/pubmed/36757756"
}


@Article{info:doi/10.2196/41518,
author="He, Zixuan
and Wang, Zhijie
and Song, Yihang
and Liu, Yilong
and Kang, Le
and Fang, Xue
and Wang, Tongchang
and Fan, Xuanming
and Li, Zhaoshen
and Wang, Shuling
and Bai, Yu",
title="The Reliability and Quality of Short Videos as a Source of Dietary Guidance for Inflammatory Bowel Disease: Cross-sectional Study",
journal="J Med Internet Res",
year="2023",
month="Feb",
day="9",
volume="25",
pages="e41518",
keywords="inflammatory bowel disease",
keywords="diet",
keywords="information quality",
keywords="social media",
keywords="gastroenterology",
keywords="nutrition",
keywords="videos",
keywords="health communication",
abstract="Background: Dietary management is considered a potential adjunctive treatment for inflammatory bowel disease (IBD). Short-video sharing platforms have enabled patients to obtain dietary advice more conveniently. However, accessing useful resources while avoiding misinformation is not an easy task for most patients. Objective: This study aimed to evaluate the quality of the information in IBD diet--related videos on Chinese short-video sharing platforms. Methods: We collected and extracted information from a total of 125 video samples related to the IBD diet on the 3 Chinese short-video sharing platforms with the most users: TikTok, Bilibili, and Kwai. Two independent physicians evaluated each video in terms of content comprehensiveness, quality (rated by Global Quality Score), and reliability (rated by a modified DISCERN tool). Finally, comparative analyses of the videos from different sources were conducted. Results: The videos were classified into 6 groups based on the identity of the uploaders, which included 3 kinds of medical professionals (ie, gastroenterologists, nongastroenterologists, and clinical nutritionists) and 3 types of non--medical professionals (ie, nonprofit organizations, individual science communicators, and IBD patients). The overall quality of the videos was poor. Further group comparisons demonstrated that videos from medical professionals were more instructive in terms of content comprehensiveness, quality, and reliability than those from non--medical professionals. Moreover, IBD diet--related recommendations from clinical nutritionists and gastroenterologists were of better quality than those from nongastroenterologists, while recommendations from nonprofit organizations did not seem to be superior to other groups of uploaders. Conclusions: The overall quality of the information in IBD diet-related videos is unsatisfactory and varies significantly depending on the source. Videos from medical professionals, especially clinical nutritionists and gastroenterologists, may provide dietary guidance with higher quality for IBD patients. ",
doi="10.2196/41518",
url="https://www.jmir.org/2023/1/e41518",
url="http://www.ncbi.nlm.nih.gov/pubmed/36757757"
}


@Article{info:doi/10.2196/39162,
author="Sun, Fei
and Zheng, Shusen
and Wu, Jian",
title="Quality of Information in Gallstone Disease Videos on TikTok: Cross-sectional Study",
journal="J Med Internet Res",
year="2023",
month="Feb",
day="8",
volume="25",
pages="e39162",
keywords="hepatobiliary",
keywords="gallstone",
keywords="gallbladder",
keywords="TikTok",
keywords="social media",
keywords="video quality",
keywords="DISCERN",
keywords="Journal of American Medical Association",
keywords="JAMA",
keywords="Global Quality Score",
keywords="GQS",
keywords="content analysis",
keywords="health information",
keywords="online health information",
keywords="digital health",
keywords="disease knowledge",
keywords="medical information",
keywords="misinformation",
keywords="infodemiology",
keywords="patient education",
keywords="dissemination",
keywords="accuracy",
keywords="credibility",
keywords="credible",
keywords="reliability",
keywords="reliable",
keywords="information quality",
abstract="Background: TikTok was an important channel for consumers to access and adopt health information. But the quality of health content in TikTok remains underinvestigated. Objective: Our study aimed to identify upload sources, contents, and feature information of gallstone disease videos on TikTok and further evaluated the factors related to video quality. Methods: We investigated the first 100 gallstone-related videos on TikTok and analyzed these videos' upload sources, content, and characteristics. The quality of videos was evaluated using quantitative scoring tools such as DISCERN instrument, the Journal of American Medical Association (JAMA) benchmark criteria, and Global Quality Scores (GQS). Moreover, the correlation between video quality and video characteristics, including duration, likes, comments, and shares, was further investigated. Results: According to video sources, 81\% of the videos were posted by doctors. Furthermore, disease knowledge was the most dominant video content, accounting for 56\% of all the videos. The mean DISCERN, JAMA, and GQS scores of all 100 videos are 39.61 (SD 11.36), 2.00 (SD 0.40), and 2.76 (SD 0.95), respectively. According to DISCERN and GQS, gallstone-related videos' quality score on TikTok is not high, mainly at fair (43/100, 43\%,) and moderate (46/100, 46\%). The total DISCERN scores of doctors were significantly higher than that of individuals and news agencies, surgery techniques were significantly higher than lifestyle and news, and disease knowledge was significantly higher than news, respectively. DISCERN scores and video duration were positively correlated. Negative correlations were found between DISCERN scores and likes and shares of videos. In GQS analysis, no significant differences were found between groups based on different sources or different contents. JAMA was excluded in the video quality and correlation analysis due to a lack of discrimination and inability to evaluate the video quality accurately. Conclusions: Although the videos of gallstones on TikTok are mainly provided by doctors and contain disease knowledge, they are of low quality. We found a positive correlation between video duration and video quality. High-quality videos received low attention, and popular videos were of low quality. Medical information on TikTok is currently not rigorous enough to guide patients to make accurate judgments. TikTok was not an appropriate source of knowledge to educate patients due to the low quality and reliability of the information. ",
doi="10.2196/39162",
url="https://www.jmir.org/2023/1/e39162",
url="http://www.ncbi.nlm.nih.gov/pubmed/36753307"
}


@Article{info:doi/10.2196/42519,
author="Athanasiou, Maria
and Fragkozidis, Georgios
and Zarkogianni, Konstantia
and Nikita, S. Konstantina",
title="Long Short-term Memory--Based Prediction of the Spread of Influenza-Like Illness Leveraging Surveillance, Weather, and Twitter Data: Model Development and Validation",
journal="J Med Internet Res",
year="2023",
month="Feb",
day="6",
volume="25",
pages="e42519",
keywords="influenza-like illness",
keywords="epidemiological surveillance",
keywords="machine learning",
keywords="deep learning",
keywords="social media",
keywords="Twitter",
keywords="meteorological parameters",
abstract="Background: The potential to harness the plurality of available data in real time along with advanced data analytics for the accurate prediction of influenza-like illness (ILI) outbreaks has gained significant scientific interest. Different methodologies based on the use of machine learning techniques and traditional and alternative data sources, such as ILI surveillance reports, weather reports, search engine queries, and social media, have been explored with the ultimate goal of being used in the development of electronic surveillance systems that could complement existing monitoring resources. Objective: The scope of this study was to investigate for the first time the combined use of ILI surveillance data, weather data, and Twitter data along with deep learning techniques toward the development of prediction models able to nowcast and forecast weekly ILI cases. By assessing the predictive power of both traditional and alternative data sources on the use case of ILI, this study aimed to provide a novel approach for corroborating evidence and enhancing accuracy and reliability in the surveillance of infectious diseases. Methods: The model's input space consisted of information related to weekly ILI surveillance, web-based social (eg, Twitter) behavior, and weather conditions. For the design and development of the model, relevant data corresponding to the period of 2010 to 2019 and focusing on the Greek population and weather were collected. Long short-term memory (LSTM) neural networks were leveraged to efficiently handle the sequential and nonlinear nature of the multitude of collected data. The 3 data categories were first used separately for training 3 LSTM-based primary models. Subsequently, different transfer learning (TL) approaches were explored with the aim of creating various feature spaces combining the features extracted from the corresponding primary models' LSTM layers for the latter to feed a dense layer. Results: The primary model that learned from weather data yielded better forecast accuracy (root mean square error [RMSE]=0.144; Pearson correlation coefficient [PCC]=0.801) than the model trained with ILI historical data (RMSE=0.159; PCC=0.794). The best performance was achieved by the TL-based model leveraging the combination of the 3 data categories (RMSE=0.128; PCC=0.822). Conclusions: The superiority of the TL-based model, which considers Twitter data, weather data, and ILI surveillance data, reflects the potential of alternative public sources to enhance accurate and reliable prediction of ILI spread. Despite its focus on the use case of Greece, the proposed approach can be generalized to other locations, populations, and social media platforms to support the surveillance of infectious diseases with the ultimate goal of reinforcing preparedness for future epidemics. ",
doi="10.2196/42519",
url="https://www.jmir.org/2023/1/e42519",
url="http://www.ncbi.nlm.nih.gov/pubmed/36745490"
}


@Article{info:doi/10.2196/40934,
author="Eppes, V. Elisabet
and Augustyn, Marycatherine
and Gross, M. Susan
and Vernon, Paris
and Caulfield, E. Laura
and Paige, M. David",
title="Engagement With and Acceptability of Digital Media Platforms for Use in Improving Health Behaviors Among Vulnerable Families: Systematic Review",
journal="J Med Internet Res",
year="2023",
month="Feb",
day="3",
volume="25",
pages="e40934",
keywords="text messaging",
keywords="social media",
keywords="mobile app",
keywords="low-income",
keywords="engagement",
keywords="health promotion",
keywords="community",
keywords="nutrition and physical activity",
keywords="pregnancy",
keywords="breastfeeding",
keywords="maternal and child health",
keywords="mobile phone",
abstract="Background: The use of digital communication platforms to improve health behaviors has increased dramatically over the last decade. Public health practitioners have adopted digital communication technologies such as text messages, mobile apps, and social media to reach diverse populations. However, the effectiveness of digital communication platforms used by community-serving agencies remains unclear, and patterns of engagement and acceptability of different platforms have not been studied. Objective: This review aimed to identify the types of digital communication strategies used by community-serving organizations to promote healthy behaviors, assess the strength of evidence for health behavioral change, and describe the degree of consumer engagement with and acceptability of these strategies. The study population included low-income pregnant women, parents of young children, and adolescents. Methods: A systematic review was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines using PubMed, Scopus, Web of Science, CINAHL, and APA PsycInfo, covering research conducted from 2009 to 2022. Studies were included if they examined the use of digital communication (ie, texting, mobile apps, or social media) to promote healthy behaviors in the target population. Risk of bias and strength of evidence were assessed using the Effective Public Health Practice Project Risk of Bias tool and criteria from Agency for Healthcare Research and Quality, respectively. Results: Twenty-three peer-reviewed research studies published between 2012 and 2022, conducted in the United States, the United Kingdom, and Australia, were included in the review. The sample comprised studies exploring the use of texting (n=12), apps (n=6), social media (n=3), and multiple platforms (n=2; eg, texting and mobile apps). Targeted health behaviors included healthy diet, physical activity, obesity prevention, healthy pregnancy, breastfeeding, vaccine use, smoking cessation, and nutrition benefit redemption. The sample included 8 randomized controlled trials, 6 pretest-posttest design, 3 mixed methods studies, 2 pilot studies, 1 feasibility study, 1 prospective cohort study, 1 descriptive study, and 1 cross-sectional study. The median sample size was 77.5. There was no strong evidence to suggest the effectiveness of digital media campaigns in improving health behaviors; however, there were moderate to high levels of engagement and high levels of acceptability across digital platforms. Conclusions: Low-income pregnant women, parents of young children, and adolescents demonstrated moderate levels of engagement with and high levels of acceptability of digital media health campaigns conducted by community-serving agencies. The effectiveness of these strategies in improving health behaviors was inconclusive. Additional rigorous studies with larger sample sizes are required. In addition, more research is required to consistently measure and report participants' engagement with each platform. Digital communication platforms are critical tools for public health practitioners, and future investigations of the effectiveness of these platforms in engaging clients and improving health behaviors will maximize client services. ",
doi="10.2196/40934",
url="https://www.jmir.org/2023/1/e40934",
url="http://www.ncbi.nlm.nih.gov/pubmed/36735286"
}


@Article{info:doi/10.2196/36764,
author="Mamey, Rose Mary
and Schrager, M. Sheree
and Rhoades, Harmony
and Goldbach, T. Jeremy",
title="Nominal Versus Realized Costs of Recruiting and Retaining a National Sample of Sexual Minority Adolescents in the United States: Longitudinal Study",
journal="J Med Internet Res",
year="2023",
month="Feb",
day="2",
volume="25",
pages="e36764",
keywords="cost analysis",
keywords="study recruitment",
keywords="longitudinal retention",
keywords="sexual minority adolescents",
keywords="mobile phone",
abstract="Background: Web-based recruitment for research studies is becoming increasingly popular and necessary. When compared with the traditional methods of recruitment, these methods may enable researchers to reach more diverse participants in less time. Social media use is highly prevalent among adolescents, and the unique context of social media may be particularly important for the recruitment of sexual minority young people who would not be captured by traditional methods. Objective: This paper described the details of a national web-based study recruitment approach aimed at sexual minority adolescents across the United States, focusing on important details of this relatively novel approach, including cost, time efficiency, and retention outcomes. Methods: This study recruited sexual minority adolescents aged 14-17 years living in the United States through targeted advertisements on Facebook, Instagram, and YouTube and through respondent-driven sampling (RDS). Potential participants completed eligibility screening surveys and were automatically directed to a baseline survey if they were eligible. After baseline survey completion, additional data checks were implemented, and the remaining participants were contacted for recruitment into a longitudinal study (surveys every 6 months for 3 years). Results: Recruitment lasted 44 weeks, and 9843 participants accessed the initial screening survey, with 2732 (27.76\%) meeting the eligibility criteria and completing the baseline survey. Of those, 2558 (93.63\%) were determined to have provided nonfraudulent, usable study data and 1076 (39.39\%) subsequently enrolled in the longitudinal study. Of the baseline sample, 79.05\% (2022/2558) was recruited through Facebook and Instagram, 3.05\% (78/2558) through YouTube, and 17.9\% (458/2558) through RDS. The average cost of recruiting a participant into the study was US \$12.98, but the recruitment cost varied by method or platform, with a realized cost of US \$13 per participant on Facebook and Instagram, US \$24 on YouTube, and US \$10 through RDS. Participant differences (sex assigned at birth, race and ethnicity, sexual orientation, region, and urbanicity) were identified between platforms and methods both in terms of overall number of participants and cost per participant. Facebook and Instagram were the most time efficient (approximately 15 days to recruit 100 participants), whereas RDS was the least time efficient (approximately 70 days to recruit 100 participants). Participants recruited through YouTube were the most likely to be longitudinally retained, followed by Facebook and Instagram, and then RDS. Conclusions: Large differences exist in study recruitment cost and efficiency when using social media and RDS. Demographic, region, and urbanicity differences in recruitment methods highlight the need for attention to demographic diversity when planning and implementing recruitment across platforms. Finally, it is more cost-effective to retain than recruit samples, and this study provided evidence that with thorough screening and data quality practices, social media recruitment can result in diverse, highly involved study populations. ",
doi="10.2196/36764",
url="https://www.jmir.org/2023/1/e36764",
url="http://www.ncbi.nlm.nih.gov/pubmed/36729597"
}


@Article{info:doi/10.2196/42856,
author="Nuo, Mingfu
and Zheng, Shaojiang
and Wen, Qinglian
and Fang, Hongjuan
and Wang, Tong
and Liang, Jun
and Han, Hongbin
and Lei, Jianbo",
title="Mining the Influencing Factors and Their Asymmetrical Effects of mHealth Sleep App User Satisfaction From Real-world User-Generated Reviews: Content Analysis and Topic Modeling",
journal="J Med Internet Res",
year="2023",
month="Jan",
day="31",
volume="25",
pages="e42856",
keywords="sleep disorder",
keywords="mobile health applications",
keywords="topic modeling",
keywords="Herzberg's 2-factor theory",
keywords="machine learning",
abstract="Background: Sleep disorders are a global challenge, affecting a quarter of the global population. Mobile health (mHealth) sleep apps are a potential solution, but 25\% of users stop using them after a single use. User satisfaction had a significant impact on continued use intention. Objective: This China-US comparison study aimed to mine the topics discussed in user-generated reviews of mHealth sleep apps, assess the effects of the topics on user satisfaction and dissatisfaction with these apps, and provide suggestions for improving users' intentions to continue using mHealth sleep apps. Methods: An unsupervised clustering technique was used to identify the topics discussed in user reviews of mHealth sleep apps. On the basis of the two-factor theory, the Tobit model was used to explore the effect of each topic on user satisfaction and dissatisfaction, and differences in the effects were analyzed using the Wald test. Results: A total of 488,071 user reviews of 10 mainstream sleep apps were collected, including 267,589 (54.8\%) American user reviews and 220,482 (45.2\%) Chinese user reviews. The user satisfaction rates of sleep apps were poor (China: 56.58\% vs the United States: 45.87\%). We identified 14 topics in the user-generated reviews for each country. In the Chinese data, 13 topics had a significant effect on the positive deviation (PD) and negative deviation (ND) of user satisfaction. The 2 variables (PD and ND) were defined by the difference between the user rating and the overall rating of the app in the app store. Among these topics, the app's sound recording function ($\beta$=1.026; P=.004) had the largest positive effect on the PD of user satisfaction, and the topic with the largest positive effect on the ND of user satisfaction was the sleep improvement effect of the app ($\beta$=1.185; P<.001). In the American data, all 14 topics had a significant effect on the PD and ND of user satisfaction. Among these, the topic with the largest positive effect on the ND of user satisfaction was the app's sleep promotion effect ($\beta$=1.389; P<.001), whereas the app's sleep improvement effect ($\beta$=1.168; P<.001) had the largest positive effect on the PD of user satisfaction. The Wald test showed that there were significant differences in the PD and ND models of user satisfaction in both countries (all P<.05), indicating that the influencing factors of user satisfaction with mHealth sleep apps were asymmetrical. Using the China-US comparison, hygiene factors (ie, stability, compatibility, cost, and sleep monitoring function) and 2 motivation factors (ie, sleep suggestion function and sleep promotion effects) of sleep apps were identified. Conclusions: By distinguishing between the hygiene and motivation factors, the use of sleep apps in the real world can be effectively promoted. ",
doi="10.2196/42856",
url="https://www.jmir.org/2023/1/e42856",
url="http://www.ncbi.nlm.nih.gov/pubmed/36719730"
}


@Article{info:doi/10.2196/42623,
author="Park, Susan
and Suh, Young-Kyoon",
title="A Comprehensive Analysis of COVID-19 Vaccine Discourse by Vaccine Brand on Twitter in Korea: Topic and Sentiment Analysis",
journal="J Med Internet Res",
year="2023",
month="Jan",
day="31",
volume="25",
pages="e42623",
keywords="COVID-19",
keywords="vaccine",
keywords="vaccination",
keywords="Pfizer",
keywords="Moderna",
keywords="AstraZeneca",
keywords="Janssen",
keywords="Novavax",
abstract="Background: ?The unprecedented speed of COVID-19 vaccine development and approval has raised public concern about its safety. However, studies on public discourses and opinions on social media focusing on adverse events (AEs) related to COVID-19 vaccine are rare. Objective: ?This study aimed to analyze Korean tweets about COVID-19 vaccines (Pfizer, Moderna, AstraZeneca, Janssen, and Novavax) after the vaccine rollout, explore the topics and sentiments of tweets regarding COVID-19 vaccines, and examine their changes over time. We also analyzed topics and sentiments focused on AEs related to vaccination using only tweets with terms about AEs. Methods: ?We devised a sophisticated methodology consisting of 5 steps: keyword search on Twitter, data collection, data preprocessing, data analysis, and result visualization. We used the Twitter Representational State Transfer application programming interface for data collection. A total of 1,659,158 tweets were collected from February 1, 2021, to March 31, 2022. Finally, 165,984 data points were analyzed after excluding retweets, news, official announcements, advertisements, duplicates, and tweets with <2 words. We applied a variety of preprocessing techniques that are suitable for the Korean language. We ran a suite of analyses using various Python packages, such as latent Dirichlet allocation, hierarchical latent Dirichlet allocation, and sentiment analysis. Results: ?The topics related to COVID-19 vaccines have a very large spectrum, including vaccine-related AEs, emotional reactions to vaccination, vaccine development and supply, and government vaccination policies. Among them, the top major topic was AEs related to COVID-19 vaccination. The AEs ranged from the adverse reactions listed in the safety profile (eg, myalgia, fever, fatigue, injection site pain, myocarditis or pericarditis, and thrombosis) to unlisted reactions (eg, irregular menstruation, changes in appetite and sleep, leukemia, and deaths). Our results showed a notable difference in the topics for each vaccine brand. The topics pertaining to the Pfizer vaccine mainly mentioned AEs. Negative public opinion has prevailed since the early stages of vaccination. In the sentiment analysis based on vaccine brand, the topics related to the Pfizer vaccine expressed the strongest negative sentiment. Conclusions: ?Considering the discrepancy between academic evidence and public opinions related to COVID-19 vaccination, the government should provide accurate information and education. Furthermore, our study suggests the need for management to correct the misinformation related to vaccine-related AEs, especially those affecting negative sentiments. This study provides valuable insights into the public discourses and opinions regarding COVID-19 vaccination. ",
doi="10.2196/42623",
url="https://www.jmir.org/2023/1/e42623",
url="http://www.ncbi.nlm.nih.gov/pubmed/36603153"
}


@Article{info:doi/10.2196/41823,
author="Han, Nuo
and Li, Sijia
and Huang, Feng
and Wen, Yeye
and Wang, Xiaoyang
and Liu, Xiaoqian
and Li, Linyan
and Zhu, Tingshao",
title="Sensing Psychological Well-being Using Social Media Language: Prediction Model Development Study",
journal="J Med Internet Res",
year="2023",
month="Jan",
day="31",
volume="25",
pages="e41823",
keywords="mental health",
keywords="psychological well-being",
keywords="social media",
keywords="machine learning",
keywords="domain knowledge",
keywords="mental well being",
keywords="mental wellbeing",
keywords="linguistic",
keywords="predict",
keywords="model",
keywords="ground truth",
keywords="lexicon",
abstract="Background: Positive mental health is arguably increasingly important and can be revealed, to some extent, in terms of psychological well-being (PWB). However, PWB is difficult to assess in real time on a large scale. The popularity and proliferation of social media make it possible to sense and monitor online users' PWB in a nonintrusive way, and the objective of this study is to test the effectiveness of using social media language expression as a predictor of PWB. Objective: This study aims to investigate the predictive power of social media corresponding to ground truth well-being data in a psychological way. Methods: We recruited 1427 participants. Their well-being was evaluated using 6 dimensions of PWB. Their posts on social media were collected, and 6 psychological lexicons were used to extract linguistic features. A multiobjective prediction model was then built with the extracted linguistic features as input and PWB as the output. Further, the validity of the prediction model was confirmed by evaluating the model's discriminant validity, convergent validity, and criterion validity. The reliability of the model was also confirmed by evaluating the split-half reliability. Results: The correlation coefficients between the predicted PWB scores of social media users and the actual scores obtained using the linguistic prediction model of this study were between 0.49 and 0.54 (P<.001), which means that the model had good criterion validity. In terms of the model's structural validity, it exhibited excellent convergent validity but less than satisfactory discriminant validity. The results also suggested that our model had good split-half reliability levels for every dimension (ranging from 0.65 to 0.85; P<.001). Conclusions: By confirming the availability and stability of the linguistic prediction model, this study verified the predictability of social media corresponding to ground truth well-being data from the perspective of PWB. Our study has positive implications for the use of social media to predict mental health in nonprofessional settings such as self-testing or a large-scale user study. ",
doi="10.2196/41823",
url="https://www.jmir.org/2023/1/e41823",
url="http://www.ncbi.nlm.nih.gov/pubmed/36719723"
}


@Article{info:doi/10.2196/40922,
author="Chin, Hyojin
and Lima, Gabriel
and Shin, Mingi
and Zhunis, Assem
and Cha, Chiyoung
and Choi, Junghoi
and Cha, Meeyoung",
title="User-Chatbot Conversations During the COVID-19 Pandemic: Study Based on Topic Modeling and Sentiment Analysis",
journal="J Med Internet Res",
year="2023",
month="Jan",
day="27",
volume="25",
pages="e40922",
keywords="chatbot",
keywords="COVID-19",
keywords="topic modeling",
keywords="sentiment analysis",
keywords="infodemiology",
keywords="discourse",
keywords="public perception",
keywords="public health",
keywords="infoveillance",
keywords="conversational agent",
keywords="global health",
keywords="health information",
abstract="Background: Chatbots have become a promising tool to support public health initiatives. Despite their potential, little research has examined how individuals interacted with chatbots during the COVID-19 pandemic. Understanding user-chatbot interactions is crucial for developing services that can respond to people's needs during a global health emergency. Objective: This study examined the COVID-19 pandemic--related topics online users discussed with a commercially available social chatbot and compared the sentiment expressed by users from 5 culturally different countries. Methods: We analyzed 19,782 conversation utterances related to COVID-19 covering 5 countries (the United States, the United Kingdom, Canada, Malaysia, and the Philippines) between 2020 and 2021, from SimSimi, one of the world's largest open-domain social chatbots. We identified chat topics using natural language processing methods and analyzed their emotional sentiments. Additionally, we compared the topic and sentiment variations in the COVID-19--related chats across countries. Results: Our analysis identified 18 emerging topics, which could be categorized into the following 5 overarching themes: ``Questions on COVID-19 asked to the chatbot'' (30.6\%), ``Preventive behaviors'' (25.3\%), ``Outbreak of COVID-19'' (16.4\%), ``Physical and psychological impact of COVID-19'' (16.0\%), and ``People and life in the pandemic'' (11.7\%). Our data indicated that people considered chatbots as a source of information about the pandemic, for example, by asking health-related questions. Users turned to SimSimi for conversation and emotional messages when offline social interactions became limited during the lockdown period. Users were more likely to express negative sentiments when conversing about topics related to masks, lockdowns, case counts, and their worries about the pandemic. In contrast, small talk with the chatbot was largely accompanied by positive sentiment. We also found cultural differences, with negative words being used more often by users in the United States than by those in Asia when talking about COVID-19. Conclusions: Based on the analysis of user-chatbot interactions on a live platform, this work provides insights into people's informational and emotional needs during a global health crisis. Users sought health-related information and shared emotional messages with the chatbot, indicating the potential use of chatbots to provide accurate health information and emotional support. Future research can look into different support strategies that align with the direction of public health policy. ",
doi="10.2196/40922",
url="https://www.jmir.org/2023/1/e40922",
url="http://www.ncbi.nlm.nih.gov/pubmed/36596214"
}


@Article{info:doi/10.2196/43174,
author="Perakslis, Eric
and Quintana, Yuri",
title="Social Media is Addictive and Influences Behavior: Should it Be Regulated as a Digital Therapeutic?",
journal="J Med Internet Res",
year="2023",
month="Jan",
day="26",
volume="25",
pages="e43174",
keywords="social media",
keywords="mental health",
keywords="suicide",
keywords="health policy",
keywords="addictions",
keywords="youth mental health",
keywords="FDA",
keywords="Food and Drug Administration",
keywords="Canada",
keywords="United Kingdom",
keywords="United States",
keywords="European Union",
keywords="privacy",
keywords="security",
keywords="adverse event",
doi="10.2196/43174",
url="https://www.jmir.org/2023/1/e43174",
url="http://www.ncbi.nlm.nih.gov/pubmed/36701180"
}


@Article{info:doi/10.2196/42162,
author="Cuomo, Raphael
and Purushothaman, Vidya
and Calac, J. Alec
and McMann, Tiana
and Li, Zhuoran
and Mackey, Tim",
title="Estimating County-Level Overdose Rates Using Opioid-Related Twitter Data: Interdisciplinary Infodemiology Study",
journal="JMIR Form Res",
year="2023",
month="Jan",
day="25",
volume="7",
pages="e42162",
keywords="overdose",
keywords="mortality",
keywords="geospatial analysis",
keywords="social media",
keywords="drug overuse",
keywords="substance use",
keywords="social media data",
keywords="mortality estimates",
keywords="real-time data",
keywords="public health data",
keywords="demographic variables",
keywords="county-level",
abstract="Background: There were an estimated 100,306 drug overdose deaths between April 2020 and April 2021, a three-quarter increase from the prior 12-month period. There is an approximate 6-month reporting lag for provisional counts of drug overdose deaths from the National Vital Statistics System, and the highest level of geospatial resolution is at the state level. By contrast, public social media data are available close to real-time and are often accessible with precise coordinates. Objective: The purpose of this study is to assess whether county-level overdose mortality burden could be estimated using opioid-related Twitter data. Methods: International Classification of Diseases (ICD) codes for poisoning or exposure to overdose at the county level were obtained from CDC WONDER. Demographics were collected from the American Community Survey. The Twitter Application Programming Interface was used to obtain tweets that contained any of the 36 terms with drug names. An unsupervised classification approach was used for clustering tweets. Population-normalized variables and polynomial population-normalized variables were produced. Furthermore, z scores of the Getis Ord Gi clustering statistic were produced, and both these scores and their polynomial counterparts were explored in regression modeling of county-level overdose mortality burden. A series of linear regression models were used for predictive modeling to explore the interpretability of the analytical output. Results: Modeling overdose mortality with normalized demographic variables alone explained only 7.4\% of the variability in county-level overdose mortality, whereas this was approximately doubled by the use of specific demographic and Twitter data covariates based on a backward selection approach. The highest adjusted R2 and lowest AIC (Akaike Info Criterion) were obtained for the model with normalized demographic variables, normalized z scores from geospatial analyses, and normalized topic counts (adjusted R2=0.133, AIC=8546.8). The z scores of the Getis Ord Gi statistic appeared to have improved utility over population-normalization alone. In this model, median age, female population, and tweets about web-based drug sales were positively associated with opioid mortality. Asian race and Hispanic ethnicity were significantly negatively associated with county-level burdens of overdose mortality. Conclusions: Social media data, when transformed using certain statistical approaches, may add utility to the goal of producing closer to real-time county-level estimates of overdose mortality. Prediction of opioid-related outcomes can be advanced to inform prevention and treatment decisions. This interdisciplinary approach can facilitate evidence-based funding decisions for various substance use disorder prevention and treatment programs. ",
doi="10.2196/42162",
url="https://formative.jmir.org/2023/1/e42162",
url="http://www.ncbi.nlm.nih.gov/pubmed/36548118"
}


@Article{info:doi/10.2196/37289,
author="Dysthe, Kristoffer Kim
and R{\o}ssberg, Ivar Jan
and Brandtzaeg, Bae Petter
and Skjuve, Marita
and Haavet, Rikard Ole
and F{\o}lstad, Asbj{\o}rn
and Klovning, Atle",
title="Analyzing User-Generated Web-Based Posts of Adolescents' Emotional, Behavioral, and Symptom Responses to Beliefs About Depression: Qualitative Thematic Analysis",
journal="J Med Internet Res",
year="2023",
month="Jan",
day="24",
volume="25",
pages="e37289",
keywords="adolescent",
keywords="depression",
keywords="internet",
keywords="education",
keywords="preventive psychiatry",
keywords="early medical intervention",
keywords="health literacy",
keywords="cognitive behavioral therapy",
abstract="Background: Depression is common during adolescence. Early intervention can prevent it from developing into more progressive mental disorders. Combining information technology and clinical psychoeducation is a promising way to intervene at an earlier stage. However, data-driven research on the cognitive response to health information targeting adolescents with symptoms of depression is lacking. Objective: This study aimed to fill this knowledge gap through a new understanding of adolescents' cognitive response to health information about depression. This knowledge can help to develop population-specific information technology, such as chatbots, in addition to clinical therapeutic tools for use in general practice. Methods: The data set consists of 1870 depression-related questions posted by adolescents on a public web-based information service. Most of the posts contain descriptions of events that lead to depression. On a sample of 100 posts, we conducted a qualitative thematic analysis based on cognitive behavioral theory investigating behavioral, emotional, and symptom responses to beliefs associated with depression. Results: Results were organized into four themes. (1) Hopelessness, appearing as a set of negative beliefs about the future, possibly results from erroneous beliefs about the causal link between risk factors and the course of depression. We found beliefs about establishing a sturdy therapy alliance as a responsibility resting on the patient. (2) Therapy hesitancy seemed to be associated with negative beliefs about therapy prognosis and doubts about confidentiality. (3) Social shame appeared as a consequence of impaired daily function when the cause is not acknowledged. (4) Failing to attain social interaction appeared to be associated with a negative symptom response. In contrast, actively obtaining social support reduces symptoms and suicidal thoughts. Conclusions: These results could be used to meet the clinical aims stated by earlier psychoeducation development, such as instilling hope through direct reattribution of beliefs about the future; challenging causal attributions, thereby lowering therapy hesitancy; reducing shame through the mechanisms of externalization by providing a tentative diagnosis despite the risk of stigmatizing; and providing initial symptom relief by giving advice on how to open up and reveal themselves to friends and family and balance the message of self-management to fit coping capabilities. An active counseling style advises the patient to approach the social environment, demonstrating an attitude toward self-action. ",
doi="10.2196/37289",
url="https://www.jmir.org/2023/1/e37289",
url="http://www.ncbi.nlm.nih.gov/pubmed/36692944"
}


@Article{info:doi/10.2196/43627,
author="Escobar-Viera, C{\'e}sar
and Coulter, S. Robert W.
and Friedman, Reuel M.
and Thoma, Brian
and Switzer, E. Galen
and Martina, Jamie
and Egan, Erin James
and Primack, Brian",
title="The Influence of Social Media Interactions and Behaviors on Depressive Symptoms Among Sexual and Gender Minority Young Adults in the United States: Protocol for a Mixed Methods Longitudinal Study",
journal="JMIR Res Protoc",
year="2023",
month="Jan",
day="24",
volume="12",
pages="e43627",
keywords="mixed methods",
keywords="longitudinal",
keywords="depression",
keywords="sexual and gender minorities",
keywords="social media",
abstract="Background: Sexual and gender minority (SGM; ie, lesbian, gay, bisexual, transgender, and otherwise queer) young adults experience disparities in depression and other internalizing psychopathology. Although social media use is widespread and SGM people have more social media accounts and are more socially active on them than non-SGM individuals, few studies have examined the impact of social media on depression in this group. Objective: The PRIDE iM study will be the first longitudinal, mixed methods research conducted to determine the impact of social media interactions and behaviors as pathways to depressive symptoms among SGM young adults living in the United States. Methods: PRIDE iM uses a bookends variation of the longitudinal sequential mixed methods design. Participants will be recruited nationally from social media. First, between July 2019 and February 2020, we conducted a qualitative phase (T1) comprising web-based individual interviews (N=58) to inform the building and content of the quantitative survey. Second, from February 2022 to September 2022, we will conduct a series of web-based surveys (N=1000 at baseline) with 4 data points (T2-T5), each one collected every 6 to 8 weeks. Third, from October 2022 to December 2022, we will conduct a second qualitative phase (T6) of web-based interviews using outcome trajectories found in the longitudinal survey analyses to purposively sample survey participants and conduct web-based interviews to contextualize and explain survey findings. Qualitative data from T1 and T6 will be analyzed using a reflexive thematic analysis approach. As we sought to capture change over time in the association between the main predictors (ie, social media interactions and behaviors) and depressive symptoms, we propose analyzing T2 to T5 data using latent growth models with a structural equation modeling framework. Data integration at the method, interpretation, and reporting levels will be achieved through building and connecting and the use of a staged approach and joint displays, respectively. At all stages, we will assess the fit of data integration as recommended by the principles of best practice for mixed methods research in psychology. Results: Data collection will be completed by December 2022. Qualitative data analyses will be completed by March 2023, and quantitative analyses of the primary outcome of interest will be completed by June 2023. Conclusions: PRIDE iM will confirm, reject, or uncover the presence of potential relationships between social media interactions and behaviors and depressive symptoms among SGM people. This study represents fundamental groundwork to develop social media--based interventions that target modifiable interactions and behaviors that are most likely to influence mental health outcomes, thus seizing the opportunity to merge the popularity of this medium among SGM people with evidence-based approaches. International Registered Report Identifier (IRRID): DERR1-10.2196/43627 ",
doi="10.2196/43627",
url="https://www.researchprotocols.org/2023/1/e43627",
url="http://www.ncbi.nlm.nih.gov/pubmed/36692929"
}


@Article{info:doi/10.2196/39640,
author="Manne, Sharon
and Pagoto, Sherry
and Peterson, Susan
and Heckman, Carolyn
and Kashy, Deborah
and Berger, Adam
and Studts, Christina
and Negr{\'o}n, Rosalyn
and Buller, David
and Paddock, Lisa
and Gallo, Joseph
and Kulik, Alexandria
and Frederick, Sara
and Pesanelli, Morgan
and Domider, Mara
and Grosso, Marissa",
title="Facebook Intervention for Young-Onset Melanoma Survivors and Families: Protocol for a Randomized Controlled Trial",
journal="JMIR Res Protoc",
year="2023",
month="Jan",
day="24",
volume="12",
pages="e39640",
keywords="cancer survivors",
keywords="melanoma survivors",
keywords="skin self-examination",
keywords="clinical skin examination",
keywords="sun protection",
keywords="behavioral intervention",
keywords="social media",
abstract="Background: Individuals diagnosed with melanoma before the age of 40 years (young-onset melanoma survivors) and their first-degree relatives (FDRs) are a growing population at risk for developing recurrent melanoma or new melanomas. Regular surveillance using clinical skin examination (CSE) and skin self-examination (SSE) and engagement in preventive behaviors including sun protection are recommended. Given the growing population of survivors and their families who are at increased risk, it is surprising that no behavioral interventions have been developed and evaluated to improve risk-reduction behaviors. Objective: We describe the rationale and methodology for a randomized controlled trial evaluating the efficacy of a Facebook intervention providing information, goal setting, and peer support to increase CSE, SSE, and sun protection for young-onset melanoma survivors and their FDRs. Methods: Overall, 577 survivors and 577 FDRs will be randomly assigned to either the Young Melanoma Family Facebook Group or the Melanoma Family Healthy Lifestyle Facebook Group condition. Participants will complete measures of CSE, SSE, and sun protection, and mediator measures of attitudes and beliefs before and after the intervention. The primary aim is to evaluate the impact of the Young Melanoma Family Facebook intervention versus the Melanoma Family Healthy Lifestyle Facebook intervention on CSE, SSE frequency and comprehensiveness, and sun protection among FDRs. The secondary aims examine the efficacy of the Young Melanoma Family Facebook intervention on survivors' SSE frequency and comprehensiveness and sun protection behaviors and mechanisms of intervention efficacy for intervention impact on FDR and survivor outcomes. The exploratory aim is to evaluate the efficacy of the 2 interventions on perceived stress, physical activity, and healthy eating. Results: This project was funded by the National Institutes of Health (R01CA221854). The project began in May 2018, and recruitment started in January 2019. We anticipate completing enrollment by November 2023. Power calculations recommended a sample size of 577 survivors and 577 FDRs. Multilevel modeling treating family as the upper-level sampling unit and individual as the lower-level sampling unit will be the primary data analytic approach. Fixed effect predictors in these models will include condition, role, sex, all 2- and 3-way interactions, and covariates. Conclusions: The Young Melanoma Family Facebook intervention aims to improve primary and secondary skin cancer prevention for young-onset melanoma survivors and their family members. The intervention's delivery via a popular, freely available social media platform increases its impact because of the potential for dissemination in many contexts. If efficacious, this program could be disseminated by dermatologist practices, public health or nonprofit organizations focused on melanoma, and existing melanoma and skin cancer Facebook groups, thereby expanding its reach. This project will produce a content library of posts and a moderation guide for others. Trial Registration: ClinicalTrials.gov NCT03677739; https://clinicaltrials.gov/ct2/show/NCT03677739 International Registered Report Identifier (IRRID): DERR1-10.2196/39640 ",
doi="10.2196/39640",
url="https://www.researchprotocols.org/2023/1/e39640",
url="http://www.ncbi.nlm.nih.gov/pubmed/36692933"
}


@Article{info:doi/10.2196/38390,
author="Turner, Jason
and Kantardzic, Mehmed
and Vickers-Smith, Rachel
and Brown, G. Andrew",
title="Detecting Tweets Containing Cannabidiol-Related COVID-19 Misinformation Using Transformer Language Models and Warning Letters From Food and Drug Administration: Content Analysis and Identification",
journal="JMIR Infodemiology",
year="2023",
month="Jan",
day="23",
volume="3",
pages="e38390",
keywords="transformer",
keywords="misinformation",
keywords="deep learning",
keywords="COVID-19",
keywords="infodemic",
keywords="pandemic",
keywords="language model",
keywords="health information",
keywords="social media",
keywords="Twitter",
keywords="content analysis",
keywords="cannabidiol",
keywords="sentence vector",
keywords="infodemiology",
abstract="Background: COVID-19 has introduced yet another opportunity to web-based sellers of loosely regulated substances, such as cannabidiol (CBD), to promote sales under false pretenses of curing the disease. Therefore, it has become necessary to innovate ways to identify such instances of misinformation. Objective: We sought to identify COVID-19 misinformation as it relates to the sales or promotion of CBD and used transformer-based language models to identify tweets semantically similar to quotes taken from known instances of misinformation. In this case, the known misinformation was the publicly available Warning Letters from Food and Drug Administration (FDA). Methods: We collected tweets using CBD- and COVID-19--related terms. Using a previously trained model, we extracted the tweets indicating commercialization and sales of CBD and annotated those containing COVID-19 misinformation according to the FDA definitions. We encoded the collection of tweets and misinformation quotes into sentence vectors and then calculated the cosine similarity between each quote and each tweet. This allowed us to establish a threshold to identify tweets that were making false claims regarding CBD and COVID-19 while minimizing the instances of false positives. Results: We demonstrated that by using quotes taken from Warning Letters issued by FDA to perpetrators of similar misinformation, we can identify semantically similar tweets that also contain misinformation. This was accomplished by identifying a cosine distance threshold between the sentence vectors of the Warning Letters and tweets. Conclusions: This research shows that commercial CBD or COVID-19 misinformation can potentially be identified and curbed using transformer-based language models and known prior instances of misinformation. Our approach functions without the need for labeled data, potentially reducing the time at which misinformation can be identified. Our approach shows promise in that it is easily adapted to identify other forms of misinformation related to loosely regulated substances. ",
doi="10.2196/38390",
url="https://infodemiology.jmir.org/2023/1/e38390",
url="http://www.ncbi.nlm.nih.gov/pubmed/36844029"
}


@Article{info:doi/10.2196/38630,
author="Hanna, J. John
and Saleh, N. Sameh
and Lehmann, U. Christoph
and Nijhawan, E. Ank
and Medford, J. Richard",
title="Reaching Populations at Risk for HIV Through Targeted Facebook Advertisements: Cost-Consequence Analysis",
journal="JMIR Form Res",
year="2023",
month="Jan",
day="20",
volume="7",
pages="e38630",
keywords="human immunodeficiency virus",
keywords="social media",
keywords="Facebook",
keywords="health behavior",
keywords="health care seeking behavior",
keywords="consumer health",
keywords="HIV diagnosis",
keywords="HIV testing",
abstract="Background: An undiagnosed HIV infection remains a public health challenge. In the digital era, social media and digital health communication have been widely used to accelerate research, improve consumer health, and facilitate public health interventions including HIV prevention. Objective: We aimed to evaluate and compare the projected cost and efficacy of different simulated Facebook (FB) advertisement (ad) approaches targeting at-risk populations for HIV based on new HIV diagnosis rates by age group and geographic region in the United States. Methods: We used the FB ad platform to simulate (without actually launching) an automatically placed video ad for a 10-day duration targeting at-risk populations for HIV. We compared the estimated total ad audience, daily reach, daily clicks, and cost. We tested ads for the age group of 13 to 24 years (in which undiagnosed HIV is most prevalent), other age groups, US geographic regions and states, and different campaign budgets. We then estimated the ad cost per new HIV diagnosis based on HIV positivity rates and the average health care industry conversion rate. Results: On April 20, 2021, the potential reach of targeted ads to at-risk populations for HIV in the United States was approximately 16 million for all age groups and 3.3 million for age group 13 to 24 years, with the highest potential reach in California, Texas, Florida, and New York. When using different FB ad budgets, the daily reach and daily clicks per US dollar followed a cumulative distribution curve of an exponential function. Using multiple US \$10 ten-day ads, the cost per every new HIV diagnosis ranged from US \$13.09 to US \$37.82, with an average cost of US \$19.45. In contrast, a 1-time national ad had a cost of US \$72.76 to US \$452.25 per new HIV diagnosis (mean US \$166.79). The estimated cost per new HIV diagnosis ranged from US \$13.96 to US \$55.10 for all age groups (highest potential reach and lowest cost in the age groups 20-29 and 30-39 years) and from US \$12.55 to US \$24.67 for all US regions (with the highest potential reach of 6.2 million and the lowest cost per new HIV diagnosis at US \$12.55 in the US South). Conclusions: Targeted personalized FB ads are a potential means to encourage at-risk populations for HIV to be tested, especially those aged 20 to 39 years in the US South, where the disease burden and potential reach on FB are high and the ad cost per new HIV diagnosis is low. Considering the cost efficiency of ads, the combined cost of multiple low-cost ads may be more economical than a single high-cost ad, suggesting that local FB ads could be more cost-effective than a single large-budget national FB ad. ",
doi="10.2196/38630",
url="https://formative.jmir.org/2023/1/e38630",
url="http://www.ncbi.nlm.nih.gov/pubmed/36662551"
}


@Article{info:doi/10.2196/43521,
author="Kim, Donghun
and Jung, Woojin
and Jiang, Ting
and Zhu, Yongjun",
title="An Exploratory Study of Medical Journal's Twitter Use: Metadata, Networks, and Content Analyses",
journal="J Med Internet Res",
year="2023",
month="Jan",
day="19",
volume="25",
pages="e43521",
keywords="medical journals",
keywords="social networks",
keywords="Twitter",
abstract="Background: An increasing number of medical journals are using social media to promote themselves and communicate with their readers. However, little is known about how medical journals use Twitter and what their social media management strategies are. Objective: This study aimed to understand how medical journals use Twitter from a global standpoint. We conducted a broad, in-depth analysis of all the available Twitter accounts of medical journals indexed by major indexing services, with a particular focus on their social networks and content. Methods: The Twitter profiles and metadata of medical journals were analyzed along with the social networks on their Twitter accounts. Results: The results showed that overall, publishers used different strategies regarding Twitter adoption, Twitter use patterns, and their subsequent decisions. The following specific findings were noted: journals with Twitter accounts had a significantly higher number of publications and a greater impact than their counterparts; subscription journals had a slightly higher Twitter adoption rate (2\%) than open access journals; journals with higher impact had more followers; and prestigious journals rarely followed other lesser-known journals on social media. In addition, an in-depth analysis of 2000 randomly selected tweets from 4 prestigious journals revealed that The Lancet had dedicated considerable effort to communicating with people about health information and fulfilling its social responsibility by organizing committees and activities to engage with a broad range of health-related issues; The New England Journal of Medicine and the Journal of the American Medical Association focused on promoting research articles and attempting to maximize the visibility of their research articles; and the British Medical Journal provided copious amounts of health information and discussed various health-related social problems to increase social awareness of the field of medicine. Conclusions: Our study used various perspectives to investigate how medical journals use Twitter and explored the Twitter management strategies of 4 of the most prestigious journals. Our study provides a detailed understanding of medical journals' use of Twitter from various perspectives and can help publishers, journals, and researchers to better use Twitter for their respective purposes. ",
doi="10.2196/43521",
url="https://www.jmir.org/2023/1/e43521",
url="http://www.ncbi.nlm.nih.gov/pubmed/36656626"
}


@Article{info:doi/10.2196/44697,
author="Ji-Xu, Antonio
and Htet, Zin Kyaw
and Leslie, S. Kieron",
title="Monkeypox Content on TikTok: Cross-sectional Analysis",
journal="J Med Internet Res",
year="2023",
month="Jan",
day="17",
volume="25",
pages="e44697",
keywords="TikTok",
keywords="social media",
keywords="monkeypox",
keywords="mpox",
keywords="pandemic",
keywords="epidemic",
keywords="infectious disease",
keywords="outbreak",
keywords="quality assessment",
keywords="content analysis",
doi="10.2196/44697",
url="https://www.jmir.org/2023/1/e44697",
url="http://www.ncbi.nlm.nih.gov/pubmed/36649057"
}


@Article{info:doi/10.2196/38112,
author="Meyerson, U. William
and Fineberg, K. Sarah
and Song, Kyung Ye
and Faber, Adam
and Ash, Garrett
and Andrade, C. Fernanda
and Corlett, Philip
and Gerstein, B. Mark
and Hoyle, H. Rick",
title="Estimation of Bedtimes of Reddit Users: Integrated Analysis of Time Stamps and Surveys",
journal="JMIR Form Res",
year="2023",
month="Jan",
day="17",
volume="7",
pages="e38112",
keywords="social media",
keywords="sleep",
keywords="parametric models",
keywords="Reddit",
keywords="observational model",
keywords="research tool",
keywords="sleep patterns",
keywords="usage data",
keywords="model",
keywords="bedtime",
abstract="Background: Individuals with later bedtimes have an increased risk of difficulties with mood and substances. To investigate the causes and consequences of late bedtimes and other sleep patterns, researchers are exploring social media as a data source. Pioneering studies inferred sleep patterns directly from social media data. While innovative, these efforts are variously unscalable, context dependent, confined to specific sleep parameters, or rest on untested assumptions, and none of the reviewed studies apply to the popular Reddit platform or release software to the research community. Objective: This study builds on this prior work. We estimate the bedtimes of Reddit users from the times tamps of their posts, test inference validity against survey data, and release our model as an R package (The R Foundation). Methods: We included 159 sufficiently active Reddit users with known time zones and known, nonanomalous bedtimes, together with the time stamps of their 2.1 million posts. The model's form was chosen by visualizing the aggregate distribution of the timing of users' posts relative to their reported bedtimes. The chosen model represents a user's frequency of Reddit posting by time of day, with a flat portion before bedtime and a quadratic depletion that begins near the user's bedtime, with parameters fitted to the data. This model estimates the bedtimes of individual Reddit users from the time stamps of their posts. Model performance is assessed through k-fold cross-validation. We then apply the model to estimate the bedtimes of 51,372 sufficiently active, nonbot Reddit users with known time zones from the time stamps of their 140 million posts. Results: The Pearson correlation between expected and observed Reddit posting frequencies in our model was 0.997 on aggregate data. On average, posting starts declining 45 minutes before bedtime, reaches a nadir 4.75 hours after bedtime that is 87\% lower than the daytime rate, and returns to baseline 10.25 hours after bedtime. The Pearson correlation between inferred and reported bedtimes for individual users was 0.61 (P<.001). In 90 of 159 cases (56.6\%), our estimate was within 1 hour of the reported bedtime; 128 cases (80.5\%) were within 2 hours. There was equivalent accuracy in hold-out sets versus training sets of k-fold cross-validation, arguing against overfitting. The model was more accurate than a random forest approach. Conclusions: We uncovered a simple, reproducible relationship between Reddit users' reported bedtimes and the time of day when high daytime posting rates transition to low nighttime posting rates. We captured this relationship in a model that estimates users' bedtimes from the time stamps of their posts. Limitations include applicability only to users who post frequently, the requirement for time zone data, and limits on generalizability. Nonetheless, it is a step forward for inferring the sleep parameters of social media users passively at scale. Our model and precomputed estimated bedtimes of 50,000 Reddit users are freely available. ",
doi="10.2196/38112",
url="https://formative.jmir.org/2023/1/e38112",
url="http://www.ncbi.nlm.nih.gov/pubmed/36649054"
}


@Article{info:doi/10.2196/39206,
author="Rutter, A. Lauren
and Howard, Jacqueline
and Lakhan, Prabhvir
and Valdez, Danny
and Bollen, Johan
and Lorenzo-Luaces, Lorenzo",
title="``I Haven't Been Diagnosed, but I Should Be''---Insight Into Self-diagnoses of Common Mental Health Disorders: Cross-sectional Study",
journal="JMIR Form Res",
year="2023",
month="Jan",
day="13",
volume="7",
pages="e39206",
keywords="assessment",
keywords="depression",
keywords="anxiety",
keywords="self-report",
keywords="social media",
abstract="Background: In recent years, social media has become a rich source of mental health data. However, there is a lack of web-based research on the accuracy and validity of self-reported diagnostic information available on the web. Objective: An analysis of the degree of correspondence between self-reported diagnoses and clinical indicators will afford researchers and clinicians higher levels of trust in social media analyses. We hypothesized that self-reported diagnoses would correspond to validated disorder-specific severity questionnaires across 2 large web-based samples. Methods: The participants of study 1 were 1123 adults from a national Qualtrics panel (mean age 34.65, SD 12.56 years; n=635, 56.65\% female participants,). The participants of study 2 were 2237 college students from a large university in the Midwest (mean age 19.08, SD 2.75 years; n=1761, 75.35\% female participants). All participants completed a web-based survey on their mental health, social media use, and demographic information. Additionally, the participants reported whether they had ever been diagnosed with a series of disorders, with the option of selecting ``Yes''; ``No, but I should be''; ``I don't know''; or ``No'' for each condition. We conducted a series of ANOVA tests to determine whether there were differences among the 4 diagnostic groups and used post hoc Tukey tests to examine the nature of the differences. Results: In study 1, for self-reported mania (F3,1097=2.75; P=.04), somatic symptom disorder (F3,1060=26.75; P<.001), and alcohol use disorder (F3,1097=77.73; P<.001), the pattern of mean differences did not suggest that the individuals were accurate in their self-diagnoses. In study 2, for all disorders but bipolar disorder (F3,659=1.43; P=.23), ANOVA results were consistent with our expectations. Across both studies and for most conditions assessed, the individuals who said that they had been diagnosed with a disorder had the highest severity scores on self-report questionnaires, but this was closely followed by individuals who had not been diagnosed but believed that they should be diagnosed. This was especially true for depression, generalized anxiety, and insomnia. For mania and bipolar disorder, the questionnaire scores did not differentiate individuals who had been diagnosed from those who had not. Conclusions: In general, if an individual believes that they should be diagnosed with an internalizing disorder, they are experiencing a degree of psychopathology similar to those who have already been diagnosed. Self-reported diagnoses correspond well with symptom severity on a continuum and can be trusted as clinical indicators, especially in common internalizing disorders such as depression and generalized anxiety disorder. Researchers can put more faith into patient self-reports, including those in web-based experiments such as social media posts, when individuals report diagnoses of depression and anxiety disorders. However, replication and further study are recommended. ",
doi="10.2196/39206",
url="https://formative.jmir.org/2023/1/e39206",
url="http://www.ncbi.nlm.nih.gov/pubmed/36637885"
}


@Article{info:doi/10.2196/44175,
author="Delgado-Ron, Andr{\'e}s Jorge
and Jeyabalan, Thiyaana
and Watt, Sarah
and Black, St{\'e}phanie
and Gumprich, Martha
and Salway, Travis",
title="Sampling Sexual and Gender Minority Youth With UnACoRN (Understanding Affirming Communities, Relationships, and Networks): Lessons From a Web-Based Survey",
journal="J Med Internet Res",
year="2023",
month="Jan",
day="12",
volume="25",
pages="e44175",
keywords="sexual and gender minorities",
keywords="transgender persons",
keywords="sexual orientation",
keywords="conversion therapy",
keywords="web-based survey",
keywords="surveys and questionnaires",
keywords="adolescence",
keywords="sexual minority youth",
keywords="transgender youth",
keywords="same-sex attraction",
keywords="gender minority",
keywords="health inequality",
keywords="online recruitment",
keywords="advertisement",
keywords="social media recruitment",
abstract="Background: Periodic surveys of sexual and gender minority (SGM) populations are essential for monitoring and investigating health inequities. Recent legislative efforts to ban so-called conversion therapy make it necessary to adapt youth surveys to reach a wider range of SGM populations, including those <18 years of age and those who may not adopt an explicit two-spirit, lesbian, gay, bisexual, transgender, and queer (2S/LGBTQ) identity. Objective: We aimed to share our experiences in recruiting SGM youth through multiple in-person and online channels and to share lessons learned for future researchers. Methods: The Understanding Affirming Communities, Relationships, and Networks (UnACoRN) web-based survey collected anonymous data in English and French from 9679 mostly SGM respondents in the United States and Canada. Respondents were recruited from March 2022 to August 2022 using word-of-mouth referrals, leaflet distribution, bus advertisements, and paid and unpaid campaigns on social media and a pornography website. We analyzed the metadata provided by these and other online resources we used for recruitment (eg, Bitly and Qualtrics) and describe the campaign's effectiveness by recruitment venue based on calculating the cost per completed survey and other secondary metrics. Results: Most participants were recruited through Meta (13,741/16,533, 83.1\%), mainly through Instagram; 88.96\% (visitors: 14,888/18,179) of our sample reached the survey through paid advertisements. Overall, the cost per survey was lower for Meta than Pornhub or the bus advertisements. Similarly, the proportion of visitors who started the survey was higher for Meta (8492/18,179, 46.7\%) than Pornhub (58/18,179, 1.02\%). Our subsample of 7037 residents of Canada had a similar geographic distribution to the general population, with an average absolute difference in proportion by province or territory of 1.4\% compared to the Canadian census. Our US subsample included 2521 participants from all US states and the District of Columbia. A total of CAD \$8571.58 (the currency exchange rate was US \$1=CAD \$1.25) was spent across 4 paid recruitment channels (Facebook, Instagram, PornHub, and bus advertisements). The most cost-effective tool of recruitment was Instagram, with an average cost per completed survey of CAD \$1.48. Conclusions: UnACoRN recruited nearly 10,000 SGM youth in the United States and Canada, and the cost per survey was CAD \$1.48. Researchers using online recruitment strategies should be aware of the differences in campaign management each website or social media platform offers and be prepared to engage with their framing (content selection and delivery) to correct any imbalances derived from it. Those who focus on SGM populations should consider how 2S/LGBTQ-oriented campaigns might deter participation from cisgender or heterosexual people or SGM people not identifying as 2S/LGBTQ, if relevant to their research design. Finally, those with limited resources may select fewer venues with lower cost per completed survey or that appeal more to their specific audience, if needed. ",
doi="10.2196/44175",
url="https://www.jmir.org/2023/1/e44175",
url="http://www.ncbi.nlm.nih.gov/pubmed/36633900"
}


@Article{info:doi/10.2196/34132,
author="Li, Yongjie
and Yan, Xiangyu
and Wang, Zekun
and Ma, Mingchang
and Zhang, Bo
and Jia, Zhongwei",
title="Comparison of the Users' Attitudes Toward Cannabidiol on Social Media Platforms: Topic Modeling Study",
journal="JMIR Public Health Surveill",
year="2023",
month="Jan",
day="11",
volume="9",
pages="e34132",
keywords="cannabidiol",
keywords="drug policy",
keywords="latent Dirichlet allocation",
keywords="social media",
keywords="sentiment analysis",
abstract="Background: As one of the major constituents of the cannabis sativa plant, cannabidiol (CBD) is approved for use in medical treatment and cosmetics because of its potential health benefits. With the rapid growth of the CBD market, customers purchase these products, and relevant discussions are becoming more active on social media. Objective: In this study, we aimed to understand the users' attitudes toward CBD products in various countries by conducting text mining on social media in countries with different substance management policies. Methods: We collected posts from Reddit and Xiaohongshu, conducted topic mining using the latent Dirichlet allocation model, and analyzed the characteristics of topics on different social media. Subsequently, a co-occurrence network of high-frequency keywords was constructed to explore potential relationships among topics. Moreover, we conducted sentiment analysis on the posts' comments and compared users' attitudes toward CBD products on Reddit and Xiaohongshu using chi-square test. Results: CBD-related posts on social media have been rapidly increasing, especially on Xiaohongshu since 2019. A total of 1790 posts from Reddit and 1951 posts from Xiaohongshu were included in the final analysis. The posts on the 2 social media platforms, Reddit and Xiaohongshu, were categorized into 7 and 8 topics, respectively, by the latent Dirichlet allocation model, and these topics on the 2 social media were grouped into 5 themes. Our study showed that the themes on Reddit were mainly related to the therapeutic effects of CBD, whereas the themes on Xiaohongshu concentrated on cosmetics, such as facial masks. Theme 2 (CBD market information) and theme 3 (attitudes toward CBD) on Reddit had more connections with other themes in the co-occurrence network, and theme 3 and theme 1 (CBD therapeutic effects) had a high co-occurrence frequency (22,803/73,865, 30.87\%). Meanwhile, theme 1 (CBD cosmetics) on Xiaohongshu had various connections with others (169,961/384,575, 44.19\%), and the co-occurrence frequency of theme 4 (CBD ingredients) and theme 1 was relatively prominent (27,128/49,312, 55.01\%). Overall, users' comments tended to be positive for CBD-related information on both Reddit and Xiaohongshu, but the percentage was higher on Xiaohongshu (82.25\% vs 86.18\%; P<.001), especially in cosmetics and medical health care products. Conclusions: The CBD market has grown rapidly, and the topics related to CBD on social media have become active. There are apparent differences in users' attitudes toward CBD in countries with different substance management policies. Targeted CBD management measures should be formulated to suit the prevalence of CBD use of each country. ",
doi="10.2196/34132",
url="https://publichealth.jmir.org/2023/1/e34132",
url="http://www.ncbi.nlm.nih.gov/pubmed/36630175"
}


@Article{info:doi/10.2196/39155,
author="Kwan, Heng Yu
and Phang, Kie Jie
and Woon, Hui Ting
and Liew, W. Jean
and Dubreuil, Maureen
and Proft, Fabian
and Ramiro, Sofia
and Molto, Anna
and Navarro-Comp{\'a}n, Victoria
and de Hooge, Manouk
and Meghnathi, Bhowmik
and Ziade, Nelly
and Zhao, Steven Sizheng
and Llop, Maria
and Baraliakos, Xenofon
and Fong, Warren",
title="Social Media Use Among Members of the Assessment of Spondyloarthritis International Society: Results of a Web-Based Survey",
journal="J Med Internet Res",
year="2023",
month="Jan",
day="10",
volume="25",
pages="e39155",
keywords="social media",
keywords="spondyloarthritis",
keywords="cross-sectional survey",
abstract="Background: The use of social media in health care may serve as a beneficial tool for education, information dissemination, telemedicine, research, networking, and communications. To better leverage the benefits of social media, it is imperative to understand the patterns of its use and potential barriers to its implementation in health care. A previous study in 2016 that investigated social media use among young clinical rheumatologists (?45 years) and basic scientists showed that there was substantial social media use among them for social and professional reasons. However, there is a limited inquiry into social media use in different areas of rheumatology, such as spondyloarthritis. Objective: We aimed to explore the motivations, barriers, and patterns of social media use among an international group of experts in spondyloarthritis. Methods: We distributed a web-based survey via email from March 2021 to June 2021 to 198 members of the Assessment of Spondyloarthritis International Society. It contained 24 questions about demographic characteristics, patterns of current social media use, and perceptions of utility. Univariable and multivariable logistic regression analyses were performed to identify the characteristics associated with use trends. Results: The response rate was 78.8\% (156/198). Of these, 93.6\% (146/156) of participants used at least one social media platform. Apart from internet-based shopping and entertainment, the use of social media for clinical updates (odds ratio [OR] 6.25, 95\% CI 2.43-16.03) and research updates (OR 3.45, 95\% CI 1.35-8.78) were associated with higher social media consumption. Among the respondents, 66\% (103/156) used social media in a work-related manner. The use of social media for new web-based resources (OR 6.55, 95\% CI 2.01-21.37), interaction with international colleagues (OR 4.66, 95\% CI 1.21-17.90), and establishing a web-based presence (OR 4.05, 95\% CI 1.25-13.13) were associated with higher levels of consumption for work-related purposes. Time investment, confidentiality concerns, and security concerns were the top 3 challenges to a wider adoption of social media. Conclusions: Most respondents (103/156, 66\%) use social media in a work-related manner. Professional development, establishing a web-based presence, and international collaboration were associated with higher use. Challenges to social media adoption should be addressed to maximize its benefits. ",
doi="10.2196/39155",
url="https://www.jmir.org/2023/1/e39155",
url="http://www.ncbi.nlm.nih.gov/pubmed/36626201"
}


@Article{info:doi/10.2196/43533,
author="Guo, Shanshan
and Dang, Yuanyuan
and Vogel, Doug
and She, Bofei",
title="The Effect of Offline Medical Resource Distribution on Online Physician-Patient Interaction: Empirical Study With Online and Offline Data",
journal="JMIR Form Res",
year="2023",
month="Jan",
day="10",
volume="7",
pages="e43533",
keywords="medical resources",
keywords="online health community",
keywords="physician-patient interaction",
keywords="online and offline",
keywords="social network analysis",
abstract="Background: The relationship between online health communities (OHCs) and offline medical care is unclear because both provide physician-patient interaction services and channels. Taking advantage of information and communication technology, patients have been using OHCs widely. However, some physical medical resources (such as hospital beds and medical devices) cannot be replicated by information and communication technologies. Therefore, it is worth studying how offline medical resources affect physician-patient interactions in OHCs and how OHCs help to solve resource scarcity and the uneven distribution of traditional medical treatment. Objective: This study aimed to support the notion that physician-patient consultations in OHCs are influenced by the objective distribution of offline health care capital (accessibility and availability) and to provide suggestions for the allocation of medical resources in practice through the judicious use of offline and online channels. Methods: The empirical data in this study were collected from both online and offline channels. The offline data include 9 years (2006-2014) of medical resource statistics of 31 provincial administrative regions in mainland China. Moreover, data regarding the geolocation-based physician-patient interaction network in the OHC were also collected. The online data come from one of China's largest OHCs. We obtained 92,492 telephone consultation records of 6006 physicians using an automatic web crawler program. Social network analysis was used to visualize the descriptive statistics of the offline geolocation-based physician-patient interaction network in the OHC. A regression model with a squared variable was applied to analyze online and offline empirical data to further test our hypothesis. Two types of robustness tests were used to increase the reliability of the test results of the initial model. Results: The results of our social network analysis show that there is a uniform geographic distribution of patients who use OHCs, whereas the physician relies more on geographic advantage (eg, a higher medical resource capability). Moreover, the empirical results of the regression model support the notion that physician-patient telephone consultations are positively influenced by physicians' online contributions ($\beta$contribution=.210; P<.001) and capital availability ($\beta$bed=.935; P=.07), and, interestingly, spatial accessibility has an inverted U--shaped effect ($\beta$distance=.199; P<.001 and $\beta$distance2=--.00449; P=.008). The results indicate that the use of OHCs, although constrained by offline medical resources, provides a channel for offline resources to flow from areas with high availability to those with low availability. Conclusions: This study explores the relationship between online and offline channels by investigating online physician-patient interactions and offline medical resources. In particular, this study analyzes the impact of offline channels on online channels and verifies the possibility of OHC capital use shifting from a high-availability area to a low-availability area. In addition, it provides a theoretical and practical basis for understanding the interaction of online and offline channels of medical care. ",
doi="10.2196/43533",
url="https://formative.jmir.org/2023/1/e43533",
url="http://www.ncbi.nlm.nih.gov/pubmed/36626204"
}


@Article{info:doi/10.2196/38848,
author="Lu, Xinyi",
title="The Effects of Patient Health Information Seeking in Online Health Communities on Patient Compliance in China: Social Perspective",
journal="J Med Internet Res",
year="2023",
month="Jan",
day="9",
volume="25",
pages="e38848",
keywords="online health communities",
keywords="OHCs",
keywords="health information seeking",
keywords="social presence",
keywords="social support",
keywords="perceived responsiveness",
abstract="Background: Online health communities (OHCs) can alleviate the uneven distribution and use of medical resources and severe hospital congestion. Patients may seek health information through OHCs before or after visiting physicians, which may affect their cognition, health literacy, decision-making preferences, and health-related behaviors such as compliance. Social factors (social support, social presence, and responsiveness) are closely related to patients' health information--seeking behavior and are significantly considered in OHCs. Objective: This study aimed to explore the effects of patients' health information--seeking behavior (way and effectiveness) on compliance with physicians from the perspectives of patients' perceived social support, social presence, and responsiveness. Methods: This study established a research model from the perspective of social information processing by using the social exchange theory. An anonymous questionnaire survey was conducted with several Chinese OHCs to collect data. Partial least squares and structural equation modeling were adopted to test the hypotheses and develop the model. Results: This study received 403 responses, of which 332 were valid, giving a validity rate of 82.4\% (332/403). Among the sample, 78.6\% (261/332) of the individuals were aged between 20 and 40 years, 59.3\% (197/332) were woman, 69.9\% (232/332) lived in urban areas, and 50\% (166/332) had at least a bachelor's degree. The reliability, convergent validity, and discriminant validity were acceptable. Both the way and effectiveness of patients seeking health information through OHCs have a positive impact on their compliance through the mediation of their perceived social support, social presence, and responsiveness from OHCs and other users, and patient compliance can be improved by guiding patient health information--seeking behavior in OHCs from a social perspective. Conclusions: This study proposes a research model to corroborate that patient health information--seeking behavior (way and effectiveness) in OHCs exerts positive effects on patient compliance with the treatment and physician's advice and provides suggestions for patients, physicians, and OHC service providers in China to help guide patients' health-related behaviors through OHCs to improve patient compliance, patient satisfaction, treatment efficiency, and health outcomes. ",
doi="10.2196/38848",
url="https://www.jmir.org/2023/1/e38848",
url="http://www.ncbi.nlm.nih.gov/pubmed/36622741"
}


@Article{info:doi/10.2196/38607,
author="Sharma, E. Anjana
and Khosla, Kiran
and Potharaju, Kameswari
and Mukherjea, Arnab
and Sarkar, Urmimala",
title="COVID-19--Associated Misinformation Across the South Asian Diaspora: Qualitative Study of WhatsApp Messages",
journal="JMIR Infodemiology",
year="2023",
month="Jan",
day="5",
volume="3",
pages="e38607",
keywords="misinformation",
keywords="COVID-19",
keywords="South Asians",
keywords="disparities",
keywords="social media",
keywords="infodemiology",
keywords="WhatsApp",
keywords="messages",
keywords="apps",
keywords="health information",
keywords="reliability",
keywords="communication",
keywords="Asian",
keywords="English",
keywords="community",
keywords="health",
keywords="organization",
keywords="public health",
keywords="pandemic",
abstract="Background: South Asians, inclusive of individuals originating in India, Pakistan, Maldives, Bangladesh, Sri Lanka, Bhutan, and Nepal, comprise the largest diaspora in the world, with large South Asian communities residing in the Caribbean, Africa, Europe, and elsewhere. There is evidence that South Asian communities have disproportionately experienced COVID-19 infections and mortality. WhatsApp, a free messaging app, is widely used in transnational communication within the South Asian diaspora. Limited studies exist on COVID-19--related misinformation specific to the South Asian community on WhatsApp. Understanding communication on WhatsApp may improve public health messaging to address COVID-19 disparities among South Asian communities worldwide. Objective: We developed the COVID-19--Associated misinfoRmation On Messaging apps (CAROM) study to identify messages containing misinformation about COVID-19 shared via WhatsApp. Methods: We collected messages forwarded globally through WhatsApp from self-identified South Asian community members between March 23 and June 3, 2021. We excluded messages that were in languages other than English, did not contain misinformation, or were not relevant to COVID-19. We deidentified each message and coded them for one or more content categories, media types (eg, video, image, text, web link, or a combination of these elements), and tone (eg, fearful, well intentioned, or pleading). We then performed a qualitative content analysis to arrive at key themes of COVID-19 misinformation. Results: We received 108 messages; 55 messages met the inclusion criteria for the final analytic sample; 32 (58\%) contained text, 15 (27\%) contained images, and 13 (24\%) contained video. Content analysis revealed the following themes: ``community transmission'' relating to misinformation on how COVID-19 spreads in the community; ``prevention'' and ``treatment,'' including Ayurvedic and traditional remedies for how to prevent or treat COVID-19 infection; and messaging attempting to sell ``products or services'' to prevent or cure COVID-19. Messages varied in audience from the general public to South Asians specifically; the latter included messages alluding to South Asian pride and solidarity. Scientific jargon and references to major organizations and leaders in health care were included to provide credibility. Messages with a pleading tone encouraged users to forward them to friends or family. Conclusions: Misinformation in the South Asian community on WhatsApp spreads erroneous ideas regarding disease transmission, prevention, and treatment. Content evoking solidarity, ``trustworthy'' sources, and encouragement to forward messages may increase the spread of misinformation. Public health outlets and social media companies must actively combat misinformation to address health disparities among the South Asian diaspora during the COVID-19 pandemic and in future public health emergencies. ",
doi="10.2196/38607",
url="https://infodemiology.jmir.org/2023/1/e38607",
url="http://www.ncbi.nlm.nih.gov/pubmed/37113380"
}


@Article{info:doi/10.2196/36729,
author="Pollack, C. Catherine
and Emond, A. Jennifer
and O'Malley, James A.
and Byrd, Anna
and Green, Peter
and Miller, E. Katherine
and Vosoughi, Soroush
and Gilbert-Diamond, Diane
and Onega, Tracy",
title="Characterizing the Prevalence of Obesity Misinformation, Factual Content, Stigma, and Positivity on the Social Media Platform Reddit Between 2011 and 2019: Infodemiology Study",
journal="J Med Internet Res",
year="2022",
month="Dec",
day="30",
volume="24",
number="12",
pages="e36729",
keywords="obesity",
keywords="misinformation",
keywords="social stigma",
keywords="social media",
keywords="Reddit",
keywords="natural language processing",
abstract="Background: Reddit is a popular social media platform that has faced scrutiny for inflammatory language against those with obesity, yet there has been no comprehensive analysis of its obesity-related content. Objective: We aimed to quantify the presence of 4 types of obesity-related content on Reddit (misinformation, facts, stigma, and positivity) and identify psycholinguistic features that may be enriched within each one. Methods: All sentences (N=764,179) containing ``obese'' or ``obesity'' from top-level comments (n=689,447) made on non--age-restricted subreddits (ie, smaller communities within Reddit) between 2011 and 2019 that contained one of a series of keywords were evaluated. Four types of common natural language processing features were extracted: bigram term frequency--inverse document frequency, word embeddings derived from Bidirectional Encoder Representations from Transformers, sentiment from the Valence Aware Dictionary for Sentiment Reasoning, and psycholinguistic features from the Linguistic Inquiry and Word Count Program. These features were used to train an Extreme Gradient Boosting machine learning classifier to label each sentence as 1 of the 4 content categories or other. Two-part hurdle models for semicontinuous data (which use logistic regression to assess the odds of a 0 result and linear regression for continuous data) were used to evaluate whether select psycholinguistic features presented differently in misinformation (compared with facts) or stigma (compared with positivity). Results: After removing ambiguous sentences, 0.47\% (3610/764,179) of the sentences were labeled as misinformation, 1.88\% (14,366/764,179) were labeled as stigma, 1.94\% (14,799/764,179) were labeled as positivity, and 8.93\% (68,276/764,179) were labeled as facts. Each category had markers that distinguished it from other categories within the data as well as an external corpus. For example, misinformation had a higher average percent of negations ($\beta$=3.71, 95\% CI 3.53-3.90; P<.001) but a lower average number of words >6 letters ($\beta$=?1.47, 95\% CI ?1.85 to ?1.10; P<.001) relative to facts. Stigma had a higher proportion of swear words ($\beta$=1.83, 95\% CI 1.62-2.04; P<.001) but a lower proportion of first-person singular pronouns ($\beta$=?5.30, 95\% CI ?5.44 to ?5.16; P<.001) relative to positivity. Conclusions: There are distinct psycholinguistic properties between types of obesity-related content on Reddit that can be leveraged to rapidly identify deleterious content with minimal human intervention and provide insights into how the Reddit population perceives patients with obesity. Future work should assess whether these properties are shared across languages and other social media platforms. ",
doi="10.2196/36729",
url="https://www.jmir.org/2022/12/e36729",
url="http://www.ncbi.nlm.nih.gov/pubmed/36583929"
}


@Article{info:doi/10.2196/39747,
author="Nguyen, Cuong Viet
and Lu, Nathaniel
and Kane, M. John
and Birnbaum, L. Michael
and De Choudhury, Munmun",
title="Cross-Platform Detection of Psychiatric Hospitalization via Social Media Data: Comparison Study",
journal="JMIR Ment Health",
year="2022",
month="Dec",
day="30",
volume="9",
number="12",
pages="e39747",
keywords="schizophrenia",
keywords="mental health",
keywords="machine learning",
keywords="clinical informatics",
keywords="social media",
keywords="mobile phone",
abstract="Background: Previous research has shown the feasibility of using machine learning models trained on social media data from a single platform (eg, Facebook or Twitter) to distinguish individuals either with a diagnosis of mental illness or experiencing an adverse outcome from healthy controls. However, the performance of such models on data from novel social media platforms unseen in the training data (eg, Instagram and TikTok) has not been investigated in previous literature. Objective: Our study examined the feasibility of building machine learning classifiers that can effectively predict an upcoming psychiatric hospitalization given social media data from platforms unseen in the classifiers' training data despite the preliminary evidence on identity fragmentation on the investigated social media platforms. Methods: Windowed timeline data of patients with a diagnosis of schizophrenia spectrum disorder before a known hospitalization event and healthy controls were gathered from 3 platforms: Facebook (254/268, 94.8\% of participants), Twitter (51/268, 19\% of participants), and Instagram (134/268, 50\% of participants). We then used a 3 {\texttimes} 3 combinatorial binary classification design to train machine learning classifiers and evaluate their performance on testing data from all available platforms. We further compared results from models in intraplatform experiments (ie, training and testing data belonging to the same platform) to those from models in interplatform experiments (ie, training and testing data belonging to different platforms). Finally, we used Shapley Additive Explanation values to extract the top predictive features to explain and compare the underlying constructs that predict hospitalization on each platform. Results: We found that models in intraplatform experiments on average achieved an F1-score of 0.72 (SD 0.07) in predicting a psychiatric hospitalization because of schizophrenia spectrum disorder, which is 68\% higher than the average of models in interplatform experiments at an F1-score of 0.428 (SD 0.11). When investigating the key drivers for divergence in construct validities between models, an analysis of top features for the intraplatform models showed both low predictive feature overlap between the platforms and low pairwise rank correlation (<0.1) between the platforms' top feature rankings. Furthermore, low average cosine similarity of data between platforms within participants in comparison with the same measurement on data within platforms between participants points to evidence of identity fragmentation of participants between platforms. Conclusions: We demonstrated that models built on one platform's data to predict critical mental health treatment outcomes such as hospitalization do not generalize to another platform. In our case, this is because different social media platforms consistently reflect different segments of participants' identities. With the changing ecosystem of social media use among different demographic groups and as web-based identities continue to become fragmented across platforms, further research on holistic approaches to harnessing these diverse data sources is required. ",
doi="10.2196/39747",
url="https://mental.jmir.org/2022/12/e39747",
url="http://www.ncbi.nlm.nih.gov/pubmed/36583932"
}


@Article{info:doi/10.2196/41517,
author="Maghsoudi, Arash
and Nowakowski, Sara
and Agrawal, Ritwick
and Sharafkhaneh, Amir
and Kunik, E. Mark
and Naik, D. Aanand
and Xu, Hua
and Razjouyan, Javad",
title="Sentiment Analysis of Insomnia-Related Tweets via a Combination of Transformers Using Dempster-Shafer Theory: Pre-- and Peri--COVID-19 Pandemic Retrospective Study",
journal="J Med Internet Res",
year="2022",
month="Dec",
day="27",
volume="24",
number="12",
pages="e41517",
keywords="COVID-19",
keywords="coronavirus",
keywords="sleep",
keywords="Twitter",
keywords="natural language processing",
keywords="sentiment analysis",
keywords="transformers",
keywords="Dempster-Shafer theory",
keywords="sleeping",
keywords="social media",
keywords="pandemic",
keywords="effect",
keywords="viral infection",
abstract="Background: The COVID-19 pandemic has imposed additional stress on population health that may result in a change of sleeping behavior. Objective: In this study, we hypothesized that using natural language processing to explore social media would help with assessing the mental health conditions of people experiencing insomnia after the outbreak of COVID-19. Methods: We designed a retrospective study that used public social media content from Twitter. We categorized insomnia-related tweets based on time, using the following two intervals: the prepandemic (January 1, 2019, to January 1, 2020) and peripandemic (January 1, 2020, to January 1, 2021) intervals. We performed a sentiment analysis by using pretrained transformers in conjunction with Dempster-Shafer theory (DST) to classify the polarity of emotions as positive, negative, and neutral. We validated the proposed pipeline on 300 annotated tweets. Additionally, we performed a temporal analysis to examine the effect of time on Twitter users' insomnia experiences, using logistic regression. Results: We extracted 305,321 tweets containing the word insomnia (prepandemic tweets: n=139,561; peripandemic tweets: n=165,760). The best combination of pretrained transformers (combined via DST) yielded 84\% accuracy. By using this pipeline, we found that the odds of posting negative tweets (odds ratio [OR] 1.39, 95\% CI 1.37-1.41; P<.001) were higher in the peripandemic interval compared to those in the prepandemic interval. The likelihood of posting negative tweets after midnight was 21\% higher than that before midnight (OR 1.21, 95\% CI 1.19-1.23; P<.001). In the prepandemic interval, while the odds of posting negative tweets were 2\% higher after midnight compared to those before midnight (OR 1.02, 95\% CI 1.00-1.07; P=.008), they were 43\% higher (OR 1.43, 95\% CI 1.40-1.46; P<.001) in the peripandemic interval. Conclusions: The proposed novel sentiment analysis pipeline, which combines pretrained transformers via DST, is capable of classifying the emotions and sentiments of insomnia-related tweets. Twitter users shared more negative tweets about insomnia in the peripandemic interval than in the prepandemic interval. Future studies using a natural language processing framework could assess tweets about other types of psychological distress, habit changes, weight gain resulting from inactivity, and the effect of viral infection on sleep. ",
doi="10.2196/41517",
url="https://www.jmir.org/2022/12/e41517",
url="http://www.ncbi.nlm.nih.gov/pubmed/36417585"
}


@Article{info:doi/10.2196/41928,
author="Kobayashi, Ryota
and Takedomi, Yuka
and Nakayama, Yuri
and Suda, Towa
and Uno, Takeaki
and Hashimoto, Takako
and Toyoda, Masashi
and Yoshinaga, Naoki
and Kitsuregawa, Masaru
and Rocha, C. Luis E.",
title="Evolution of Public Opinion on COVID-19 Vaccination in Japan: Large-Scale Twitter Data Analysis",
journal="J Med Internet Res",
year="2022",
month="Dec",
day="22",
volume="24",
number="12",
pages="e41928",
keywords="COVID-19",
keywords="vaccine",
keywords="vaccination",
keywords="Twitter",
keywords="public opinion",
keywords="topic modeling",
keywords="longitudinal study",
keywords="topic dynamics",
keywords="social events",
keywords="interrupted time series regression",
abstract="Background: Vaccines are promising tools to control the spread of COVID-19. An effective vaccination campaign requires government policies and community engagement, sharing experiences for social support, and voicing concerns about vaccine safety and efficiency. The increasing use of online social platforms allows us to trace large-scale communication and infer public opinion in real time. Objective: This study aimed to identify the main themes in COVID-19 vaccine-related discussions on Twitter in Japan and track how the popularity of the tweeted themes evolved during the vaccination campaign. Furthermore, we aimed to understand the impact of critical social events on the popularity of the themes. Methods: We collected more than 100 million vaccine-related tweets written in Japanese and posted by 8 million users (approximately 6.4\% of the Japanese population) from January 1 to October 31, 2021. We used Latent Dirichlet Allocation to perform automated topic modeling of tweet text during the vaccination campaign. In addition, we performed an interrupted time series regression analysis to evaluate the impact of 4 critical social events on public opinion. Results: We identified 15 topics grouped into the following 4 themes: (1) personal issue, (2) breaking news, (3) politics, and (4) conspiracy and humor. The evolution of the popularity of themes revealed a shift in public opinion, with initial sharing of attention over personal issues (individual aspect), collecting information from news (knowledge acquisition), and government criticism to focusing on personal issues. Our analysis showed that the Tokyo Olympic Games affected public opinion more than other critical events but not the course of vaccination. Public opinion about politics was significantly affected by various social events, positively shifting attention in the early stages of the vaccination campaign and negatively shifting attention later. Conclusions: This study showed a striking shift in public interest in Japan, with users splitting their attention over various themes early in the vaccination campaign and then focusing only on personal issues, as trust in vaccines and policies increased. An interrupted time series regression analysis showed that the vaccination rollout to the general population (under 65 years) increased the popularity of tweets about practical advice and personal vaccination experience, and the Tokyo Olympic Games disrupted public opinion but not the course of the vaccination campaign. The methodology developed here allowed us to monitor the evolution of public opinion and evaluate the impact of social events on public opinion, using large-scale Twitter data. ",
doi="10.2196/41928",
url="https://www.jmir.org/2022/12/e41928",
url="http://www.ncbi.nlm.nih.gov/pubmed/36343186"
}


@Article{info:doi/10.2196/42084,
author="Yabumoto, Megan
and Miller, Emily
and Rao, Anoushka
and Tabor, K. Holly
and Ormond, E. Kelly
and Halley, C. Meghan",
title="Perspectives of Rare Disease Social Media Group Participants on Engaging With Genetic Counselors: Mixed Methods Study",
journal="J Med Internet Res",
year="2022",
month="Dec",
day="21",
volume="24",
number="12",
pages="e42084",
keywords="social media",
keywords="rare disease",
keywords="genetic counseling",
keywords="genetics",
keywords="genomics",
keywords="delivery of health care",
abstract="Background: Social media provides a potential avenue for genetic counselors to address gaps in access to reliable genetics information for rare disease communities. However, only limited research has examined patient and family attitudes toward engaging with genetic counselors through social media. Objective: Our study assessed the attitudes of members of rare disease social media groups toward engaging with genetic counselors through social media, characteristics associated with greater interest, and the benefits and potential pitfalls of various approaches to such engagement. Methods: We conducted a mixed methods survey of patients and family members recruited from a systematic sample of rare disease Facebook groups. Patient characteristics and their associations with interest in engagement with genetic counselors were evaluated using univariate and bivariate statistics. Responses to open-ended questions were analyzed using thematic content analysis. Results: In total, 1053 individuals from 103 rare disease groups participated. The median overall interest in engaging with genetic counselors on social media was moderately high at 7.0 (IQR 4.0-9.0, range 0-10). No past experience with a genetic counselor was associated with greater interest in engaging with one through social media ({\textmu}=6.5 vs 6.0, P=.04). Participants expressed greatest interest (median 9.0, IQR 5.0-10.0) in engagement models allowing direct communication with genetic counselors, which was corroborated by the majority (n=399, 61.3\%) of individuals who responded to open-ended questions explicitly stating their interest in 1-on-1 interactions. When asked what forms of support they would request from genetic counselors through social media, participants desired individualized support and information about how to access services. However, participants also expressed concerns regarding privacy and confidentiality. Conclusions: Patients and family members in rare disease social media groups appear interested in engaging with genetic counselors through social media, particularly for individualized support. This form of engagement on social media is not meant to replace the current structure and content of genetic counseling (GC) services, but genetic counselors could more actively use social media as a communication tool to address gaps in knowledge and awareness about genetics services and gaps in accessible patient information. Although encouraging, concerns regarding privacy and feasibility require further consideration, pointing to the need for professional guidelines in this area. ",
doi="10.2196/42084",
url="https://www.jmir.org/2022/12/e42084",
url="http://www.ncbi.nlm.nih.gov/pubmed/36542454"
}


@Article{info:doi/10.2196/40198,
author="DePaula, Nic
and Hagen, Loni
and Roytman, Stiven
and Alnahass, Dana",
title="Platform Effects on Public Health Communication: A Comparative and National Study of Message Design and Audience Engagement Across Twitter and Facebook",
journal="JMIR Infodemiology",
year="2022",
month="Dec",
day="20",
volume="2",
number="2",
pages="e40198",
keywords="platform effects",
keywords="COVID-19",
keywords="social media",
keywords="health communication",
keywords="message design",
keywords="risk communication",
keywords="Twitter",
keywords="Facebook",
keywords="user engagement",
keywords="e-government",
abstract="Background: Public health agencies widely adopt social media for health and risk communication. Moreover, different platforms have different affordances, which may impact the quality and nature of the messaging and how the public engages with the content. However, these platform effects are not often compared in studies of health and risk communication and not previously for the COVID-19 pandemic. Objective: This study measures the potential media effects of Twitter and Facebook on public health message design and engagement by comparing message elements and audience engagement in COVID-19--related posts by local, state, and federal public health agencies in the United States during the pandemic, to advance theories of public health messaging on social media and provide recommendations for tailored social media communication strategies. Methods: We retrieved all COVID-19--related posts from major US federal agencies related to health and infectious disease, all major state public health agencies, and selected local public health departments on Twitter and Facebook. A total of 100,785 posts related to COVID-19, from 179 different accounts of 96 agencies, were retrieved for the entire year of 2020. We adopted a framework of social media message elements to analyze the posts across Facebook and Twitter. For manual content analysis, we subsampled 1677 posts. We calculated the prevalence of various message elements across the platforms and assessed the statistical significance of differences. We also calculated and assessed the association between message elements with normalized measures of shares and likes for both Facebook and Twitter. Results: Distributions of message elements were largely similar across both sites. However, political figures (P<.001), experts (P=.01), and nonpolitical personalities (P=.01) were significantly more present on Facebook posts compared to Twitter. Infographics (P<.001), surveillance information (P<.001), and certain multimedia elements (eg, hyperlinks, P<.001) were more prevalent on Twitter. In general, Facebook posts received more (normalized) likes (0.19\%) and (normalized) shares (0.22\%) compared to Twitter likes (0.08\%) and shares (0.05\%). Elements with greater engagement on Facebook included expressives and collectives, whereas posts related to policy were more engaged with on Twitter. Science information (eg, scientific explanations) comprised 8.5\% (73/851) of Facebook and 9.4\% (78/826) of Twitter posts. Correctives of misinformation only appeared in 1.2\% (11/851) of Facebook and 1.4\% (12/826) of Twitter posts. Conclusions: In general, we find a data and policy orientation for Twitter messages and users and a local and personal orientation for Facebook, although also many similarities across platforms. Message elements that impact engagement are similar across platforms but with some notable distinctions. This study provides novel evidence for differences in COVID-19 public health messaging across social media sites, advancing knowledge of public health communication on social media and recommendations for health and risk communication strategies on these online platforms. ",
doi="10.2196/40198",
url="https://infodemiology.jmir.org/2022/2/e40198",
url="http://www.ncbi.nlm.nih.gov/pubmed/36575712"
}


@Article{info:doi/10.2196/39984,
author="Ahmadi, Reihaneh
and Lim, Hajin
and Mutlu, Bilge
and Duff, Melissa
and Toma, Catalina
and Turkstra, Lyn",
title="Facebook Experiences of Users With Traumatic Brain Injury: A Think-Aloud Study",
journal="JMIR Rehabil Assist Technol",
year="2022",
month="Dec",
day="16",
volume="9",
number="4",
pages="e39984",
keywords="traumatic brain injury",
keywords="rehabilitation",
keywords="disability",
keywords="cognitive communication",
keywords="social media",
abstract="Background: A critical gap in our knowledge about social media is whether we can alleviate accessibility barriers and challenges for individuals with traumatic brain injury (TBI), to improve their social participation and health. To do this, we need real-time information about these barriers and challenges, to design appropriate aids. Objective: The aim of this study was to characterize the ways people with TBI accessed and used social media websites and understand unique challenges they faced. Methods: We invited 8 adults with moderate to severe TBI to log onto their own Facebook page and use it as they regularly would while thinking aloud. Their comments were recorded and transcribed for qualitative analysis. We first analyzed participants' utterances using a priori coding based on a framework proposed by Meshi et al to classify adults' motives for accessing social media. We next used an open coding method to understand the challenges that people with TBI faced while using Facebook. In other words, we analyzed participants' needs for using Facebook and then identified Facebook features that made it challenging for them to meet those needs. Results: Participants used all categories of codes in the framework by Meshi et al and provided detailed feedback about the Facebook user interface. A priori coding revealed 2 dimensions that characterized participants' Facebook use: whether they were active or passive about posting and self-disclosure on Facebook and their familiarity and fluency in using Facebook. The open coding analysis revealed 6 types of challenges reported by participants with TBI, including difficulty with language production and interpretation, attention and information overload, perceptions of negativity and emotional contagion, insufficient guidance to use Facebook, concerns about web-based scams and frauds, and general accessibility concerns. Conclusions: Results showed that individuals with TBI used Facebook for the same reasons typical adults do, suggesting that it can help increase social communication and reduce isolation and loneliness. Participants also identified barriers, and we propose modifications that could improve access for individuals with brain injury. On the basis of identified functions and challenges, we conclude by proposing design ideas for social media support tools that can promote more active use of social media sites by adults with TBI. ",
doi="10.2196/39984",
url="https://rehab.jmir.org/2022/4/e39984",
url="http://www.ncbi.nlm.nih.gov/pubmed/36525296"
}


@Article{info:doi/10.2196/42179,
author="de Vere Hunt, Isabella
and Linos, Eleni",
title="Social Media for Public Health: Framework for Social Media--Based Public Health Campaigns",
journal="J Med Internet Res",
year="2022",
month="Dec",
day="14",
volume="24",
number="12",
pages="e42179",
keywords="social media",
keywords="digital heath",
keywords="health communication",
keywords="campaign",
keywords="public health",
keywords="framework",
keywords="health promotion",
keywords="public awareness",
keywords="misinformation",
keywords="tailored message",
keywords="tailored messaging",
keywords="information sharing",
keywords="information exchange",
keywords="advertise",
keywords="advertising",
doi="10.2196/42179",
url="https://www.jmir.org/2022/12/e42179",
url="http://www.ncbi.nlm.nih.gov/pubmed/36515995"
}


@Article{info:doi/10.2196/39460,
author="Wu, Dezhi
and Kasson, Erin
and Singh, Kumar Avineet
and Ren, Yang
and Kaiser, Nina
and Huang, Ming
and Cavazos-Rehg, A. Patricia",
title="Topics and Sentiment Surrounding Vaping on Twitter and Reddit During the 2019 e-Cigarette and Vaping Use--Associated Lung Injury Outbreak: Comparative Study",
journal="J Med Internet Res",
year="2022",
month="Dec",
day="13",
volume="24",
number="12",
pages="e39460",
keywords="vaping",
keywords="e-cigarette",
keywords="social media",
keywords="Twitter",
keywords="Reddit",
keywords="e-cigarette and vaping use--associated lung injury",
keywords="EVALI",
keywords="sentiment analysis",
keywords="topic analysis",
abstract="Background: Vaping or e-cigarette use has become dramatically more popular in the United States in recent years. e-Cigarette and vaping use--associated lung injury (EVALI) cases caused an increase in hospitalizations and deaths in 2019, and many instances were later linked to unregulated products. Previous literature has leveraged social media data for surveillance of health topics. Individuals are willing to share mental health experiences and other personal stories on social media platforms where they feel a sense of community, reduced stigma, and empowerment. Objective: This study aimed to compare vaping-related content on 2 popular social media platforms (ie, Twitter and Reddit) to explore the context surrounding vaping during the 2019 EVALI outbreak and to support the feasibility of using data from both social platforms to develop in-depth and intelligent vaping detection models on social media. Methods: Data were extracted from both Twitter (316,620 tweets) and Reddit (17,320 posts) from July 2019 to September 2019 at the peak of the EVALI crisis. High-throughput computational analyses (sentiment analysis and topic analysis) were conducted. In addition, in-depth manual content analyses were performed and compared with computational analyses of content on both platforms (577 tweets and 613 posts). Results: Vaping-related posts and unique users on Twitter and Reddit increased from July 2019 to September 2019, with the average post per user increasing from 1.68 to 1.81 on Twitter and 1.19 to 1.21 on Reddit. Computational analyses found the number of positive sentiment posts to be higher on Reddit (P<.001, 95\% CI 0.4305-0.4475) and the number of negative posts to be higher on Twitter (P<.001, 95\% CI --0.4289 to ?0.4111). These results were consistent with the clinical content analyses results indicating that negative sentiment posts were higher on Twitter (273/577, 47.3\%) than Reddit (184/613, 30\%). Furthermore, topics prevalent on both platforms by keywords and based on manual post reviews included mentions of youth, marketing or regulation, marijuana, and interest in quitting. Conclusions: Post content and trending topics overlapped on both Twitter and Reddit during the EVALI period in 2019. However, crucial differences in user type and content keywords were also found, including more frequent mentions of health-related keywords on Twitter and more negative health outcomes from vaping mentioned on both Reddit and Twitter. Use of both computational and clinical content analyses is critical to not only identify signals of public health trends among vaping-related social media content but also to provide context for vaping risks and behaviors. By leveraging the strengths of both Twitter and Reddit as publicly available data sources, this research may provide technical and clinical insights to inform automatic detection of social media users who are vaping and may benefit from digital intervention and proactive outreach strategies on these platforms. ",
doi="10.2196/39460",
url="https://www.jmir.org/2022/12/e39460",
url="http://www.ncbi.nlm.nih.gov/pubmed/36512403"
}


@Article{info:doi/10.2196/39340,
author="Li, Chuqin
and Jordan, Alexis
and Song, Jun
and Ge, Yaorong
and Park, Albert",
title="A Novel Approach to Characterize State-level Food Environment and Predict Obesity Rate Using Social Media Data: Correlational Study",
journal="J Med Internet Res",
year="2022",
month="Dec",
day="13",
volume="24",
number="12",
pages="e39340",
keywords="obesity",
keywords="social media",
keywords="machine learning",
keywords="lifestyle",
keywords="environment",
keywords="food",
keywords="correlation",
keywords="modeling",
keywords="predict",
keywords="rates",
keywords="outcome",
keywords="category",
keywords="dishes",
keywords="popular",
keywords="mobile phone",
abstract="Background: Community obesity outcomes can reflect the food environment to which the community belongs. Recent studies have suggested that the local food environment can be measured by the degree of food accessibility, and survey data are normally used to calculate food accessibility. However, compared with survey data, social media data are organic, continuously updated, and cheaper to collect. Objective: The objective of our study was to use publicly available social media data to learn the relationship between food environment and obesity rates at the state level. Methods: To characterize the caloric information of the local food environment, we used food categories from Yelp and collected caloric information from MyFitnessPal for each category based on their popular dishes. We then calculated the average calories for each category and created a weighted score for each state. We also calculated 2 other dimensions from the concept of access, acceptability and affordability, to build obesity prediction models. Results: The local food environment characterized using only publicly available social media data had a statistically significant correlation with the state obesity rate. We achieved a Pearson correlation of 0.796 between the predicted obesity rate and the reported obesity rate from the Behavioral Risk Factor Surveillance System across US states and the District of Columbia. The model with 3 generated feature sets achieved the best performance. Conclusions: Our study proposed a method for characterizing state-level food environments only using continuously updated social media data. State-level food environments were accurately described using social media data, and the model also showed a disparity in the available food between states with different obesity rates. The proposed method should elastically apply to local food environments of different sizes and predict obesity rates effectively. ",
doi="10.2196/39340",
url="https://www.jmir.org/2022/12/e39340",
url="http://www.ncbi.nlm.nih.gov/pubmed/36512396"
}


@Article{info:doi/10.2196/40298,
author="Pekarsky, Chloe
and Skiffington, Janice
and Leijser, M. Lara
and Slater, Donna
and Metcalfe, Amy",
title="Social Media Recruitment Strategies to Recruit Pregnant Women Into a Longitudinal Observational Cohort Study: Usability Study",
journal="J Med Internet Res",
year="2022",
month="Dec",
day="12",
volume="24",
number="12",
pages="e40298",
keywords="social media",
keywords="Facebook",
keywords="Twitter",
keywords="Instagram",
keywords="recruitment",
keywords="pregnancy",
keywords="surveys",
keywords="questionnaires",
keywords="fraudulent responses",
abstract="Background: Use of social media for study recruitment is becoming increasingly common. Previous studies have typically focused on using Facebook; however, there are limited data to support the use of other social media platforms for participant recruitment, notably in the context of a pregnancy study. Objective: Our study aimed to evaluate the effectiveness of Facebook, Twitter, and Instagram in recruiting a representative sample of pregnant women in a longitudinal pregnancy cohort study in Calgary, Alberta, between September 27, 2021, and April 24, 2022. Methods: Paid advertisements were targeted at 18- to 50-year-old women in Calgary, with interests in pregnancy. Data regarding reach, link clicks, and costs were collected through Facebook Ads Manager (Meta Platforms, Inc) and Twitter Analytics (Twitter, Inc). The feasibility of each platform for recruitment was assessed based on the recruitment rate and cost-effectiveness. The demographic characteristics of the participants recruited through each source were compared using the chi-square test. Results: Paid advertisements reached 159,778 social media users, resulting in 2390 link clicks and 324 participants being recruited. Facebook reached and recruited the highest number of participants (153/324, 47.2\%), whereas Instagram saw the highest number of link clicks relative to the number of users who saw the advertisement (418/19,764, 2.11\%). Facebook and Instagram advertisements were cost-effective, with an average cost-per-click of CAD \$0.65 (US \$0.84; SD \$0.27, US \$0.35) and cost-per-completer of CAD \$7.89 (US \$10.25; SD CAD \$4.08, US \$5.30). Twitter advertisements were less successful in terms of recruitment and costs. Demographic characteristics of participants did not differ based on recruitment source, except for education and income, where more highly educated and higher-income participants were recruited through Instagram or Twitter. Many issues related to fraudulent responses were encountered throughout the recruitment period. Conclusions: Paid social media advertisements (especially Facebook and Instagram) are feasible and cost-effective methods for recruiting a large sample of pregnant women for survey-based research. However, future research should be aware of the potential for fraudulent responses when using social media for recruitment and consider strategies to mitigate this problem. ",
doi="10.2196/40298",
url="https://www.jmir.org/2022/12/e40298",
url="http://www.ncbi.nlm.nih.gov/pubmed/36508244"
}


@Article{info:doi/10.2196/41198,
author="Xu, Wayne Weiai
and Tshimula, Marie Jean
and Dub{\'e}, {\`E}ve
and Graham, E. Janice
and Greyson, Devon
and MacDonald, E. Noni
and Meyer, B. Samantha",
title="Unmasking the Twitter Discourses on Masks During the COVID-19 Pandemic: User Cluster--Based BERT Topic Modeling Approach",
journal="JMIR Infodemiology",
year="2022",
month="Dec",
day="9",
volume="2",
number="2",
pages="e41198",
keywords="infoveillance",
keywords="data analytics",
keywords="Twitter",
keywords="social media",
keywords="user classification",
keywords="COVID-19",
abstract="Background: The COVID-19 pandemic has spotlighted the politicization of public health issues. A public health monitoring tool must be equipped to reveal a public health measure's political context and guide better interventions. In its current form, infoveillance tends to neglect identity and interest-based users, hence being limited in exposing how public health discourse varies by different political groups. Adopting an algorithmic tool to classify users and their short social media texts might remedy that limitation. Objective: We aimed to implement a new computational framework to investigate discourses and temporal changes in topics unique to different user clusters. The framework was developed to contextualize how web-based public health discourse varies by identity and interest-based user clusters. We used masks and mask wearing during the early stage of the COVID-19 pandemic in the English-speaking world as a case study to illustrate the application of the framework. Methods: We first clustered Twitter users based on their identities and interests as expressed through Twitter bio pages. Exploratory text network analysis reveals salient political, social, and professional identities of various user clusters. It then uses BERT Topic modeling to identify topics by the user clusters. It reveals how web-based discourse has shifted over time and varied by 4 user clusters: conservative, progressive, general public, and public health professionals. Results: This study demonstrated the importance of a priori user classification and longitudinal topical trends in understanding the political context of web-based public health discourse. The framework reveals that the political groups and the general public focused on the science of mask wearing and the partisan politics of mask policies. A populist discourse that pits citizens against elites and institutions was identified in some tweets. Politicians (such as Donald Trump) and geopolitical tensions with China were found to drive the discourse. It also shows limited participation of public health professionals compared with other users. Conclusions: We conclude by discussing the importance of a priori user classification in analyzing web-based discourse and illustrating the fit of BERT Topic modeling in identifying contextualized topics in short social media texts. ",
doi="10.2196/41198",
url="https://infodemiology.jmir.org/2022/2/e41198",
url="http://www.ncbi.nlm.nih.gov/pubmed/36536763"
}


@Article{info:doi/10.2196/37331,
author="Luo, Kai
and Yang, Yang
and Teo, Hai Hock",
title="The Asymmetric Influence of Emotion in the Sharing of COVID-19 Science on Social Media: Observational Study",
journal="JMIR Infodemiology",
year="2022",
month="Dec",
day="8",
volume="2",
number="2",
pages="e37331",
keywords="COVID-19",
keywords="science communication",
keywords="emotion",
keywords="COVID-19 science",
keywords="online social networks",
keywords="computational social science",
keywords="social media",
abstract="Background: Unlike past pandemics, COVID-19 is different to the extent that there is an unprecedented surge in both peer-reviewed and preprint research publications, and important scientific conversations about it are rampant on online social networks, even among laypeople. Clearly, this new phenomenon of scientific discourse is not well understood in that we do not know the diffusion patterns of peer-reviewed publications vis-{\`a}-vis preprints and what makes them viral. Objective: This paper aimed to examine how the emotionality of messages about preprint and peer-reviewed publications shapes their diffusion through online social networks in order to inform health science communicators' and policy makers' decisions on how to promote reliable sharing of crucial pandemic science on social media. Methods: We collected a large sample of Twitter discussions of early (January to May 2020) COVID-19 medical research outputs, which were tracked by Altmetric, in both preprint servers and peer-reviewed journals, and conducted statistical analyses to examine emotional valence, specific emotions, and the role of scientists as content creators in influencing the retweet rate. Results: Our large-scale analyses (n=243,567) revealed that scientific publication tweets with positive emotions were transmitted faster than those with negative emotions, especially for messages about preprints. Our results also showed that scientists' participation in social media as content creators could accentuate the positive emotion effects on the sharing of peer-reviewed publications. Conclusions: Clear communication of critical science is crucial in the nascent stage of a pandemic. By revealing the emotional dynamics in the social media sharing of COVID-19 scientific outputs, our study offers scientists and policy makers an avenue to shape the discussion and diffusion of emerging scientific publications through manipulation of the emotionality of tweets. Scientists could use emotional language to promote the diffusion of more reliable peer-reviewed articles, while avoiding using too much positive emotional language in social media messages about preprints if they think that it is too early to widely communicate the preprint (not peer reviewed) data to the public. ",
doi="10.2196/37331",
url="https://infodemiology.jmir.org/2022/2/e37331",
url="http://www.ncbi.nlm.nih.gov/pubmed/36536762"
}


@Article{info:doi/10.2196/37924,
author="Germone, Monique
and Wright, D. Casey
and Kimmons, Royce
and Coburn, Skelley Shayna",
title="Twitter Trends for Celiac Disease and the Gluten-Free Diet: Cross-sectional Descriptive Analysis",
journal="JMIR Infodemiology",
year="2022",
month="Dec",
day="5",
volume="2",
number="2",
pages="e37924",
keywords="celiac disease",
keywords="social media",
keywords="Twitter",
keywords="gluten-free",
keywords="social networking site",
keywords="diet",
keywords="infodemiology",
keywords="education",
keywords="online",
keywords="content",
keywords="accuracy",
keywords="credibility",
abstract="Background: Few studies have systematically analyzed information regarding chronic medical conditions and available treatments on social media. Celiac disease (CD) is an exemplar of the need to investigate web-based educational sources. CD is an autoimmune condition wherein the ingestion of gluten causes intestinal damage and, if left untreated by a strict gluten-free diet (GFD), can result in significant nutritional deficiencies leading to cancer, bone disease, and death. Adherence to the GFD can be difficult owing to cost and negative stigma, including misinformation about what gluten is and who should avoid it. Given the significant impact that negative stigma and common misunderstandings have on the treatment of CD, this condition was chosen to systematically investigate the scope and nature of sources and information distributed through social media. Objective: To address concerns related to educational social media sources, this study explored trends on the social media platform Twitter about CD and the GFD to identify primary influencers and the type of information disseminated by these influencers. Methods: This cross-sectional study used data mining to collect tweets and users who used the hashtags \#celiac and \#glutenfree from an 8-month time frame. Tweets were then analyzed to describe who is disseminating information via this platform and the content, source, and frequency of such information. Results: More content was posted for \#glutenfree (1501.8 tweets per day) than for \#celiac (69 tweets per day). A substantial proportion of the content was produced by a small percentage of contributors (ie, ``Superuser''), who could be categorized as self-promotors (eg, bloggers, writers, authors; 13.9\% of \#glutenfree tweets and 22.7\% of \#celiac tweets), self-identified female family members (eg, mother; 4.3\% of \#glutenfree tweets and 8\% of \#celiac tweets), or commercial entities (eg, restaurants and bakeries). On the other hand, relatively few self-identified scientific, nonprofit, and medical provider users made substantial contributions on Twitter related to the GFD or CD (1\% of \#glutenfree tweets and 3.1\% of \#celiac tweets, respectively). Conclusions: Most material on Twitter was provided by self-promoters, commercial entities, or self-identified female family members, which may not have been supported by current medical and scientific practices. Researchers and medical providers could potentially benefit from contributing more to this space to enhance the web-based resources for patients and families. ",
doi="10.2196/37924",
url="https://infodemiology.jmir.org/2022/2/e37924",
url="http://www.ncbi.nlm.nih.gov/pubmed/37113453"
}


@Article{info:doi/10.2196/42241,
author="Tang, Qihang
and Zhou, Runtao
and Xie, Zidian
and Li, Dongmei",
title="Monitoring and Identifying Emerging e-Cigarette Brands and Flavors on Twitter: Observational Study",
journal="JMIR Form Res",
year="2022",
month="Dec",
day="5",
volume="6",
number="12",
pages="e42241",
keywords="e-cigarettes",
keywords="brand",
keywords="flavor",
keywords="Twitter",
abstract="Background: Flavored electronic cigarettes (e-cigarettes) have become very popular in recent years. e-Cigarette users like to share their e-cigarette products and e-cigarette use (vaping) experiences on social media. e-Cigarette marketing and promotions are also prevalent online. Objective: This study aims to develop a method to identify new e-cigarette brands and flavors mentioned on Twitter and to monitor e-cigarette brands and flavors mentioned on Twitter from May 2021 to December 2021. Methods: We collected 1.9 million tweets related to e-cigarettes between May 3, 2021, and December 31, 2021, by using the Twitter streaming application programming interface. Commercial and noncommercial tweets were characterized based on promotion-related keywords. We developed a depletion method to identify new e-cigarette brands by removing the keywords that already existed in the reference data set (Twitter data related to e-cigarettes from May 3, 2021, to August 31, 2021) or our previously identified brand list from the keywords in the target data set (e-cigarette--related Twitter data from September 1, 2021, to December 31, 2021), followed by a manual Google search to identify new e-cigarette brands. To identify new e-cigarette flavors, we constructed a flavor keyword list based on our previously collected e-cigarette flavor names, which were used to identify potential tweet segments that contain at least one of the e-cigarette flavor keywords. Tweets or tweet segments with flavor keywords but not any known flavor names were marked as potential new flavor candidates, which were further verified by a web-based search. The longitudinal trends in the number of tweets mentioning e-cigarette brands and flavors were examined in both commercial and noncommercial tweets. Results: Through our developed methods, we identified 34 new e-cigarette brands and 97 new e-cigarette flavors from commercial tweets as well as 56 new e-cigarette brands and 164 new e-cigarette flavors from noncommercial tweets. The longitudinal trend of the e-cigarette brands showed that JUUL was the most popular e-cigarette brand mentioned on Twitter; however, there was a decreasing trend in the mention of JUUL over time on Twitter. Menthol flavor was the most popular e-cigarette flavor mentioned in the commercial tweets, whereas mango flavor was the most popular e-cigarette flavor mentioned in the noncommercial tweets during our study period. Conclusions: Our proposed methods can successfully identify new e-cigarette brands and flavors mentioned on Twitter. Twitter data can be used for monitoring the dynamic changes in the popularity of e-cigarette brands and flavors. ",
doi="10.2196/42241",
url="https://formative.jmir.org/2022/12/e42241",
url="http://www.ncbi.nlm.nih.gov/pubmed/36469415"
}


@Article{info:doi/10.2196/37609,
author="Harrison, Anna
and Folk, Johanna
and Rodriguez, Christopher
and Wallace, Amanda
and Tolou-Shams, Marina",
title="Using Social Media to Engage Justice-Involved Young Adults in Digital Health Interventions for Substance Use: Pilot Feasibility Survey Study",
journal="JMIR Form Res",
year="2022",
month="Dec",
day="2",
volume="6",
number="12",
pages="e37609",
keywords="substance use",
keywords="young adult",
keywords="social media",
keywords="digital health technology",
keywords="mobile phone",
abstract="Background: Young adults involved in the justice system have high rates of substance use disorders and low rates of treatment engagement. Most justice-involved young adults are supervised in the community---not incarcerated in jail or prison---where they have ongoing access to substances and experience significant barriers to care. When they do engage in treatment, they tend to have worse outcomes than justice-involved adolescents and older adults. Despite the need to develop targeted treatments, there are unique challenges in recruiting this population into clinical research. Digital health technology offers many novel avenues for recruiting justice-involved young adults into clinical research studies and disseminating substance use disorder treatments to justice-involved young adults. Because the vast majority of young adults regularly use one or more social media platforms, social media may offer a cost-effective and efficient way to achieve these goals. Objective: This study aimed to describe the process and feasibility of using social media platforms (Facebook and Reddit) to recruit justice-involved young adults into clinical research. Justice-involved young adults recruited from these platforms completed a survey assessing the acceptability of digital health interventions to address substance use in this population. Methods: Justice-involved young adults (aged 18-24 years) were recruited through paid advertisements placed on Facebook and Reddit. Participants responded to a web-based survey focused on their substance use, treatment use history, and acceptability of various digital health interventions focused on substance use. Results: A national sample of justice-involved young adults were successfully enrolled and completed the survey (N=131). Participants were racially diverse (8/131, 6.1\% American Indian individuals; 27/131, 20.6\% Asian individuals; 23/131, 17.6\% Black individuals; 26/131, 19.8\% Latinx individuals; 8/131, 6.1\% Pacific Islander individuals; 49/131, 37.4\% White individuals; and 2/131, 1.5\% individuals who identified as ``other'' race and ethnicity). Advertisements were cost-effective (US \$0.66 per click on Facebook and US \$0.47 per click on Reddit). More than half (72/131, 54.9\%) of the participants were on probation or parole in the past year and reported hazardous alcohol (54/131, 51.9\%) or drug (66/131, 57.4\%) use. Most of the participants (103/131, 78.6\%) were not currently participating in substance use treatment. Nearly two-third (82/131, 62.6\%) of the participants were willing to participate in one or more hypothetical digital health interventions. Conclusions: Social media is a feasible and cost-effective method for reaching justice-involved young adults to participate in substance use research trials. With limited budgets, researchers can reach a broad audience, many of whom could benefit from treatment but are not currently engaged in care. Proposed digital health interventions focusing on reducing substance use, such as private Facebook groups, SMS text message--based appointment reminders, and coaching, had high acceptability. Future work will build on these findings to develop substance use treatment interventions for this population. ",
doi="10.2196/37609",
url="https://formative.jmir.org/2022/12/e37609",
url="http://www.ncbi.nlm.nih.gov/pubmed/36459404"
}


@Article{info:doi/10.2196/41785,
author="Galimov, Artur
and Vassey, Julia
and Galstyan, Ellen
and Unger, B. Jennifer
and Kirkpatrick, G. Matthew
and Allem, Jon-Patrick",
title="Ice Flavor--Related Discussions on Twitter: Content Analysis",
journal="J Med Internet Res",
year="2022",
month="Nov",
day="30",
volume="24",
number="11",
pages="e41785",
keywords="electronic cigarettes",
keywords="Twitter",
keywords="social media",
keywords="ice flavors",
keywords="tobacco policy",
keywords="public health",
keywords="infodemiology",
keywords="FDA",
keywords="tobacco",
keywords="smoking",
keywords="vaping",
keywords="e-cigarette",
keywords="public",
abstract="Background: The US Food and Drug Administration (FDA) recently restricted characterizing flavors in tobacco products. As a result, ice hybrid--flavored e-cigarettes, which combine a cooling flavor with fruit or other flavors (eg, banana ice), emerged on the market. Like menthol, ice-flavored e-cigarettes produce a cooling sensory experience. It is unclear if ice hybrid--flavored e-cigarettes should be considered characterizing flavors or menthol, limiting regulatory action. Monitoring the public's conversations about ice-flavored e-cigarettes on Twitter may help inform the tobacco control community about these products and contribute to the US FDA policy targets in the future. Objective: This study documented the themes pertaining to vaping and ice flavor--related conversations on Twitter. Our goal was to identify key conversation trends and ascertain users' recent experiences with ice-flavored e-cigarette products. Methods: Posts containing vaping-related (eg, ``vape,'' ``ecig,'' ``e-juice,'' or ``e-cigarette'') and ice-related (ie, ``Ice,'' ``Cool,'' ``Frost,'' and ``Arctic'') terms were collected from Twitter's streaming application programming interface from January 1 to July 21, 2021. After removing retweets, a random sample of posts (N=2001) was selected, with 590 posts included in the content analysis. Themes were developed through an inductive approach. Theme co-occurrence was also examined. Results: Many of the 590 posts were marked as (or consisted of) marketing material (n=306, 51.9\%), contained positive personal testimonials (n=180, 30.5\%), and mentioned disposable pods (n=117, 19.8\%). Other themes had relatively low prevalence in the sample: neutral personal testimonials (n=45, 7.6\%), cannabidiol products (n=41, 7\%), negative personal testimonials (n=41, 7\%), ``official'' flavor description (n=37, 6.3\%), ice-flavored JUUL (n=19, 3.2\%), information seeking (n=14, 2.4\%), and comparison to combustible tobacco (n=10, 1.7\%). The most common co-occurring themes in a single tweet were related to marketing and disposable pods (n=73, 12.4\%). Conclusions: Our findings offer insight into the public's experience with and understanding of ice-flavored e-cigarette products. Ice-flavored e-cigarette products are actively marketed on Twitter, and the messages about them are positive. Public health education campaigns on the harms of flavored e-cigarettes may help to reduce positive social norms about ice-flavored products. Future studies should evaluate the relationship between exposure to personal testimonials of ice-flavored vaping products and curiosity, harm perceptions, and experimentation with these products among priority populations. ",
doi="10.2196/41785",
url="https://www.jmir.org/2022/11/e41785",
url="http://www.ncbi.nlm.nih.gov/pubmed/36449326"
}


@Article{info:doi/10.2196/40905,
author="Ahmad, Areebah
and Alhanshali, Lina
and Jefferson, S. Itisha
and Dellavalle, Robert",
title="Cochrane Skin Group's Global Social Media Reach: Content Analysis of Facebook, Instagram, and Twitter Posts",
journal="JMIR Dermatol",
year="2022",
month="Nov",
day="30",
volume="5",
number="4",
pages="e40905",
keywords="social media",
keywords="Cochrane Skin",
keywords="dermatology",
keywords="content engagement",
keywords="Facebook",
keywords="Cochrane",
keywords="Twitter",
keywords="social media analysis",
keywords="content analysis",
keywords="skin disease",
keywords="dermatologist",
abstract="Background: Researchers in all medical specialties increasingly use social media to educate the public, share new publications with peers, and diversify their audiences. Objective: Given Cochrane Skin Group's expanded use of social media in the past years, we aimed to characterize Cochrane Skin Group's international social media audience and identify themes that result in increased content engagement. Methods: Cochrane Skin Group's Facebook, Instagram, and Twitter analytics data were extracted for follower demographics and the most viewed posts within a 3-year span (June 2019 to June 2022). Results: Overall, Cochrane Skin Group had the highest number of followers on Facebook (n=1037). The number of Instagram and Twitter followers reached 214 and 352, respectively. The greatest numbers of Facebook followers were from Brazil, Egypt, and India, with 271, 299, and 463 followers, respectively. Facebook's most viewed post about Cochrane Skin Group's annual meeting received 1041 views. The top post on Instagram, which introduced Cochrane Skin Group's social media editors, received 2522 views. Conclusions: Each of the social media platforms used by Cochrane Skin Group reached varying audiences all over the world. Across social media platforms, posts regarding Cochrane Skin Group meetings, members, and professional opportunities received the most views. Overall, Cochrane Skin Group's multiplatform social media approach will continue to grow an international audience, connecting people interested in skin disease. ",
doi="10.2196/40905",
url="https://derma.jmir.org/2022/4/e40905",
url="http://www.ncbi.nlm.nih.gov/pubmed/37632904"
}


@Article{info:doi/10.2196/42126,
author="Shaveet, Eden
and Urquhart, Catherine
and Gallegos, Marissa
and Dammann, Olaf
and Corlin, Laura",
title="Web-Based Health Information--Seeking Methods and Time Since Provider Engagement: Cross-sectional Study",
journal="JMIR Form Res",
year="2022",
month="Nov",
day="30",
volume="6",
number="11",
pages="e42126",
keywords="internet",
keywords="social media",
keywords="information-seeking behavior",
keywords="consumer health information",
keywords="physician-patient relations",
keywords="trust",
abstract="Background: The use of web-based methods to seek health information is increasing in popularity. As web-based health information (WHI)--seeking affects health-related decision support and chronic symptom self-management, WHI-seeking from online sources may impact health care decisions and outcomes, including care-seeking decisions. Patients who are routinely connected to physicians are more likely to receive better and more consistent care. Little is known about whether WHI-seeking impacts the frequency at which patients engage with health care providers. Objective: Our primary objective was to describe the associations between the use of web-based methods to seek information about one's own health and the time since last engaging with a health care provider about one's own health. Additionally, we aimed to assess participants' trust in health care organizations to contextualize our findings. Methods: We analyzed data from US adults participating in the nationally representative Tufts Equity in Health, Wealth, and Civic Engagement Survey (N=1034). Bivariate associations between demographic characteristics and health information--seeking methods were assessed with Pearson chi-squared tests. Bivariate associations of Medical Mistrust Index (MMI) scores with each health information--seeking method and time since provider engagement were assessed with F tests and adjusted Wald tests. We fit a multivariable logistic regression model to assess the association between WHI-seeking within the 12 months prior to survey (alone or in combination with provider-based methods versus provider only) and engagement with a provider more than 1 year prior to the time of survey, adjusting for age, race and ethnicity, sex, education, insurance coverage, and MMI. Results: Age, race and ethnicity, educational attainment, health insurance source, MMI, and time since provider engagement were each significantly associated with the health information--seeking method in bivariate analyses. Compared to using only provider-based health information seeking methods, WHI-based methods alone or in combination with provider-based methods were associated with a 51\% lower likelihood (odds ratio 0.49, 95\% CI 0.27-0.87) of engaging with a provider within the previous year. Participants who used WHI-seeking methods alone and those who had not engaged with a health care provider within the previous year demonstrated a higher mean MMI score; however, MMI was not a significant predictor of time since engagement with a provider in the multivariable analysis. Conclusions: Our findings from a nationally representative survey suggest that for those who use WHI-seeking methods (alone or in combination with provider-based information-seeking methods), there is a statistically significant lower likelihood of engaging with a provider in a year compared to those who only use provider-based methods. Future research should consider the intent of a person's visit with a provider, trust in health care systems, methods of provider engagement, and specific web-based platforms for health information. ",
doi="10.2196/42126",
url="https://formative.jmir.org/2022/11/e42126",
url="http://www.ncbi.nlm.nih.gov/pubmed/36449328"
}


@Article{info:doi/10.2196/40380,
author="Takats, Courtney
and Kwan, Amy
and Wormer, Rachel
and Goldman, Dari
and Jones, E. Heidi
and Romero, Diana",
title="Ethical and Methodological Considerations of Twitter Data for Public Health Research: Systematic Review",
journal="J Med Internet Res",
year="2022",
month="Nov",
day="29",
volume="24",
number="11",
pages="e40380",
keywords="systematic review",
keywords="Twitter",
keywords="social media",
keywords="public health ethics",
keywords="public health",
keywords="ethics",
keywords="ethical considerations",
keywords="public health research",
keywords="research topics",
keywords="Twitter data",
keywords="ethical framework",
keywords="research ethics",
abstract="Background: Much research is being carried out using publicly available Twitter data in the field of public health, but the types of research questions that these data are being used to answer and the extent to which these projects require ethical oversight are not clear. Objective: This review describes the current state of public health research using Twitter data in terms of methods and research questions, geographic focus, and ethical considerations including obtaining informed consent from Twitter handlers. Methods: We implemented a systematic review, following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, of articles published between January 2006 and October 31, 2019, using Twitter data in secondary analyses for public health research, which were found using standardized search criteria on SocINDEX, PsycINFO, and PubMed. Studies were excluded when using Twitter for primary data collection, such as for study recruitment or as part of a dissemination intervention. Results: We identified 367 articles that met eligibility criteria. Infectious disease (n=80, 22\%) and substance use (n=66, 18\%) were the most common topics for these studies, and sentiment mining (n=227, 62\%), surveillance (n=224, 61\%), and thematic exploration (n=217, 59\%) were the most common methodologies employed. Approximately one-third of articles had a global or worldwide geographic focus; another one-third focused on the United States. The majority (n=222, 60\%) of articles used a native Twitter application programming interface, and a significant amount of the remainder (n=102, 28\%) used a third-party application programming interface. Only one-third (n=119, 32\%) of studies sought ethical approval from an institutional review board, while 17\% of them (n=62) included identifying information on Twitter users or tweets and 36\% of them (n=131) attempted to anonymize identifiers. Most studies (n=272, 79\%) included a discussion on the validity of the measures and reliability of coding (70\% for interreliability of human coding and 70\% for computer algorithm checks), but less attention was paid to the sampling frame, and what underlying population the sample represented. Conclusions: Twitter data may be useful in public health research, given its access to publicly available information. However, studies should exercise greater caution in considering the data sources, accession method, and external validity of the sampling frame. Further, an ethical framework is necessary to help guide future research in this area, especially when individual, identifiable Twitter users and tweets are shared and discussed. Trial Registration: PROSPERO CRD42020148170; https://www.crd.york.ac.uk/prospero/display\_record.php?RecordID=148170 ",
doi="10.2196/40380",
url="https://www.jmir.org/2022/11/e40380",
url="http://www.ncbi.nlm.nih.gov/pubmed/36445739"
}


@Article{info:doi/10.2196/37941,
author="Gao, Yajing
and Chen, Xuemei
and Zhang, Wei
and Wang, Qiuyi
and Liu, Jing
and Zhou, Lanshou",
title="Online Ethnography for People With Chronic Conditions: Scoping Review",
journal="J Med Internet Res",
year="2022",
month="Nov",
day="29",
volume="24",
number="11",
pages="e37941",
keywords="online ethnography",
keywords="chronic condition",
keywords="scoping review",
keywords="review",
keywords="ethnography",
keywords="online",
keywords="research",
keywords="online users",
abstract="Background: Online ethnography has been making a unique contribution to people with chronic conditions as a complement to offline ethnography. It can also be used to study the complexities and contingencies of people with chronic conditions in the context of the internet. Therefore, there is a need to synthesize existing knowledge on research activities concerning online ethnography for people with chronic conditions. Objective: This scoping review aimed to profile the existing evidence on the application of online ethnography for people with chronic conditions, focusing on the characteristics, contributions, and implementation process. This will provide recommendations for the future use of online ethnography. Methods: We followed the scoping review methodologies developed by Arksey and O' Malley and the Joanna Briggs Institute. A comprehensive search was conducted on the PubMed, CINAHL, Embase, Scopus, and PsycInfo databases using preselected keywords. The search was limited to documents written in English and published between January 1, 2000, and February 1, 2022. After removal of duplicates, articles were screened by 2 independent reviewers reading the title, abstract, and full text. One reviewer extracted data, which were descriptively analyzed to map the existing knowledge. Results: After 2836 titles and abstracts and 51 full texts were screened, 27 publications were included in the analysis, published between 2009 and 2022. Most studies were from the United States (11/27, 40.7\%), and most articles collected data from online forums (10/27, 37.0\%). Moreover, the most commonly used type of researcher involvement was passive analysis (24/27, 88.9\%), and 18.5\% (5/27) of the topics concerned people with mental illness. Notably, the majority of articles did not report the immersion process in detail (17/25, 63.0\%). Ethical issues were mentioned in 88.9\% (24/27) of the included articles. Conclusions: We analyzed the current literature across fields and found that online ethnography can be exploited to explore the deeper experience of people with chronic conditions that are difficult to investigate using traditional ethnography. We found that there was diversity in researcher involvement, immersion process, data collection, and data analysis. However, most studies reported the insufficient immersion into the online environment. Researchers should determine the research approaches and data resources in order to complete culture immersion before researching. We also found that there was no uniform standard for ethical issues. Therefore, we recommend that researchers collect public and private data, obtain informed consent, and preserve the privacy and confidentiality of online users with chronic conditions. The findings can provide a practical reference for the use of online health care in studying chronic conditions. ",
doi="10.2196/37941",
url="https://www.jmir.org/2022/11/e37941",
url="http://www.ncbi.nlm.nih.gov/pubmed/36445746"
}


@Article{info:doi/10.2196/38441,
author="Weeks, Rose
and White, Sydney
and Hartner, Anna-Maria
and Littlepage, Shea
and Wolf, Jennifer
and Masten, Kristin
and Tingey, Lauren",
title="COVID-19 Messaging on Social Media for American Indian and Alaska Native Communities: Thematic Analysis of Audience Reach and Web Behavior",
journal="JMIR Infodemiology",
year="2022",
month="Nov",
day="25",
volume="2",
number="2",
pages="e38441",
keywords="COVID-19",
keywords="American Indian or Alaska Native",
keywords="social media",
keywords="communication",
keywords="tribal organization",
keywords="community health",
keywords="infodemiology",
keywords="Twitter",
keywords="online behavior",
keywords="content analysis",
keywords="thematic analysis",
abstract="Background: During the COVID-19 pandemic, tribal and health organizations used social media to rapidly disseminate public health guidance highlighting protective behaviors such as masking and vaccination to mitigate the pandemic's disproportionate burden on American Indian and Alaska Native (AI/AN) communities. Objective: Seeking to provide guidance for future communication campaigns prioritizing AI/AN audiences, this study aimed to identify Twitter post characteristics associated with higher performance, measured by audience reach (impressions) and web behavior (engagement rate). Methods: We analyzed Twitter posts published by a campaign by the Johns Hopkins Center for Indigenous Health from July 2020 to June 2021. Qualitative analysis was informed by in-depth interviews with members of a Tribal Advisory Board and thematically organized according to the Health Belief Model. A general linearized model was used to analyze associations between Twitter post themes, impressions, and engagement rates. Results: The campaign published 162 Twitter messages, which organically generated 425,834 impressions and 6016 engagements. Iterative analysis of these Twitter posts identified 10 unique themes under theory- and culture-related categories of framing knowledge, cultural messaging, normalizing mitigation strategies, and interactive opportunities, which were corroborated by interviews with Tribal Advisory Board members. Statistical analysis of Twitter impressions and engagement rate by theme demonstrated that posts featuring culturally resonant community role models (P=.02), promoting web-based events (P=.002), and with messaging as part of Twitter Chats (P<.001) were likely to generate higher impressions. In the adjusted analysis controlling for the date of posting, only the promotion of web-based events (P=.003) and Twitter Chat messaging (P=.01) remained significant. Visual, explanatory posts promoting self-efficacy (P=.01; P=.01) and humorous posts (P=.02; P=.01) were the most likely to generate high--engagement rates in both the adjusted and unadjusted analysis. Conclusions: Results from the 1-year Twitter campaign provide lessons to inform organizations designing social media messages to reach and engage AI/AN social media audiences. The use of interactive events, instructional graphics, and Indigenous humor are promising practices to engage community members, potentially opening audiences to receiving important and time-sensitive guidance. ",
doi="10.2196/38441",
url="https://infodemiology.jmir.org/2022/2/e38441",
url="http://www.ncbi.nlm.nih.gov/pubmed/36471705"
}


@Article{info:doi/10.2196/37559,
author="Kim, Jung Sunny
and Schiffelbein, E. Jenna
and Imset, Inger
and Olson, L. Ardis",
title="Countering Antivax Misinformation via Social Media: Message-Testing Randomized Experiment for Human Papillomavirus Vaccination Uptake",
journal="J Med Internet Res",
year="2022",
month="Nov",
day="24",
volume="24",
number="11",
pages="e37559",
keywords="misinformation",
keywords="vaccine hesitancy",
keywords="vaccine communication",
keywords="social media",
keywords="human papillomavirus",
keywords="HPV",
keywords="HPV vaccine",
abstract="Background: Suboptimal adolescent human papillomavirus (HPV) vaccination rates have been attributed to parental perceptions of the HPV vaccine. The internet has been cited as a setting where misinformation and controversy about HPV vaccination have been amplified. Objective: We aimed to test message effectiveness in changing parents' attitudes and behavioral intentions toward HPV vaccination. Methods: We conducted a web-based message-testing experiment with 6 control messages and 25 experimental messages and 5 from each of the 5 salient themes about HPV vaccination (theme 1: safety, side effects, risk, and ingredient concerns and long-term or major adverse events; theme 2: distrust of the health care system; theme 3: HPV vaccine effectiveness concerns; theme 4: connection to sexual activity; and theme 5: misinformation about HPV or HPV vaccine). Themes were identified from previous web-based focus group research with parents, and specific messages were developed by the study team using content from credible scientific sources. Through an iterative process of message development, the messages were crafted to be appropriate for presentation on a social media platform. Among the 1713 participants recruited via social media and crowdsourcing sites, 1043 eligible parents completed a pretest survey questionnaire. Participants were then randomly assigned to 1 of the 31 messages and asked to complete a posttest survey questionnaire that assessed attitudes toward the vaccine and perceived effectiveness of the viewed message. A subgroup of participants (189/995, 19\%) with unvaccinated children aged 9 to 14 years was also assessed for their behavioral intention to vaccinate their children against HPV. Results: Parents in the experimental group had increased positive attitudes toward HPV vaccination compared with those in the control group (t969=3.03, P=.003), which was associated with increased intention to vaccinate among parents of unvaccinated children aged 9 to 14 years (r=1.14, P=.05). At the thematic level, we identified 4 themes (themes 2-5) that were relatively effective in increasing behavioral intentions by positively influencing attitudes toward the HPV vaccine ($\chi$25=5.97, P=.31, root mean square error of approximation [RMSEA]=0.014, comparative fit index [CFI]=0.91, standardized root mean square residual [SRMR]=0.031). On the message level, messages that provided scientific evidence from government-related sources (eg, the Centers for Disease Control and Prevention) and corrected misinformation (eg, ``vaccines like the HPV vaccine are simply a way for pharmaceutical companies to make money. That isn't true'') were effective in forming positive perceptions toward the HPV vaccination messages. Conclusions: Evidence-based messages directly countering misinformation and promoting HPV vaccination in social media environments can positively influence parents' attitudes and behavioral intentions to vaccinate their children against HPV. ",
doi="10.2196/37559",
url="https://www.jmir.org/2022/11/e37559",
url="http://www.ncbi.nlm.nih.gov/pubmed/36422887"
}


@Article{info:doi/10.2196/39849,
author="D{\'e}guilhem, Am{\'e}lia
and Malaab, Joelle
and Talmatkadi, Manissa
and Renner, Simon
and Foulqui{\'e}, Pierre
and Fagherazzi, Guy
and Loussikian, Paul
and Marty, Tom
and Mebarki, Adel
and Texier, Nathalie
and Schuck, Stephane",
title="Identifying Profiles and Symptoms of Patients With Long COVID in France: Data Mining Infodemiology Study Based on Social Media",
journal="JMIR Infodemiology",
year="2022",
month="Nov",
day="22",
volume="2",
number="2",
pages="e39849",
keywords="long COVID",
keywords="social media",
keywords="Long Haulers",
keywords="difficulties encountered",
keywords="symptoms",
keywords="infodemiology study",
keywords="infodemiology",
keywords="COVID-19",
keywords="patient-reported outcomes",
keywords="persistent",
keywords="condition",
keywords="topics",
keywords="discussion",
keywords="content",
abstract="Background: Long COVID---a condition with persistent symptoms post COVID-19 infection---is the first illness arising from social media. In France, the French hashtag \#ApresJ20 described symptoms persisting longer than 20 days after contracting COVID-19. Faced with a lack of recognition from medical and official entities, patients formed communities on social media and described their symptoms as long-lasting, fluctuating, and multisystemic. While many studies on long COVID relied on traditional research methods with lengthy processes, social media offers a foundation for large-scale studies with a fast-flowing outburst of data. Objective: We aimed to identify and analyze Long Haulers' main reported symptoms, symptom co-occurrences, topics of discussion, difficulties encountered, and patient profiles. Methods: Data were extracted based on a list of pertinent keywords from public sites (eg, Twitter) and health-related forums (eg, Doctissimo). Reported symptoms were identified via the MedDRA dictionary, displayed per the volume of posts mentioning them, and aggregated at the user level. Associations were assessed by computing co-occurrences in users' messages, as pairs of preferred terms. Discussion topics were analyzed using the Biterm Topic Modeling; difficulties and unmet needs were explored manually. To identify patient profiles in relation to their symptoms, each preferred term's total was used to create user-level hierarchal clusters. Results: Between January 1, 2020, and August 10, 2021, overall, 15,364 messages were identified as originating from 6494 patients of long COVID or their caregivers. Our analyses revealed 3 major symptom co-occurrences: asthenia-dyspnea (102/289, 35.3\%), asthenia-anxiety (65/289, 22.5\%), and asthenia-headaches (50/289, 17.3\%). The main reported difficulties were symptom management (150/424, 35.4\% of messages), psychological impact (64/424,15.1\%), significant pain (51/424, 12.0\%), deterioration in general well-being (52/424, 12.3\%), and impact on daily and professional life (40/424, 9.4\% and 34/424, 8.0\% of messages, respectively). We identified 3 profiles of patients in relation to their symptoms: profile A (n=406 patients) reported exclusively an asthenia symptom; profile B (n=129) expressed anxiety (n=129, 100\%), asthenia (n=28, 21.7\%), dyspnea (n=15, 11.6\%), and ageusia (n=3, 2.3\%); and profile C (n=141) described dyspnea (n=141, 100\%), and asthenia (n=45, 31.9\%). Approximately 49.1\% of users (79/161) continued expressing symptoms after more than 3 months post infection, and 20.5\% (33/161) after 1 year. Conclusions: Long COVID is a lingering condition that affects people worldwide, physically and psychologically. It impacts Long Haulers' quality of life, everyday tasks, and professional activities. Social media played an undeniable role in raising and delivering Long Haulers' voices and can potentially rapidly provide large volumes of valuable patient-reported information. Since long COVID was a self-titled condition by patients themselves via social media, it is imperative to continuously include their perspectives in related research. Our results can help design patient-centric instruments to be further used in clinical practice to better capture meaningful dimensions of long COVID. ",
doi="10.2196/39849",
url="https://infodemiology.jmir.org/2022/2/e39849",
url="http://www.ncbi.nlm.nih.gov/pubmed/36447795"
}


@Article{info:doi/10.2196/36871,
author="Erturk, Sinan
and Hudson, Georgie
and Jansli, M. Sonja
and Morris, Daniel
and Odoi, M. Clarissa
and Wilson, Emma
and Clayton-Turner, Angela
and Bray, Vanessa
and Yourston, Gill
and Cornwall, Andrew
and Cummins, Nicholas
and Wykes, Til
and Jilka, Sagar",
title="Codeveloping and Evaluating a Campaign to Reduce Dementia Misconceptions on Twitter: Machine Learning Study",
journal="JMIR Infodemiology",
year="2022",
month="Nov",
day="22",
volume="2",
number="2",
pages="e36871",
keywords="machine learning",
keywords="patient and public involvement",
keywords="codevelopment",
keywords="misconceptions",
keywords="stigma",
keywords="Twitter",
keywords="social media",
abstract="Background: Dementia misconceptions on Twitter can have detrimental or harmful effects. Machine learning (ML) models codeveloped with carers provide a method to identify these and help in evaluating awareness campaigns. Objective: This study aimed to develop an ML model to distinguish between misconceptions and neutral tweets and to develop, deploy, and evaluate an awareness campaign to tackle dementia misconceptions. Methods: Taking 1414 tweets rated by carers from our previous work, we built 4 ML models. Using a 5-fold cross-validation, we evaluated them and performed a further blind validation with carers for the best 2 ML models; from this blind validation, we selected the best model overall. We codeveloped an awareness campaign and collected pre-post campaign tweets (N=4880), classifying them with our model as misconceptions or not. We analyzed dementia tweets from the United Kingdom across the campaign period (N=7124) to investigate how current events influenced misconception prevalence during this time. Results: A random forest model best identified misconceptions with an accuracy of 82\% from blind validation and found that 37\% of the UK tweets (N=7124) about dementia across the campaign period were misconceptions. From this, we could track how the prevalence of misconceptions changed in response to top news stories in the United Kingdom. Misconceptions significantly rose around political topics and were highest (22/28, 79\% of the dementia tweets) when there was controversy over the UK government allowing to continue hunting during the COVID-19 pandemic. After our campaign, there was no significant change in the prevalence of misconceptions. Conclusions: Through codevelopment with carers, we developed an accurate ML model to predict misconceptions in dementia tweets. Our awareness campaign was ineffective, but similar campaigns could be enhanced through ML to respond to current events that affect misconceptions in real time. ",
doi="10.2196/36871",
url="https://infodemiology.jmir.org/2022/2/e36871",
url="http://www.ncbi.nlm.nih.gov/pubmed/37113444"
}


@Article{info:doi/10.2196/40764,
author="Xue, Haoning
and Zhang, Jingwen
and Sagae, Kenji
and Nishimine, Brian
and Fukuoka, Yoshimi",
title="Analyzing Public Conversations About Heart Disease and Heart Health on Facebook From 2016 to 2021: Retrospective Observational Study Applying Latent Dirichlet Allocation Topic Modeling",
journal="JMIR Cardio",
year="2022",
month="Nov",
day="22",
volume="6",
number="2",
pages="e40764",
keywords="heart health",
keywords="heart disease",
keywords="topic modeling",
keywords="sentiment analysis",
keywords="social media",
keywords="Facebook",
keywords="COVID-19",
keywords="women's heart health",
abstract="Background: Heart disease continues to be the leading cause of death in men and women in the United States. The COVID-19 pandemic has further led to increases in various long-term cardiovascular complications. Objective: This study analyzed public conversations related to heart disease and heart health on Facebook in terms of their thematic topics and sentiments. In addition, it provided in-depth analyses of 2 subtopics with important practical implications: heart health for women and heart health during the COVID-19 pandemic. Methods: We collected 34,885 posts and 51,835 comments spanning from June 2016 to June 2021 that were related to heart disease and health from public Facebook pages and groups. We used latent Dirichlet allocation topic modeling to extract discussion topics illuminating the public's interests and concerns regarding heart disease and heart health. We also used Linguistic Inquiry and Word Count (Pennebaker Conglomerates, Inc) to identify public sentiments regarding heart health. Results: We observed an increase in discussions related to heart health on Facebook. Posts and comments increased from 3102 and 3632 in 2016 to 8550 (176\% increase) and 14,617 (302\% increase) in 2021, respectively. Overall, 35.37\% (12,340/34,885) of the posts were created after January 2020, the start of the COVID-19 pandemic. In total, 39.21\% (13,677/34,885) of the posts were by nonprofit health organizations. We identified 6 topics in the posts (heart health promotion, personal experiences, risk-reduction education, heart health promotion for women, educational information, and physicians' live discussion sessions). We identified 6 topics in the comments (personal experiences, survivor stories, risk reduction, religion, medical questions, and appreciation of physicians and information on heart health). During the pandemic (from January 2020 to June 2021), risk reduction was a major topic in both posts and comments. Unverified information on alternative treatments and promotional content was also prevalent. Among all posts, 14.91\% (5200/34,885) were specifically about heart health for women centering on local event promotion and distinctive symptoms of heart diseases for women. Conclusions: Our results tracked the public's ongoing discussions on heart disease and heart health on one prominent social media platform, Facebook. The public's discussions and information sharing on heart health increased over time, especially since the start of the COVID-19 pandemic. Various levels of health organizations on Facebook actively promoted heart health information and engaged a large number of users. Facebook presents opportunities for more targeted heart health interventions that can reach and engage diverse populations. ",
doi="10.2196/40764",
url="https://cardio.jmir.org/2022/2/e40764",
url="http://www.ncbi.nlm.nih.gov/pubmed/36318640"
}


@Article{info:doi/10.2196/37617,
author="Mills, Marie Christine
and Parniak, Simone
and Hand, Carri
and McGrath, Colleen
and Laliberte Rudman, Debbie
and Chislett, Cassandra
and Giberson, Mariah
and White, Lauren
and DePaul, Vincent
and Donnelly, Catherine",
title="The Impact of a Naturally Occurring Retirement Community Supportive Services Program on Older Adult Participants' Social Networks: Semistructured Interview Study",
journal="JMIR Aging",
year="2022",
month="Nov",
day="21",
volume="5",
number="4",
pages="e37617",
keywords="aging in place",
keywords="naturally occurring retirement communities",
keywords="social networks",
keywords="social networking",
keywords="social capital",
keywords="aged",
abstract="Background: Most older adults want to age in place, in their homes and communities. However, this can be challenging for many, frequently owing to lack of supports that allow for aging in place. Naturally occurring retirement community supportive services programs (NORC-SSPs) offer an approach to help older adults age in place. Although qualitative studies have examined the experiences of NORC-SSP participants, little is known about how participation in NORC-SSP programming affects participants' social networks. Objective: This study aimed to explore the experiences of 13 NORC-SSP residents who participated in Oasis Senior Supportive Living (Oasis) and how participating in NORC-SSP programming, specifically based on the Oasis model, influenced their social networks. Methods: Participants were recruited, using convenience sampling, from 4 naturally occurring retirement communities (NORCs) in Ontario, Canada. All participants (13/13, 100\%) had participated in Oasis programming. Semistructured qualitative interviews were conducted with participants. Social network theory informed the interview guide and thematic analysis. Results: In total, 13 participants (n=12, 92\% women and n=1, 8\% men) were interviewed. These participants were from 4 different NORCs where Oasis had been implemented, comprising 2 midrise apartment buildings, 1 low-rise apartment building, and 1 mobile home community. Overall, 3 main themes were identified from the interviews with Oasis participants: expansion and deepening of social networks, Oasis activities (something to do, someone to do it with), and self-reported impact of Oasis on mental health and well-being (feeling and coping with life better). Participants noted that Oasis provided them with opportunities to meet new people and broaden their social networks, both within and outside their NORCs. They also indicated that Oasis provided them with meaningful ways to spend their time, including opportunities to socialize and try new activities. Participants stated that participating in Oasis helped to alleviate loneliness and improved their quality of life. They noted that Oasis provided them with a reason to get up in the morning. However, the experiences described by participants may not be reflective of all Oasis members. Those who had positive experiences may have been more likely to agree to be interviewed. Conclusions: On the basis of the participants' interviews, Oasis is an effective aging-in-place model that has been successfully implemented in low-rise apartment buildings, midrise apartment buildings, and mobile home communities. Participating in Oasis allowed participants to expand their social networks and improve their mental health and well-being. Therefore, NORCs may offer an ideal opportunity to build strong communities that provide deep, meaningful social connections that expand social networks. NORC-SSPs, such as Oasis, can support healthy aging and allow older adults to age in place. ",
doi="10.2196/37617",
url="https://aging.jmir.org/2022/4/e37617",
url="http://www.ncbi.nlm.nih.gov/pubmed/36409533"
}


@Article{info:doi/10.2196/40701,
author="Wang, Dandan
and Zhou, Yadong
and Ma, Feicheng",
title="Opinion Leaders and Structural Hole Spanners Influencing Echo Chambers in Discussions About COVID-19 Vaccines on Social Media in China: Network Analysis",
journal="J Med Internet Res",
year="2022",
month="Nov",
day="18",
volume="24",
number="11",
pages="e40701",
keywords="COVID-19",
keywords="COVID-19 vaccine",
keywords="echo chamber",
keywords="opinion leader",
keywords="structural hole spanner",
keywords="topic",
keywords="sentiment",
keywords="social media",
keywords="vaccine hesitancy",
keywords="public health",
keywords="vaccination",
keywords="health promotion",
keywords="online campaign",
keywords="social network analysis",
abstract="Background: Social media provide an ideal medium for breeding and reinforcing vaccine hesitancy, especially during public health emergencies. Algorithmic recommendation--based technology along with users' selective exposure and group pressure lead to online echo chambers, causing inefficiency in vaccination promotion. Avoiding or breaking echo chambers largely relies on key users' behavior. Objective: With the ultimate goal of eliminating the impact of echo chambers related to vaccine hesitancy on social media during public health emergencies, the aim of this study was to develop a framework to quantify the echo chamber effect in users' topic selection and attitude contagion about COVID-19 vaccines or vaccinations; detect online opinion leaders and structural hole spanners based on network attributes; and explore the relationships of their behavior patterns and network locations, as well as the relationships of network locations and impact on topic-based and attitude-based echo chambers. Methods: We called the Sina Weibo application programming interface to crawl tweets related to the COVID-19 vaccine or vaccination and user information on Weibo, a Chinese social media platform. Adopting social network analysis, we examined the low echo chamber effect based on topics in representational networks of information, according to attitude in communication flow networks of users under different interactive mechanisms (retweeting, commenting). Statistical and visual analyses were used to characterize behavior patterns of key users (opinion leaders, structural hole spanners), and to explore their function in avoiding or breaking topic-based and attitude-based echo chambers. Results: Users showed a low echo chamber effect in vaccine-related topic selection and attitude interaction. For the former, the homophily was more obvious in retweeting than in commenting, whereas the opposite trend was found for the latter. Speakers, replicators, and monologists tended to be opinion leaders, whereas common users, retweeters, and networkers tended to be structural hole spanners. Both leaders and spanners tended to be ``bridgers'' to disseminate diverse topics and communicate with users holding cross-cutting attitudes toward COVID-19 vaccines. Moreover, users who tended to echo a single topic could bridge multiple attitudes, while users who focused on diverse topics also tended to serve as bridgers for different attitudes. Conclusions: This study not only revealed a low echo chamber effect in vaccine hesitancy, but further elucidated the underlying reasons from the perspective of users, offering insights for research about the form, degree, and formation of echo chambers, along with depolarization, social capital, stakeholder theory, user portraits, dissemination pattern of topic, and sentiment. Therefore, this work can help to provide strategies for public health and public opinion managers to cooperate toward avoiding or correcting echo chamber chaos and effectively promoting online vaccine campaigns. ",
doi="10.2196/40701",
url="https://www.jmir.org/2022/11/e40701",
url="http://www.ncbi.nlm.nih.gov/pubmed/36367965"
}


@Article{info:doi/10.2196/40160,
author="Russell, M. Alex
and Valdez, Danny
and Chiang, C. Shawn
and Montemayor, N. Ben
and Barry, E. Adam
and Lin, Hsien-Chang
and Massey, M. Philip",
title="Using Natural Language Processing to Explore ``Dry January'' Posts on Twitter: Longitudinal Infodemiology Study",
journal="J Med Internet Res",
year="2022",
month="Nov",
day="18",
volume="24",
number="11",
pages="e40160",
keywords="alcohol",
keywords="drinking",
keywords="social media",
keywords="Twitter",
keywords="Dry January",
keywords="infodemiology",
keywords="infoveillance",
keywords="natural language processing",
abstract="Background: Dry January, a temporary alcohol abstinence campaign, encourages individuals to reflect on their relationship with alcohol by temporarily abstaining from consumption during the month of January. Though Dry January has become a global phenomenon, there has been limited investigation into Dry January participants' experiences. One means through which to gain insights into individuals' Dry January-related experiences is by leveraging large-scale social media data (eg, Twitter chatter) to explore and characterize public discourse concerning Dry January. Objective: We sought to answer the following questions: (1) What themes are present within a corpus of tweets about Dry January, and is there consistency in the language used to discuss Dry January across multiple years of tweets (2020-2022)? (2) Do unique themes or patterns emerge in Dry January 2021 tweets after the onset of the COVID-19 pandemic? and (3) What is the association with tweet composition (ie, sentiment and human-authored vs bot-authored) and engagement with Dry January tweets? Methods: We applied natural language processing techniques to a large sample of tweets (n=222,917) containing the term ``dry january'' or ``dryjanuary'' posted from December 15 to February 15 across three separate years of participation (2020-2022). Term frequency inverse document frequency, k-means clustering, and principal component analysis were used for data visualization to identify the optimal number of clusters per year. Once data were visualized, we ran interpretation models to afford within-year (or within-cluster) comparisons. Latent Dirichlet allocation topic modeling was used to examine content within each cluster per given year. Valence Aware Dictionary and Sentiment Reasoner sentiment analysis was used to examine affect per cluster per year. The Botometer automated account check was used to determine average bot score per cluster per year. Last, to assess user engagement with Dry January content, we took the average number of likes and retweets per cluster and ran correlations with other outcome variables of interest. Results: We observed several similar topics per year (eg, Dry January resources, Dry January health benefits, updates related to Dry January progress), suggesting relative consistency in Dry January content over time. Although there was overlap in themes across multiple years of tweets, unique themes related to individuals' experiences with alcohol during the midst of the COVID-19 global pandemic were detected in the corpus of tweets from 2021. Also, tweet composition was associated with engagement, including number of likes, retweets, and quote-tweets per post. Bot-dominant clusters had fewer likes, retweets, or quote tweets compared with human-authored clusters. Conclusions: The findings underscore the utility for using large-scale social media, such as discussions on Twitter, to study drinking reduction attempts and to monitor the ongoing dynamic needs of persons contemplating, preparing for, or actively pursuing attempts to quit or cut down on their drinking. ",
doi="10.2196/40160",
url="https://www.jmir.org/2022/11/e40160",
url="http://www.ncbi.nlm.nih.gov/pubmed/36343184"
}


@Article{info:doi/10.2196/42261,
author="Ljaji{\'c}, Adela
and Prodanovi{\'c}, Nikola
and Medvecki, Darija
and Ba{\vs}aragin, Bojana
and Mitrovi{\'c}, Jelena",
title="Uncovering the Reasons Behind COVID-19 Vaccine Hesitancy in Serbia: Sentiment-Based Topic Modeling",
journal="J Med Internet Res",
year="2022",
month="Nov",
day="17",
volume="24",
number="11",
pages="e42261",
keywords="topic modeling",
keywords="sentiment analysis",
keywords="LDA",
keywords="NMF",
keywords="BERT",
keywords="vaccine hesitancy",
keywords="COVID-19",
keywords="Twitter",
keywords="Serbian language processing",
keywords="vaccine",
keywords="public health",
keywords="NLP",
keywords="vaccination",
keywords="Serbia",
abstract="Background: Since the first COVID-19 vaccine appeared, there has been a growing tendency to automatically determine public attitudes toward it. In particular, it was important to find the reasons for vaccine hesitancy, since it was directly correlated with pandemic protraction. Natural language processing (NLP) and public health researchers have turned to social media (eg, Twitter, Reddit, and Facebook) for user-created content from which they can gauge public opinion on vaccination. To automatically process such content, they use a number of NLP techniques, most notably topic modeling. Topic modeling enables the automatic uncovering and grouping of hidden topics in the text. When applied to content that expresses a negative sentiment toward vaccination, it can give direct insight into the reasons for vaccine hesitancy. Objective: This study applies NLP methods to classify vaccination-related tweets by sentiment polarity and uncover the reasons for vaccine hesitancy among the negative tweets in the Serbian language. Methods: To study the attitudes and beliefs behind vaccine hesitancy, we collected 2 batches of tweets that mention some aspects of COVID-19 vaccination. The first batch of 8817 tweets was manually annotated as either relevant or irrelevant regarding the COVID-19 vaccination sentiment, and then the relevant tweets were annotated as positive, negative, or neutral. We used the annotated tweets to train a sequential bidirectional encoder representations from transformers (BERT)-based classifier for 2 tweet classification tasks to augment this initial data set. The first classifier distinguished between relevant and irrelevant tweets. The second classifier used the relevant tweets and classified them as negative, positive, or neutral. This sequential classifier was used to annotate the second batch of tweets. The combined data sets resulted in 3286 tweets with a negative sentiment: 1770 (53.9\%) from the manually annotated data set and 1516 (46.1\%) as a result of automatic classification. Topic modeling methods (latent Dirichlet allocation [LDA] and nonnegative matrix factorization [NMF]) were applied using the 3286 preprocessed tweets to detect the reasons for vaccine hesitancy. Results: The relevance classifier achieved an F-score of 0.91 and 0.96 for relevant and irrelevant tweets, respectively. The sentiment polarity classifier achieved an F-score of 0.87, 0.85, and 0.85 for negative, neutral, and positive sentiments, respectively. By summarizing the topics obtained in both models, we extracted 5 main groups of reasons for vaccine hesitancy: concern over vaccine side effects, concern over vaccine effectiveness, concern over insufficiently tested vaccines, mistrust of authorities, and conspiracy theories. Conclusions: This paper presents a combination of NLP methods applied to find the reasons for vaccine hesitancy in Serbia. Given these reasons, it is now possible to better understand the concerns of people regarding the vaccination process. ",
doi="10.2196/42261",
url="https://www.jmir.org/2022/11/e42261",
url="http://www.ncbi.nlm.nih.gov/pubmed/36301673"
}


@Article{info:doi/10.2196/42441,
author="Vassey, Julia
and Donaldson, I. Scott
and Dormanesh, Allison
and Allem, Jon-Patrick",
title="Themes in TikTok Videos Featuring Little Cigars and Cigarillos: Content Analysis",
journal="J Med Internet Res",
year="2022",
month="Nov",
day="16",
volume="24",
number="11",
pages="e42441",
keywords="cigarillo",
keywords="little cigar",
keywords="social media",
keywords="TikTok",
keywords="video",
keywords="cigar",
keywords="cigarette",
keywords="smoker",
keywords="smoking",
keywords="tobacco",
keywords="content analysis",
keywords="youth",
keywords="young adult",
keywords="adolescent",
keywords="user generated content",
abstract="Background: Little cigars and cigarillos (LCCs) are popular tobacco products among youth (ie, adolescents and young adults). A variety of LCC-related promotional and user-generated content is present on social media. However, research on LCC-related posts on social media has been largely focused on platforms that are primarily text- or image-based, such as Twitter and Instagram. Objective: This study analyzed LCC-related content on TikTok, an audio and video--based platform popular among youth. Methods: Publicly available posts (N=811) that contained the LCC-related hashtags \#swishersweets or \#backwoods were collected on TikTok from January 2019 to May 2021. Metadata were also collected, including numbers of likes, comments, shares, and views per video. Using an inductive approach, a codebook consisting of 26 themes was developed to help summarize the underlying themes evident in the TikTok videos and corresponding captions. A pairwise co-occurrence analysis of themes was also conducted to evaluate connections among themes. Results: Among the 811 posts, the LCC presence theme (ie, a visible LCC) occurred in the most prominent number of posts (n=661, 81.5\%), followed by music (n=559, 68.9\%), youth (n=332, 40.9\%), humor (n=263, 32.4\%), LCC use (n=242, 29.8\%), flavors (n=232, 28.6\%), branding (n=182, 22.4\%), paraphernalia (n=137, 16.9\%), blunt rolling (n=94, 11.6\%), and price (n=84, 10.4\%). Product reviews had the highest engagement, with a median 44 (mean 2857, range 36,499) likes and median 491 (mean 15,711, range 193,590) views; followed by product comparisons, with a median 44 (mean 1920, range 36,500) likes and median 671 (mean 11,277, range 193,798) views. Promotions had the lowest engagement, with a median 4 (mean 8, range 34) likes and median 78 (mean 213, range 1131) views. The most prevalent themes co-occurring with LCC presence were (1) music (434/811, 53.5\%), (2) youth (264/811, 32.6\%), (3) humor (219/811, 27\%), (4) flavors (214/811, 26.4\%), and (5) LCC use (207/811, 25.5\%). Conclusions: LCC-related marketing and user-generated content was present on TikTok, including videos showing youth discussing, displaying, or using LCCs. Such content may be in violation of TikTok's community guidelines prohibiting the display, promotion, or posting of tobacco-related content on its platform, including the display of possession or consumption of tobacco by a minor. Further improvement in the enforcement of TikTok community guidelines and additional scrutiny from public health policy makers may be necessary for protecting youth from future exposure to tobacco-related posts. Observational and experimental studies are needed to understand the impact of exposure to LCC-related videos on attitudes and behaviors related to LCC use among youth. Finally, there may be a need for engaging antitobacco videos that appeal to youth on TikTok to counter the protobacco content on this platform. ",
doi="10.2196/42441",
url="https://www.jmir.org/2022/11/e42441",
url="http://www.ncbi.nlm.nih.gov/pubmed/36383406"
}


@Article{info:doi/10.2196/35974,
author="Khademi Habibabadi, Sedigheh
and Hallinan, Christine
and Bonomo, Yvonne
and Conway, Mike",
title="Consumer-Generated Discourse on Cannabis as a Medicine: Scoping Review of Techniques",
journal="J Med Internet Res",
year="2022",
month="Nov",
day="16",
volume="24",
number="11",
pages="e35974",
keywords="social media",
keywords="data mining",
keywords="internet and the web technology",
keywords="consumer-generated data",
keywords="medicinal cannabis",
keywords="medical marijuana",
abstract="Background: Medicinal cannabis is increasingly being used for a variety of physical and mental health conditions. Social media and web-based health platforms provide valuable, real-time, and cost-effective surveillance resources for gleaning insights regarding individuals who use cannabis for medicinal purposes. This is particularly important considering that the evidence for the optimal use of medicinal cannabis is still emerging. Despite the web-based marketing of medicinal cannabis to consumers, currently, there is no robust regulatory framework to measure clinical health benefits or individual experiences of adverse events. In a previous study, we conducted a systematic scoping review of studies that contained themes of the medicinal use of cannabis and used data from social media and search engine results. This study analyzed the methodological approaches and limitations of these studies. Objective: We aimed to examine research approaches and study methodologies that use web-based user-generated text to study the use of cannabis as a medicine. Methods: We searched MEDLINE, Scopus, Web of Science, and Embase databases for primary studies in the English language from January 1974 to April 2022. Studies were included if they aimed to understand web-based user-generated text related to health conditions where cannabis is used as a medicine or where health was mentioned in general cannabis-related conversations. Results: We included 42 articles in this review. In these articles, Twitter was used 3 times more than other computer-generated sources, including Reddit, web-based forums, GoFundMe, YouTube, and Google Trends. Analytical methods included sentiment assessment, thematic analysis (manual and automatic), social network analysis, and geographic analysis. Conclusions: This study is the first to review techniques used by research on consumer-generated text for understanding cannabis as a medicine. It is increasingly evident that consumer-generated data offer opportunities for a greater understanding of individual behavior and population health outcomes. However, research using these data has some limitations that include difficulties in establishing sample representativeness and a lack of methodological best practices. To address these limitations, deidentified annotated data sources should be made publicly available, researchers should determine the origins of posts (organizations, bots, power users, or ordinary individuals), and powerful analytical techniques should be used. ",
doi="10.2196/35974",
url="https://www.jmir.org/2022/11/e35974",
url="http://www.ncbi.nlm.nih.gov/pubmed/36383417"
}


@Article{info:doi/10.2196/38862,
author="Moyano, Luz Daniela
and Lopez, Victoria Mar{\'i}a
and Cavallo, Ana
and Candia, Patricia Julia
and Kaen, Aaron
and Irazola, Vilma
and Beratarrechea, Andrea",
title="The Use of 2 e-Learning Modalities for Diabetes Education Using Facebook in 2 Cities of Argentina During the COVID-19 Pandemic: Qualitative Study",
journal="JMIR Form Res",
year="2022",
month="Nov",
day="16",
volume="6",
number="11",
pages="e38862",
keywords="COVID-19",
keywords="social media",
keywords="diabetes mellitus",
keywords="public health",
keywords="qualitative research",
keywords="COVID-19 pandemic",
keywords="teaching and learning settings",
keywords="online learning",
keywords="eHealth literacy",
abstract="Background: The COVID-19 pandemic and the confinement that was implemented in Argentina generated a need to implement innovative tools for the strengthening of diabetes care. Diabetes self-management education (DSME) is a core element of diabetes care; however, because of COVID-19 restrictions, in-person diabetes educational activities were suspended. Social networks have played an instrumental role in this context to provide DSME in 2 cities of Argentina and help persons with diabetes in their daily self-management. Objective: The aim of this study is to evaluate 2 diabetes education modalities (synchronous and asynchronous) using the social media platform Facebook through the content of posts on diabetes educational sessions in 2 cities of Argentina during the COVID-19 pandemic. Methods: In this qualitative study, we explored 2 modalities of e-learning (synchronous and asynchronous) for diabetes education that used the Facebook pages of public health institutions in Chaco and La Rioja, Argentina, in the context of confinement. Social media metrics and the content of the messages posted by users were analyzed. Results: A total of 332 messages were analyzed. We found that in the asynchronous modality, there was a higher number of visualizations, while in the synchronous modality, there were more posts and interactions between educators and users. We also observed that the number of views increased when primary care clinics were incorporated as disseminators, sharing educational videos from the sessions via social media. Positive aspects were observed in the posts, consisting of messages of thanks and, to a lesser extent, reaffirmations, reflections or personal experiences, and consultations related to the subject treated. Another relevant finding was that the educator/moderator role had a greater presence in the synchronous modality, where posts were based on motivation for participation, help to resolve connectivity problems, and answers to specific user queries. Conclusions: Our findings show positive contributions of an educational intervention for diabetes care using the social media platform Facebook in the context of the COVID-19 pandemic. Although each modality (synchronous vs asynchronous) could have differential and particular advantages, we believe that these strategies have potential to be replicated and adapted to other contexts. However, more documented experiences are needed to explore their sustainability and long-term impact from the users' perspective. ",
doi="10.2196/38862",
url="https://formative.jmir.org/2022/11/e38862",
url="http://www.ncbi.nlm.nih.gov/pubmed/36322794"
}


@Article{info:doi/10.2196/38232,
author="Teodorowski, Piotr
and Rodgers, E. Sarah
and Fleming, Kate
and Frith, Lucy",
title="Use of the Hashtag \#DataSavesLives on Twitter: Exploratory and Thematic Analysis",
journal="J Med Internet Res",
year="2022",
month="Nov",
day="15",
volume="24",
number="11",
pages="e38232",
keywords="consumer involvement",
keywords="patient participation",
keywords="stakeholder participation",
keywords="social media",
keywords="public engagement",
keywords="campaign",
keywords="big data",
keywords="research",
keywords="trust",
keywords="tweets",
keywords="Twitter",
keywords="perception",
keywords="usage",
keywords="users",
keywords="data sharing",
keywords="ethics",
keywords="community",
keywords="hashtag",
abstract="Background: ``Data Saves Lives'' is a public engagement campaign that highlights the benefits of big data research and aims to establish public trust for this emerging research area. Objective: This study explores how the hashtag \#DataSavesLives is used on Twitter. We focused on the period when the UK government and its agencies adopted \#DataSavesLives in an attempt to support their plans to set up a new database holding National Health Service (NHS) users' medical data. Methods: Public tweets published between April 19 and July 15, 2021, using the hashtag \#DataSavesLives were saved using NCapture for NVivo 12. All tweets were coded twice. First, each tweet was assigned a positive, neutral, or negative attitude toward the campaign. Second, inductive thematic analysis was conducted. The results of the thematic analysis were mapped under 3 models of public engagement: deficit, dialogue, and participatory. Results: Of 1026 unique tweets available for qualitative analysis, discussion around \#DataSavesLives was largely positive (n=716, 69.8\%) or neutral (n=276, 26.9\%) toward the campaign with limited negative attitudes (n=34, 3.3\%). Themes derived from the \#DataSavesLives debate included ethical sharing, proactively engaging the public, coproducing knowledge with the public, harnessing potential, and gaining an understanding of big data research. The Twitter discourse was largely positive toward the campaign. The hashtag is predominantly used by similar-minded Twitter users to share information about big data projects and to spread positive messages about big data research when there are public controversies. The hashtag is generally used by organizations and people supportive of big data research. Tweet authors recognize that the public should be proactively engaged and involved in big data projects. The campaign remains UK centric. The results indicate that the communication around big data research is driven by the professional community and remains 1-way as members of the public rarely use the hashtag. Conclusions: The results demonstrate the potential of social media but draws attention to hashtag usage being generally confined to ``Twitter bubbles'': groups of similar-minded Twitter users. ",
doi="10.2196/38232",
url="https://www.jmir.org/2022/11/e38232",
url="http://www.ncbi.nlm.nih.gov/pubmed/36378518"
}


@Article{info:doi/10.2196/39571,
author="Yoon, Young Ho
and You, Han Kyung
and Kwon, Hye Jung
and Kim, Sun Jung
and Rha, Young Sun
and Chang, Jung Yoon
and Lee, Sang-Cheol",
title="Understanding the Social Mechanism of Cancer Misinformation Spread on YouTube and Lessons Learned: Infodemiological Study",
journal="J Med Internet Res",
year="2022",
month="Nov",
day="14",
volume="24",
number="11",
pages="e39571",
keywords="cancer misinformation",
keywords="social media health misinformation",
keywords="fenbendazole",
keywords="self-administration",
keywords="complex contagion",
keywords="YouTube",
keywords="social media factual information delivery strategy",
abstract="Background: A knowledge gap exists between the list of required actions and the action plan for countering cancer misinformation on social media. Little attention has been paid to a social media strategy for disseminating factual information while also disrupting misinformation on social media networks. Objective: The aim of this study was to, first, identify the spread structure of cancer misinformation on YouTube. We asked the question, ``How do YouTube videos play an important role in spreading information about the self-administration of anthelmintics for dogs as a cancer medicine for humans?'' Second, the study aimed to suggest an action strategy for disrupting misinformation diffusion on YouTube by exploiting the network logic of YouTube information flow and the recommendation system. We asked the question, ``What would be a feasible and effective strategy to block cancer misinformation diffusion on YouTube?'' Methods: The study used the YouTube case of the self-administration of anthelmintics for dogs as an alternative cancer medicine in South Korea. We gathered Korean YouTube videos about the self-administration of fenbendazole. Using the YouTube application programming interface for the query ``fenbendazole,'' 702 videos from 227 channels were compiled. Then, videos with at least 50,000 views, uploaded between September 2019 and September 2020, were selected from the collection, resulting in 90 videos. Finally, 10 recommended videos for each of the 90 videos were compiled, totaling 573 videos. Social network visualization for the recommended videos was used to identify three intervention strategies for disrupting the YouTube misinformation network. Results: The study found evidence of complex contagion by human and machine recommendation systems. By exposing stakeholders to multiple information sources on fenbendazole self-administration and by linking them through a recommendation algorithm, YouTube has become the perfect infrastructure for reinforcing the belief that fenbendazole can cure cancer, despite government warnings about the risks and dangers of self-administration. Conclusions: Health authorities should upload pertinent information through multiple channels and should exploit the existing YouTube recommendation algorithm to disrupt the misinformation network. Considering the viewing habits of patients and caregivers, the direct use of YouTube hospital channels is more effective than the indirect use of YouTube news media channels or government channels that report public announcements and statements. Reinforcing through multiple channels is the key. ",
doi="10.2196/39571",
url="https://www.jmir.org/2022/11/e39571",
url="http://www.ncbi.nlm.nih.gov/pubmed/36374534"
}


@Article{info:doi/10.2196/37505,
author="Guetz, Bernhard
and Bidmon, Sonja",
title="The Impact of Social Influence on the Intention to Use Physician Rating Websites: Moderated Mediation Analysis Using a Mixed Methods Approach",
journal="J Med Internet Res",
year="2022",
month="Nov",
day="14",
volume="24",
number="11",
pages="e37505",
keywords="social influence",
keywords="eHealth literacy",
keywords="patient satisfaction",
keywords="physician rating websites",
abstract="Background: Physician rating websites (PRWs) have become increasingly important in the cross-section between health and digitalization. Social influence plays a crucial role in human behavior in many domains of life, as can be demonstrated by the increase in high-profile influential individuals such as social media influencers (SMIs). Particularly in the health-specific environment, the opinion of family and friends has a significant influence on health-related decisions. However, so far, there has been little discussion about the role of social influence as an antecedent of behavioral intention to use PRWs. Objective: On the basis of theories of social psychology and technology acceptance and theories from the economic perspective, this study aimed to evaluate the impact of social influence on the behavioral intention to use PRWs. Methods: We conducted 2 studies by applying a mixed methods approach including a total of 712 participants from the Austrian population. The impact of social influence on the behavioral intention to use PRWs was investigated through linear regression and mediation and moderated mediation analysis using the PROCESS macro 4.0 in SPSS 27 (IBM Corp). Results: The 2 studies show similar results. In study 1, an experiment, no direct effect of social influence on the behavioral intention to use PRWs could be detected. However, an indirect effect of social influence on the behavioral intention to use PRWs via credibility (b=0.572; P=.005) and performance expectancy (b=0.340; P<.001) could be confirmed. The results of study 2, a cross-sectional study, demonstrate that social influence seems to have a direct impact on the behavioral intention to use PRWs (b=0.410; P<.001). However, when calculating the proposed mediation model, it becomes clear that this impact may partly be explained through the 2 mediator variables---credibility (b=0.208; P<.001) and performance expectancy (b=0.312; P<.001). In contrast to the observed direct and indirect effect, neither demographic nor psychographic variables have a significant moderating impact on the influencing chain in study 2. Conclusions: This study provides an indication that social influence has at least an indirect impact on the behavioral intention to use PRWs. It was observed that this impact is exerted through credibility and performance expectancy. According to the findings of both studies, social influence has the potential to boost the use of PRWs. As a result, these web-based networks might be a promising future interface between health care and digitalization, allowing health care practitioners to gain a beneficial external impact while also learning from feedback. Social influence nowadays is not just limited to friends and family but can also be exerted by SMIs in the domain of PRW use. Thus, from a marketing perspective, PRW providers could think of collaborating with SMIs, and our results could contribute to stimulating discussion in this vein. ",
doi="10.2196/37505",
url="https://www.jmir.org/2022/11/e37505",
url="http://www.ncbi.nlm.nih.gov/pubmed/36374547"
}


@Article{info:doi/10.2196/37698,
author="Chen, Xi
and Yik, Michelle",
title="The Emotional Anatomy of the Wuhan Lockdown: Sentiment Analysis Using Weibo Data",
journal="JMIR Form Res",
year="2022",
month="Nov",
day="14",
volume="6",
number="11",
pages="e37698",
keywords="Wuhan lockdown",
keywords="COVID-19",
keywords="public health emergency",
keywords="emotion",
keywords="circumplex model of affect",
keywords="Weibo",
keywords="jiayou",
abstract="Background: On January 23, 2020, the city of Wuhan, China, was sealed off in response to the COVID-19 pandemic. Studies have found that the lockdown was associated with both positive and negative emotions, although their findings are not conclusive. In these studies, emotional responses to the Wuhan lockdown were identified using lexicons based on limited emotion types. Objective: This study aims to map Chinese people's emotional responses to the Wuhan lockdown and compare Wuhan residents' emotions with those of people elsewhere in China by analyzing social media data from Weibo using a lexicon based on the circumplex model of affect. Methods: Social media posts on Weibo from 2 weeks before to 2 weeks after the Wuhan lockdown was imposed (January 9, 2020, to February 6, 2020) were collected. Each post was coded using a valence score and an arousal score. To map emotional trajectories during the study period, we used a data set of 359,190 posts. To compare the immediate emotional responses to the lockdown and its longer-term emotional impact on Wuhan residents (n=1236) and non-Hubei residents (n=12,714), we used a second data set of 57,685 posts for multilevel modeling analyses. Results: Most posts (248,757/359,190, 69.25\%) made during the studied lockdown period indicated a pleasant mood with low arousal. A gradual increase in both valence and arousal before the lockdown was observed. The posts after the lockdown was imposed had higher valence and arousal than prelockdown posts. On the day of lockdown, the non-Hubei group had a temporarily boosted valence ($\gamma$20=0.118; SE 0.021; P<.001) and arousal ($\gamma$30=0.293; SE 0.022; P<.001). Compared with non-Hubei residents, the Wuhan group had smaller increases in valence ($\gamma$21=?0.172; SE 0.052; P<.001) and arousal ($\gamma$31=?0.262; SE 0.053; P<.001) on the day of lockdown. Weibo users' emotional valence ($\gamma$40=0.000; SE 0.001; P=.71) and arousal ($\gamma$40=0.001; SE 0.001; P=.56) remained stable over the 2 weeks after the lockdown was imposed regardless of geographical location (valence: $\gamma$41=?0.004, SE 0.003, and P=.16; arousal: $\gamma$41=0.003, SE 0.003, and P=.26). Conclusions: During the early stages of the pandemic, most Weibo posts indicated a pleasant mood with low arousal. The overall increase in the posts' valence and arousal after the lockdown announcement might indicate collective cohesion and mutual support in web-based communities during a public health crisis. Compared with the temporary increases in valence and arousal of non-Hubei users on the day of lockdown, Wuhan residents' emotions were less affected by the announcement. Overall, our data suggest that Weibo users were not influenced by the lockdown measures in the 2 weeks after the lockdown announcement. Our findings offer policy makers insights into the usefulness of social connections in maintaining the psychological well-being of people affected by a lockdown. ",
doi="10.2196/37698",
url="https://formative.jmir.org/2022/11/e37698",
url="http://www.ncbi.nlm.nih.gov/pubmed/36166650"
}


@Article{info:doi/10.2196/39339,
author="Lewis, Dana
and Salmi, Liz
and Staley, Alicia
and Harlow, John",
title="From Individuals to Systems and Contributions to Creations: Novel Framework for Mapping the Efforts of Individuals by Convening The Center of Health and Health Care",
journal="J Particip Med",
year="2022",
month="Nov",
day="3",
volume="14",
number="1",
pages="e39339",
keywords="patient-centered care",
keywords="patient role",
keywords="patient involvement",
keywords="access to care",
keywords="patient-centered outcomes",
keywords="co-design",
keywords="participatory design",
keywords="patient and public involvement",
abstract="Background: People with lived health care experiences (often referred to as ``patients'') are increasingly contributing to health care and are most effective when they are involved as partners who can contribute complementary knowledge alongside other stakeholders in health care. Objective: Convening The Center aimed to bring together ``people known as patients''---the center of health care---to address priorities as they defined them. Methods: According to the original project design, an in-person gathering was to be conducted; however, as a result of the COVID-19 pandemic, the in-person gathering was transformed into a series of digital gatherings, including an in-depth interview phase, small-group gatherings, and a collective convening of 25 participants (22 women and 3 men from the United States, India, Costa Rica, Sweden, and Pakistan). Each participant was interviewed on Zoom (Zoom Video Communications Inc), and the interview data were thematically analyzed to design a subsequent small group and then full cohort Zoom sessions. Visual note-taking was used to reinforce a shared understanding of each individual- and group-level conversation. Results: The interviews and gatherings for Convening The Center offered unique perspectives on patient activities in research, health innovation, and problem-solving. This project further developed a novel, two-spectrum framework for assessing different experiences that patients may have or seek to gain, based on what patients actually do, and different levels of patients' involvement, ranging from individual to community to systemic involvement. Conclusions: The descriptors of patients in academic literature typically focus on what health care providers think patients ``are'' rather than on what patients ``do.'' The primary result of this project is a framework for mapping what patients ``do'' and ``where'' they do their work along two spectra: from creating their own projects to contributing to work initiated by others and from working at levels ranging from individual to community to systems. A better understanding of these spectra may enable researchers to more effectively engage and leverage patient expertise in health care research and innovation. ",
doi="10.2196/39339",
url="https://jopm.jmir.org/2022/1/e39339",
url="http://www.ncbi.nlm.nih.gov/pubmed/36326807"
}


@Article{info:doi/10.2196/38794,
author="Ismail, Nashwa
and Kbaier, Dhouha
and Farrell, Tracie
and Kane, Annemarie",
title="The Experience of Health Professionals With Misinformation and Its Impact on Their Job Practice: Qualitative Interview Study",
journal="JMIR Form Res",
year="2022",
month="Nov",
day="2",
volume="6",
number="11",
pages="e38794",
keywords="health misinformation",
keywords="social media",
keywords="health professional",
keywords="patients",
keywords="trust",
keywords="communication, COVID-19",
keywords="intervention",
keywords="qualitative research",
keywords="interpretive phenomenological analysis",
keywords="thematic analysis",
keywords="misinformation",
keywords="health practitioner",
keywords="infodemiology",
abstract="Background: Misinformation is often disseminated through social media, where information is spread rapidly and easily. Misinformation affects many patients' decisions to follow a treatment prescribed by health professionals (HPs). For example, chronic patients (eg, those with diabetes) may not follow their prescribed treatment plans. During the recent pandemic, misinformed people rejected COVID-19 vaccines and public health measures, such as masking and physical distancing, and used unproven treatments. Objective: This study investigated the impact of health-threatening misinformation on the practices of health care professionals in the United Kingdom, especially during the outbreaks of diseases where a great amount of health-threatening misinformation is produced and released. The study examined the misinformation surrounding the COVID-19 outbreak to determine how it may have impacted practitioners' perceptions of misinformation and how that may have influenced their practice. In particular, this study explored the answers to the following questions: How do HPs react when they learn that a patient has been misinformed? What misinformation do they believe has the greatest impact on medical practice? What aspects of change and intervention in HPs' practice are in response to misinformation? Methods: This research followed a qualitative approach to collect rich data from a smaller subset of health care practitioners working in the United Kingdom. Data were collected through 1-to-1 online interviews with 13 health practitioners, including junior and senior physicians and nurses in the United Kingdom. Results: Research findings indicated that HPs view misinformation in different ways according to the scenario in which it occurs. Some HPs consider it to be an acute incident exacerbated by the pandemic, while others see it as an ongoing phenomenon (always present) and address it as part of their daily work. HPs are developing pathways for dealing with misinformation. Two main pathways were identified: first, to educate the patient through coaching, advising, or patronizing and, second, to devote resources, such as time and effort, to facilitate 2-way communication between the patient and the health care provider through listening and talking to them. Conclusions: HPs do not receive the confidence they deserve from patients. The lack of trust in health care practitioners has been attributed to several factors, including (1) trusting alternative sources of information (eg, social media) (2) patients' doubts about HPs' experience (eg, a junior doctor with limited experience), and (3) limited time and availability for patients, especially during the pandemic. There are 2 dimensions of trust: patient-HP trust and patient-information trust. There are 2 necessary actions to address the issue of lack of trust in these dimensions: (1) building trust and (2) maintaining trust. The main recommendations of the HPs are to listen to patients, give them more time, and seek evidence-based resources. ",
doi="10.2196/38794",
url="https://formative.jmir.org/2022/11/e38794",
url="http://www.ncbi.nlm.nih.gov/pubmed/36252133"
}


@Article{info:doi/10.2196/37258,
author="Johnson, K. Amy
and Bhaumik, Runa
and Nandi, Debarghya
and Roy, Abhishikta
and Mehta, D. Supriya",
title="Sexually Transmitted Disease--Related Reddit Posts During the COVID-19 Pandemic: Latent Dirichlet Allocation Analysis",
journal="J Med Internet Res",
year="2022",
month="Oct",
day="31",
volume="24",
number="10",
pages="e37258",
keywords="infodemiology",
keywords="Latent Dirichlet Allocation",
keywords="natural language processing",
keywords="Reddit",
keywords="sexually transmitted infections",
keywords="surveillance",
keywords="social media",
keywords="COVID-19",
keywords="social media content",
keywords="content analysis",
keywords="health outcome",
keywords="infoveillance",
keywords="health information",
keywords="sexually transmitted disease",
keywords="STD",
abstract="Background: Sexually transmitted diseases (STDs) are common and costly, impacting approximately 1 in 5 people annually. Reddit, the sixth most used internet site in the world, is a user-generated social media discussion platform that may be useful in monitoring discussion about STD symptoms and exposure. Objective: This study sought to define and identify patterns and insights into STD-related discussions on Reddit over the course of the COVID-19 pandemic. Methods: We extracted posts from Reddit from March 2019 through July 2021. We used a topic modeling method, Latent Dirichlet Allocation, to identify the most common topics discussed in the Reddit posts. We then used word clouds, qualitative topic labeling, and spline regression to characterize the content and distribution of the topics observed. Results: Our extraction resulted in 24,311 total posts. Latent Dirichlet Allocation topic modeling showed that with 8 topics for each time period, we achieved high coherence values (pre--COVID-19=0.41, prevaccination=0.42, and postvaccination=0.44). Although most topic categories remained the same over time, the relative proportion of topics changed and new topics emerged. Spline regression revealed that some key terms had variability in the percentage of posts that coincided with pre--COVID-19 and post--COVID-19 periods, whereas others were uniform across the study periods. Conclusions: Our study's use of Reddit is a novel way to gain insights into STD symptoms experienced, potential exposures, testing decisions, common questions, and behavior patterns (eg, during lockdown periods). For example, reduction in STD screening may result in observed negative health outcomes due to missed cases, which also impacts onward transmission. As Reddit use is anonymous, users may discuss sensitive topics with greater detail and more freely than in clinical encounters. Data from anonymous Reddit posts may be leveraged to enhance the understanding of the distribution of disease and need for targeted outreach or screening programs. This study provides evidence in favor of establishing Reddit as having feasibility and utility to enhance the understanding of sexual behaviors, STD experiences, and needed health engagement with the public. ",
doi="10.2196/37258",
url="https://www.jmir.org/2022/10/e37258",
url="http://www.ncbi.nlm.nih.gov/pubmed/36219757"
}


@Article{info:doi/10.2196/37861,
author="Ke, Yang Si
and Neeley-Tass, Shannon E.
and Barnes, Michael
and Hanson, L. Carl
and Giraud-Carrier, Christophe
and Snell, Quinn",
title="COVID-19 Health Beliefs Regarding Mask Wearing and Vaccinations on Twitter: Deep Learning Approach",
journal="JMIR Infodemiology",
year="2022",
month="Oct",
day="31",
volume="2",
number="2",
pages="e37861",
keywords="COVID-19",
keywords="Health Belief Model",
keywords="deep learning",
keywords="mask",
keywords="vaccination",
keywords="machine learning",
keywords="vaccine data set",
keywords="Twitter",
keywords="content analysis",
keywords="infodemic",
keywords="infodemiology",
keywords="misinformation",
keywords="health belief",
abstract="Background: Amid the global COVID-19 pandemic, a worldwide infodemic also emerged with large amounts of COVID-19--related information and misinformation spreading through social media channels. Various organizations, including the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC), and other prominent individuals issued high-profile advice on preventing the further spread of COVID-19. Objective: The purpose of this study is to leverage machine learning and Twitter data from the pandemic period to explore health beliefs regarding mask wearing and vaccines and the influence of high-profile cues to action. Methods: A total of 646,885,238 COVID-19--related English tweets were filtered, creating a mask-wearing data set and a vaccine data set. Researchers manually categorized a training sample of 3500 tweets for each data set according to their relevance to Health Belief Model (HBM) constructs and used coded tweets to train machine learning models for classifying each tweet in the data sets. Results: In total, 5 models were trained for both the mask-related and vaccine-related data sets using the XLNet transformer model, with each model achieving at least 81\% classification accuracy. Health beliefs regarding perceived benefits and barriers were most pronounced for both mask wearing and immunization; however, the strength of those beliefs appeared to vary in response to high-profile cues to action. Conclusions: During both the COVID-19 pandemic and the infodemic, health beliefs related to perceived benefits and barriers observed through Twitter using a big data machine learning approach varied over time and in response to high-profile cues to action from prominent organizations and individuals. ",
doi="10.2196/37861",
url="https://infodemiology.jmir.org/2022/2/e37861",
url="http://www.ncbi.nlm.nih.gov/pubmed/36348979"
}


@Article{info:doi/10.2196/37029,
author="Kokoska, E. Ryan
and Kim, S. Lori
and Szeto, D. Mindy
and Aukerman, L. Erica
and Dellavalle, P. Robert",
title="Top Pediatric Dermatology Twitter Post Characteristics and Trends From 2020 to 2021: Content Analysis",
journal="JMIR Dermatol",
year="2022",
month="Oct",
day="26",
volume="5",
number="4",
pages="e37029",
keywords="pediatric dermatology",
keywords="pediatrics",
keywords="dermatology",
keywords="Twitter",
keywords="social media",
keywords="social media engagement",
keywords="content analysis",
doi="10.2196/37029",
url="https://derma.jmir.org/2022/4/e37029",
url="http://www.ncbi.nlm.nih.gov/pubmed/37632885"
}


@Article{info:doi/10.2196/40049,
author="Bacsu, Juanita-Dawne
and Cammer, Allison
and Ahmadi, Soheila
and Azizi, Mehrnoosh
and Grewal, S. Karl
and Green, Shoshana
and Gowda-Sookochoff, Rory
and Berger, Corinne
and Knight, Sheida
and Spiteri, J. Raymond
and O'Connell, E. Megan",
title="Examining the Twitter Discourse on Dementia During Alzheimer's Awareness Month in Canada: Infodemiology Study",
journal="JMIR Form Res",
year="2022",
month="Oct",
day="26",
volume="6",
number="10",
pages="e40049",
keywords="Twitter",
keywords="social media",
keywords="dementia",
keywords="Alzheimer disease",
keywords="awareness",
keywords="public health campaigns",
abstract="Background: Twitter has become a primary platform for public health campaigns, ranging from mental health awareness week to diabetes awareness month. However, there is a paucity of knowledge about how Twitter is being used during health campaigns, especially for Alzheimer's Awareness Month. Objective: The purpose of our study was to examine dementia discourse during Canada's Alzheimer's Awareness Month in January to inform future awareness campaigns. Methods: We collected 1289 relevant tweets using the Twint application in Python from January 1 to January 31, 2022. Thematic analysis was used to analyze the data. Results: Guided by our analysis, 4 primary themes were identified: dementia education and advocacy, fundraising and promotion, experiences of dementia, and opportunities for future actions. Conclusions: Although our study identified many educational, promotional, and fundraising tweets to support dementia awareness, we also found numerous tweets with cursory messaging (ie, simply referencing January as Alzheimer's Awareness Month in Canada). While these tweets promoted general awareness, they also highlight an opportunity for targeted educational content to counter stigmatizing messages and misinformation about dementia. In addition, awareness strategies partnering with diverse stakeholders (such as celebrities, social media influencers, and people living with dementia and their care partners) may play a pivotal role in fostering dementia dialogue and education. Further research is needed to develop, implement, and evaluate dementia awareness strategies on Twitter. Increased knowledge, partnerships, and research are essential to enhancing dementia awareness during Canada's Alzheimer's Awareness Month and beyond. ",
doi="10.2196/40049",
url="https://formative.jmir.org/2022/10/e40049",
url="http://www.ncbi.nlm.nih.gov/pubmed/36287605"
}


@Article{info:doi/10.2196/38316,
author="van Kampen, Katherine
and Laski, Jeremi
and Herman, Gabrielle
and Chan, M. Teresa",
title="Investigating COVID-19 Vaccine Communication and Misinformation on TikTok: Cross-sectional Study",
journal="JMIR Infodemiology",
year="2022",
month="Oct",
day="25",
volume="2",
number="2",
pages="e38316",
keywords="TikTok",
keywords="COVID-19 vaccines",
keywords="vaccinations",
keywords="misinformation",
keywords="COVID-19",
keywords="Infodemiology",
keywords="social media",
keywords="health information",
keywords="content analysis",
keywords="vaccine hesitancy",
keywords="public health",
keywords="web-based health information",
abstract="Background: The COVID-19 pandemic has highlighted the need for reliable information, especially around vaccines. Vaccine hesitancy is a growing concern and a great threat to broader public health. The prevalence of social media within our daily lives emphasizes the importance of accurately analyzing how health information is being disseminated to the public. TikTok is of particular interest, as it is an emerging social media platform that young adults may be increasingly using to access health information. Objective: The objective of this study was to examine and describe the content within the top 100 TikToks trending with the hashtag \#covidvaccine. Methods: The top 250 most viewed TikToks with the hashtag \#covidvaccine were batch downloaded on July 1, 2021, with their respective metadata. Each TikTok was subsequently viewed and encoded by 2 independent reviewers. Coding continued until 100 TikToks could be included based on language and content. Descriptive features were recorded including health care professional (HCP) status of creator, verification of HCP status, genre, and misinformation addressed. Primary inclusion criteria were any TikToks in English with discussion of a COVID-19 vaccine. Results: Of 102 videos included, the median number of plays was 1,700,000, with median shares of 9224 and 62,200 followers. Upon analysis, 14.7\% (15/102) of TikToks included HCPs, of which 80\% (12/102) could be verified via social media or regulatory body search; 100\% (15/15) of HCP-created TikToks supported vaccine use, and overall, 81.3\% (83/102) of all TikToks (created by either a layperson or an HCP) supported vaccine use. Conclusions: As the pandemic continues, vaccine hesitancy poses a threat to lifting restrictions, and discovering reasons for this hesitancy is important to public health measures. This study summarizes the discourse around vaccine use on TikTok. Importantly, it opens a frank discussion about the necessity to incorporate new social media platforms into medical education, so we might ensure our trainees are ready to engage with patients on novel platforms. ",
doi="10.2196/38316",
url="https://infodemiology.jmir.org/2022/2/e38316",
url="http://www.ncbi.nlm.nih.gov/pubmed/36338548"
}


@Article{info:doi/10.2196/39324,
author="Lorenzo-Luaces, Lorenzo
and Howard, Jacqueline
and Edinger, Andy
and Yan, Yaojun Harry
and Rutter, A. Lauren
and Valdez, Danny
and Bollen, Johan",
title="Sociodemographics and Transdiagnostic Mental Health Symptoms in SOCIAL (Studies of Online Cohorts for Internalizing Symptoms and Language) I and II: Cross-sectional Survey and Botometer Analysis",
journal="JMIR Form Res",
year="2022",
month="Oct",
day="20",
volume="6",
number="10",
pages="e39324",
keywords="depression",
keywords="anxiety",
keywords="pain",
keywords="alcohol",
keywords="social media",
abstract="Background: Internalizing, externalizing, and somatoform disorders are the most common and disabling forms of psychopathology. Our understanding of these clinical problems is limited by a reliance on self-report along with research using small samples. Social media has emerged as an exciting channel for collecting a large sample of longitudinal data from individuals to study psychopathology. Objective: This study reported the results of 2 large ongoing studies in which we collected data from Twitter and self-reported clinical screening scales, the Studies of Online Cohorts for Internalizing Symptoms and Language (SOCIAL) I and II. Methods: The participants were a sample of Twitter-using adults (SOCIAL I: N=1123) targeted to be nationally representative in terms of age, sex assigned at birth, race, and ethnicity, as well as a sample of college students in the Midwest (SOCIAL II: N=1988), of which 61.78\% (1228/1988) were Twitter users. For all participants who were Twitter users, we asked for access to their Twitter handle, which we analyzed using Botometer, which rates the likelihood of an account belonging to a bot. We divided participants into 4 groups: Twitter users who did not give us their handle or gave us invalid handles (invalid), those who denied being Twitter users (no Twitter, only available for SOCIAL II), Twitter users who gave their handles but whose accounts had high bot scores (bot-like), and Twitter users who provided their handles and had low bot scores (valid). We explored whether there were significant differences among these groups in terms of their sociodemographic features, clinical symptoms, and aspects of social media use (ie, platforms used and time). Results: In SOCIAL I, most individuals were classified as valid (580/1123, 51.65\%), and a few were deemed bot-like (190/1123, 16.91\%). A total of 31.43\% (353/1123) gave no handle or gave an invalid handle (eg, entered ``N/A''). In SOCIAL II, many individuals were not Twitter users (760/1988, 38.23\%). Of the Twitter users in SOCIAL II (1228/1988, 61.78\%), most were classified as either invalid (515/1228, 41.94\%) or valid (484/1228, 39.41\%), with a smaller fraction deemed bot-like (229/1228, 18.65\%). Participants reported high rates of mental health diagnoses as well as high levels of symptoms, especially in SOCIAL II. In general, the differences between individuals who provided or did not provide their social media handles were small and not statistically significant. Conclusions: Triangulating passively acquired social media data and self-reported questionnaires offers new possibilities for large-scale assessment and evaluation of vulnerability to mental disorders. The propensity of participants to share social media handles is likely not a source of sample bias in subsequent social media analytics. ",
doi="10.2196/39324",
url="https://formative.jmir.org/2022/10/e39324",
url="http://www.ncbi.nlm.nih.gov/pubmed/36264616"
}


@Article{info:doi/10.2196/36767,
author="Blunck, Dominik
and Kastner, Lena
and Nissen, Michael
and Winkler, Jacqueline",
title="The Effectiveness of Patient Training in Inflammatory Bowel Disease Knowledge via Instagram: Randomized Controlled Trial",
journal="J Med Internet Res",
year="2022",
month="Oct",
day="19",
volume="24",
number="10",
pages="e36767",
keywords="social media",
keywords="Instagram",
keywords="patient training",
keywords="patient education",
keywords="disease-related knowledge",
keywords="RCT",
keywords="randomized controlled trial",
keywords="Germany",
keywords="inflammatory bowel disease",
keywords="IBD-KNOW",
abstract="Background: Patients' knowledge was found to be a key contributor to the success of therapy. Many efforts have been made to educate patients in their disease. However, research found that many patients still lack knowledge regarding their disease. Integrating patient education into social media platforms can bring materials closer to recipients. Objective: The aim of this study is to test the effectiveness of patient education via Instagram. Methods: A randomized controlled trial was conducted to test the effectiveness of patient education via Instagram among patients with inflammatory bowel disease. Participants were recruited online from the open Instagram page of a patient organization. The intervention group was educated via Instagram for 5 weeks by the research team; the control group did not receive any educational intervention. The knowledge about their disease was measured pre- and postintervention using the Inflammatory Bowel Disease Knowledge questionnaire. Data were analyzed by comparing mean knowledge scores and by regression analysis. The trial was purely web based. Results: In total, 49 participants filled out both questionnaires. The intervention group included 25 participants, and the control group included 24 participants. The preintervention knowledge level of the intervention group was reflected as a score of 18.67 out of 24 points; this improved by 3 points to 21.67 postintervention. The postintervention difference between the control and intervention groups was 3.59 points and was statistically significant (t32.88=--4.56, 95\% CI 1.98-5.19; P<.001). Results of the regression analysis, accounting for preintervention knowledge and group heterogeneity, indicated an increase of 3.33 points that was explained by the intervention (P<.001). Conclusions: Patient education via Instagram is an effective way to increase disease-related knowledge. Future studies are needed to assess the effects in other conditions and to compare different means of patient education. Trial Registration: German Clinical Trials Register DRKS00022935; https://tinyurl.com/bed4bzvh ",
doi="10.2196/36767",
url="https://www.jmir.org/2022/10/e36767",
url="http://www.ncbi.nlm.nih.gov/pubmed/36260385"
}


@Article{info:doi/10.2196/40408,
author="Melton, A. Chad
and White, M. Brianna
and Davis, L. Robert
and Bednarczyk, A. Robert
and Shaban-Nejad, Arash",
title="Fine-tuned Sentiment Analysis of COVID-19 Vaccine--Related Social Media Data: Comparative Study",
journal="J Med Internet Res",
year="2022",
month="Oct",
day="17",
volume="24",
number="10",
pages="e40408",
keywords="sentiment analysis",
keywords="DistilRoBERTa",
keywords="natural language processing",
keywords="social media",
keywords="Twitter",
keywords="Reddit",
keywords="COVID-19",
keywords="vaccination",
keywords="vaccine",
keywords="content analysis",
keywords="public health",
keywords="surveillance",
keywords="misinformation",
keywords="infodemiology",
keywords="information quality",
abstract="Background: The emergence of the novel coronavirus (COVID-19) and the necessary separation of populations have led to an unprecedented number of new social media users seeking information related to the pandemic. Currently, with an estimated 4.5 billion users worldwide, social media data offer an opportunity for near real-time analysis of large bodies of text related to disease outbreaks and vaccination. These analyses can be used by officials to develop appropriate public health messaging, digital interventions, educational materials, and policies. Objective: Our study investigated and compared public sentiment related to COVID-19 vaccines expressed on 2 popular social media platforms---Reddit and Twitter---harvested from January 1, 2020, to March 1, 2022. Methods: To accomplish this task, we created a fine-tuned DistilRoBERTa model to predict the sentiments of approximately 9.5 million tweets and 70 thousand Reddit comments. To fine-tune our model, our team manually labeled the sentiment of 3600 tweets and then augmented our data set through back-translation. Text sentiment for each social media platform was then classified with our fine-tuned model using Python programming language and the Hugging Face sentiment analysis pipeline. Results: Our results determined that the average sentiment expressed on Twitter was more negative (5,215,830/9,518,270, 54.8\%) than positive, and the sentiment expressed on Reddit was more positive (42,316/67,962, 62.3\%) than negative. Although the average sentiment was found to vary between these social media platforms, both platforms displayed similar behavior related to the sentiment shared at key vaccine-related developments during the pandemic. Conclusions: Considering this similar trend in shared sentiment demonstrated across social media platforms, Twitter and Reddit continue to be valuable data sources that public health officials can use to strengthen vaccine confidence and combat misinformation. As the spread of misinformation poses a range of psychological and psychosocial risks (anxiety and fear, etc), there is an urgency in understanding the public perspective and attitude toward shared falsities. Comprehensive educational delivery systems tailored to a population's expressed sentiments that facilitate digital literacy, health information--seeking behavior, and precision health promotion could aid in clarifying such misinformation. ",
doi="10.2196/40408",
url="https://www.jmir.org/2022/10/e40408",
url="http://www.ncbi.nlm.nih.gov/pubmed/36174192"
}


@Article{info:doi/10.2196/38949,
author="Jain, Shikha
and Dhaon, R. Serena
and Majmudar, Shivani
and Zimmermann, J. Laura
and Mordell, Lisa
and Walker, Garth
and Wallia, Amisha
and Akbarnia, Halleh
and Khan, Ali
and Bloomgarden, Eve
and Arora, M. Vineet",
title="Empowering Health Care Workers on Social Media to Bolster Trust in Science and Vaccination During the Pandemic: Making IMPACT Using a Place-Based Approach",
journal="J Med Internet Res",
year="2022",
month="Oct",
day="17",
volume="24",
number="10",
pages="e38949",
keywords="misinformation",
keywords="COVID-19",
keywords="place-based",
keywords="infodemic",
keywords="infographic",
keywords="social media",
keywords="advocacy",
keywords="infodemiology",
keywords="vaccination",
keywords="health care worker",
keywords="policy maker",
keywords="health policy",
keywords="community health",
abstract="Background: Given the widespread and concerted efforts to propagate health misinformation on social media, particularly centered around vaccination during the pandemic, many groups of clinicians and scientists were organized on social media to tackle misinformation and promote vaccination, using a national or international lens. Although documenting the impact of such social media efforts, particularly at the community level, can be challenging, a more hyperlocal or ``place-based approach'' for social media campaigns could be effective in tackling misinformation and improving public health outcomes at a community level. Objective: We aimed to describe and document the effectiveness of a place-based strategy for a coordinated group of Chicago health care workers on social media to tackle misinformation and improve vaccination rates in the communities they serve. Methods: The Illinois Medical Professionals Action Collaborative Team (IMPACT) was founded in March 2020 in response to the COVID-19 pandemic, with representatives from major academic teaching hospitals in Chicago (eg, University of Chicago, Northwestern University, University of Illinois, and Rush University) and community-based organizations. Through crowdsourcing on multiple social media platforms (eg, Facebook, Twitter, and Instagram) with a place-based approach, IMPACT engaged grassroots networks of thousands of Illinois health care workers and the public to identify gaps, needs, and viewpoints to improve local health care delivery during the pandemic. Results: To address vaccine misinformation, IMPACT created 8 ``myth debunking'' infographics and a ``vaccine information series'' of 14 infographics that have generated >340,000 impressions and informed the development of vaccine education for the Chicago Public Libraries. IMPACT delivered 13 policy letters focusing on different topics, such as health care worker personal protective equipment, universal masking, and vaccination, with >4000 health care workers signatures collected through social media and delivered to policy makers; it published over 50 op-eds on COVID-19 topics in high-impact news outlets and contributed to >200 local and national news features.Using the crowdsourcing approach on IMPACT social media channels, IMPACT mobilized health care and lay volunteers to staff >400 vaccine events for >120,000 individuals, many in Chicago's hardest-hit neighborhoods. The group's recommendations have influenced public health awareness campaigns and initiatives, as well as research, advocacy, and policy recommendations, and they have been recognized with local and national awards. Conclusions: A coordinated group of health care workers on social media, using a hyperlocal place-based approach, can not only work together to address misinformation but also collaborate to boost vaccination rates in their surrounding communities. ",
doi="10.2196/38949",
url="https://www.jmir.org/2022/10/e38949",
url="http://www.ncbi.nlm.nih.gov/pubmed/35917489"
}


@Article{info:doi/10.2196/39676,
author="Li, Minghui
and Hua, Yining
and Liao, Yanhui
and Zhou, Li
and Li, Xue
and Wang, Ling
and Yang, Jie",
title="Tracking the Impact of COVID-19 and Lockdown Policies on Public Mental Health Using Social Media: Infoveillance Study",
journal="J Med Internet Res",
year="2022",
month="Oct",
day="13",
volume="24",
number="10",
pages="e39676",
keywords="COVID-19",
keywords="mental health",
keywords="social media",
keywords="Twitter",
keywords="topic model",
keywords="health care workers",
abstract="Background: The COVID-19 pandemic and its corresponding preventive and control measures have increased the mental burden on the public. Understanding and tracking changes in public mental status can facilitate optimizing public mental health intervention and control strategies. Objective: This study aimed to build a social media--based pipeline that tracks public mental changes and use it to understand public mental health status regarding the pandemic. Methods: This study used COVID-19--related tweets posted from February 2020 to April 2022. The tweets were downloaded using unique identifiers through the Twitter application programming interface. We created a lexicon of 4 mental health problems (depression, anxiety, insomnia, and addiction) to identify mental health--related tweets and developed a dictionary for identifying health care workers. We analyzed temporal and geographic distributions of public mental health status during the pandemic and further compared distributions among health care workers versus the general public, supplemented by topic modeling on their underlying foci. Finally, we used interrupted time series analysis to examine the statewide impact of a lockdown policy on public mental health in 12 states. Results: We extracted 4,213,005 tweets related to mental health and COVID-19 from 2,316,817 users. Of these tweets, 2,161,357 (51.3\%) were related to ``depression,'' whereas 1,923,635 (45.66\%), 225,205 (5.35\%), and 150,006 (3.56\%) were related to ``anxiety,'' ``insomnia,'' and ``addiction,'' respectively. Compared to the general public, health care workers had higher risks of all 4 types of problems (all P<.001), and they were more concerned about clinical topics than everyday issues (eg, ``students' pressure,'' ``panic buying,'' and ``fuel problems'') than the general public. Finally, the lockdown policy had significant associations with public mental health in 4 out of the 12 states we studied, among which Pennsylvania showed a positive association, whereas Michigan, North Carolina, and Ohio showed the opposite (all P<.05). Conclusions: The impact of COVID-19 and the corresponding control measures on the public's mental status is dynamic and shows variability among different cohorts regarding disease types, occupations, and regional groups. Health agencies and policy makers should primarily focus on depression (reported by 51.3\% of the tweets) and insomnia (which has had an ever-increasing trend since the beginning of the pandemic), especially among health care workers. Our pipeline timely tracks and analyzes public mental health changes, especially when primary studies and large-scale surveys are difficult to conduct. ",
doi="10.2196/39676",
url="https://www.jmir.org/2022/10/e39676",
url="http://www.ncbi.nlm.nih.gov/pubmed/36191167"
}


@Article{info:doi/10.2196/37695,
author="Chen, Shiqi Sikky
and Lam, Pong Tai
and Lam, Fai Kwok
and Lo, Lam Tak
and Chao, Kiong David Vai
and Mak, Yan Ki
and Lam, Wo Edmund Wing
and Tang, Sin Wai
and Chan, Yan Hoi
and Yip, Fai Paul Siu",
title="The Use of Close Friends on Instagram, Help-Seeking Willingness, and Suicidality Among Hong Kong Youth: Exploratory Sequential Mixed Methods Study",
journal="J Med Internet Res",
year="2022",
month="Oct",
day="12",
volume="24",
number="10",
pages="e37695",
keywords="Close Friends",
keywords="private online expression",
keywords="help-seeking willingness",
keywords="suicide",
keywords="youth",
abstract="Background: Social networking sites (SNSs) have gained popularity in recent years for help seeking and self-distress expression among adolescents. Although online suicidal expression is believed to have major benefits, various concerns have also been raised, particularly around privacy issues. Understanding youths' help-seeking behavior on SNSs is critical for effective suicide prevention; however, most research neglects the impacts of the private SNS context. Objective: This study aims to examine youths' private SNS use via the new Instagram feature, Close Friends, and its association with both online and offline help-seeking willingness as well as youths' suicidality. Methods: This study employed an exploratory sequential mixed methods approach with a combination of explorative qualitative interviews and a systematic quantitative survey, targeting youth aged 15-19 years in Hong Kong. The motivations for utilizing Close Friends and concerns regarding online expression were addressed in the focus group and individual interviews (n=40). A cross-sectional survey (n=1676) was conducted subsequently with eligible secondary school students to examine the prevalence of Close Friends usage, their online and offline help-seeking willingness, and suicide-related experiences. Results: A total of 3 primary motives for using Close Friends were identified during interviews, including (1) interaction and help seeking, (2) release of negative emotions, and (3) ventilation and self-expression. Most participants also highlighted the privacy concerns associated with public online communication and the importance of contacting close friends for emotional support. Survey results showed that use of Close Friends was quite prevalent among adolescents (1163/1646, 70.66\%), with around 46\% (754/1646, 45.81\%) of respondents being frequent users. Differences by gender and school academic banding were also revealed. Regarding help-seeking intentions, youths were generally positive about seeking help from peers and friends offline (1010/1266, 79.78\%) yet negative about seeking assistance from online friends or professionals with whom they had not yet developed a real-world connection (173/1266, 13.67\%). Most notably, frequencies of Close Friends usage were differentially associated with online and offline help-seeking willingness and youths' suicidality. Compared with nonusers, those who had ever used the feature were more likely to seek offline support (adjusted odds ratios [AORs] 1.82-2.36), whereas heavy use of Close Friends was associated with increased odds of online help-seeking willingness (AOR\thinspace1.76, 95\% CI 1.06-2.93) and a higher risk of suicidality (AOR\thinspace1.53, 95\% CI 1.01-2.31). Conclusions: The popularity of Close Friends reflects the increasing need for private online expression among youth. This study demonstrates the importance of Close Friends for self-expression and private conversation and inadequacy of peer support for suicidal adolescents. Further research is needed to identify the causal relationship between Close Friends usage and help-seeking willingness to guide the advancement of suicide prevention strategies. Researchers and social media platforms may cooperate to co-design a risk monitoring system tailored to the private SNS context, assisting professionals in identifying youth at risk of suicide. ",
doi="10.2196/37695",
url="https://www.jmir.org/2022/10/e37695",
url="http://www.ncbi.nlm.nih.gov/pubmed/36223182"
}


@Article{info:doi/10.2196/35923,
author="Yang, Shanyin
and Huang, Jiegang
and Ye, Li
and Lin, Jianyan
and Xie, Zhiman
and Guo, Baodong
and Li, Yanjun
and Liang, Bingyu
and Zheng, Zhigang
and Lunze, Karsten
and Abdullah, S. Abu
and Liang, Hao
and Quintiliani, M. Lisa",
title="Factors Related to Smoking and Perceptions of a Behavioral Counseling and Messenger Service--Delivered Smoking Cessation Intervention for People With HIV in China: Qualitative Study",
journal="JMIR Form Res",
year="2022",
month="Oct",
day="12",
volume="6",
number="10",
pages="e35923",
keywords="mobile health",
keywords="mHealth",
keywords="China",
keywords="smoking",
keywords="smoking cessation",
keywords="HIV",
keywords="qualitative research",
keywords="SMS text messages",
keywords="WeChat",
abstract="Background: China, where half of the adult male population smoke tobacco, has one of the highest global burdens of smoking. Smoking rates are even higher among people with HIV. People with HIV can be affected by smoking in multiple ways, including more severe HIV-related symptoms and worse antiretroviral therapy treatment outcomes. However, smoking cessation services targeted for people with HIV are not routinely integrated into HIV care in China. Given the widespread mobile phone ownership, an exploration of factors related to smoking among people with HIV in China who smoke could inform the design and implementation of mobile smoking cessation interventions that target the needs of this vulnerable population. Objective: This study aims to explore the perspectives of smoking, barriers and facilitators to quitting, and perceptions related to a smoking cessation intervention delivered through behavioral counseling sessions and brief daily messenger service (WeChat)--delivered messages. Methods: We recruited people with HIV from the People's 4th Hospital of Nanning, Guangxi, China, and conducted semistructured face-to-face interviews. All interviews were audio-recorded, transcribed verbatim in Chinese, and translated into English for data analysis. We conducted a thematic analysis using a codebook, which was guided by a team-based consensus approach to identify 5 main themes. We also explored themes according to the demographic groups. Results: A total of 24 participants were enrolled in the study. The mean age was 37.2 (SD=13.5) years. The participants had lived with HIV for a mean of 2.4 years. The majority were male (18/24, 75\%) and lived in urban or metropolitan settings (19/24, 79\%). We identified five main themes: variable knowledge of the harms of smoking, both related and unrelated to HIV; willpower perceived as the primary quitting strategy; a duality of the effect of social factors on quitting; perceptions about optimal features of the smoking cessation intervention (eg, messages should be brief and most frequent during the first few weeks); and the largely negative impact of their HIV diagnosis on smoking behaviors. In addition, some themes differed according to participant demographic characteristics such as age, sex, and education level. Conclusions: We identified barriers to and facilitators of smoking cessation among people with HIV in China by conducting semistructured qualitative interviews. Owing to the adverse impact of smoking on HIV outcomes, targeting cessation interventions to the unique needs and preferences of people with HIV in China may be needed to increase the effectiveness of future interventions. A pilot clinical trial will be conducted in the future to evaluate this behavioral counseling and brief daily messenger service (WeChat)--delivered messages approach among people with HIV who smoke in China. ",
doi="10.2196/35923",
url="https://formative.jmir.org/2022/10/e35923",
url="http://www.ncbi.nlm.nih.gov/pubmed/36222795"
}


@Article{info:doi/10.2196/40265,
author="Sasseville, Maxime
and Barony Sanchez, H. Romina
and Yameogo, R. Achille
and Bergeron-Drolet, Laurie-Ann
and Bergeron, Fr{\'e}d{\'e}ric
and Gagnon, Marie-Pierre",
title="Interactive Conversational Agents for Health Promotion, Prevention, and Care: Protocol for a Mixed Methods Systematic Scoping Review",
journal="JMIR Res Protoc",
year="2022",
month="Oct",
day="11",
volume="11",
number="10",
pages="e40265",
keywords="conversational agents",
keywords="chatbots",
keywords="scoping review",
keywords="literature review",
keywords="healthcare",
keywords="health care",
keywords="health promotion",
keywords="prevention",
keywords="care",
keywords="computer",
keywords="natural language processing",
keywords="literature",
keywords="community",
abstract="Background: Interactive conversational agents, also known as ``chatbots,'' are computer programs that use natural language processing to engage in conversations with humans to provide or collect information. Although the literature on the development and use of chatbots for health interventions is growing, important knowledge gaps remain, such as identifying design aspects relevant to health care and functions to offer transparency in decision-making automation. Objective: This paper presents the protocol for a scoping review that aims to identify and categorize the interactive conversational agents currently used in health care. Methods: A mixed methods systematic scoping review will be conducted according to the Arksey and O'Malley framework and the guidance of Peters et al for systematic scoping reviews. A specific search strategy will be formulated for 5 of the most relevant databases to identify studies published in the last 20 years. Two reviewers will independently apply the inclusion criteria using the full texts and extract data. We will use structured narrative summaries of main themes to present a portrait of the current scope of available interactive conversational agents targeting health promotion, prevention, and care. We will also summarize the differences and similarities between these conversational agents. Results: The search strategy and screening steps were completed in March 2022. Data extraction and analysis started in May 2022, and the results are expected to be published in October 2022. Conclusions: This fundamental knowledge will be useful for the development of interactive conversational agents adapted to specific groups in vulnerable situations in health care and community settings. International Registered Report Identifier (IRRID): DERR1-10.2196/40265 ",
doi="10.2196/40265",
url="https://www.researchprotocols.org/2022/10/e40265",
url="http://www.ncbi.nlm.nih.gov/pubmed/36222804"
}


@Article{info:doi/10.2196/40323,
author="Alhuzali, Hassan
and Zhang, Tianlin
and Ananiadou, Sophia",
title="Emotions and Topics Expressed on Twitter During the COVID-19 Pandemic in the United Kingdom: Comparative Geolocation and Text Mining Analysis",
journal="J Med Internet Res",
year="2022",
month="Oct",
day="5",
volume="24",
number="10",
pages="e40323",
keywords="Twitter",
keywords="COVID-19",
keywords="geolocation",
keywords="emotion detection",
keywords="sentiment analysis",
keywords="topic modeling",
keywords="social media",
keywords="natural language processing",
keywords="deep learning",
abstract="Background: In recent years, the COVID-19 pandemic has brought great changes to public health, society, and the economy. Social media provide a platform for people to discuss health concerns, living conditions, and policies during the epidemic, allowing policymakers to use this content to analyze the public emotions and attitudes for decision-making. Objective: The aim of this study was to use deep learning--based methods to understand public emotions on topics related to the COVID-19 pandemic in the United Kingdom through a comparative geolocation and text mining analysis on Twitter. Methods: Over 500,000 tweets related to COVID-19 from 48 different cities in the United Kingdom were extracted, with the data covering the period of the last 2 years (from February 2020 to November 2021). We leveraged three advanced deep learning--based models for topic modeling to geospatially analyze the sentiment, emotion, and topics of tweets in the United Kingdom: SenticNet 6 for sentiment analysis, SpanEmo for emotion recognition, and combined topic modeling (CTM). Results: We observed a significant change in the number of tweets as the epidemiological situation and vaccination situation shifted over the 2 years. There was a sharp increase in the number of tweets from January 2020 to February 2020 due to the outbreak of COVID-19 in the United Kingdom. Then, the number of tweets gradually declined as of February 2020. Moreover, with identification of the COVID-19 Omicron variant in the United Kingdom in November 2021, the number of tweets grew again. Our findings reveal people's attitudes and emotions toward topics related to COVID-19. For sentiment, approximately 60\% of tweets were positive, 20\% were neutral, and 20\% were negative. For emotion, people tended to express highly positive emotions in the beginning of 2020, while expressing highly negative emotions over time toward the end of 2021. The topics also changed during the pandemic. Conclusions: Through large-scale text mining of Twitter, our study found meaningful differences in public emotions and topics regarding the COVID-19 pandemic among different UK cities. Furthermore, efficient location-based and time-based comparative analysis can be used to track people's thoughts and feelings, and to understand their behaviors. Based on our analysis, positive attitudes were common during the pandemic; optimism and anticipation were the dominant emotions. With the outbreak and epidemiological change, the government developed control measures and vaccination policies, and the topics also shifted over time. Overall, the proportion and expressions of emojis, sentiments, emotions, and topics varied geographically and temporally. Therefore, our approach of exploring public emotions and topics on the pandemic from Twitter can potentially lead to informing how public policies are received in a particular geographical area. ",
doi="10.2196/40323",
url="https://www.jmir.org/2022/10/e40323",
url="http://www.ncbi.nlm.nih.gov/pubmed/36150046"
}


@Article{info:doi/10.2196/34403,
author="So{\'o}s, Judit Merc{\'e}desz
and Coulson, S. Neil
and Davies, Bethan E.",
title="Exploring Social Support in an Online Support Community for Tourette Syndrome and Tic Disorders: Analysis of Postings",
journal="J Med Internet Res",
year="2022",
month="Oct",
day="4",
volume="24",
number="10",
pages="e34403",
keywords="Tourette syndrome",
keywords="tic disorders",
keywords="social support",
keywords="online support communities",
keywords="online health communities",
keywords="thematic analysis",
keywords="online support",
keywords="peer support",
keywords="support group",
keywords="Tourette",
keywords="online health community",
abstract="Background: Online support communities have become an accessible way of gaining social, emotional, and informational support from peers and may be particularly useful for individuals with chronic conditions. To date, there have been few studies exploring the online support available for tic disorders, such as Tourette syndrome. An exploratory study looking at users' experiences with using online support communities for tic disorders suggested that members used such communities to share experiences, information, and strategies for tic management. Objective: To build on these preliminary findings, this study examined the provision of social support in an online community for Tourette syndrome. Methods: Data were collected from one publicly available online support community for Tourette syndrome and tics, from its inception to December 2019, by randomly selecting 10\% of posts and their corresponding comments from each year for analysis. This resulted in 510 unique posts and 3802 comments posted from 1270 unique usernames. The data were analyzed using inductive thematic analysis. Results: The findings of this study suggest that users utilized the online community as a multifaceted virtual place where they could share and ask for information about tics, unload and share their feelings arising from living with Tourette syndrome, find people facing similar situations and experiences, and freely share the realities of living with Tourette syndrome. Conclusions: The results complement the findings from a preliminary study and suggest that online support communities have a potentially valuable role as a mechanism for sharing and gaining information on illness experiences from similar peers experiencing tics and can promote self-management of tics. Limitations and recommendations for future research are discussed. ",
doi="10.2196/34403",
url="https://www.jmir.org/2022/10/e34403",
url="http://www.ncbi.nlm.nih.gov/pubmed/36194454"
}


@Article{info:doi/10.2196/35744,
author="Fu, Chunye
and Lyu, Xiaokang
and Mi, Mingdi",
title="Collective Value Promotes the Willingness to Share Provaccination Messages on Social Media in China: Randomized Controlled Trial",
journal="JMIR Form Res",
year="2022",
month="Oct",
day="4",
volume="6",
number="10",
pages="e35744",
keywords="individual value",
keywords="collective value",
keywords="vaccination",
keywords="message-sharing willingness",
keywords="perceived responsibility",
keywords="misinformation",
keywords="vaccine misinformation",
keywords="public health",
keywords="influenza vaccine",
keywords="social media",
keywords="COVID-19",
abstract="Background: The proliferation of vaccine misinformation on social media has seriously corrupted the public's confidence in vaccination. Proactively sharing provaccination messages on social media is a cost-effective way to enhance global vaccination rates and resist vaccine misinformation. However, few strategies for encouraging the public to proactively share vaccine-related knowledge on social media have been developed. Objective: This research examines the effect of value type (individual vs collective) and message framing (gain vs loss) on influenza vaccination intention (experiment 1) and the willingness to share provaccination messages (experiment 2) among Chinese adults during the COVID-19 pandemic. The primary aim was to evaluate whether messages that emphasized collective value were more effective in increasing the willingness to share than messages that emphasized individual value. Methods: We enrolled 450 Chinese adults for experiment 1 (n=250, 55.6\%) and experiment 2 (n=200, 44.4\%). Participants were randomly assigned to individual-gain, individual-loss, collective-gain, or collective-loss conditions with regard to the message in each experiment using the online survey platform's randomization function. Experiment 1 also included a control group. The primary outcome was influenza vaccination intention in experiment 1 and the willingness to share provaccination messages in experiment 2. Results: The valid sample included 213 adults in experiment 1 (females: n=151, 70.9\%; mean age 29 [SD 9] years; at least some college education: n=202, 94.8\%; single: n=131, 61.5\%) and 171 adults in experiment 2 (females: n=106, 62.0\%; mean age 28 [SD 7] years; at least some college education: n=163, 95.3\%; single: n=95, 55.6\%). Influenza vaccination intention was stronger in the individual-value conditions than in the collective-value conditions (F3,166=4.96, P=.03, $\eta$2=0.03). The reverse result was found for the willingness to share provaccination messages (F3,165=6.87, P=.01, $\eta$2=0.04). Specifically, participants who received a message emphasizing collective value had a higher intention to share the message than participants who read a message emphasizing individual value (F3,165=6.87, P=.01, $\eta$2=0.04), and the perceived responsibility for message sharing played a mediating role (indirect effect=0.23, 95\% lower limit confidence interval [LLCI] 0.41, 95\% upper limit confidence interval [ULCI] 0.07). In addition, gain framing facilitated influenza vaccination intention more than loss framing (F3,166=5.96, P=.02, $\eta$2=0.04). However, experiment 2 did not find that message framing affected message-sharing willingness. Neither experiment found an interaction between value type and message framing. Conclusions: Strengthened individual value rather than collective value is more likely to persuade Chinese adults to vaccinate. However, these adults are more likely to share a message that emphasizes collective rather than individual value, and the perceived responsibility for message sharing plays a mediating role. ",
doi="10.2196/35744",
url="https://formative.jmir.org/2022/10/e35744",
url="http://www.ncbi.nlm.nih.gov/pubmed/36067417"
}


@Article{info:doi/10.2196/39710,
author="You, Yueyue
and Yang-Huang, Junwen
and Raat, Hein
and Van Grieken, Amy",
title="Social Media Use and Health-Related Quality of Life Among Adolescents: Cross-sectional Study",
journal="JMIR Ment Health",
year="2022",
month="Oct",
day="4",
volume="9",
number="10",
pages="e39710",
keywords="adolescents",
keywords="social media platforms",
keywords="social media",
keywords="health-related quality of life",
keywords="EuroQol 5-dimension questionnaire, youth version",
abstract="Background: Using social media is a time-consuming activity of children and adolescents. Health authorities have warned that excessive use of social media can negatively affect adolescent social, physical, and psychological health. However, scientific findings regarding associations between time spent on social media and adolescent health-related quality of life (HRQoL) are not consistent. Adolescents typically use multiple social media platforms. Whether the use of multiple social media platforms impacts adolescent health is unclear. Objective: The aim of this study was to examine the relationship between social media use, including the number of social media platforms used and time spent on social media, and adolescent HRQoL. Methods: We analyzed the data of 3397 children (mean age 13.5, SD 0.4 years) from the Generation R Study, a population-based cohort study in the Netherlands. Children reported the number of social media platforms used and time spent on social media during weekdays and weekends separately. Children's HRQoL was self-reported with the EuroQol 5-dimension questionnaire--youth version. Data on social media use and HRQoL were collected from 2015 to 2019. Multiple logistic and linear regressions were applied. Results: In this study, 72.6\% (2466/3397) of the children used 3 or more social media platforms, and 37.7\% (1234/3276) and 58.3\% (1911/3277) of the children used social media at least 2 hours per day during weekdays and weekends, respectively. Children using more social media platforms (7 or more platforms) had a higher odds of reporting having some or a lot of problems on ``having pain or discomfort'' (OR 1.55, 95\% CI 1.20 to 1.99) and ``feeling worried, sad or unhappy'' (OR 1.99, 95\% CI 1.52 to 2.60) dimensions and reported lower self-rated health ($\beta$ --3.81, 95\% CI --5.54 to --2.09) compared with children who used 0 to 2 social media platforms. Both on weekdays and weekends, children spent more time on social media were more likely to report having some or a lot of problems on ``doing usual activities,'' ``having pain or discomfort,'' ``feeling worried, sad or unhappy,'' and report lower self-rated health (all P<.001). Conclusions: Our findings indicate that using more social media platforms and spending more time on social media were significantly related to lower HRQoL. We recommend future research to study the pathway between social media use and HRQoL among adolescents. ",
doi="10.2196/39710",
url="https://mental.jmir.org/2022/10/e39710",
url="http://www.ncbi.nlm.nih.gov/pubmed/36194460"
}


@Article{info:doi/10.2196/39504,
author="Ferawati, Kiki
and Liew, Kongmeng
and Aramaki, Eiji
and Wakamiya, Shoko",
title="Monitoring Mentions of COVID-19 Vaccine Side Effects on Japanese and Indonesian Twitter: Infodemiological Study",
journal="JMIR Infodemiology",
year="2022",
month="Oct",
day="4",
volume="2",
number="2",
pages="e39504",
keywords="COVID-19",
keywords="vaccine",
keywords="COVID-19 vaccine",
keywords="Pfizer",
keywords="Moderna",
keywords="vaccine side effects",
keywords="side effects",
keywords="Twitter",
keywords="logistic regression",
abstract="Background: The year 2021 was marked by vaccinations against COVID-19, which spurred wider discussion among the general population, with some in favor and some against vaccination. Twitter, a popular social media platform, was instrumental in providing information about the COVID-19 vaccine and has been effective in observing public reactions. We focused on tweets from Japan and Indonesia, 2 countries with a large Twitter-using population, where concerns about side effects were consistently stated as a strong reason for vaccine hesitancy. Objective: This study aimed to investigate how Twitter was used to report vaccine-related side effects and to compare the mentions of these side effects from 2 messenger RNA (mRNA) vaccine types developed by Pfizer and Moderna, in Japan and Indonesia. Methods: We obtained tweet data from Twitter using Japanese and Indonesian keywords related to COVID-19 vaccines and their side effects from January 1, 2021, to December 31, 2021. We then removed users with a high frequency of tweets and merged the tweets from multiple users as a single sentence to focus on user-level analysis, resulting in a total of 214,165 users (Japan) and 12,289 users (Indonesia). Then, we filtered the data to select tweets mentioning Pfizer or Moderna only and removed tweets mentioning both. We compared the side effect counts to the public reports released by Pfizer and Moderna. Afterward, logistic regression models were used to compare the side effects for the Pfizer and Moderna vaccines for each country. Results: We observed some differences in the ratio of side effects between the public reports and tweets. Specifically, fever was mentioned much more frequently in tweets than would be expected based on the public reports. We also observed differences in side effects reported between Pfizer and Moderna vaccines from Japan and Indonesia, with more side effects reported for the Pfizer vaccine in Japanese tweets and more side effects with the Moderna vaccine reported in Indonesian tweets. Conclusions: We note the possible consequences of vaccine side effect surveillance on Twitter and information dissemination, in that fever appears to be over-represented. This could be due to fever possibly having a higher severity or measurability, and further implications are discussed. ",
doi="10.2196/39504",
url="https://infodemiology.jmir.org/2022/2/e39504",
url="http://www.ncbi.nlm.nih.gov/pubmed/36277140"
}


@Article{info:doi/10.2196/39582,
author="Koss, Jonathan
and Bohnet-Joschko, Sabine",
title="Social Media Mining of Long-COVID Self-Medication Reported by Reddit Users: Feasibility Study to Support Drug Repurposing",
journal="JMIR Form Res",
year="2022",
month="Oct",
day="3",
volume="6",
number="10",
pages="e39582",
keywords="social media mining",
keywords="drug repurposing",
keywords="long-COVID",
keywords="crowdsourcing",
keywords="COVID-19",
keywords="Reddit",
keywords="social media",
keywords="content analysis",
keywords="network analysis",
keywords="recognition algorithm",
keywords="treatment",
abstract="Background: Since the beginning of the COVID-19 pandemic, over 480 million people have been infected and more than 6 million people have died from COVID-19 worldwide. In some patients with acute COVID-19, symptoms manifest over a longer period, which is also called ``long-COVID.'' Unmet medical needs related to long-COVID are high, since there are no treatments approved. Patients experiment with various medications and supplements hoping to alleviate their suffering. They often share their experiences on social media. Objective: The aim of this study was to explore the feasibility of social media mining methods to extract important compounds from the perspective of patients. The goal is to provide an overview of different medication strategies and important agents mentioned in Reddit users' self-reports to support hypothesis generation for drug repurposing, by incorporating patients' experiences. Methods: We used named-entity recognition to extract substances representing medications or supplements used to treat long-COVID from almost 70,000 posts on the ``/r/covidlonghaulers'' subreddit. We analyzed substances by frequency, co-occurrences, and network analysis to identify important substances and substance clusters. Results: The named-entity recognition algorithm achieved an F1 score of 0.67. A total of 28,447 substance entities and 5789 word co-occurrence pairs were extracted. ``Histamine antagonists,'' ``famotidine,'' ``magnesium,'' ``vitamins,'' and ``steroids'' were the most frequently mentioned substances. Network analysis revealed three clusters of substances, indicating certain medication patterns. Conclusions: This feasibility study indicates that network analysis can be used to characterize the medication strategies discussed in social media. Comparison with existing literature shows that this approach identifies substances that are promising candidates for drug repurposing, such as antihistamines, steroids, or antidepressants. In the context of a pandemic, the proposed method could be used to support drug repurposing hypothesis development by prioritizing substances that are important to users. ",
doi="10.2196/39582",
url="https://formative.jmir.org/2022/10/e39582",
url="http://www.ncbi.nlm.nih.gov/pubmed/36007131"
}


@Article{info:doi/10.2196/40436,
author="Nguyen, Jean Cassandra
and Pham, Christian
and Jackson, M. Alexandra
and Ellison, Kamakahiolani Nicole Lee
and Sinclair, Ka`imi",
title="Online Food Security Discussion Before and During the COVID-19 Pandemic in Native Hawaiian and Pacific Islander Community Groups and Organizations: Content Analysis of Facebook Posts",
journal="Asian Pac Isl Nurs J",
year="2022",
month="Sep",
day="30",
volume="6",
number="1",
pages="e40436",
keywords="social media",
keywords="oceanic ancestry group",
keywords="food insecurity",
keywords="social networking",
keywords="COVID-19",
keywords="Facebook",
keywords="community",
keywords="Hawaiian",
keywords="Pacific Islander",
keywords="online",
keywords="food",
keywords="risk factor",
keywords="disease",
keywords="cardiometabolic",
keywords="diabetes",
keywords="hypertension",
keywords="food security",
keywords="digital",
keywords="support",
keywords="culture",
abstract="Background: The Native Hawaiian and Pacific Islander (NHPI) population experiences disproportionately higher rates of food insecurity, which is a risk factor for cardiometabolic diseases such as cardiovascular disease, type 2 diabetes, obesity, and hypertension, when compared to white individuals. Novel and effective approaches that address food insecurity are needed for the NHPI population, particularly in areas of the continental United States, which is a popular migration area for many NHPI families. Social media may serve as an opportune setting to reduce food insecurity and thus the risk factors for cardiometabolic diseases among NHPI people; however, it is unclear if and how food insecurity is discussed in online communities targeting NHPI individuals. Objective: The objective of this study was to characterize the quantity, nature, and audience engagement of messages related to food insecurity posted online in community groups and organizations that target NHPI audiences. Methods: Publicly accessible Facebook pages and groups focused on serving NHPI community members living in the states of Washington or Oregon served as the data source. Facebook posts between March and June 2019 (before the COVID-19 pandemic) and from March to June 2020 (during the COVID-19 pandemic) that were related to food security were identified using a set of 36 related keywords. Data on the post and any user engagement (ie, comments, shares, or digital reactions) were extracted for all relevant posts. A content analytical approach was used to identify and quantify the nature of the identified posts and any related comments. The codes resulting from the content analysis were described and compared by year, page type, and engagement. Results: Of the 1314 nonduplicated posts in the 7 relevant Facebook groups and pages, 88 were related to food security (8 in 2019 and 80 in 2020). The nature of posts was broadly classified into literature-based codes, food assistance (the most common), perspectives of food insecurity, community gratitude and support, and macrolevel contexts. Among the 88 posts, 74\% (n=65) had some form of engagement, and posts reflecting community gratitude and support or culture had more engagement than others (mean 19.9, 95\% CI 11.2-28.5 vs mean 6.1, 95\% CI 1.7-10.4; and mean 26.8, 95\% CI 12.7-40.9 vs mean 5.3, 95\% CI 3.0-7.7, respectively). Conclusions: Food security--related posts in publicly accessible Facebook groups targeting NHPI individuals living in Washington and Oregon largely focused on food assistance, although cultural values of gratitude, maintaining NHPI culture, and supporting children were also reflected. Future work should capitalize on social media as a potential avenue to reach a unique cultural group in the United States experiencing inequitably high rates of food insecurity and risk of cardiometabolic diseases. ",
doi="10.2196/40436",
url="https://apinj.jmir.org/2022/1/e40436",
url="http://www.ncbi.nlm.nih.gov/pubmed/36212246"
}


@Article{info:doi/10.2196/40171,
author="Hong, Alicia Y.
and Shen, Kang
and Lu, Kate Huixing
and Chen, Hsiaoyin
and Gong, Yang
and Ta Park, Van
and Han, Hae-Ra",
title="A Social Media--Based Intervention for Chinese American Caregivers of Persons With Dementia: Protocol Development",
journal="JMIR Aging",
year="2022",
month="Sep",
day="29",
volume="5",
number="3",
pages="e40171",
keywords="Alzheimer disease",
keywords="dementia",
keywords="caregivers",
keywords="Chinese Americans",
keywords="mHealth intervention",
keywords="mobile health",
keywords="WeChat",
keywords="social media",
keywords="aging",
abstract="Background: Racial/ethnic minority and immigrant caregivers of persons with dementia experience high rates of psychosocial stress and adverse health outcomes. Few culturally tailored mobile health (mHealth) programs were designed for these vulnerable populations. Objective: This study reports the development of a culturally tailored mHealth program called Wellness Enhancement for Caregivers (WECARE) to improve caregiving skills, reduce distress, and improve the psychosocial well-being of Chinese American family caregivers of persons with dementia. Methods: Community-based user-centered design principles were applied in the program development. First, the structure and curriculum of the WECARE program were crafted based on existing evidence-based interventions for caregivers with input from 4 experts. Second, through working closely with 8 stakeholders, we culturally adapted evidence-based programs into multimedia program components. Lastly, 5 target users tested the initial WECARE program; their experience and feedback were used to further refine the program. Results: The resulting WECARE is a 7-week mHealth program delivered via WeChat, a social media app highly popular in Chinese Americans. By subscribing to the official WECARE account, users can receive 6 interactive multimedia articles pushed to their WeChat accounts each week for 7 weeks. The 7 major themes include (1) facts of dementia and caregiving; (2) the enhancement of caregiving skills; (3) effective communication with health care providers, care partners, and family members; (4) problem-solving skills for caregiving stress management; (5) stress reduction and depression prevention; (6) the practice of self-care and health behaviors; and (7) social support and available resources. Users also have the option of joining group chats for peer support. The WECARE program also includes a back-end database that manages intervention delivery and tracks user engagement. Conclusions: The WECARE program represents one of the first culturally tailored social media--based interventions for Chinese American caregivers of persons with dementia. It demonstrates the use of community-based user-centered design principles in developing an mHealth intervention program in underserved communities. We call for more cultural adaptation and development of mHealth interventions for immigrant and racial/ethnic minority caregivers of persons with dementia. ",
doi="10.2196/40171",
url="https://aging.jmir.org/2022/3/e40171",
url="http://www.ncbi.nlm.nih.gov/pubmed/36173667"
}


@Article{info:doi/10.2196/38140,
author="Yu, Deahan
and Vydiswaran, Vinod V. G.",
title="An Assessment of Mentions of Adverse Drug Events on Social Media With Natural Language Processing: Model Development and Analysis",
journal="JMIR Med Inform",
year="2022",
month="Sep",
day="28",
volume="10",
number="9",
pages="e38140",
keywords="natural language processing",
keywords="machine learning",
keywords="adverse drug event",
keywords="pharmacovigilance",
keywords="social media",
keywords="drug",
keywords="clinical",
keywords="public health",
keywords="health monitoring",
keywords="surveillance",
keywords="drug effects",
keywords="drug safety",
abstract="Background: Adverse reactions to drugs attract significant concern in both clinical practice and public health monitoring. Multiple measures have been put into place to increase postmarketing surveillance of the adverse effects of drugs and to improve drug safety. These measures include implementing spontaneous reporting systems and developing automated natural language processing systems based on data from electronic health records and social media to collect evidence of adverse drug events that can be further investigated as possible adverse reactions. Objective: While using social media for collecting evidence of adverse drug events has potential, it is not clear whether social media are a reliable source for this information. Our work aims to (1) develop natural language processing approaches to identify adverse drug events on social media and (2) assess the reliability of social media data to identify adverse drug events. Methods: We propose a collocated long short-term memory network model with attentive pooling and aggregated, contextual representation generated by a pretrained model. We applied this model on large-scale Twitter data to identify adverse drug event--related tweets. We conducted a qualitative content analysis of these tweets to validate the reliability of social media data as a means to collect such information. Results: The model outperformed a variant without contextual representation during both the validation and evaluation phases. Through the content analysis of adverse drug event tweets, we observed that adverse drug event--related discussions had 7 themes. Mental health--related, sleep-related, and pain-related adverse drug event discussions were most frequent. We also contrast known adverse drug reactions to those mentioned in tweets. Conclusions: We observed a distinct improvement in the model when it used contextual information. However, our results reveal weak generalizability of the current systems to unseen data. Additional research is needed to fully utilize social media data and improve the robustness and reliability of natural language processing systems. The content analysis, on the other hand, showed that Twitter covered a sufficiently wide range of adverse drug events, as well as known adverse reactions, for the drugs mentioned in tweets. Our work demonstrates that social media can be a reliable data source for collecting adverse drug event mentions. ",
doi="10.2196/38140",
url="https://medinform.jmir.org/2022/9/e38140",
url="http://www.ncbi.nlm.nih.gov/pubmed/36170004"
}


@Article{info:doi/10.2196/36941,
author="Hu, Mengke
and Conway, Mike",
title="Perspectives of the COVID-19 Pandemic on Reddit: Comparative Natural Language Processing Study of the United States, the United Kingdom, Canada, and Australia",
journal="JMIR Infodemiology",
year="2022",
month="Sep",
day="27",
volume="2",
number="2",
pages="e36941",
keywords="COVID-19",
keywords="social media",
keywords="natural language processing",
keywords="Reddit",
abstract="Background: Since COVID-19 was declared a pandemic by the World Health Organization on March 11, 2020, the disease has had an unprecedented impact worldwide. Social media such as Reddit can serve as a resource for enhancing situational awareness, particularly regarding monitoring public attitudes and behavior during the crisis. Insights gained can then be utilized to better understand public attitudes and behaviors during the COVID-19 crisis, and to support communication and health-promotion messaging. Objective: The aim of this study was to compare public attitudes toward the 2020-2021 COVID-19 pandemic across four predominantly English-speaking countries (the United States, the United Kingdom, Canada, and Australia) using data derived from the social media platform Reddit. Methods: We utilized a topic modeling natural language processing method (more specifically latent Dirichlet allocation). Topic modeling is a popular unsupervised learning technique that can be used to automatically infer topics (ie, semantically related categories) from a large corpus of text. We derived our data from six country-specific, COVID-19--related subreddits (r/CoronavirusAustralia, r/CoronavirusDownunder, r/CoronavirusCanada, r/CanadaCoronavirus, r/CoronavirusUK, and r/coronavirusus). We used topic modeling methods to investigate and compare topics of concern for each country. Results: Our consolidated Reddit data set consisted of 84,229 initiating posts and 1,094,853 associated comments collected between February and November 2020 for the United States, the United Kingdom, Canada, and Australia. The volume of posting in COVID-19--related subreddits declined consistently across all four countries during the study period (February 2020 to November 2020). During lockdown events, the volume of posts peaked. The UK and Australian subreddits contained much more evidence-based policy discussion than the US or Canadian subreddits. Conclusions: This study provides evidence to support the contention that there are key differences between salient topics discussed across the four countries on the Reddit platform. Further, our approach indicates that Reddit data have the potential to provide insights not readily apparent in survey-based approaches. ",
doi="10.2196/36941",
url="https://infodemiology.jmir.org/2022/2/e36941",
url="http://www.ncbi.nlm.nih.gov/pubmed/36196144"
}


@Article{info:doi/10.2196/39360,
author="Liang, Jing
and Wang, Linlin
and Song, Shijie
and Dong, Man
and Xu, Yidan
and Zuo, Xinyu
and Zhang, Jingyi
and Adrian Sherif, Akil
and Ehsan, Jafree
and Ma, Jianjun
and Li, Pengyang",
title="Quality and Audience Engagement of Takotsubo Syndrome--Related Videos on TikTok: Content Analysis",
journal="J Med Internet Res",
year="2022",
month="Sep",
day="26",
volume="24",
number="9",
pages="e39360",
keywords="TikTok",
keywords="short video apps",
keywords="information quality",
keywords="Takotsubo syndrome",
keywords="patient education",
keywords="social media",
keywords="audience engagement",
abstract="Background: The incidence of Takotsubo syndrome (TTS), also known as the broken heart syndrome or stress cardiomyopathy, is increasing worldwide. The understanding of its prognosis has been progressively evolving and currently appears to be poorer than previously thought, which has attracted the attention of researchers. An attempt to recognize the awareness of this condition among the general population drove us to analyze the dissemination of this topic on TikTok, a popular short-video--based social media platform. We found a considerable number of videos on TTS on TikTok; however, the quality of the presented information remains unknown. Objective: The aim of this study was to analyze the quality and audience engagement of TTS-related videos on TikTok. Methods: Videos on the TikTok platform were explored on August 2, 2021 to identify those related to TTS by using 6 Chinese keywords. A total of 2549 videos were found, of which 80 met our inclusion criteria and were evaluated for their characteristics, content, quality, and reliability. The quality and reliability were rated using the DISCERN instrument and the Journal of the American Medical Association (JAMA) criteria by 2 reviewers independently, and a score was assigned. Descriptive statistics were generated, and the Kruskal-Wallis test was used for statistical analysis. Multiple linear regression was performed to evaluate the association between audience engagement and other factors such as video content, video quality, and author types. Results: The scores assigned to the selected video content were low with regard to the diagnosis (0.66/2) and management (0.34/2) of TTS. The evaluated videos were found to have an average score of 36.93 out of 80 on the DISCERN instrument and 1.51 out of 4 per the JAMA criteria. None of the evaluated videos met all the JAMA criteria. The quality of the relayed information varied by source (All P<.05). TTS-related videos made by health care professionals accounted for 28\% (22/80) of all the evaluated videos and had the highest DISCERN scores with an average of 40.59 out of 80. Multiple linear regression analysis showed that author types that identified as health professionals (exponentiated regression coefficient 17.48, 95\% CI 2.29-133.52; P=.006) and individual science communicators (exponentiated regression coefficient 13.38, 95\% CI 1.83-97.88; P=.01) were significant and independent determinants of audience engagement (in terms of the number of likes). Other author types of videos, video content, and DISCERN document scores were not associated with higher likes. Conclusions: We found that the quality of videos regarding TTS for patient education on TikTok is poor. Patients should be cautious about health-related information on TikTok. The formulation of a measure for video quality review is necessary, especially when the purpose of the published content is to educate and increase awareness on a health-related topic. ",
doi="10.2196/39360",
url="https://www.jmir.org/2022/9/e39360",
url="http://www.ncbi.nlm.nih.gov/pubmed/36155486"
}


@Article{info:doi/10.2196/35035,
author="Coffin, Tara
and Bowen, Deborah
and Lu, Karen
and Swisher, M. Elizabeth
and Rayes, Nadine
and Norquist, Barbara
and Blank, V. Stephanie
and Levine, A. Douglas
and Bakkum-Gamez, Nadine Jamie
and Fleming, F. Gini
and I Olopade, Olufunmilayo
and Romero, Iris
and D'Andrea, Alan
and Nebgen, R. Denise
and Peterson, Christine
and Munsell, F. Mark
and Gavin, Kathleen
and Crase, Jamie
and Polinsky, Deborah
and Lechner, Rebecca",
title="Using Social Media to Facilitate Communication About Women's Testing: Tool Validation Study",
journal="JMIR Form Res",
year="2022",
month="Sep",
day="26",
volume="6",
number="9",
pages="e35035",
keywords="ovarian cancer",
keywords="hereditary cancer",
keywords="genetic testing",
keywords="online social media recruitment",
keywords="Facebook",
keywords="social media",
keywords="mobile phone",
abstract="Background: Strong participant recruitment practices are critical to public health research but are difficult to achieve. Traditional recruitment practices are often time consuming, costly, and fail to adequately target difficult-to-reach populations. Social media platforms such as Facebook are well-positioned to address this area of need, enabling researchers to leverage existing social networks and deliver targeted information. The MAGENTA (Making Genetic Testing Accessible) study aimed to improve the availability of genetic testing for hereditary cancer susceptibility in at-risk individuals through the use of a web-based communication system along with social media advertisements to improve reach. Objective: This paper is aimed to evaluate the effectiveness of Facebook as an outreach tool for targeting women aged ?30 years for recruitment in the MAGENTA study. Methods: We designed and implemented paid and unpaid social media posts with ongoing assessment as a primary means of research participant recruitment in collaboration with patient advocates. Facebook analytics were used to assess the effectiveness of paid and unpaid outreach efforts. Results: Over the course of the reported recruitment period, Facebook materials had a reach of 407,769 people and 57,248 (14.04\%) instances of engagement, indicating that approximately 14.04\% of people who saw information about the study on Facebook engaged with the content. Paid advertisements had a total reach of 373,682. Among those reached, just <15\% (54,117/373,682, 14.48\%) engaged with the page content. Unpaid posts published on the MAGENTA Facebook page resulted in a total of 34,087 reach and 3131 instances of engagement, indicating that around 9.19\% (3131/34,087) of people who saw unpaid posts engaged. Women aged ?65 years reported the best response rate, with approximately 43.95\% (15,124/34,410) of reaches translating to engagement. Among the participants who completed the eligibility questionnaire, 27.44\% (3837/13,983) had heard about the study through social media or another webpage. Conclusions: Facebook is a useful way of enhancing clinical trial recruitment of women aged ?30 years who have a potentially increased risk for ovarian cancer by promoting news stories over social media, collaborating with patient advocacy groups, and running paid and unpaid campaigns. Trial Registration: ClinicalTrials.gov NCT02993068; https://clinicaltrials.gov/ct2/show/NCT02993068 ",
doi="10.2196/35035",
url="https://formative.jmir.org/2022/9/e35035",
url="http://www.ncbi.nlm.nih.gov/pubmed/36155347"
}


@Article{info:doi/10.2196/35648,
author="Stafylis, Chrysovalantis
and Vavala, Gabriella
and Wang, Qiao
and McLeman, Bethany
and Lemley, M. Shea
and Young, D. Sean
and Xie, Haiyi
and Matthews, G. Abigail
and Oden, Neal
and Revoredo, Leslie
and Shmueli-Blumberg, Dikla
and Hichborn, G. Emily
and McKelle, Erin
and Moran, M. Landhing
and Jacobs, Petra
and Marsch, A. Lisa
and Klausner, D. Jeffrey",
title="Relative Effectiveness of Social Media, Dating Apps, and Information Search Sites in Promoting HIV Self-testing: Observational Cohort Study",
journal="JMIR Form Res",
year="2022",
month="Sep",
day="23",
volume="6",
number="9",
pages="e35648",
keywords="HIV prevention",
keywords="PrEP",
keywords="home HIV test",
keywords="social media",
keywords="dating apps",
keywords="search engines",
keywords="HIV",
keywords="human immunodeficiency virus",
keywords="self-testing",
keywords="infection",
keywords="digital health",
keywords="health promotion",
keywords="MSM",
keywords="pre-exposure prophylaxis",
keywords="medical information",
abstract="Background: Social media sites, dating apps, and information search sites have been used to reach individuals at high risk for HIV infection. However, it is not clear which platform is the most efficient in promoting home HIV self-testing, given that the users of various platforms may have different characteristics that impact their readiness for HIV testing. Objective: This study aimed to compare the relative effectiveness of social media sites, dating apps, and information search sites in promoting HIV self-testing among minority men who have sex with men (MSM) at an increased risk of HIV infection. Test kit order rates were used as a proxy to evaluate promotion effectiveness. In addition, we assessed differences in characteristics between participants who ordered and did not order an HIV test kit. Methods: Culturally appropriate advertisements were placed on popular sites of three different platforms: social media sites (Facebook, Instagram), dating apps (Grindr, Jack'D), and information search sites (Google, Bing). Advertisements targeted young (18-30 years old) and minority (Black or Latinx) MSM at risk of HIV exposure. Recruitment occurred in 2 waves, with each wave running advertisements on 1 platform of each type over the same period. Participants completed a baseline survey assessing sexual or injection use behavior, substance use including alcohol, psychological readiness to test, attitudes toward HIV testing and treatment, and HIV-related stigma. Participants received an electronic code to order a free home-based HIV self-test kit. Follow-up assessments were conducted to assess HIV self-test kit use and uptake of pre-exposure prophylaxis (PrEP) at 14 and 60 days post enrollment. Results: In total, 271 participants were enrolled, and 254 were included in the final analysis. Among these 254 participants, 177 (69.7\%) ordered a home HIV self-test kit. Most of the self-test kits were ordered by participants enrolled from dating apps. Due to waves with low enrollment, between wave statistical comparisons were not feasible. Within wave comparison revealed that Jack'D showed higher order rates (3.29 kits/day) compared to Instagram (0.34 kits/day) and Bing (0 kits/day). There were no associations among self-test kit ordering and HIV-related stigma, perceptions about HIV testing and treatment, and mistrust of medical organizations. Conclusions: Our findings show that using popular dating apps might be an efficient way to promote HIV self-testing. Stigma, perceptions about HIV testing and treatment, or mistrust of medical organizations may not affect order rates of HIV test kits promoted on the internet. Trial Registration: ClinicalTrials.gov NCT04155502; https://clinicaltrials.gov/ct2/show/NCT04155502 International Registered Report Identifier (IRRID): RR2-10.2196/20417 ",
doi="10.2196/35648",
url="https://formative.jmir.org/2022/9/e35648",
url="http://www.ncbi.nlm.nih.gov/pubmed/36149729"
}


@Article{info:doi/10.2196/40331,
author="Silver, Nathan
and Kierstead, Elexis
and Kostygina, Ganna
and Tran, Hy
and Briggs, Jodie
and Emery, Sherry
and Schillo, Barbara",
title="The Influence of Provaping ``Gatewatchers'' on the Dissemination of COVID-19 Misinformation on Twitter: Analysis of Twitter Discourse Regarding Nicotine and the COVID-19 Pandemic",
journal="J Med Internet Res",
year="2022",
month="Sep",
day="22",
volume="24",
number="9",
pages="e40331",
keywords="social media",
keywords="tobacco",
keywords="COVID-19",
keywords="nicotine",
keywords="misinformation",
keywords="Twitter",
keywords="information",
keywords="infodemiology",
keywords="vaping",
keywords="therapeutic",
keywords="influence",
keywords="environment",
keywords="harmful",
keywords="consequences",
abstract="Background: There is a lot of misinformation about a potential protective role of nicotine against COVID-19 spread on Twitter despite significant evidence to the contrary. We need to examine the role of vape advocates in the dissemination of such information through the lens of the gatewatching framework, which posits that top users can amplify and exert a disproportionate influence over the dissemination of certain content through curating, sharing, or, in the case of Twitter, retweeting it, serving more as a vector for misinformation rather than the source. Objective: This research examines the Twitter discourse at the intersection of COVID-19 and tobacco (1) to identify the extent to which the most outspoken contributors to this conversation self-identify as vaping advocates and (2) to understand how and to what extent these vape advocates serve as gatewatchers through disseminating content about a therapeutic role of tobacco, nicotine, or vaping against COVID-19. Methods: Tweets about tobacco, nicotine, or vaping and COVID-19 (N=1,420,271) posted during the first 9 months of the pandemic (January-September 2020) were identified from within a larger corpus of tobacco-related tweets using validated keyword filters. The top posters (ie, tweeters and retweeters) were identified and characterized, along with the most shared Uniform Resource Locators (URLs), most used hashtags, and the 1000 most retweeted posts. Finally, we examined the role of both top users and vape advocates in retweeting the most retweeted posts about the therapeutic role of nicotine, tobacco, or vaping against COVID-19. Results: Vape advocates comprised between 49.7\% (n=81) of top 163 and 88\% (n=22) of top 25 users discussing COVID-19 and tobacco on Twitter. Content about the ability of tobacco, nicotine, or vaping to treat or prevent COVID-19 was disseminated broadly, accounting for 22.5\% (n=57) of the most shared URLs and 10\% (n=107) of the most retweeted tweets. Finally, among top users, retweets comprised an average of 78.6\% of the posts from vape advocates compared to 53.1\% from others (z=3.34, P<.001). Vape advocates were also more likely to retweet the top tweeted posts about a therapeutic role of nicotine, with 63\% (n=51) of vape advocates retweeting at least 1 post compared to 40.3\% (n=29) of other top users (z=2.80, P=.01). Conclusions: Provaping users dominated discussions of tobacco use during the COVID-19 pandemic on Twitter and were instrumental in disseminating the most retweeted posts about a potential therapeutic role of tobacco use against the virus. Subsequent research is needed to better understand the extent of this influence and how to mitigate the influence of vape advocates over the broader narrative of tobacco regulation on Twitter. ",
doi="10.2196/40331",
url="https://www.jmir.org/2022/9/e40331",
url="http://www.ncbi.nlm.nih.gov/pubmed/36070451"
}


@Article{info:doi/10.2196/38359,
author="Saunders, H. Catherine
and Sierpe, Ailyn
and Stevens, Gabrielle
and Elwyn, Glyn
and Cantrell, Matthew
and Engel, Jaclyn
and Gonzalez, Melissa
and Hayward, Martha
and Huebner, Joellen
and Johnson, Lisa
and Jimenez, Alejandro
and Little, Ruth Nancy
and McKenna, Corinne
and Onteeru, Manu
and Oo Khine, May
and Pogue, Jacqueline
and Salinas Vargas, Luis Jos{\'e}
and Schmidt, Peter
and Thomeer, Rachael
and 
and Durand, Marie-Anne",
title="Co-Development of a Web Application (COVID-19 Social Site) for Long-Term Care Workers (``Something for Us''): User-Centered Design and Participatory Research Study",
journal="J Med Internet Res",
year="2022",
month="Sep",
day="22",
volume="24",
number="9",
pages="e38359",
keywords="COVID-19",
keywords="vaccine hesitancy",
keywords="long-term care",
keywords="social media",
keywords="web application",
keywords="website",
keywords="intervention development, information and communications technology",
abstract="Background: Improving confidence in and uptake of COVID-19 vaccines and boosters among long-term care workers (LTCWs) is a crucial public health goal, given their role in the care of elderly people and people at risk. While difficult to reach with workplace communication interventions, most LTCWs regularly use social media and smartphones. Various social media interventions have improved attitudes and uptake for other vaccines and hold promise for the LTCW population. Objective: We aimed to develop a curated social web application (interactive website) to increase COVID-19 vaccine confidence (a 3-arm randomized trial is underway). Methods: Following user-centric design and participatory research approaches, we undertook the following 3 steps: (1) content identification, (2) platform development, and (3) community building. A LTCW and stakeholder advisory group provided iterative input. For content identification (step 1), we identified topics of concern about COVID-19 vaccines via desktop research (published literature, public opinion polls, and social media monitoring), refined by interviewing and polling LTCWs. We also conducted a national online panel survey. We curated and fact-checked posts from popular social media platforms that addressed the identified concerns. During platform development (step 2), we solicited preferences for design and functionality via interviews and user experience testing with LTCWs. We also identified best practices for online community building (step 3). Results: In the interviews (n=9), we identified 3 themes: (1) LTCWs are proud of their work but feel undervalued; (2) LTCWs have varying levels of trust in COVID-19--related information; and (3) LTCWs would welcome a curated COVID-19 resource that is easy to understand and use-``something for us''. Through desktop research, LTCW interviews, and our national online panel survey (n=592) we found that participants are interested in information about COVID-19 in general, vaccine benefits, vaccine risks, and vaccine development. Content identification resulted in 434 posts addressing these topic areas, with 209 uploaded to the final web application. Our LTCW poll (n=8) revealed preferences for personal stories and video content. The platform we developed is an accessible WordPress-based social media web application, refined through formal (n=3) and informal user experience testing. Users can sort posts by topic or subtopic and react to or comment on posts. To build an online community, we recruited 3 LTCW ``community ambassadors'' and instructed them to encourage discussion, acknowledge concerns, and offer factual information on COVID-19 vaccines. We also set ``community standards'' for the web application. Conclusions: An iterative, user-centric, participatory approach led to the launch of an accessible social media web application with curated content for COVID-19 vaccines targeting LTCWs in the United States. Through our trial, we will determine if this approach successfully improves vaccine confidence. If so, a similar social media resource could be used to develop curated social media interventions in other populations and with other public health goals. ",
doi="10.2196/38359",
url="https://www.jmir.org/2022/9/e38359",
url="http://www.ncbi.nlm.nih.gov/pubmed/35926074"
}


@Article{info:doi/10.2196/39068,
author="Lyall, Matthew
and Crawford, Rebecca
and Bell, Timothy
and Mamolo, Carla
and Neuhof, Alexander
and Levy, Courtney
and Heyes, Anne",
title="Characterizing the Patient Journey in Multiple Myeloma: Qualitative Review",
journal="JMIR Cancer",
year="2022",
month="Sep",
day="22",
volume="8",
number="3",
pages="e39068",
keywords="multiple myeloma",
keywords="literature review",
keywords="patient-centered insights",
keywords="patient experience",
keywords="patient perspectives",
keywords="patient-reported information",
keywords="social media",
keywords="YouTube",
abstract="Background: The patient experience of multiple myeloma (MM) is multifaceted and varies substantially between individuals. Current published information on the patient perspective and treatment of MM is limited, making it difficult to gain insights into patient needs regarding the condition. Objective: In this review, a combined research method approach (ie, the review of published literature and social media posts) was undertaken to provide insight into patients' perspectives on the burden and treatment of MM, the impact of the COVID-19 pandemic, and the impact of MM on caregivers of patients with MM. Methods: Targeted searches of PubMed and PsycINFO were conducted from November 16, 2010, to November 16, 2020; in parallel, patient-reported information derived from social media posts from 6 patient advocacy websites and YouTube were searched. The review of patient advocacy websites and YouTube targeted patient-reported information from patients with a self-reported diagnosis of MM who discussed their experience of MM and its treatments. Results: A total of 27 articles and 138 posts were included (patient-reported information included data from 76 individuals), and results from both sources showed that patients experienced a variety of symptoms and treatment side effects, including neuropathy, fatigue, nausea, and back pain. These can affect areas of health-related quality of life (HRQOL), including physical functioning; emotional, psychological, and social well-being; the ability to work; and relationships. Patients valued involvement in treatment decision-making, and both the patient-reported information and the literature indicated that efficacy and tolerability strongly influence treatment decision-making. For patients, caregivers, and physicians, the preference for treatments was strongest when associated with increased survival. Caregivers can struggle to balance care responsibilities and jobs, and their HRQOL is affected in several areas, including emotional-, role-, social-, and work-related aspects of life. The COVID-19 pandemic has challenged patients' ability to manage MM because of limited hospital access and restrictions that negatively affected their lives, psychological well-being, and HRQOL. Unmet patient needs identified in the literature and patient-reported information were for more productive appointments with health care professionals, better-tolerated therapies, and more support for themselves and their caregivers. Conclusions: The combination of published literature and patient-reported information provides valuable and rich details on patient experiences and perceptions of MM and its treatment. The data highlighted that patients' HRQOL is impeded not only by the disease but also by treatment-related side effects. Patients in the literature and patient-reported information showed a strong preference for treatments that prolong life, and patients appeared to value participation in treatment decisions. However, there remain unmet needs and areas for further research, including treatment, caregiver burden, and how to conduct appointments with health care professionals. This may help improve the understanding of the journey of patients with MM. Plain Language Summary: Multiple Myeloma (MM) is the second most common cancer that affects blood cells. In this study, researchers wanted to know patients' views on the effects of MM and the treatments they received. Researchers also looked at the impact of the COVID-19 pandemic on patients' treatment and the impact of MM on caregivers. To this end, the researchers reviewed information from 27 published studies and 138 social media posts by 76 patients with MM. Patients commonly reported nerve pain, tiredness, feeling sick, and back pain caused by MM and the treatments they received. The effects of MM and treatments affected patients' physical function; emotional, psychological, and social well-being; ability to work; and relationships. The researchers found that patients wanted to be involved in decisions related to their treatment. The effectiveness against MM and known negative effects strongly influenced the choice of treatments for patients. Increased survival was the strongest factor in the choice of treatment for patients, caregivers, and doctors. Researchers found that the emotional-, role-, social-, and work-related aspects of caregivers' lives were affected by caring for patients with MM. The COVID-19 pandemic also affected the ability of patients to manage their MM because of limited hospital access and the effects of restrictions that impacted their lives and psychological well-being. Finally, the researchers identified some areas requiring improvement, including unproductive appointments with health care professionals, the need for treatments with fewer negative effects, and more support for patients with MM and their caregivers. This information may be useful to improve and understand the experience of patients with MM. ",
doi="10.2196/39068",
url="https://cancer.jmir.org/2022/3/e39068",
url="http://www.ncbi.nlm.nih.gov/pubmed/36136395"
}


@Article{info:doi/10.2196/38449,
author="Berger, N. Matthew
and Taba, Melody
and Marino, L. Jennifer
and Lim, C. Megan S.
and Skinner, Rachel S.",
title="Social Media Use and Health and Well-being of Lesbian, Gay, Bisexual, Transgender, and Queer Youth: Systematic Review",
journal="J Med Internet Res",
year="2022",
month="Sep",
day="21",
volume="24",
number="9",
pages="e38449",
keywords="lesbian, gay, bisexual, transgender, and queer",
keywords="LGBTQ",
keywords="adolescence",
keywords="youth",
keywords="well-being",
keywords="mental health",
keywords="social media",
keywords="identity",
keywords="support",
keywords="mobile phone",
abstract="Background: Lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals are at higher risk of poor mental health and well-being. Social media platforms can provide LGBTQ youths with a space that counters heteronormative environments and potentially supports mental health and well-being. Mental health includes an individual's state of psychological and emotional well-being and not merely the absence of mental disorders. Objective: We sought to identify how LGBTQ youths and adolescents use social media for connection with other LGBTQ peers and groups, identity development, and social support and how these affect mental health and well-being. Methods: PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) procedures were used to guide this review. Searches were conducted in ACM Digital Library, CINAHL, Ovid Embase, Ovid MEDLINE, and Web of Science in March 2021. This review focused on LGBTQ youths aged 10 to 24 years. Included peer-reviewed studies must comprise social media; explore peer connection, identity development, or social support; and be published from 2012 onward. In total, 2 researchers extracted data and performed quality assessments independently using the Newcastle-Ottawa Scale for quantitative articles and the Critical Appraisal Skills Programme for qualitative articles. Qualitative synthesis was performed on articles that satisfied the eligibility criteria. Results: A total of 26 studies (n=15, 58\% qualitative; n=8, 31\% quantitative; n=3, 12\% mixed methods) met the inclusion criteria. Of the 8 quantitative studies, 6 (75\%) were cross-sectional, and 2 (25\%) were cohort studies. All studies ranged from moderate to high quality. Social media was a popular tool used by LGBTQ youths to connect with LGBTQ communities. In qualitative data, we found that LGBTQ youths negotiated and explored identity and obtained support from peers on social media. Instagram, Tumblr, and Twitter were commonly used to access LGBTQ content owing to ease of anonymity. Identity management was the most studied social media affordance, important to LGBTQ youths for strategic disclosure. Key strategies for managing identities included being anonymous, censoring locations or content, restricting audiences, and using multiple accounts. Quantitative studies (3/8, 38\%) showed that social media was associated with reduced mental health concerns and increased well-being among LGBTQ youths. Mental health concerns arising from social media use were attributed to discrimination, victimization, and policies that did not accommodate changed identities. Conclusions: We found that social media may support the mental health and well-being of LGBTQ youths through peer connection, identity management, and social support, but findings were limited by weaknesses in the evidence. More robust and longitudinal studies are needed to determine the relationship between social media use and LGBTQ mental health, particularly among adolescents. The findings may inform interventions to promote social media health literacy and the mental health and well-being of this vulnerable group. Trial Registration: PROSPERO CRD42020222535; https://www.crd.york.ac.uk/prospero/display\_record.php?RecordID=222535 ",
doi="10.2196/38449",
url="https://www.jmir.org/2022/9/e38449",
url="http://www.ncbi.nlm.nih.gov/pubmed/36129741"
}


@Article{info:doi/10.2196/38944,
author="Ahmed, Saifuddin
and Rasul, Ehab Muhammad",
title="Social Media News Use and COVID-19 Misinformation Engagement: Survey Study",
journal="J Med Internet Res",
year="2022",
month="Sep",
day="20",
volume="24",
number="9",
pages="e38944",
keywords="COVID-19",
keywords="misinformation",
keywords="personality",
keywords="cognitive ability",
keywords="social media",
keywords="Singapore",
abstract="Background: Social media is widely used as a source of news and information regarding COVID-19. However, the abundance of misinformation on social media platforms has raised concerns regarding the spreading infodemic. Accordingly, many have questioned the utility and impact of social media news use on users' engagement with (mis)information. Objective: This study offers a conceptual framework for how social media news use influences COVID-19 misinformation engagement. More specifically, we examined how news consumption on social media leads to COVID-19 misinformation sharing by inducing belief in such misinformation. We further explored if the effects of social media news use on COVID-19 misinformation engagement depend on individual differences in cognition and personality traits. Methods: We used data from an online survey panel administered by a survey agency (Qualtrics) in Singapore. The survey was conducted in March 2022, and 500 respondents answered the survey. All participants were older than 21 years and provided consent before taking part in the study. We used linear regression, mediation, and moderated mediation analyses to explore the proposed relationships between social media news use, cognitive ability, personality traits, and COVID-19 misinformation belief and sharing intentions. Results: The results suggested that those who frequently used social media for news consumption were more likely to believe COVID-19 misinformation and share it on social media. Further probing the mechanism suggested that social media news use translated into sharing intent via the perceived accuracy of misinformation. Simply put, social media news users shared COVID-19 misinformation because they believed it to be accurate. We also found that those with high levels of extraversion than those with low levels were more likely to perceive the misinformation to be accurate and share it. Those with high levels of neuroticism and openness than those with low levels were also likely to perceive the misinformation to be accurate. Finally, it was observed that personality traits did not significantly influence misinformation sharing at higher levels of cognitive ability, but low cognitive users largely drove misinformation sharing across personality traits. Conclusions: The reliance on social media platforms for news consumption during the COVID-19 pandemic has amplified, with dire consequences for misinformation sharing. This study shows that increased social media news consumption is associated with believing and sharing COVID-19 misinformation, with low cognitive users being the most vulnerable. We offer recommendations to newsmakers, social media moderators, and policymakers toward efforts in limiting COVID-19 misinformation propagation and safeguarding citizens. ",
doi="10.2196/38944",
url="https://www.jmir.org/2022/9/e38944",
url="http://www.ncbi.nlm.nih.gov/pubmed/36067414"
}


@Article{info:doi/10.2196/37757,
author="Adams, J. Elizabeth
and Tallman, David
and Haynam, L. Marcy
and Nekhlyudov, Larissa
and Lustberg, B. Maryam",
title="Psychosocial Needs of Gynecological Cancer Survivors: Mixed Methods Study",
journal="J Med Internet Res",
year="2022",
month="Sep",
day="20",
volume="24",
number="9",
pages="e37757",
keywords="mixed methods",
keywords="quantitative",
keywords="qualitative",
keywords="cancer survivorship",
keywords="gynecological cancer",
keywords="uterine cancer",
keywords="ovarian cancer",
keywords="cancer informatics",
keywords="patient discussion",
keywords="social media",
abstract="Background: Internet and social media platforms offer insights into the lived experiences of survivors of cancer and their caregivers; however, the volume of narrative data available is often cumbersome for thorough analysis. Survivors of gynecological cancer have unique needs, such as those related to a genetic predisposition to future cancers, impact of cancer on sexual health, the advanced stage at which many are diagnosed, and the influx of new therapeutic approaches. Objective: This study aimed to present a unique methodology to leverage large amounts of data from internet-based platforms for mixed methods analysis. We analyzed discussion board posts made by survivors of gynecological cancer on the American Cancer Society website with a particular interest in evaluating the psychosocial aspects of survivorship. Methods: All posts from the ovarian, uterine, and gynecological cancers (other than ovarian and uterine) discussion boards on the American Cancer Society Cancer Survivors Network were included. Posts were web scraped using Python and organized by psychosocial themes described in the Quality of Cancer Survivorship Care Framework. Keywords related to each theme were generated and verified. Keywords identified posts related to the predetermined psychosocial themes. Quantitative analysis was completed using Python and R Foundation for Statistical Computing packages. Qualitative analysis was completed on a subset of posts as a proof of concept. Themes discovered through latent Dirichlet allocation (LDA), an unsupervised topic modeling technique, were assessed and compared with the predetermined themes of interest. Results: A total of 125,498 posts made by 6436 survivors of gynecological cancer and caregivers between July 2000 and February 2020 were evaluated. Of the 125,489 posts, 23,458 (18.69\%) were related to the psychosocial experience of cancer and were included in the mixed methods psychosocial analysis. Quantitative analysis (23,458 posts) revealed that survivors across all gynecological cancer discussion boards most frequently discussed the role of friends and family in care, as well as fatigue, the effect of cancer on interpersonal relationships, and health insurance status. Words related to psychosocial aspects of survivorship most often used in posts included ``family,'' ``hope,'' and ``help.'' Qualitative analysis (20 of the 23,458 posts) similarly demonstrated that survivors frequently discussed coping strategies, distress and worry, the role of family and caregivers in their cancer care, and the toll of managing financial and insurance concerns. Using LDA, we discovered 8 themes, none of which were directly related to psychosocial aspects of survivorship. Of the 56 keywords identified by LDA, 2 (4\%), ``sleep'' and ``work,'' were included in the keyword list that we independently devised. Conclusions: Web-based discussion platforms offer a great opportunity to learn about patient experiences of survivorship. Our novel methodology expedites the quantitative and qualitative analyses of such robust data, which may be used for additional patient populations. ",
doi="10.2196/37757",
url="https://www.jmir.org/2022/9/e37757",
url="http://www.ncbi.nlm.nih.gov/pubmed/36125848"
}


@Article{info:doi/10.2196/37518,
author="Renner, Simon
and Loussikian, Paul
and Foulqui{\'e}, Pierre
and Arnould, Benoit
and Marrel, Alexia
and Barbier, Valentin
and Mebarki, Adel
and Sch{\"u}ck, St{\'e}phane
and Bharmal, Murtuza",
title="Perceived Unmet Needs in Patients Living With Advanced Bladder Cancer and Their Caregivers: Infodemiology Study Using Data From Social Media in the United States",
journal="JMIR Cancer",
year="2022",
month="Sep",
day="20",
volume="8",
number="3",
pages="e37518",
keywords="real-world evidence",
keywords="unmet needs",
keywords="quality of life",
keywords="social media",
keywords="bladder cancer",
keywords="caregivers",
abstract="Background: Locally advanced or metastatic bladder cancer (BC), which is generally termed advanced BC (aBC), has a very poor prognosis, and in addition to its physical symptoms, it is associated with emotional and social challenges. However, few studies have assessed the unmet needs and burden of aBC from patient and caregiver perspectives. Infodemiology, that is, epidemiology based on internet health-related content, can help obtain more insights on patients' and caregivers' experiences with aBC. Objective: The study aimed to identify the main discussion themes and the unmet needs of patients with aBC and their caregivers through a mixed methods analysis of social media posts. Methods: Social media posts were collected between January 2015 and April 2021 from US geolocalized sites using specific keywords for aBC. Automatic natural language processing (regular expressions and machine learning) methods were used to filter out irrelevant content and identify verbatim posts from patients and caregivers. The verbatim posts were analyzed to identify main discussion themes using biterm topic modeling. Difficulties or unmet needs were further explored using qualitative research methods by 2 independent annotators until saturation of concepts. Results: A total of 688 posts from 262 patients and 1214 posts from 679 caregivers discussing aBC were identified. Analysis of 340 randomly selected patient posts and 423 randomly selected caregiver posts uncovered 33 unique unmet need categories among patients and 36 among caregivers. The main unmet patient needs were related to challenges regarding adverse events (AEs; 28/95, 29\%) and the psychological impact of aBC (20/95, 21\%). Other patient unmet needs identified were prognosis or diagnosis errors (9/95, 9\%) and the need for better management of aBC symptoms (9/95, 9\%). The main unmet caregiver needs were related to the psychological impacts of aBC (46/177, 26.0\%), the need for support groups and to share experiences between peers (28/177, 15.8\%), and the fear and management of patient AEs (22/177, 12.4\%). Conclusions: The combination of manual and automatic methods allowed the extraction and analysis of several hundreds of social media posts from patients with aBC and their caregivers. The results highlighted the emotional burden of cancer for both patients and caregivers. Additional studies on patients with aBC and their caregivers are required to quantitatively explore the impact of this disease on quality of life. ",
doi="10.2196/37518",
url="https://cancer.jmir.org/2022/3/e37518",
url="http://www.ncbi.nlm.nih.gov/pubmed/36125861"
}


@Article{info:doi/10.2196/38573,
author="Charbonneau, Esther
and Mellouli, Sehl
and Chouikh, Arbi
and Couture, Laurie-Jane
and Desroches, Sophie",
title="The Information Sharing Behaviors of Dietitians and Twitter Users in the Nutrition and COVID-19 Infodemic: Content Analysis Study of Tweets",
journal="JMIR Infodemiology",
year="2022",
month="Sep",
day="16",
volume="2",
number="2",
pages="e38573",
keywords="nutrition",
keywords="COVID-19",
keywords="dietitians",
keywords="Twitter",
keywords="public",
keywords="themes",
keywords="behavior",
keywords="content accuracy",
keywords="user engagement",
keywords="content analysis",
keywords="misinformation",
keywords="disinformation",
keywords="infodemic",
abstract="Background: The COVID-19 pandemic has generated an infodemic, an overabundance of online and offline information. In this context, accurate information as well as misinformation and disinformation about the links between nutrition and COVID-19 have circulated on Twitter since the onset of the pandemic. Objective: The purpose of this study was to compare tweets on nutrition in times of COVID-19 published by 2 groups, namely, a preidentified group of dietitians and a group of general users of Twitter, in terms of themes, content accuracy, use of behavior change factors, and user engagement, in order to contrast their information sharing behaviors during the pandemic. Methods: Public English-language tweets published between December 31, 2019, and December 31, 2020, by 625 dietitians from Canada and the United States, and Twitter users were collected using hashtags and keywords related to nutrition and COVID-19. After filtration, tweets were coded against an original codebook of themes and the Theoretical Domains Framework (TDF) for identifying behavior change factors, and were compared to reliable nutritional recommendations pertaining to COVID-19. The numbers of likes, replies, and retweets per tweet were also collected to determine user engagement. Results: In total, 2886 tweets (dietitians, n=1417; public, n=1469) were included in the analyses. Differences in frequency between groups were found in 11 out of 15 themes. Grocery (271/1417, 19.1\%), and diets and dietary patterns (n=507, 34.5\%) were the most frequently addressed themes by dietitians and the public, respectively. For 9 out of 14 TDF domains, there were differences in the frequency of usage between groups. ``Skills'' was the most used domain by both groups, although they used it in different proportions (dietitians: 612/1417, 43.2\% vs public: 529/1469, 36.0\%; P<.001). A higher proportion of dietitians' tweets were accurate compared with the public's tweets (532/575, 92.5\% vs 250/382, 65.5\%; P<.001). The results for user engagement were mixed. While engagement by likes varied between groups according to the theme, engagement by replies and retweets was similar across themes but varied according to the group. Conclusions: Differences in tweets between groups, notably ones related to content accuracy, themes, and engagement in the form of likes, shed light on potentially useful and relevant elements to include in timely social media interventions aiming at fighting the COVID-19--related infodemic or future infodemics. ",
doi="10.2196/38573",
url="https://infodemiology.jmir.org/2022/2/e38573",
url="http://www.ncbi.nlm.nih.gov/pubmed/36188421"
}


@Article{info:doi/10.2196/39547,
author="Klein, Z. Ari
and Magge, Arjun
and O'Connor, Karen
and Gonzalez-Hernandez, Graciela",
title="Automatically Identifying Twitter Users for Interventions to Support Dementia Family Caregivers: Annotated Data Set and Benchmark Classification Models",
journal="JMIR Aging",
year="2022",
month="Sep",
day="16",
volume="5",
number="3",
pages="e39547",
keywords="natural language processing",
keywords="social media",
keywords="data mining",
keywords="dementia",
keywords="Alzheimer disease",
keywords="caregivers",
abstract="Background: More than 6 million people in the United States have Alzheimer disease and related dementias, receiving help from more than 11 million family or other informal caregivers. A range of traditional interventions has been developed to support family caregivers; however, most of them have not been implemented in practice and remain largely inaccessible. While recent studies have shown that family caregivers of people with dementia use Twitter to discuss their experiences, methods have not been developed to enable the use of Twitter for interventions. Objective: The objective of this study is to develop an annotated data set and benchmark classification models for automatically identifying a cohort of Twitter users who have a family member with dementia. Methods: Between May 4 and May 20, 2021, we collected 10,733 tweets, posted by 8846 users, that mention a dementia-related keyword, a linguistic marker that potentially indicates a diagnosis, and a select familial relationship. Three annotators annotated 1 random tweet per user to distinguish those that indicate having a family member with dementia from those that do not. Interannotator agreement was 0.82 (Fleiss kappa). We used the annotated tweets to train and evaluate support vector machine and deep neural network classifiers. To assess the scalability of our approach, we then deployed automatic classification on unlabeled tweets that were continuously collected between May 4, 2021, and March 9, 2022. Results: A deep neural network classifier based on a BERT (bidirectional encoder representations from transformers) model pretrained on tweets achieved the highest F1-score of 0.962 (precision=0.946 and recall=0.979) for the class of tweets indicating that the user has a family member with dementia. The classifier detected 128,838 tweets that indicate having a family member with dementia, posted by 74,290 users between May 4, 2021, and March 9, 2022---that is, approximately 7500 users per month. Conclusions: Our annotated data set can be used to automatically identify Twitter users who have a family member with dementia, enabling the use of Twitter on a large scale to not only explore family caregivers' experiences but also directly target interventions at these users. ",
doi="10.2196/39547",
url="https://aging.jmir.org/2022/3/e39547",
url="http://www.ncbi.nlm.nih.gov/pubmed/36112408"
}


@Article{info:doi/10.2196/38749,
author="Toussaint, A. Philipp
and Renner, Maximilian
and Lins, Sebastian
and Thiebes, Scott
and Sunyaev, Ali",
title="Direct-to-Consumer Genetic Testing on Social Media: Topic Modeling and Sentiment Analysis of YouTube Users' Comments",
journal="JMIR Infodemiology",
year="2022",
month="Sep",
day="15",
volume="2",
number="2",
pages="e38749",
keywords="direct-to-consumer genetic testing",
keywords="health information",
keywords="social media",
keywords="YouTube",
keywords="sentiment analysis",
keywords="topic modeling",
keywords="content analysis",
keywords="online health information",
keywords="user discourse",
keywords="infodemiology",
abstract="Background: With direct-to-consumer (DTC) genetic testing enabling self-responsible access to novel information on ancestry, traits, or health, consumers often turn to social media for assistance and discussion. YouTube, the largest social media platform for videos, offers an abundance of DTC genetic testing--related videos. Nevertheless, user discourse in the comments sections of these videos is largely unexplored. Objective: This study aims to address the lack of knowledge concerning user discourse in the comments sections of DTC genetic testing--related videos on YouTube by exploring topics discussed and users' attitudes toward these videos. Methods: We employed a 3-step research approach. First, we collected metadata and comments of the 248 most viewed DTC genetic testing--related videos on YouTube. Second, we conducted topic modeling using word frequency analysis, bigram analysis, and structural topic modeling to identify topics discussed in the comments sections of those videos. Finally, we employed Bing (binary), National Research Council Canada (NRC) emotion, and 9-level sentiment analysis to identify users' attitudes toward these DTC genetic testing--related videos, as expressed in their comments. Results: We collected 84,082 comments from the 248 most viewed DTC genetic testing--related YouTube videos. With topic modeling, we identified 6 prevailing topics on (1) general genetic testing, (2) ancestry testing, (3) relationship testing, (4) health and trait testing, (5) ethical concerns, and (6) YouTube video reaction. Further, our sentiment analysis indicates strong positive emotions (anticipation, joy, surprise, and trust) and a neutral-to-positive attitude toward DTC genetic testing--related videos. Conclusions: With this study, we demonstrate how to identify users' attitudes on DTC genetic testing by examining topics and opinions based on YouTube video comments. Shedding light on user discourse on social media, our findings suggest that users are highly interested in DTC genetic testing and related social media content. Nonetheless, with this novel market constantly evolving, service providers, content providers, or regulatory authorities may still need to adapt their services to users' interests and desires. ",
doi="10.2196/38749",
url="https://infodemiology.jmir.org/2022/2/e38749",
url="http://www.ncbi.nlm.nih.gov/pubmed/37113449"
}


@Article{info:doi/10.2196/37775,
author="Yousef, Murooj
and Dietrich, Timo
and Rundle-Thiele, Sharyn",
title="Actions Speak Louder Than Words: Sentiment and Topic Analysis of COVID-19 Vaccination on Twitter and Vaccine Uptake",
journal="JMIR Form Res",
year="2022",
month="Sep",
day="15",
volume="6",
number="9",
pages="e37775",
keywords="COVID-19",
keywords="COVID-19 vaccination",
keywords="sentiment analysis",
keywords="public health campaigns",
keywords="vaccine uptake",
keywords="Twitter",
keywords="social media",
keywords="vaccines",
abstract="Background: The lack of trust in vaccines is a major contributor to vaccine hesitancy. To overcome vaccine hesitancy for the COVID-19 vaccine, the Australian government launched multiple public health campaigns to encourage vaccine uptake. This sentiment analysis examines the effect of public health campaigns and COVID-19--related events on sentiment and vaccine uptake. Objective: This study aims to examine the relationship between sentiment and COVID-19 vaccine uptake and government actions that impacted public sentiment about the vaccine. Methods: Using machine learning methods, we collected 137,523 publicly available English language tweets published in Australia between February and October 2021 that contained COVID-19 vaccine--related keywords. Machine learning methods were used to extract topics and sentiments relating to COVID-19 vaccination. The relationship between public vaccination sentiment on Twitter and vaccine uptake was examined. Results: The majority of collected tweets expressed negative (n=91,052, 66\%) rather than positive (n=21,686, 16\%) or neutral (n=24,785, 18\%) sentiments. Topics discussed within the study time frame included the role of the government in the vaccination rollout, availability and accessibility of the vaccine, and vaccine efficacy. There was a significant positive correlation between negative sentiment and the number of vaccine doses administered daily (r267=.15, P<.05), with positive sentiment showing the inverse effect. Public health campaigns, lockdowns, and antivaccination protests were associated with increased negative sentiment, while vaccination mandates had no significant effect on sentiment. Conclusions: The study findings demonstrate that negative sentiment was more prevalent on Twitter during the Australian vaccination rollout but vaccine uptake remained high. Australians expressed anger at the slow rollout and limited availability of the vaccine during the study period. Public health campaigns, lockdowns, and antivaccination rallies increased negative sentiment. In contrast, news of increased vaccine availability for the public and government acquisition of more doses were key government actions that reduced negative sentiment. These findings can be used to inform government communication planning. ",
doi="10.2196/37775",
url="https://formative.jmir.org/2022/9/e37775",
url="http://www.ncbi.nlm.nih.gov/pubmed/36007136"
}


@Article{info:doi/10.2196/38242,
author="Marcon, R. Alessandro
and Wagner, N. Darren
and Giles, Carly
and Isenor, Cynthia",
title="Web-Based Perspectives of Deemed Consent Organ Donation Legislation in Nova Scotia: Thematic Analysis of Commentary in Facebook Groups",
journal="JMIR Infodemiology",
year="2022",
month="Sep",
day="14",
volume="2",
number="2",
pages="e38242",
keywords="organ donation",
keywords="organ transplantation",
keywords="deemed consent",
keywords="presumed consent",
keywords="social media",
keywords="Facebook",
keywords="public perceptions",
keywords="public policy",
keywords="thematic analysis",
abstract="Background: The Canadian province of Nova Scotia recently became the first jurisdiction in North America to implement deemed consent organ donation legislation. Changing the consent models constituted one aspect of a larger provincial program to increase organ and tissue donation and transplantation rates. Deemed consent legislation can be controversial among the public, and public participation is integral to the successful implementation of the program. Objective: Social media constitutes key spaces where people express opinions and discuss topics, and social media discourse can influence public perceptions. This project aimed to examine how the public in Nova Scotia responded to legislative changes in Facebook groups. Methods: Using Facebook's search engine, we searched for posts in public Facebook groups using the terms ``deemed consent,'' ``presumed consent,'' ``opt out,'' or ``organ donation'' and ``Nova Scotia,'' appearing from January 1, 2020, to May 1, 2021. The finalized data set included 2337 comments on 26 relevant posts in 12 different public Nova Scotia--based Facebook groups. We conducted thematic and content analyses of the comments to determine how the public responded to the legislative changes and how the participants interacted with one another in the discussions. Results: Our thematic analysis revealed principal themes that supported and critiqued the legislation, raised specific issues, and reflected on the topic from a neutral perspective. Subthemes showed individuals presenting perspectives through a variety of themes, including compassion, anger, frustration, mistrust, and a range of argumentative tactics. The comments included personal narratives, beliefs about the government, altruism, autonomy, misinformation, and reflections on religion and death. Content analysis revealed that Facebook users reacted to popular comments with ``likes'' more than other reactions. Comments with the most reactions included both negative and positive perspectives about the legislation. Personal donation and transplantation success stories, as well as attempts to correct misinformation, were some of the most ``liked'' positive comments. Conclusions: The findings provide key insights into perspectives of individuals from Nova Scotia on deemed consent legislation, as well as organ donation and transplantation broadly. The insights derived from this analysis can contribute to public understanding, policy creation, and public outreach efforts that might occur in other jurisdictions considering the enactment of similar legislation. ",
doi="10.2196/38242",
url="https://infodemiology.jmir.org/2022/2/e38242",
url="http://www.ncbi.nlm.nih.gov/pubmed/37113450"
}


@Article{info:doi/10.2196/38297,
author="Thompson, L. Erika
and Preston, M. Sharice
and Francis, R. Jenny K.
and Rodriguez, A. Serena
and Pruitt, L. Sandi
and Blackwell, James-Michael
and Tiro, A. Jasmin",
title="Social Media Perceptions and Internet Verification Skills Associated With Human Papillomavirus Vaccine Decision-Making Among Parents of Children and Adolescents: Cross-sectional Survey",
journal="JMIR Pediatr Parent",
year="2022",
month="Sep",
day="14",
volume="5",
number="3",
pages="e38297",
keywords="HPV vaccination",
keywords="human papillomavirus",
keywords="social media",
keywords="decision-making",
keywords="vaccination",
keywords="teens",
keywords="adolescents",
keywords="parent",
keywords="USA",
keywords="United States",
keywords="misinformation",
keywords="internet",
keywords="survey",
keywords="unvaccinated",
keywords="child",
keywords="online",
keywords="health",
keywords="literacy",
keywords="decision",
keywords="health care",
keywords="teen",
keywords="vaccine",
abstract="Background: Human Papillomavirus (HPV) vaccination is recommended for children aged 11-12 years in the United States. One factor that may contribute to low national HPV vaccine uptake is parental exposure to misinformation on social media. Objective: This study aimed to examine the association between parents' perceptions of the HPV vaccine information on social media and internet verification strategies used with the HPV vaccine decision-making stage for their child. Methods: Parents of children and adolescents aged 9-17 years were recruited for a cross-sectional survey in North Texas (n=1192) and classified into 3 groups: children and adolescents who (1) were vaccinated, (2) unvaccinated and did not want the vaccine, and (3) unvaccinated and wanted the vaccine. Multinomial logistic regression models were estimated to identify factors associated with the HPV vaccine decision-making stage with children and adolescents who were vaccinated as the referent group. Results: Of the 1192 respondents, 44.7\% (n=533) had an HPV-vaccinated child, 38.8\% (n=463) had an unvaccinated child and did not want the vaccine, and 16.4\% (n=196) had an unvaccinated child and wanted the vaccine. Respondents were less likely to be ``undecided/not wanting the vaccine'' if they agreed that HPV information on social media is credible (adjusted odds ratio [aOR] 0.40, 95\% CI 0.26-0.60; P=.001), disagreed that social media makes them question the HPV vaccine (aOR 0.22, 95\% CI 0.15-0.33; P<.001), or had a higher internet verification score (aOR 0.74, 95\% CI 0.62-0.88; P<.001). Conclusions: Interventions that promote web-based health literacy skills are needed so parents can protect their families from misinformation and make informed health care decisions. ",
doi="10.2196/38297",
url="https://pediatrics.jmir.org/2022/3/e38297",
url="http://www.ncbi.nlm.nih.gov/pubmed/36103216"
}


@Article{info:doi/10.2196/38541,
author="Ceretti, Elisabetta
and Covolo, Loredana
and Cappellini, Francesca
and Nanni, Alberto
and Sorosina, Sara
and Beatini, Andrea
and Taranto, Mirella
and Gasparini, Arianna
and De Castro, Paola
and Brusaferro, Silvio
and Gelatti, Umberto",
title="Evaluating the Effectiveness of Internet-Based Communication for Public Health: Systematic Review",
journal="J Med Internet Res",
year="2022",
month="Sep",
day="13",
volume="24",
number="9",
pages="e38541",
keywords="internet-based communication",
keywords="websites",
keywords="social media",
keywords="public health",
keywords="efficacy",
keywords="systematic review",
keywords="communication",
keywords="internet-based",
keywords="health information",
keywords="exchange",
keywords="health care",
keywords="web-based",
keywords="campaigns",
abstract="Background: Communicating strategically is a key issue for health organizations. Over the past decade, health care communication via social media and websites has generated a great deal of studies examining different realities of communication strategies. However, when it comes to systematic reviews, there is fragmentary evidence on this type of communication. Objective: The aim of this systematic review was to summarize the evidence on web institutional health communication for public health authorities to evaluate possible aim-specific key points based on these existing studies. Methods: Guided by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement, we conducted a comprehensive review across 2 electronic databases (PubMed and Web of Science) from January 1, 2011, to October 7, 2021, searching for studies investigating institutional health communication. In total, 2 independent researchers (AN and SS) reviewed the articles for inclusion, and the assessment of methodological quality was based on the Kmet appraisal checklist. Results: A total of 78 articles were selected. Most studies (35/78, 45\%) targeted health promotion and disease prevention, followed by crisis communication (24/78, 31\%), general health (13/78, 17\%), and misinformation correction and health promotion (6/78, 8\%). Engagement and message framing were the most analyzed aspects. Few studies (14/78, 18\%) focused on campaign effectiveness. Only 23\% (18/78) of the studies had an experimental design. The Kmet evaluation was used to distinguish studies presenting a solid structure from lacking studies. In particular, considering the 0.75-point threshold, 36\% (28/78) of the studies were excluded. Studies above this threshold were used to identify a series of aim-specific and medium-specific suggestions as the communication strategies used differed greatly. Conclusions: Overall, the findings suggest that no single strategy works best in the case of web-based health care communication. The extreme variability of outcomes and the lack of a unitary measure for assessing the end points of a specific campaign or study lead us to reconsider the tools we use to evaluate the efficacy of web-based health communication. ",
doi="10.2196/38541",
url="https://www.jmir.org/2022/9/e38541",
url="http://www.ncbi.nlm.nih.gov/pubmed/36098994"
}


@Article{info:doi/10.2196/39766,
author="Ottwell, Ryan
and Cox, Katherine
and Dobson, Taylor
and Shah, Muneeb
and Hartwell, Micah",
title="Evaluating the Public's Interest in Testicle Tanning: Observational Study",
journal="JMIR Dermatol",
year="2022",
month="Sep",
day="12",
volume="5",
number="3",
pages="e39766",
keywords="general dermatology",
keywords="google trends",
keywords="testicle tanning",
keywords="UV radiation",
keywords="public trends",
keywords="skin cancer",
keywords="cancer",
keywords="harmful",
keywords="internet",
keywords="health trends",
keywords="tanning",
abstract="Background: A new and potentially dangerous health trend, testicle tanning, received extensive media attention following a popular television program where a health and fitness influencer touted that testicular tanning increases testosterone levels. It has been shown that the public has a particular interest in tanning wellness trends; thus, given the vague nomenclature of the practice, the abundance of misleading information and support for using UV light by other health influencers may lead to an increase in men exposing themselves to UV radiation and developing associated complications. Objective: The aim of this paper is to evaluate the public's interest in testicle tanning. Methods: Relative search interest was collected from Google Trends, and daily tweet volume was collected using Twitter via Sprout Social. The search was filtered to observe internet activity between February 1, 2022, and August 18, 2022. Autoregressive integrated moving average models were applied to forecast the predicted values through April 30 to compare to the actual observed values immediately following the airing of the show. Results: We found that the relative search interest for testicle tanning peaked (100) on April 19, 2022, following a discussion of the topic on a television program. Compared to the forecasted relative search interest of 1.36 (95\% CI --3.29 to 6.01), had the topic not been discussed, it showed a 7252\% increase in relative search interest. A similar spike was observed in the volume of tweets peaking on April 18 with 42,736. The expected number of tweets from the autoregressive integrated moving average model was 122 (95\% CI --154 to 397), representing a 35,053\% increase. Conclusions: Our results show that the promotion of testicle tanning generated significant public interest in an evidence-lacking and potentially dangerous health trend. Dermatologists and other health care professionals should be aware of these new viral health trends to best counsel patients and combat health misinformation. ",
doi="10.2196/39766",
url="https://derma.jmir.org/2022/3/e39766",
url="http://www.ncbi.nlm.nih.gov/pubmed/37632896"
}


@Article{info:doi/10.2196/39201,
author="Huang, Austin
and Zhu, Harrison
and Zhou, Kelvin
and Kirby, Parker R.
and Dasari, Nina
and Calderara, A. Gianmarco
and Cordova, Kathryn
and Sorensen, Ryan
and Bhatnagar, Anshul
and Kim, Jung Soo",
title="Social Media Impact of Articles Published by Dermatology Residents During Medical School: Cross-sectional Study",
journal="JMIR Dermatol",
year="2022",
month="Sep",
day="12",
volume="5",
number="3",
pages="e39201",
keywords="Altmetric score",
keywords="bibliometrics",
keywords="social media",
keywords="dermatology",
keywords="resident",
keywords="medical student",
keywords="publication",
keywords="citation",
keywords="Altmetric",
keywords="research quality",
keywords="publish",
keywords="impact factor",
keywords="Scientometrics",
abstract="Background: The Altmetric score (AS) is a novel measure of publication impact that is calculated by the number of mentions across various social media websites. This method may have advantages over traditional bibliometrics in the context of research by medical students. Objective: This study aimed to determine whether dermatology matriculants who graduated from higher-ranked medical schools published more articles with greater impact (ie, a higher AS) than those from lower-ranked institutions. Methods: A PubMed search for articles published by dermatology residents who started medical school in 2020 was conducted. Demographic information and Altmetric data were collected, and medical schools were sorted according to US News' top-25 and non--top-25 categories. Results: Residents who completed their medical training at a top-25 institution published more papers (mean 4.93, SD 4.18 vs mean 3.11, SD 3.32; P<.001) and accrued a significantly higher total AS (mean 67.9, SD 160 vs mean 22.9, SD 75.9; P<.001) and average AS (mean 13.1, SD 23.7 vs mean 6.71, SD 32.3; P<.001) per article than those who graduated from non--top-25 schools. Conclusions: Our results indicate that students in top-25 schools may have greater access to research resources and opportunities. With a pass/fail United States Medical Licensing Examination Step 1 exam that may increasingly shift focus toward scholarly output from medical students, further discussion on how to create a more equitable dermatology match is essential. ",
doi="10.2196/39201",
url="https://derma.jmir.org/2022/3/e39201",
url="http://www.ncbi.nlm.nih.gov/pubmed/37632895"
}


@Article{info:doi/10.2196/37984,
author="Matharaarachchi, Surani
and Domaratzki, Mike
and Katz, Alan
and Muthukumarana, Saman",
title="Discovering Long COVID Symptom Patterns: Association Rule Mining and Sentiment Analysis in Social Media Tweets",
journal="JMIR Form Res",
year="2022",
month="Sep",
day="7",
volume="6",
number="9",
pages="e37984",
keywords="COVID-19",
keywords="long COVID symptoms",
keywords="social media analysis",
keywords="association rule mining",
keywords="bigram analysis",
keywords="natural language processing",
keywords="Twitter",
keywords="content analysis",
keywords="data mining",
keywords="infodemiology",
keywords="health information",
abstract="Background: The COVID-19 pandemic is a substantial public health crisis that negatively affects human health and well-being. As a result of being infected with the coronavirus, patients can experience long-term health effects called long COVID syndrome. Multiple symptoms characterize this syndrome, and it is crucial to identify these symptoms as they may negatively impact patients' day-to-day lives. Breathlessness, fatigue, and brain fog are the 3 most common continuing and debilitating symptoms that patients with long COVID have reported, often months after the onset of COVID-19. Objective: This study aimed to understand the patterns and behavior of long COVID symptoms reported by patients on the Twitter social media platform, which is vital to improving our understanding of long COVID. Methods: Long COVID--related Twitter data were collected from May 1, 2020, to December 31, 2021. We used association rule mining techniques to identify frequent symptoms and establish relationships between symptoms among patients with long COVID in Twitter social media discussions. The highest confidence level--based detection was used to determine the most significant rules with 10\% minimum confidence and 0.01\% minimum support with a positive lift. Results: Among the 30,327 tweets included in our study, the most frequent symptoms were brain fog (n=7812, 25.8\%), fatigue (n=5284, 17.4\%), breathing/lung issues (n=4750, 15.7\%), heart issues (n=2900, 9.6\%), flu symptoms (n=2824, 9.3\%), depression (n=2256, 7.4\%) and general pains (n=1786, 5.9\%). Loss of smell and taste, cold, cough, chest pain, fever, headache, and arm pain emerged in 1.6\% (n=474) to 5.3\% (n=1616) of patients with long COVID. Furthermore, the highest confidence level--based detection successfully demonstrates the potential of association analysis and the Apriori algorithm to establish patterns to explore 57 meaningful relationship rules among long COVID symptoms. The strongest relationship revealed that patients with lung/breathing problems and loss of taste are likely to have a loss of smell with 77\% confidence. Conclusions: There are very active social media discussions that could support the growing understanding of COVID-19 and its long-term impact. These discussions enable a potential field of research to analyze the behavior of long COVID syndrome. Exploratory data analysis using natural language processing methods revealed the symptoms and medical conditions related to long COVID discussions on the Twitter social media platform. Using Apriori algorithm--based association rules, we determined interesting and meaningful relationships between symptoms. ",
doi="10.2196/37984",
url="https://formative.jmir.org/2022/9/e37984",
url="http://www.ncbi.nlm.nih.gov/pubmed/36069846"
}


@Article{info:doi/10.2196/37752,
author="Nakagawa, Keisuke
and Yang, Tsang Nuen
and Wilson, Machelle
and Yellowlees, Peter",
title="Twitter Usage Among Physicians From 2016 to 2020: Algorithm Development and Longitudinal Analysis Study",
journal="J Med Internet Res",
year="2022",
month="Sep",
day="6",
volume="24",
number="9",
pages="e37752",
keywords="social media",
keywords="internet",
keywords="health informatics",
keywords="internet use",
keywords="public health",
keywords="Twitter",
keywords="physician",
abstract="Background: Physicians are increasingly using Twitter as a channel for communicating with colleagues and the public. Identifying physicians on Twitter is difficult due to the varied and imprecise ways that people self-identify themselves on the social media platform. This is the first study to describe a reliable, repeatable methodology for identifying physicians on Twitter. By using this approach, we characterized the longitudinal activity of US physicians on Twitter. Objective: We aimed to develop a reliable and repeatable methodology for identifying US physicians on Twitter and to characterize their activity on Twitter over 5 years by activity, tweeted topic, and account type. Methods: In this study, 5 years of Twitter data (2016-2020) were mined for physician accounts. US physicians on Twitter were identified by using a custom-built algorithm to screen for physician identifiers in the Twitter handles, user profiles, and tweeted content. The number of tweets by physician accounts from the 5-year period were counted and analyzed. The top 100 hashtags were identified, categorized into topics, and analyzed. Results: Approximately 1 trillion tweets were mined to identify 6,399,146 (<0.001\%) tweets originating from 39,084 US physician accounts. Over the 5-year period, the number of US physicians tweeting more than doubled (ie, increased by 112\%). Across all 5 years, the most popular themes were general health, medical education, and mental health, and in specific years, the number of tweets related to elections (2016 and 2020), Black Lives Matter (2020), and COVID-19 (2020) increased. Conclusions: Twitter has become an increasingly popular social media platform for US physicians over the past 5 years, and their use of Twitter has evolved to cover a broad range of topics, including science, politics, social activism, and COVID-19. We have developed an accurate, repeatable methodology for identifying US physicians on Twitter and have characterized their activity. ",
doi="10.2196/37752",
url="https://www.jmir.org/2022/9/e37752",
url="http://www.ncbi.nlm.nih.gov/pubmed/36066939"
}


@Article{info:doi/10.2196/39805,
author="Kong, Dexia
and Chen, Anfan
and Zhang, Jingwen
and Xiang, Xiaoling
and Lou, Vivian W. Q.
and Kwok, Timothy
and Wu, Bei",
title="Public Discourse and Sentiment Toward Dementia on Chinese Social Media: Machine Learning Analysis of Weibo Posts",
journal="J Med Internet Res",
year="2022",
month="Sep",
day="2",
volume="24",
number="9",
pages="e39805",
keywords="dementia",
keywords="public discourse",
keywords="sentiment",
keywords="Weibo",
keywords="social media",
keywords="machine learning",
keywords="infodemiology",
keywords="aging",
keywords="elderly population",
keywords="content analysis",
keywords="topic modeling",
keywords="thematic analysis",
keywords="social support",
keywords="sentiment analysis",
abstract="Background: Dementia is a global public health priority due to rapid growth of the aging population. As China has the world's largest population with dementia, this debilitating disease has created tremendous challenges for older adults, family caregivers, and health care systems on the mainland nationwide. However, public awareness and knowledge of the disease remain limited in Chinese society. Objective: This study examines online public discourse and sentiment toward dementia among the Chinese public on a leading Chinese social media platform Weibo. Specifically, this study aims to (1) assess and examine public discourse and sentiment toward dementia among the Chinese public, (2) determine the extent to which dementia-related discourse and sentiment vary among different user groups (ie, government, journalists/news media, scientists/experts, and the general public), and (3) characterize temporal trends in public discourse and sentiment toward dementia among different user groups in China over the past decade. Methods: In total, 983,039 original dementia-related posts published by 347,599 unique users between 2010 and 2021, together with their user information, were analyzed. Machine learning analytical techniques, including topic modeling, sentiment analysis, and semantic network analyses, were used to identify salient themes/topics and their variations across different user groups (ie, government, journalists/news media, scientists/experts, and the general public). Results: Topic modeling results revealed that symptoms, prevention, and social support are the most prevalent dementia-related themes on Weibo. Posts about dementia policy/advocacy have been increasing in volume since 2018. Raising awareness is the least discussed topic over time. Sentiment analysis indicated that Weibo users generally attach negative attitudes/emotions to dementia, with the general public holding a more negative attitude than other user groups. Conclusions: Overall, dementia has received greater public attention on social media since 2018. In particular, discussions related to dementia advocacy and policy are gaining momentum in China. However, disparaging language is still used to describe dementia in China; therefore, a nationwide initiative is needed to alter the public discourse on dementia. The results contribute to previous research by providing a macrolevel understanding of the Chinese public's discourse and attitudes toward dementia, which is essential for building national education and policy initiatives to create a dementia-friendly society. Our findings indicate that dementia is associated with negative sentiments, and symptoms and prevention dominate public discourse. The development of strategies to address unfavorable perceptions of dementia requires policy and public health attention. The results further reveal that an urgent need exists to increase public knowledge about dementia. Social media platforms potentially could be leveraged for future dementia education interventions to increase dementia awareness and promote positive attitudes. ",
doi="10.2196/39805",
url="https://www.jmir.org/2022/9/e39805",
url="http://www.ncbi.nlm.nih.gov/pubmed/36053565"
}


@Article{info:doi/10.2196/37862,
author="Tong, Chau
and Margolin, Drew
and Chunara, Rumi
and Niederdeppe, Jeff
and Taylor, Teairah
and Dunbar, Natalie
and King, J. Andy",
title="Search Term Identification Methods for Computational Health Communication: Word Embedding and Network Approach for Health Content on YouTube",
journal="JMIR Med Inform",
year="2022",
month="Aug",
day="30",
volume="10",
number="8",
pages="e37862",
keywords="health information retrieval",
keywords="search term identification",
keywords="social media",
keywords="health communication",
keywords="public health",
keywords="computational textual analysis",
keywords="natural language processing",
keywords="NLP",
keywords="word2vec",
keywords="word embeddings",
keywords="network analysis",
abstract="Background: Common methods for extracting content in health communication research typically involve using a set of well-established queries, often names of medical procedures or diseases, that are often technical or rarely used in the public discussion of health topics. Although these methods produce high recall (ie, retrieve highly relevant content), they tend to overlook health messages that feature colloquial language and layperson vocabularies on social media. Given how such messages could contain misinformation or obscure content that circumvents official medical concepts, correctly identifying (and analyzing) them is crucial to the study of user-generated health content on social media platforms. Objective: Health communication scholars would benefit from a retrieval process that goes beyond the use of standard terminologies as search queries. Motivated by this, this study aims to put forward a search term identification method to improve the retrieval of user-generated health content on social media. We focused on cancer screening tests as a subject and YouTube as a platform case study. Methods: We retrieved YouTube videos using cancer screening procedures (colonoscopy, fecal occult blood test, mammogram, and pap test) as seed queries. We then trained word embedding models using text features from these videos to identify the nearest neighbor terms that are semantically similar to cancer screening tests in colloquial language. Retrieving more YouTube videos from the top neighbor terms, we coded a sample of 150 random videos from each term for relevance. We then used text mining to examine the new content retrieved from these videos and network analysis to inspect the relations between the newly retrieved videos and videos from the seed queries. Results: The top terms with semantic similarities to cancer screening tests were identified via word embedding models. Text mining analysis showed that the 5 nearest neighbor terms retrieved content that was novel and contextually diverse, beyond the content retrieved from cancer screening concepts alone. Results from network analysis showed that the newly retrieved videos had at least one total degree of connection (sum of indegree and outdegree) with seed videos according to YouTube relatedness measures. Conclusions: We demonstrated a retrieval technique to improve recall and minimize precision loss, which can be extended to various health topics on YouTube, a popular video-sharing social media platform. We discussed how health communication scholars can apply the technique to inspect the performance of the retrieval strategy before investing human coding resources and outlined suggestions on how such a technique can be extended to other health contexts. ",
doi="10.2196/37862",
url="https://medinform.jmir.org/2022/8/e37862",
url="http://www.ncbi.nlm.nih.gov/pubmed/36040760"
}


@Article{info:doi/10.2196/38319,
author="Singh, Lisa
and Gresenz, Roan Carole
and Wang, Yanchen
and Hu, Sonya",
title="Assessing Social Media Data as a Resource for Firearm Research: Analysis of Tweets Pertaining to Firearm Deaths",
journal="J Med Internet Res",
year="2022",
month="Aug",
day="25",
volume="24",
number="8",
pages="e38319",
keywords="firearms",
keywords="fatalities",
keywords="Twitter",
keywords="firearm research",
keywords="social media data",
abstract="Background: Historic constraints on research dollars and reliable information have limited firearm research. At the same time, interest in the power and potential of social media analytics, particularly in health contexts, has surged. Objective: The aim of this study is to contribute toward the goal of establishing a foundation for how social media data may best be used, alone or in conjunction with other data resources, to improve the information base for firearm research. Methods: We examined the value of social media data for estimating a firearm outcome for which robust benchmark data exist---specifically, firearm mortality, which is captured in the National Vital Statistics System (NVSS). We hand curated tweet data from the Twitter application programming interface spanning January 1, 2017, to December 31, 2018. We developed machine learning classifiers to identify tweets that pertain to firearm deaths and develop estimates of the volume of Twitter firearm discussion by month. We compared within-state variation over time in the volume of tweets pertaining to firearm deaths with within-state trends in NVSS-based estimates of firearm fatalities using Pearson linear correlations. Results: The correlation between the monthly number of firearm fatalities measured by the NVSS and the monthly volume of tweets pertaining to firearm deaths was weak (median 0.081) and highly dispersed across states (range --0.31 to 0.535). The median correlation between month-to-month changes in firearm fatalities in the NVSS and firearm deaths discussed in tweets was moderate (median 0.30) and exhibited less dispersion among states (range --0.06 to 0.69). Conclusions: Our findings suggest that Twitter data may hold value for tracking dynamics in firearm-related outcomes, particularly for relatively populous cities that are identifiable through location mentions in tweet content. The data are likely to be particularly valuable for understanding firearm outcomes not currently measured, not measured well, or not measurable through other available means. This research provides an important building block for future work that continues to develop the usefulness of social media data for firearm research. ",
doi="10.2196/38319",
url="https://www.jmir.org/2022/8/e38319",
url="http://www.ncbi.nlm.nih.gov/pubmed/36006693"
}


@Article{info:doi/10.2196/36555,
author="Naserianhanzaei, Elahe
and Koschate-Reis, Miriam",
title="Effects of Substance Use, Recovery, and Non--Drug-Related Online Community Participation on the Risk of a Use Episode During Remission From Opioid Use Disorder: Longitudinal Observational Study",
journal="J Med Internet Res",
year="2022",
month="Aug",
day="22",
volume="24",
number="8",
pages="e36555",
keywords="online communities",
keywords="opioid addiction",
keywords="recovery capital",
keywords="social identity",
keywords="Reddit",
keywords="social media",
abstract="Background: Opioid addiction is currently one of the most pressing public health issues. Despite several treatment options for opioid addiction, the recurrence of use episodes during remission remains high. Research indicates that meaningful membership in various social groups underpins the successful transition from addiction to long-term remission. However, much of the current literature focuses on online peer-support groups for individuals in remission from substance use, sometimes also called recovery groups, a term we will use in line with the terminology used by the online community we studied. In contrast, online group memberships that promote substance use and groups that are unrelated to substance use and remission (non--drug-related groups) are rarely studied. Objective: This study aims to understand whether engagement with a variety of Reddit subforums (subreddits) provides those in remission from opioid use disorder (OUD) with social capital, thereby reducing their risk of a use episode over several years. More specifically, it aims to examine the different effects of engagement with substance use, recovery, and non--drug-related subreddits. Methods: A data set of 457 individuals in remission from OUD who posted their remission start date on Reddit was collected, of whom 219 (47.9\%) indicated at least one use episode during the remission period. Using a Cox proportional hazards model, the effects of the number of non--drug-related, recovery, and substance use subreddits an individual had engaged with on the risk of a use episode were tested. Group engagement was assessed both in terms of the absolute number of subreddits and as a proportion of the total number of subreddits in which an individual had posted. Results: Engagement with a larger number of non--drug-related online communities reduced the likelihood of a use episode irrespective of the number of posts and comments made in these forums. This was true for both the absolute number of non--drug-related communities (P<.001) and the proportion of communities with which a person engaged (P<.001). The findings were less conclusive for recovery support and substance use groups; although participating in more recovery support subreddits reduced the risk of a use episode (P<.001), being part of a higher proportion of recovery support groups relative to other subreddits increased the risk (P=.01). A higher proportion of substance use subreddits marginally increased the risk of a use episode (P=.06); however, the absolute number of substance use subreddits significantly reduced the risk of a use episode (P=.002). Conclusions: Our work indicates that even minimal regular engagement with several non--drug-related online forums may provide those in remission from OUD with an opportunity to grow their social capital and reduce the risk of a use episode over several years. ",
doi="10.2196/36555",
url="https://www.jmir.org/2022/8/e36555",
url="http://www.ncbi.nlm.nih.gov/pubmed/35994333"
}


@Article{info:doi/10.2196/36244,
author="Herbert, S. Amber
and Hassan, Naeemul
and Malik, D. Rena
and Loeb, Stacy
and Myrie, Akya",
title="Exploring Urological Malignancies on Pinterest: Content Analysis",
journal="JMIR Cancer",
year="2022",
month="Aug",
day="22",
volume="8",
number="3",
pages="e36244",
keywords="bladder cancer",
keywords="Pinterest",
keywords="prostate cancer",
keywords="kidney cancer",
keywords="testicular cancer",
keywords="urological cancer",
keywords="misinformation",
keywords="genitourinary",
keywords="malignancy",
keywords="oncology",
keywords="content",
keywords="information",
keywords="social media",
keywords="accuracy",
keywords="quality",
abstract="Background: Pinterest is a visually oriented social media platform with over 250 million monthly users. Previous studies have found misinformative content on genitourinary malignancies to be broadly disseminated on YouTube; however, no study has assessed the quality of this content on Pinterest. Objective: Our objective was to evaluate the quality, understandability, and actionability of genitourinary malignancy content on Pinterest. Methods: We examined 540 Pinterest posts or pins, using the following search terms: ``bladder cancer,'' ``kidney cancer,'' ``prostate cancer,'' and ``testicular cancer.'' The pins were limited to English language and topic-specific content, resulting in the following exclusions: bladder (n=88), kidney (n=4), prostate (n=79), and testicular cancer (n=10), leaving 359 pins as the final analytic sample. Pinterest pins were classified based on publisher and perceived race or ethnicity. Content was assessed using 2 validated grading systems: DISCERN quality criteria and the Patient Education Materials Assessment Tool. The presence of misinformation was evaluated using a published Likert scale ranging from 1=none to 5=high. Results: Overall, 359 pins with a total of 8507 repins were evaluated. The primary publisher of genitourinary malignancy pins were health and wellness groups (n=162, 45\%). Across all genitourinary malignancy pins with people, only 3\% (n=7) were perceived as Black. Additionally, Asian (n=2, 1\%) and Latinx (n=1, 0.5\%) individuals were underrepresented in all pins. Nearly 75\% (n=298) of the pins had moderate- to poor-quality information. Misinformative content was apparent in 4\%-26\% of all genitourinary cancer pins. Understandability and actionability were poor in 55\% (n=198) and 100\% (n=359) of the pins, respectively. Conclusions: On Pinterest, the majority of the urological oncology patient-centric content is of low quality and lacks diversity. This widely used, yet unregulated platform has the ability to influence consumers' health knowledge and decision-making. Ultimately, this can lead to consumers making suboptimal medical decisions. Moreover, our findings demonstrate underrepresentation across many racial and ethnic groups. Efforts should be made to ensure the dissemination of diverse, high-quality, and accurate health care information to the millions of users on Pinterest and other social media platforms. ",
doi="10.2196/36244",
url="https://cancer.jmir.org/2022/3/e36244",
url="http://www.ncbi.nlm.nih.gov/pubmed/35994318"
}


@Article{info:doi/10.2196/37829,
author="Singhal, Aditya
and Baxi, Kaur Manmeet
and Mago, Vijay",
title="Synergy Between Public and Private Health Care Organizations During COVID-19 on Twitter: Sentiment and Engagement Analysis Using Forecasting Models",
journal="JMIR Med Inform",
year="2022",
month="Aug",
day="18",
volume="10",
number="8",
pages="e37829",
keywords="social media",
keywords="health care",
keywords="Twitter",
keywords="content analysis",
keywords="user engagement",
keywords="sentiment forecasting",
keywords="natural language processing",
keywords="public health",
keywords="pharmaceutical",
keywords="public engagement",
abstract="Background: Social media platforms (SMPs) are frequently used by various pharmaceutical companies, public health agencies, and nongovernment organizations (NGOs) for communicating health concerns, new advancements, and potential outbreaks. Although the benefits of using them as a tool have been extensively discussed, the online activity of various health care organizations on SMPs during COVID-19 in terms of engagement and sentiment forecasting has not been thoroughly investigated. Objective: The purpose of this research is to analyze the nature of information shared on Twitter, understand the public engagement generated on it, and forecast the sentiment score for various organizations. Methods: Data were collected from the Twitter handles of 5 pharmaceutical companies, 10 US and Canadian public health agencies, and the World Health Organization (WHO) from January 1, 2017, to December 31, 2021. A total of 181,469 tweets were divided into 2 phases for the analysis, before COVID-19 and during COVID-19, based on the confirmation of the first COVID-19 community transmission case in North America on February 26, 2020. We conducted content analysis to generate health-related topics using natural language processing (NLP)-based topic-modeling techniques, analyzed public engagement on Twitter, and performed sentiment forecasting using 16 univariate moving-average and machine learning (ML) models to understand the correlation between public opinion and tweet contents. Results: We utilized the topics modeled from the tweets authored by the health care organizations chosen for our analysis using nonnegative matrix factorization (NMF): cumass=--3.6530 and --3.7944 before and during COVID-19, respectively. The topics were chronic diseases, health research, community health care, medical trials, COVID-19, vaccination, nutrition and well-being, and mental health. In terms of user impact, WHO (user impact=4171.24) had the highest impact overall, followed by public health agencies, the Centers for Disease Control and Prevention (CDC; user impact=2895.87), and the National Institutes of Health (NIH; user impact=891.06). Among pharmaceutical companies, Pfizer's user impact was the highest at 97.79. Furthermore, for sentiment forecasting, autoregressive integrated moving average (ARIMA) and seasonal autoregressive integrated moving average with exogenous factors (SARIMAX) models performed best on the majority of the subsets of data (divided as per the health care organization and period), with the mean absolute error (MAE) between 0.027 and 0.084, the mean square error (MSE) between 0.001 and 0.011, and the root-mean-square error (RMSE) between 0.031 and 0.105. Conclusions: Our findings indicate that people engage more on topics such as COVID-19 than medical trials and customer experience. In addition, there are notable differences in the user engagement levels across organizations. Global organizations, such as WHO, show wide variations in engagement levels over time. The sentiment forecasting method discussed presents a way for organizations to structure their future content to ensure maximum user engagement. ",
doi="10.2196/37829",
url="https://medinform.jmir.org/2022/8/e37829",
url="http://www.ncbi.nlm.nih.gov/pubmed/35849795"
}


@Article{info:doi/10.2196/34705,
author="Metzler, Hannah
and Baginski, Hubert
and Niederkrotenthaler, Thomas
and Garcia, David",
title="Detecting Potentially Harmful and Protective Suicide-Related Content on Twitter: Machine Learning Approach",
journal="J Med Internet Res",
year="2022",
month="Aug",
day="17",
volume="24",
number="8",
pages="e34705",
keywords="suicide prevention",
keywords="Twitter",
keywords="social media",
keywords="machine learning",
keywords="deep learning",
abstract="Background: Research has repeatedly shown that exposure to suicide-related news media content is associated with suicide rates, with some content characteristics likely having harmful and others potentially protective effects. Although good evidence exists for a few selected characteristics, systematic and large-scale investigations are lacking. Moreover, the growing importance of social media, particularly among young adults, calls for studies on the effects of the content posted on these platforms. Objective: This study applies natural language processing and machine learning methods to classify large quantities of social media data according to characteristics identified as potentially harmful or beneficial in media effects research on suicide and prevention. Methods: We manually labeled 3202 English tweets using a novel annotation scheme that classifies suicide-related tweets into 12 categories. Based on these categories, we trained a benchmark of machine learning models for a multiclass and a binary classification task. As models, we included a majority classifier, an approach based on word frequency (term frequency-inverse document frequency with a linear support vector machine) and 2 state-of-the-art deep learning models (Bidirectional Encoder Representations from Transformers [BERT] and XLNet). The first task classified posts into 6 main content categories, which are particularly relevant for suicide prevention based on previous evidence. These included personal stories of either suicidal ideation and attempts or coping and recovery, calls for action intending to spread either problem awareness or prevention-related information, reporting of suicide cases, and other tweets irrelevant to these 5 categories. The second classification task was binary and separated posts in the 11 categories referring to actual suicide from posts in the off-topic category, which use suicide-related terms in another meaning or context. Results: In both tasks, the performance of the 2 deep learning models was very similar and better than that of the majority or the word frequency classifier. BERT and XLNet reached accuracy scores above 73\% on average across the 6 main categories in the test set and F1-scores between 0.69 and 0.85 for all but the suicidal ideation and attempts category (F1=0.55). In the binary classification task, they correctly labeled around 88\% of the tweets as about suicide versus off-topic, with BERT achieving F1-scores of 0.93 and 0.74, respectively. These classification performances were similar to human performance in most cases and were comparable with state-of-the-art models on similar tasks. Conclusions: The achieved performance scores highlight machine learning as a useful tool for media effects research on suicide. The clear advantage of BERT and XLNet suggests that there is crucial information about meaning in the context of words beyond mere word frequencies in tweets about suicide. By making data labeling more efficient, this work has enabled large-scale investigations on harmful and protective associations of social media content with suicide rates and help-seeking behavior. ",
doi="10.2196/34705",
url="https://www.jmir.org/2022/8/e34705",
url="http://www.ncbi.nlm.nih.gov/pubmed/35976193"
}


@Article{info:doi/10.2196/35937,
author="Burgess, Raquel
and Feliciano, T. Josemari
and Lizbinski, Leonardo
and Ransome, Yusuf",
title="Trends and Characteristics of \#HIVPrevention Tweets Posted Between 2014 and 2019: Retrospective Infodemiology Study",
journal="JMIR Public Health Surveill",
year="2022",
month="Aug",
day="11",
volume="8",
number="8",
pages="e35937",
keywords="HIV",
keywords="social media",
keywords="Twitter",
keywords="prevention",
keywords="infodemiology",
abstract="Background: Twitter is becoming an increasingly important avenue for people to seek information about HIV prevention. Tweets about HIV prevention may reflect or influence current norms about the acceptability of different HIV prevention methods. Therefore, it may be useful to empirically investigate trends in the level of attention paid to different HIV prevention topics on Twitter over time. Objective: The primary objective of this study was to investigate temporal trends in the frequency of tweets about different HIV prevention topics on Twitter between 2014 and 2019. Methods: We used the Twitter application programming interface to obtain English-language tweets employing \#HIVPrevention between January 1, 2014, and December 31, 2019 (n=69,197, globally). Using iterative qualitative content analysis on samples of tweets, we developed a keyword list to categorize the tweets into 10 prevention topics (eg, condom use, preexposure prophylaxis [PrEP]) and compared the frequency of tweets mentioning each topic over time. We assessed the overall change in the proportions of \#HIVPrevention tweets mentioning each prevention topic in 2019 as compared with 2014 using chi-square and Fisher exact tests. We also conducted descriptive analyses to identify the accounts posting the most original tweets, the accounts retweeted most frequently, the most frequently used word pairings, and the spatial distribution of tweets in the United States compared with the number of state-level HIV cases. Results: PrEP (13,895 tweets; 20.08\% of all included tweets) and HIV testing (7688, 11.11\%) were the most frequently mentioned topics, whereas condom use (2941, 4.25\%) and postexposure prophylaxis (PEP; 823, 1.19\%) were mentioned relatively less frequently. The proportions of tweets mentioning PrEP (327/2251, 14.53\%, in 2014, 5067/12,971, 39.1\%, in 2019; P?.001), HIV testing (208/2251, 9.24\%, in 2014, 2193/12,971, 16.91\% in 2019; P?.001), and PEP (25/2251, 1.11\%, in 2014, 342/12,971, 2.64\%, in 2019; P?.001) were higher in 2019 compared with 2014, whereas the proportions of tweets mentioning abstinence, condom use, circumcision, harm reduction, and gender inequity were lower in 2019 compared with 2014. The top retweeted accounts were mostly UN-affiliated entities; celebrities and HIV advocates were also represented. Geotagged \#HIVPrevention tweets in the United States between 2014 and 2019 (n=514) were positively correlated with the number of state-level HIV cases in 2019 (r=0.81, P?.01). Conclusions: Twitter may be a useful source for identifying HIV prevention trends. During our evaluation period (2014-2019), the most frequently mentioned prevention topics were PrEP and HIV testing in tweets using \#HIVPrevention. Strategic responses to these tweets that provide information about where to get tested or how to obtain PrEP may be potential approaches to reduce HIV incidence. ",
doi="10.2196/35937",
url="https://publichealth.jmir.org/2022/8/e35937",
url="http://www.ncbi.nlm.nih.gov/pubmed/35969453"
}


@Article{info:doi/10.2196/38776,
author="Hsu, Tze-Hou Jerome
and Tsai, Tzong-Han Richard",
title="Increased Online Aggression During COVID-19 Lockdowns: Two-Stage Study of Deep Text Mining and Difference-in-Differences Analysis",
journal="J Med Internet Res",
year="2022",
month="Aug",
day="9",
volume="24",
number="8",
pages="e38776",
keywords="natural language processing",
keywords="lockdown",
keywords="online aggression",
keywords="infoveillance",
keywords="causal relationship",
keywords="social media",
keywords="neural networks",
keywords="computer",
keywords="pandemic",
keywords="COVID-19",
keywords="emotions",
keywords="internet",
keywords="sentiment analysis",
keywords="Twitter",
keywords="content analysis",
keywords="infodemiology",
abstract="Background: The COVID-19 pandemic caused a critical public health crisis worldwide, and policymakers are using lockdowns to control the virus. However, there has been a noticeable increase in aggressive social behaviors that threaten social stability. Lockdown measures might negatively affect mental health and lead to an increase in aggressive emotions. Discovering the relationship between lockdown and increased aggression is crucial for formulating appropriate policies that address these adverse societal effects. We applied natural language processing (NLP) technology to internet data, so as to investigate the social and emotional impacts of lockdowns. Objective: This research aimed to understand the relationship between lockdown and increased aggression using NLP technology to analyze the following 3 kinds of aggressive emotions: anger, offensive language, and hate speech, in spatiotemporal ranges of tweets in the United States. Methods: We conducted a longitudinal internet study of 11,455 Twitter users by analyzing aggressive emotions in 1,281,362 tweets they posted from 2019 to 2020. We selected 3 common aggressive emotions (anger, offensive language, and hate speech) on the internet as the subject of analysis. To detect the emotions in the tweets, we trained a Bidirectional Encoder Representations from Transformers (BERT) model to analyze the percentage of aggressive tweets in every state and every week. Then, we used the difference-in-differences estimation to measure the impact of lockdown status on increasing aggressive tweets. Since most other independent factors that might affect the results, such as seasonal and regional factors, have been ruled out by time and state fixed effects, a significant result in this difference-in-differences analysis can not only indicate a concrete positive correlation but also point to a causal relationship. Results: In the first 6 months of lockdown in 2020, aggression levels in all users increased compared to the same period in 2019. Notably, users under lockdown demonstrated greater levels of aggression than those not under lockdown. Our difference-in-differences estimation discovered a statistically significant positive correlation between lockdown and increased aggression (anger: P=.002, offensive language: P<.001, hate speech: P=.005). It can be inferred from such results that there exist causal relations. Conclusions: Understanding the relationship between lockdown and aggression can help policymakers address the personal and societal impacts of lockdown. Applying NLP technology and using big data on social media can provide crucial and timely information for this effort. ",
doi="10.2196/38776",
url="https://www.jmir.org/2022/8/e38776",
url="http://www.ncbi.nlm.nih.gov/pubmed/35943771"
}


@Article{info:doi/10.2196/37818,
author="Cui, Bin
and Wang, Jian
and Lin, Hongfei
and Zhang, Yijia
and Yang, Liang
and Xu, Bo",
title="Emotion-Based Reinforcement Attention Network for Depression Detection on Social Media: Algorithm Development and Validation",
journal="JMIR Med Inform",
year="2022",
month="Aug",
day="9",
volume="10",
number="8",
pages="e37818",
keywords="depression detection",
keywords="emotional semantic features",
keywords="social media",
keywords="sentence-level attention",
keywords="emotion-based reinforcement",
abstract="Background: Depression detection has recently received attention in the field of natural language processing. The task aims to detect users with depression based on their historical posts on social media. However, existing studies in this area use the entire historical posts of the users and select depression indicator posts. Moreover, these methods fail to effectively extract deep emotional semantic features or simply concatenate emotional representation. To solve this problem, we propose a model to extract deep emotional semantic features and select depression indicator posts based on the emotional states. Objective: This study aims to develop an emotion-based reinforcement attention network for depression detection of users on social media. Methods: The proposed model is composed of 2 components: the emotion extraction network, which is used to capture deep emotional semantic information, and the reinforcement learning (RL) attention network, which is used to select depression indicator posts based on the emotional states. Finally, we concatenated the output of these 2 parts and send them to the classification layer for depression detection. Results: Experimental results of our model on the multimodal depression data set outperform the state-of-the-art baselines. Specifically, the proposed model achieved accuracy, precision, recall, and F1-score of 90.6\%, 91.2\%, 89.7\%, and 90.4\%, respectively. Conclusions: The proposed model utilizes historical posts of users to effectively identify users' depression tendencies. The experimental results show that the emotion extraction network and the RL selection layer based on emotional states can effectively improve the accuracy of detection. In addition, sentence-level attention layer can capture core posts. ",
doi="10.2196/37818",
url="https://medinform.jmir.org/2022/8/e37818",
url="http://www.ncbi.nlm.nih.gov/pubmed/35943770"
}


@Article{info:doi/10.2196/35585,
author="Vuku{\vs}i{\'c} Rukavina, Tea
and Machala Popla{\vs}en, Lovela
and Majer, Marjeta
and Reli{\'c}, Danko
and Viski{\'c}, Jo{\vs}ko
and Mareli{\'c}, Marko",
title="Defining Potentially Unprofessional Behavior on Social Media for Health Care Professionals: Mixed Methods Study",
journal="JMIR Med Educ",
year="2022",
month="Aug",
day="9",
volume="8",
number="3",
pages="e35585",
keywords="professionalism",
keywords="e-professionalism",
keywords="internet",
keywords="social media",
keywords="social networking",
keywords="medicine",
keywords="dental medicine",
keywords="health care professionals",
keywords="students",
keywords="faculty",
abstract="Background: Social media presence among health care professionals is ubiquitous and largely beneficial for their personal and professional lives. New standards are forming in the context of e-professionalism, which are loosening the predefined older and offline terms. With these benefits also come dangers, with exposure to evaluation on all levels from peers, superiors, and the public, as witnessed in the \#medbikini movement. Objective: The objectives of this study were to develop an improved coding scheme (SMePROF coding scheme) for the assessment of unprofessional behavior on Facebook of medical or dental students and faculty, compare reliability between coding schemes used in previous research and SMePROF coding scheme, compare gender-based differences for the assessment of the professional content on Facebook, validate the SMePROF coding scheme, and assess the level of and to characterize web-based professionalism on publicly available Facebook profiles of medical or dental students and faculty. Methods: A search was performed via a new Facebook account using a systematic probabilistic sample of students and faculty in the University of Zagreb School of Medicine and School of Dental Medicine. Each profile was subsequently assessed with regard to professionalism based on previously published criteria and compared using the SMePROF coding scheme developed for this study. Results: Intercoder reliability increased when the SMePROF coding scheme was used for the comparison of gender-based coding results. Results showed an increase in the gender-based agreement of the final codes for the category professionalism, from 85\% in the first phase to 96.2\% in the second phase. Final results of the second phase showed that there was almost no difference between female and male coders for coding potentially unprofessional content for students (7/240, 2.9\% vs 5/203, 2.5\%) or for coding unprofessional content for students (11/240, 4.6\% vs 11/203, 5.4\%). Comparison of definitive results between the first and second phases indicated an understanding of web-based professionalism, with unprofessional content being very low, both for students (9/222, 4.1\% vs 12/206, 5.8\%) and faculty (1/25, 4\% vs 0/23, 0\%). For assessment of the potentially unprofessional content, we observed a 4-fold decrease, using the SMePROF rubric, for students (26/222, 11.7\% to 6/206, 2.9\%) and a 5-fold decrease for faculty (6/25, 24\% to 1/23, 4\%). Conclusions: SMePROF coding scheme for assessing professionalism of health-care professionals on Facebook is a validated and more objective instrument. This research emphasizes the role that context plays in the perception of unprofessional and potentially unprofessional content and provides insight into the existence of different sets of rules for web-based and offline interaction that marks behavior as unprofessional. The level of e-professionalism on Facebook profiles of medical or dental students and faculty available for public viewing has shown a high level of understanding of e-professionalism. ",
doi="10.2196/35585",
url="https://mededu.jmir.org/2022/3/e35585",
url="http://www.ncbi.nlm.nih.gov/pubmed/35758"
}


@Article{info:doi/10.2196/39280,
author="Walker, Elizabeth Ruth
and Quong, Sara
and Olivier, Patrick
and Wu, Ling
and Xie, Jue
and Boyle, Jacqueline",
title="Understanding Preconception Women's Needs and Preferences for Digital Health Resources: Qualitative Study",
journal="JMIR Form Res",
year="2022",
month="Aug",
day="5",
volume="6",
number="8",
pages="e39280",
keywords="digital health",
keywords="preconception",
keywords="health promotion",
keywords="behavior change",
keywords="women's health",
keywords="maternal health",
keywords="digital health resource",
keywords="healthy life style",
keywords="qualitative analysis",
keywords="online health information",
abstract="Background: Improving preconception health can benefit all women, their children, and their families regardless of their individual pregnancy intentions. Rapidly increasing access to information technology and online engagement have created opportunities to use digital health resources to engage with preconception women regarding lifestyle behaviors. Objective: This study explores how preconception women engage with digital health resources and online platforms to inform the design and development of a digital health resource to support women to make positive behavior change for their preconception health. Methods: This codesign research followed the Double Diamond process, which focuses on contextualization and explorative processes in phase 1 and ideation and development processes in phase 2. Phase 1 is reported on in this study and was undertaken via a series of 1-on-1 in-depth interviews with female participants (N=12) aged 18-45 years over 3 months. Interviews were designed to explore participants' lived experiences in relation to their health and desired supports for healthy lifestyle behaviors. The first interview focused on participants' perceptions of health and health behaviors, the second interview focused on social connections for health, and the third interview focused on digital health information and supports. Conversations from the first interview informed the development of the second interview, and conversations from the second interview informed the development of the third interview. Community advisors (N=8) met to provide feedback and advice to the researchers throughout the interview process. Qualitative analyses of transcripts from interviews were undertaken by 2 researchers before a deductive process identified themes mapped to the capability, opportunity, motivation, and behavior (COM-B) framework. Results: In total, 9 themes and 8 subthemes were identified from 124 codes. In relation to digital health resources, specifically, participants were already engaging with a range of digital health resources and had high expectations of these. Digital health resources needed to be easy to access, make women's busy lives easier, be evidence based, and be reputable. Social connectedness was also highly important to our participants, with information and advice from peers with similar experiences being preferred over yet more online health information. Online communities facilitated these social interactions. Participants were open to the idea of chatbots and virtual assistants but acknowledged that they would not replace authentic social interactions. Conclusions: Codesigned digital health resources should be evidence based, reputable, and easy to access. Social connections were considered highly important to women, and designers of digital health resources should consider how they can increase opportunities for women to connect and learn from each other to promote health behaviors. ",
doi="10.2196/39280",
url="https://formative.jmir.org/2022/8/e39280",
url="http://www.ncbi.nlm.nih.gov/pubmed/35930344"
}


@Article{info:doi/10.2196/37367,
author="Skafle, Ingjerd
and Nordahl-Hansen, Anders
and Quintana, S. Daniel
and Wynn, Rolf
and Gabarron, Elia",
title="Misinformation About COVID-19 Vaccines on Social Media: Rapid Review",
journal="J Med Internet Res",
year="2022",
month="Aug",
day="4",
volume="24",
number="8",
pages="e37367",
keywords="social media",
keywords="misinformation",
keywords="COVID-19 vaccines",
keywords="vaccination hesitancy",
keywords="autism spectrum disorder",
abstract="Background: The development of COVID-19 vaccines has been crucial in fighting the pandemic. However, misinformation about the COVID-19 pandemic and vaccines is spread on social media platforms at a rate that has made the World Health Organization coin the phrase infodemic. False claims about adverse vaccine side effects, such as vaccines being the cause of autism, were already considered a threat to global health before the outbreak of COVID-19. Objective: We aimed to synthesize the existing research on misinformation about COVID-19 vaccines spread on social media platforms and its effects. The secondary aim was to gain insight and gather knowledge about whether misinformation about autism and COVID-19 vaccines is being spread on social media platforms. Methods: We performed a literature search on September 9, 2021, and searched PubMed, PsycINFO, ERIC, EMBASE, Cochrane Library, and the Cochrane COVID-19 Study Register. We included publications in peer-reviewed journals that fulfilled the following criteria: original empirical studies, studies that assessed social media and misinformation, and studies about COVID-19 vaccines. Thematic analysis was used to identify the patterns (themes) of misinformation. Narrative qualitative synthesis was undertaken with the guidance of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 Statement and the Synthesis Without Meta-analysis reporting guideline. The risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal tool. Ratings of the certainty of evidence were based on recommendations from the Grading of Recommendations Assessment, Development and Evaluation Working Group. Results: The search yielded 757 records, with 45 articles selected for this review. We identified 3 main themes of misinformation: medical misinformation, vaccine development, and conspiracies. Twitter was the most studied social media platform, followed by Facebook, YouTube, and Instagram. A vast majority of studies were from industrialized Western countries. We identified 19 studies in which the effect of social media misinformation on vaccine hesitancy was measured or discussed. These studies implied that the misinformation spread on social media had a negative effect on vaccine hesitancy and uptake. Only 1 study contained misinformation about autism as a side effect of COVID-19 vaccines. Conclusions: To prevent these misconceptions from taking hold, health authorities should openly address and discuss these false claims with both cultural and religious awareness in mind. Our review showed that there is a need to examine the effect of social media misinformation on vaccine hesitancy with a more robust experimental design. Furthermore, this review also demonstrated that more studies are needed from the Global South and on social media platforms other than the major platforms such as Twitter and Facebook. Trial Registration: PROSPERO International Prospective Register of Systematic Reviews CRD42021277524; https://www.crd.york.ac.uk/prospero/display\_record.php?ID=CRD42021277524 International Registered Report Identifier (IRRID): RR2-10.31219/osf.io/tyevj ",
doi="10.2196/37367",
url="https://www.jmir.org/2022/8/e37367",
url="http://www.ncbi.nlm.nih.gov/pubmed/35816685"
}


@Article{info:doi/10.2196/38015,
author="Darko, Mirekuwaa Elizabeth
and Kleib, Manal
and Olson, Joanne",
title="Social Media Use for Research Participant Recruitment: Integrative Literature Review",
journal="J Med Internet Res",
year="2022",
month="Aug",
day="4",
volume="24",
number="8",
pages="e38015",
keywords="advertisement",
keywords="recruitment",
keywords="research participants",
keywords="social media",
keywords="mobile phone",
abstract="Background: Social media tools have provided health researchers with the opportunity to engage with communities and groups in a nonconventional manner to recruit participants for health research. Using social media to advertise research opportunities and recruit participants facilitates accessibility to participants from broad geographical areas and diverse populations. However, little guidance is provided by ethics review boards for researchers to effectively use this recruitment method in their research. Objective: This study sought to explore the literature on the use of social media for participant recruitment for research studies and identify the best practices for recruiting participants using this method. Methods: An integrative review approach was used to synthesize the literature. A total of 5 health sciences databases, namely, EMBASE (Ovid), MEDLINE (Ovid and EBSCOhost), PsycINFO (Ovid), Scopus (Elsevier), and CINAHL Plus with Full Text (EBSCOhost), were searched using predefined keywords and inclusion and exclusion criteria. The initial search was conducted in October 2020 and was updated in February 2022. Descriptive and content analyses were applied to synthesize the results, and the findings are presented in a narrative and tabular format. Results: A total of 96 records were included in this review, 83 (86\%) from the initial search and 13 (14\%) from the updated search. The publication year ranged between 2011 and 2022, with most publications (63/96, 66\%) being from the United States. Regarding recruitment strategy, 45\% (43/96) of the studies exclusively used social media, whereas 51\% (49/96) used social media in conjunction with other strategies. The remaining 4\% (4/96) provided guidelines and recommendations for social media recruitment. Notably, 38\% (36/96) of these studies involved hard-to-reach populations. The findings also revealed that the use of social media is a cost-effective and efficient strategy for recruiting research participants. Despite the expanded use across different populations, there is limited participation of older adults in social media recruitment. Conclusions: This review provides important insights into the current use of social media for health research participant recruitment. Ethics boards and research support services in academic institutions are encouraged to explicitly provide researchers with guidelines on the use of social media for health research participant recruitment. A preliminary guideline prepared based on the findings of this review is proposed to spark further development in this area. ",
doi="10.2196/38015",
url="https://www.jmir.org/2022/8/e38015",
url="http://www.ncbi.nlm.nih.gov/pubmed/35925655"
}


@Article{info:doi/10.2196/36850,
author="Jeong, Heejin
and Bayro, Allison
and Umesh, Patipati Sai
and Mamgain, Kaushal
and Lee, Moontae",
title="Social Media Users' Perceptions of a Wearable Mixed Reality Headset During the COVID-19 Pandemic: Aspect-Based Sentiment Analysis",
journal="JMIR Serious Games",
year="2022",
month="Aug",
day="4",
volume="10",
number="3",
pages="e36850",
keywords="HoloLens 2",
keywords="sentiment analysis",
keywords="natural language processing, Twitter",
keywords="COVID-19",
keywords="usability evaluation",
abstract="Background: Mixed reality (MR) devices provide real-time environments for physical-digital interactions across many domains. Owing to the unprecedented COVID-19 pandemic, MR technologies have supported many new use cases in the health care industry, enabling social distancing practices to minimize the risk of contact and transmission. Despite their novelty and increasing popularity, public evaluations are sparse and often rely on social interactions among users, developers, researchers, and potential buyers. Objective: The purpose of this study is to use aspect-based sentiment analysis to explore changes in sentiment during the onset of the COVID-19 pandemic as new use cases emerged in the health care industry; to characterize net insights for MR developers, researchers, and users; and to analyze the features of HoloLens 2 (Microsoft Corporation) that are helpful for certain fields and purposes. Methods: To investigate the user sentiment, we collected 8492 tweets on a wearable MR headset, HoloLens 2, during the initial 10 months since its release in late 2019, coinciding with the onset of the pandemic. Human annotators rated the individual tweets as positive, negative, neutral, or inconclusive. Furthermore, by hiring an interannotator to ensure agreements between the annotators, we used various word vector representations to measure the impact of specific words on sentiment ratings. Following the sentiment classification for each tweet, we trained a model for sentiment analysis via supervised learning. Results: The results of our sentiment analysis showed that the bag-of-words tokenizing method using a random forest supervised learning approach produced the highest accuracy of the test set at 81.29\%. Furthermore, the results showed an apparent change in sentiment during the COVID-19 pandemic period. During the onset of the pandemic, consumer goods were severely affected, which aligns with a drop in both positive and negative sentiment. Following this, there is a sudden spike in positive sentiment, hypothesized to be caused by the new use cases of the device in health care education and training. This pandemic also aligns with drastic changes in the increased number of practical insights for MR developers, researchers, and users and positive net sentiments toward the HoloLens 2 characteristics. Conclusions: Our approach suggests a simple yet effective way to survey public opinion about new hardware devices quickly. The findings of this study contribute to a holistic understanding of public perception and acceptance of MR technologies during the COVID-19 pandemic and highlight several new implementations of HoloLens 2 in health care. We hope that these findings will inspire new use cases and technological features. ",
doi="10.2196/36850",
url="https://games.jmir.org/2022/3/e36850",
url="http://www.ncbi.nlm.nih.gov/pubmed/35708916"
}


@Article{info:doi/10.2196/34422,
author="Robin, Charlotte
and Symons, Charles
and Carter, Holly",
title="Local Community Response to Mass Asymptomatic COVID-19 Testing in Liverpool, England: Social Media Analysis",
journal="JMIR Form Res",
year="2022",
month="Aug",
day="4",
volume="6",
number="8",
pages="e34422",
keywords="COVID-19",
keywords="asymptomatic testing",
keywords="social media",
keywords="attitude",
keywords="behavioral science",
keywords="testing",
keywords="behavior",
keywords="community",
keywords="England",
keywords="acceptance",
keywords="barrier",
keywords="motivator",
keywords="hesitancy",
keywords="communication",
abstract="Background: Mass asymptomatic testing for COVID-19 was piloted for the first time in the United Kingdom in Liverpool in November 2020. There is limited evidence on uptake of mass testing, and previously where surge testing has been deployed, uptake has been low. Objective: There was an urgent need to rapidly evaluate acceptance of asymptomatic testing, specifically identifying barriers and facilitators to taking part. Methods: As part of the wider evaluation, we conducted a rapid thematic analysis of local community narratives on social media to provide insights from people unlikely to engage in testing or other standard evaluation techniques, such as surveys or interviews. We identified 3 publicly available data sources: the comments section of a local online newspaper, the city council Facebook page, and Twitter. Data were collected between November 2, 2020, and November 8, 2020, to cover the period between announcement of mass testing in Liverpool and the first week of testing. Overall, 1096 comments were sampled: 219 newspaper comments, 472 Facebook comments, and 405 tweets. Data were analyzed using an inductive thematic approach. Results: Key barriers were accessibility, including site access and concerns over queuing. Queues were also highlighted as a concern due to risk of transmission. Consequences of testing, including an increase in cases leading to further restrictions and financial impact of the requirement for self-isolation, were also identified as barriers. In addition, a lack of trust in authorities and the test (including test accuracy and purpose of testing) was identified. Comments coded as indicative of lack of trust were coded in some cases as indicative of strong collective identity with the city of Liverpool and marginalization due to feeling like test subjects. However, other comments coded as identification with Liverpool were coded as indicative of motivation to engage in testing and encourage others to do so; for this group, being part of a pilot was seen as a positive experience and an opportunity to demonstrate the city could successfully manage the virus. Conclusions: Our analysis highlights the importance of promoting honest and open communication to encourage and harness existing community identities to enhance the legitimacy of asymptomatic testing as a policy. In addition, adequate and accessible financial support needs to be in place prior to the implementation of community asymptomatic testing to mitigate any concerns surrounding financial hardship. Rapid thematic analysis of social media is a pragmatic method to gather insights from communities around acceptability of public health interventions, such as mass testing or vaccination uptake. ",
doi="10.2196/34422",
url="https://formative.jmir.org/2022/8/e34422",
url="http://www.ncbi.nlm.nih.gov/pubmed/35658094"
}


@Article{info:doi/10.2196/35702,
author="Liu, Yongtai
and Yin, Zhijun
and Wan, Zhiyu
and Yan, Chao
and Xia, Weiyi
and Ni, Congning
and Clayton, Wright Ellen
and Vorobeychik, Yevgeniy
and Kantarcioglu, Murat
and Malin, A. Bradley",
title="Implicit Incentives Among Reddit Users to Prioritize Attention Over Privacy and Reveal Their Faces When Discussing Direct-to-Consumer Genetic Test Results: Topic and Attention Analysis",
journal="JMIR Infodemiology",
year="2022",
month="Aug",
day="3",
volume="2",
number="2",
pages="e35702",
keywords="direct-to-consumer genetic testing",
keywords="topic modeling",
keywords="social media",
abstract="Background: As direct-to-consumer genetic testing services have grown in popularity, the public has increasingly relied upon online forums to discuss and share their test results. Initially, users did so anonymously, but more recently, they have included face images when discussing their results. Various studies have shown that sharing images on social media tends to elicit more replies. However, users who do this forgo their privacy. When these images truthfully represent a user, they have the potential to disclose that user's identity. Objective: This study investigates the face image sharing behavior of direct-to-consumer genetic testing users in an online environment to determine if there exists an association between face image sharing and the attention received from other users. Methods: This study focused on r/23andme, a subreddit dedicated to discussing direct-to-consumer genetic testing results and their implications. We applied natural language processing to infer the themes associated with posts that included a face image. We applied a regression analysis to characterize the association between the attention that a post received, in terms of the number of comments, the karma score (defined as the number of upvotes minus the number of downvotes), and whether the post contained a face image. Results: We collected over 15,000 posts from the r/23andme subreddit, published between 2012 and 2020. Face image posting began in late 2019 and grew rapidly, with over 800 individuals revealing their faces by early 2020. The topics in posts including a face were primarily about sharing, discussing ancestry composition, or sharing family reunion photos with relatives discovered via direct-to-consumer genetic testing. On average, posts including a face image received 60\% (5/8) more comments and had karma scores 2.4 times higher than other posts. Conclusions: Direct-to-consumer genetic testing consumers in the r/23andme subreddit are increasingly posting face images and testing reports on social platforms. The association between face image posting and a greater level of attention suggests that people are forgoing their privacy in exchange for attention from others. To mitigate this risk, platform organizers and moderators could inform users about the risk of posting face images in a direct, explicit manner to make it clear that their privacy may be compromised if personal images are shared. ",
doi="10.2196/35702",
url="https://infodemiology.jmir.org/2022/2/e35702",
url="http://www.ncbi.nlm.nih.gov/pubmed/37113452"
}


@Article{info:doi/10.2196/29186,
author="Stemmer, Maya
and Parmet, Yisrael
and Ravid, Gilad",
title="Identifying Patients With Inflammatory Bowel Disease on Twitter and Learning From Their Personal Experience: Retrospective Cohort Study",
journal="J Med Internet Res",
year="2022",
month="Aug",
day="2",
volume="24",
number="8",
pages="e29186",
keywords="patient identification",
keywords="inflammatory bowel disease",
keywords="IBD",
keywords="user classification",
keywords="Twitter",
keywords="natural language processing",
keywords="NLP",
keywords="sentiment analysis",
abstract="Background: Patients use social media as an alternative information source, where they share information and provide social support. Although large amounts of health-related data are posted on Twitter and other social networking platforms each day, research using social media data to understand chronic conditions and patients' lifestyles is limited. Objective: In this study, we contributed to closing this gap by providing a framework for identifying patients with inflammatory bowel disease (IBD) on Twitter and learning from their personal experiences. We enabled the analysis of patients' tweets by building a classifier of Twitter users that distinguishes patients from other entities. This study aimed to uncover the potential of using Twitter data to promote the well-being of patients with IBD by relying on the wisdom of the crowd to identify healthy lifestyles. We sought to leverage posts describing patients' daily activities and their influence on their well-being to characterize lifestyle-related treatments. Methods: In the first stage of the study, a machine learning method combining social network analysis and natural language processing was used to automatically classify users as patients or not. We considered 3 types of features: the user's behavior on Twitter, the content of the user's tweets, and the social structure of the user's network. We compared the performances of several classification algorithms within 2 classification approaches. One classified each tweet and deduced the user's class from their tweet-level classification. The other aggregated tweet-level features to user-level features and classified the users themselves. Different classification algorithms were examined and compared using 4 measures: precision, recall, F1 score, and the area under the receiver operating characteristic curve. In the second stage, a classifier from the first stage was used to collect patients' tweets describing the different lifestyles patients adopt to deal with their disease. Using IBM Watson Service for entity sentiment analysis, we calculated the average sentiment of 420 lifestyle-related words that patients with IBD use when describing their daily routine. Results: Both classification approaches showed promising results. Although the precision rates were slightly higher for the tweet-level approach, the recall and area under the receiver operating characteristic curve of the user-level approach were significantly better. Sentiment analysis of tweets written by patients with IBD identified frequently mentioned lifestyles and their influence on patients' well-being. The findings reinforced what is known about suitable nutrition for IBD as several foods known to cause inflammation were pointed out in negative sentiment, whereas relaxing activities and anti-inflammatory foods surfaced in a positive context. Conclusions: This study suggests a pipeline for identifying patients with IBD on Twitter and collecting their tweets to analyze the experimental knowledge they share. These methods can be adapted to other diseases and enhance medical research on chronic conditions. ",
doi="10.2196/29186",
url="https://www.jmir.org/2022/8/e29186",
url="http://www.ncbi.nlm.nih.gov/pubmed/35917151"
}


@Article{info:doi/10.2196/24306,
author="Kiesewetter, Jan
and Hege, Inga
and Sailer, Michael
and Bauer, Elisabeth
and Schulz, Claudia
and Platz, Manfred
and Adler, Martin",
title="Implementing Remote Collaboration in a Virtual Patient Platform: Usability Study",
journal="JMIR Med Educ",
year="2022",
month="Jul",
day="28",
volume="8",
number="3",
pages="e24306",
keywords="collaborative learning",
keywords="clinical reasoning",
keywords="webRTC",
keywords="collaboration",
keywords="collaborative",
keywords="decision making",
abstract="Background: Learning with virtual patients is highly popular for fostering clinical reasoning in medical education. However, little learning with virtual patients is done collaboratively, despite the potential learning benefits of collaborative versus individual learning. Objective: This paper describes the implementation of student collaboration in a virtual patient platform. Our aim was to allow pairs of students to communicate remotely with each other during virtual patient learning sessions. We hypothesized that we could provide a collaborative tool that did not impair the usability of the system compared to individual learning and that this would lead to better diagnostic accuracy for the pairs of students. Methods: Implementing the collaboration tool had five steps: (1) searching for a suitable software library, (2) implementing the application programming interface, (3) performing technical adaptations to ensure high-quality connections for the users, (4) designing and developing the user interface, and (5) testing the usability of the tool in 270 virtual patient sessions. We compared dyad to individual diagnostic accuracy and usability with the 10-item System Usability Scale. Results: We recruited 137 students who worked on 6 virtual patients. Out of 270 virtual patient sessions per group (45 dyads times 6 virtual patients, and 47 students working individually times 6 virtual patients minus 2 randomly selected deleted sessions) the students made successful diagnoses in 143/270 sessions (53\%, SD 26\%) when working alone and 192/270 sessions (71\%, SD 20\%) when collaborating (P=.04, $\eta$2=0.12). A usability questionnaire given to the students who used the collaboration tool showed a usability score of 82.16 (SD 1.31), representing a B+ grade. Conclusions: The collaboration tool provides a generic approach for collaboration that can be used with most virtual patient systems. The collaboration tool helped students diagnose virtual patients and had good overall usability. More broadly, the collaboration tool will provide an array of new possibilities for researchers and medical educators alike to design courses for collaborative learning with virtual patients. ",
doi="10.2196/24306",
url="https://mededu.jmir.org/2022/3/e24306",
url="http://www.ncbi.nlm.nih.gov/pubmed/35900827"
}


@Article{info:doi/10.2196/38068,
author="Xu, Ran
and Divito, Joseph
and Bannor, Richard
and Schroeder, Matthew
and Pagoto, Sherry",
title="Predicting Participant Engagement in a Social Media--Delivered Lifestyle Intervention Using Microlevel Conversational Data: Secondary Analysis of Data From a Pilot Randomized Controlled Trial",
journal="JMIR Form Res",
year="2022",
month="Jul",
day="28",
volume="6",
number="7",
pages="e38068",
keywords="weight loss",
keywords="social media intervention",
keywords="engagement",
keywords="data science",
keywords="natural language processing",
keywords="NLP",
keywords="social media",
keywords="lifestyle",
keywords="machine learning",
keywords="mobile phone",
abstract="Background: Social media--delivered lifestyle interventions have shown promising outcomes, often generating modest but significant weight loss. Participant engagement appears to be an important predictor of weight loss outcomes; however, engagement generally declines over time and is highly variable both within and across studies. Research on factors that influence participant engagement remains scant in the context of social media--delivered lifestyle interventions. Objective: This study aimed to identify predictors of participant engagement from the content generated during a social media--delivered lifestyle intervention, including characteristics of the posts, the conversation that followed the post, and participants' previous engagement patterns. Methods: We performed secondary analyses using data from a pilot randomized trial that delivered 2 lifestyle interventions via Facebook. We analyzed 80 participants' engagement data over a 16-week intervention period and linked them to predictors, including characteristics of the posts, conversations that followed the post, and participants' previous engagement, using a mixed-effects model. We also performed machine learning--based classification to confirm the importance of the significant predictors previously identified and explore how well these measures can predict whether participants will engage with a specific post. Results: The probability of participants' engagement with each post decreased by 0.28\% each week (P<.001; 95\% CI 0.16\%-0.4\%). The probability of participants engaging with posts generated by interventionists was 6.3\% (P<.001; 95\% CI 5.1\%-7.5\%) higher than posts generated by other participants. Participants also had a 6.5\% (P<.001; 95\% CI 4.9\%-8.1\%) and 6.1\% (P<.001; 95\% CI 4.1\%-8.1\%) higher probability of engaging with posts that directly mentioned weight and goals, respectively, than other types of posts. Participants were 44.8\% (P<.001; 95\% CI 42.8\%-46.9\%) and 46\% (P<.001; 95\% CI 44.1\%-48.0\%) more likely to engage with a post when they were replied to by other participants and by interventionists, respectively. A 1 SD decrease in the sentiment of the conversation on a specific post was associated with a 5.4\% (P<.001; 95\% CI 4.9\%-5.9\%) increase in the probability of participants' subsequent engagement with the post. Participants' engagement in previous posts was also a predictor of engagement in subsequent posts (P<.001; 95\% CI 0.74\%-0.79\%). Moreover, using a machine learning approach, we confirmed the importance of the predictors previously identified and achieved an accuracy of 90.9\% in terms of predicting participants' engagement using a balanced testing sample with 1600 observations. Conclusions: Findings revealed several predictors of engagement derived from the content generated by interventionists and other participants. Results have implications for increasing engagement in asynchronous, remotely delivered lifestyle interventions, which could improve outcomes. Our results also point to the potential of data science and natural language processing to analyze microlevel conversational data and identify factors influencing participant engagement. Future studies should validate these results in larger trials. Trial Registration: ClinicalTrials.gov NCT02656680; https://clinicaltrials.gov/ct2/show/NCT02656680 ",
doi="10.2196/38068",
url="https://formative.jmir.org/2022/7/e38068",
url="http://www.ncbi.nlm.nih.gov/pubmed/35900824"
}


@Article{info:doi/10.2196/34549,
author="Clavier, Thomas
and Occhiali, Emilie
and Guenet, Claire
and Vannier, Naurine
and Hache, Camille
and Compere, Vincent
and Selim, Jean
and Besnier, Emmanuel",
title="Worldwide Presence of National Anesthesia Societies on Four Major Social Networks in 2021: Observational Case Study",
journal="JMIR Perioper Med",
year="2022",
month="Jul",
day="20",
volume="5",
number="1",
pages="e34549",
keywords="social network, social media",
keywords="anaesthesia",
keywords="society",
keywords="Facebook",
keywords="Twitter",
keywords="Instagram",
keywords="YouTube",
abstract="Background: Although the presence of medical societies on social networks (SNs) could be interesting for disseminating professional information, there is no study investigating their presence on SNs. Objective: The aim of this viewpoint is to describe the worldwide presence and activity of national anesthesia societies on SNs. Methods: This observational study assessed the active presence (?1 post in the year preceding the collection date) of the World Federation of Societies of Anesthesiologists member societies on the SNs Twitter, Facebook, Instagram, and YouTube. We collected data concerning each anesthesia society on the World Federation of Societies of Anesthesiologists website. Results: Among the 136 societies, 66 (48.5\%) had an active presence on at least one SN. The most used SN was Facebook (n=60, 44.1\%), followed by Twitter (n=37, 27.2\%), YouTube (n=26, 19.1\%), and Instagram (n=16, 11.8\%). The SN with the largest number of followers was Facebook for 52 (78.8\%) societies and Twitter for 12 (18.2\%) societies. The number of followers was 361 (IQR 75-1806) on Twitter, 2494 (IQR 1049-5369) on Facebook, 1400 (IQR 303-3058) on Instagram, and 214 (IQR 33-955) on YouTube. There was a strong correlation between the number of posts and the number of followers on Twitter (r=0.95, 95\% CI 0.91-0.97; P<.001), Instagram (r=0.83, 95\% CI 0.58-0.94; P<.001), and YouTube (r=0.69, 95\% CI 0.42-0.85; P<.001). According to the density of anesthetists in the country, there was no difference between societies with and without active SN accounts. Conclusions: Less than half of national anesthesia societies have at least one active account on SNs. Twitter and Facebook are the most used SNs. ",
doi="10.2196/34549",
url="https://periop.jmir.org/2022/1/e34549",
url="http://www.ncbi.nlm.nih.gov/pubmed/35857379"
}


@Article{info:doi/10.2196/36268,
author="Al-Rawi, Ahmed
and Zemenchik, Kiana",
title="Sex Workers' Lived Experiences With COVID-19 on Social Media: Content Analysis of Twitter Posts",
journal="JMIR Form Res",
year="2022",
month="Jul",
day="14",
volume="6",
number="7",
pages="e36268",
keywords="sex work",
keywords="social media",
keywords="COVID-19",
keywords="pandemic",
keywords="Twitter",
keywords="infodemiology",
keywords="social stigma",
keywords="sex worker",
keywords="risk",
keywords="public health",
abstract="Background: The COVID-19 pandemic has drawn attention to various inequalities in global societies, highlighting discrepancies in terms of safety, accessibility, and overall health. In particular, sex workers are disproportionately at risk due to the nature of their work and the social stigma that comes alongside it. Objective: This study examines how public social media can be used as a tool of professional and personal expression by sex workers during the COVID-19 pandemic. We aimed to explore an underresearched topic by focusing on sex workers' experiences with the ongoing COVID-19 pandemic on the social media platform Twitter. In particular, we aimed to find the main issues that sex workers discuss on social media in relation to the COVID-19 pandemic. Methods: A literature review followed by a qualitative analysis of 1458 (re)tweets from 22 sex worker Twitter accounts was used for this study. The tweets were qualitatively coded by theme through the use of intercoder reliability. Empirical, experimental, and observational studies were included in this review to provide context and support for our findings. Results: In total, 5 major categories were identified as a result of the content analysis used for this study: concerns (n=542, 37.2\%), solicitation (n=336, 23.0\%), herd mentality (n=231, 15.8\%), humor (n=190, 13.0\%), and blame (n=146, 10.0\%). The concerns category was the most prominent category, which could be due to its multifaceted nature of including individual concerns, health issues, concerns for essential workers and businesses, as well as concerns about inequalities or intersectionality. When using gender as a control factor, the majority of the results were not noteworthy, save for the blame category, in which sexual and gender minorities (SGMs) were more likely to post content. Conclusions: Though there has been an increase in the literature related to the experiences of sex workers, this paper recommends that future studies could benefit from further examining these 5 major categories through mixed methods research. Examining this phenomenon could recognize the challenges unique to this working community during the COVID-19 pandemic and potentially reduce the widespread stigma associated with sex work in general. ",
doi="10.2196/36268",
url="https://formative.jmir.org/2022/7/e36268",
url="http://www.ncbi.nlm.nih.gov/pubmed/35767693"
}


@Article{info:doi/10.2196/34114,
author="Gao, Yankun
and Xie, Zidian
and Li, Dongmei",
title="Investigating the Impact of the New York State Flavor Ban on e-Cigarette--Related Discussions on Twitter: Observational Study",
journal="JMIR Public Health Surveill",
year="2022",
month="Jul",
day="8",
volume="8",
number="7",
pages="e34114",
keywords="New York State flavor ban",
keywords="e-cigarettes",
keywords="twitter",
keywords="topic modeling",
keywords="sentiment analysis",
abstract="Background: On May 18, 2020, the New York State Department of Health implemented a statewide flavor ban to prohibit the sales of all flavored vapor products, except for tobacco or any other authorized flavor. Objective: This study aims to investigate the discussion changes in e-cigarette--related tweets over time with the implementation of the New York State flavor ban. Methods: Through the Twitter streaming application programming interface, 59,883 e-cigarette--related tweets were collected within the New York State from February 6, 2020, to May 17, 2020 (period 1, before the implementation of the flavor ban), May 18, 2020-June 30, 2020 (period 2, between the implementation of the flavor ban and the online sales ban), July 1, 2020-September 15, 2020 (period 3, the short term after the online sales ban), and September 16, 2020-November 30, 2020 (period 4, the long term after the online sales ban). Sentiment analysis and topic modeling were conducted to investigate the changes in public attitudes and discussions in e-cigarette--related tweets. The popularity of different e-cigarette flavor categories was compared before and after the implementation of the New York State flavor ban. Results: Our results showed that the proportion of e-cigarette--related tweets with negative sentiment significantly decreased (4305/13,246, 32.5\% vs 3855/14,455, 26.67\%, P<.001), and tweets with positive sentiment significantly increased (5246/13,246, 39.6\% vs 7038/14,455, 48.69\%, P<.001) in period 4 compared to period 3. ``Teens and nicotine products'' was the most frequently discussed e-cigarette--related topic in the negative tweets. In contrast, ``nicotine products and quitting'' was more prevalent in positive tweets. The proportion of tweets mentioning mint and menthol flavors significantly increased right after the flavor ban and decreased to lower levels over time. The proportions of fruit and sweet flavors were most frequently mentioned in period 1, decreased in period 2, and dominated again in period 4. Conclusions: The proportion of e-cigarette--related tweets with different attitudes and frequently discussed flavor categories changed over time after the implementation of the New York State ban of flavored vaping products. This change indicated a potential impact of the flavor ban on public discussions of flavored e-cigarettes. ",
doi="10.2196/34114",
url="https://publichealth.jmir.org/2022/7/e34114",
url="http://www.ncbi.nlm.nih.gov/pubmed/35802417"
}


@Article{info:doi/10.2196/37806,
author="Ngai, Bik Cindy Sing
and Singh, Gill Rita
and Yao, Le",
title="Impact of COVID-19 Vaccine Misinformation on Social Media Virality: Content Analysis of Message Themes and Writing Strategies",
journal="J Med Internet Res",
year="2022",
month="Jul",
day="6",
volume="24",
number="7",
pages="e37806",
keywords="antivaccine misinformation",
keywords="content themes",
keywords="writing strategies",
keywords="COVID-19",
keywords="virality",
keywords="social media",
keywords="content analysis",
abstract="Background: Vaccines serve an integral role in containing pandemics, yet vaccine hesitancy is prevalent globally. One key reason for this hesitancy is the pervasiveness of misinformation on social media. Although considerable research attention has been drawn to how exposure to misinformation is closely associated with vaccine hesitancy, little scholarly attention has been given to the investigation or robust theorizing of the various content themes pertaining to antivaccine misinformation about COVID-19 and the writing strategies in which these content themes are manifested. Virality of such content on social media exhibited in the form of comments, shares, and reactions has practical implications for COVID-19 vaccine hesitancy. Objective: We investigated whether there were differences in the content themes and writing strategies used to disseminate antivaccine misinformation about COVID-19 and their impact on virality on social media. Methods: We constructed an antivaccine misinformation database from major social media platforms during September 2019-August 2021 to examine how misinformation exhibited in the form of content themes and how these themes manifested in writing were associated with virality in terms of likes, comments, and shares. Antivaccine misinformation was retrieved from two globally leading and widely cited fake news databases, COVID Global Misinformation Dashboard and International Fact-Checking Network Corona Virus Facts Alliance Database, which aim to track and debunk COVID-19 misinformation. We primarily focused on 140 Facebook posts, since most antivaccine misinformation posts on COVID-19 were found on Facebook. We then  employed quantitative content analysis to examine the content themes (ie, safety concerns, conspiracy theories, efficacy concerns) and manifestation strategies of misinformation (ie, mimicking of news and scientific reports in terms of the format and language features, use of a conversational style, use of amplification) in these posts and their association with virality of misinformation in the form of likes, comments, and shares. Results: Our study revealed that safety concern was the most prominent content theme and a negative predictor of likes and shares. Regarding the writing strategies manifested in content themes, a conversational style and mimicking of news and scientific reports via the format and language features were frequently employed in COVID-19 antivaccine misinformation, with the latter being a positive predictor of likes. Conclusions: This study contributes to a richer research-informed understanding of which concerns about content theme and manifestation strategy need to be countered on antivaccine misinformation circulating on social media so that accurate information on COVID-19 vaccines can be disseminated to the public, ultimately reducing vaccine hesitancy. The liking of COVID-19 antivaccine posts that employ language features to mimic news or scientific reports is perturbing since a large audience can be reached on social media, potentially exacerbating the spread of misinformation and hampering global efforts to combat the virus. ",
doi="10.2196/37806",
url="https://www.jmir.org/2022/7/e37806",
url="http://www.ncbi.nlm.nih.gov/pubmed/35731969"
}


@Article{info:doi/10.2196/33172,
author="Kelly, Jennifer Katherine
and Doucet, Shelley
and Luke, Alison
and Azar, Rima
and Montelpare, William",
title="Experiences, Motivations, and Perceived Impact of Participation in a Facebook-Based Support Group for Caregivers of Children and Youth With Complex Care Needs: Qualitative Descriptive Study",
journal="JMIR Pediatr Parent",
year="2022",
month="Jul",
day="6",
volume="5",
number="3",
pages="e33172",
keywords="caregiver experiences",
keywords="peer-to-peer support",
keywords="social support",
keywords="social media",
keywords="children with complex care needs",
keywords="Facebook group",
abstract="Background: Caregivers of children and youth with complex care needs (CCNs) often require considerable support to ensure the well-being of their families. Social media present an opportunity to better support caregivers through computer-mediated communication for social support. Peer-to-peer (P2P) support groups are a way in which caregivers are accessing needed support; however, the experiences of caregivers who use these groups and the perceived impact that participation has on caregivers of children and youth with CCNs are not known. Objective: This study aimed to explore the experiences of caregivers of children and youth with CCNs who use a Facebook-based P2P support group to communicate, understand their motivations to use the group, and investigate its perceived impact on knowledge of programs and services and sense of community belonging among caregivers. Methods: A qualitative descriptive design was used to explore the experiences and perceived impact of a Facebook-based (Meta Platforms) P2P support group for caregivers of children and youth with CCNs in New Brunswick, Canada. The group was launched on the web in October 2020, during the COVID-19 pandemic, and resulted in 108 caregivers joining the group. A web-based survey was distributed, and semistructured interviews were conducted in February 2021 with a subsample of members. Thematic analysis was used to identify and report patterns related to caregivers' experiences and perceived impacts of participation. Results: A subsample of members in the Facebook group completed the web-based survey (39/108, 36.1\%) and interviews (14/108, 12.9\%). A total of 5 themes emerged from the interviews: safe space, informational support and direction, web-based connection with peers, impact on knowledge of programs and services, and degree of community belonging. Participants reported joining the group to obtain geography-specific information support and connect with peers. Many participants reported an improvement in their knowledge of programs and services and felt connected to the community; however, the short observation period and diversity among the caregiver population were cited as barriers to community belonging. Conclusions: Social media present an important opportunity to facilitate the exchange of support between patients and caregivers in an accessible and curated environment. Findings from this study suggest that involvement in web-based, geography-specific P2P support groups can influence perceived knowledge of services and resources and sense of community belonging among caregivers of children and youth with CCNs. Furthermore, this study provides insight into the experiences and motivations of caregivers of children and youth with CCNs who participate in a private social media environment. ",
doi="10.2196/33172",
url="https://pediatrics.jmir.org/2022/3/e33172",
url="http://www.ncbi.nlm.nih.gov/pubmed/35793139"
}


@Article{info:doi/10.2196/34285,
author="Sigalo, Nekabari
and St Jean, Beth
and Frias-Martinez, Vanessa",
title="Using Social Media to Predict Food Deserts in the United States: Infodemiology Study of Tweets",
journal="JMIR Public Health Surveill",
year="2022",
month="Jul",
day="5",
volume="8",
number="7",
pages="e34285",
keywords="social media",
keywords="Twitter",
keywords="food deserts",
keywords="food insecurity",
abstract="Background: The issue of food insecurity is becoming increasingly important to public health practitioners because of the adverse health outcomes and underlying racial disparities associated with insufficient access to healthy foods. Prior research has used data sources such as surveys, geographic information systems, and food store assessments to identify regions classified as food deserts but perhaps the individuals in these regions unknowingly provide their own accounts of food consumption and food insecurity through social media. Social media data have proved useful in answering questions related to public health; therefore, these data are a rich source for identifying food deserts in the United States. Objective: The aim of this study was to develop, from geotagged Twitter data, a predictive model for the identification of food deserts in the United States using the linguistic constructs found in food-related tweets. Methods: Twitter's streaming application programming interface was used to collect a random 1\% sample of public geolocated tweets across 25 major cities from March 2020 to December 2020. A total of 60,174 geolocated food-related tweets were collected across the 25 cities. Each geolocated tweet was mapped to its respective census tract using point-to-polygon mapping, which allowed us to develop census tract--level features derived from the linguistic constructs found in food-related tweets, such as tweet sentiment and average nutritional value of foods mentioned in the tweets. These features were then used to examine the associations between food desert status and the food ingestion language and sentiment of tweets in a census tract and to determine whether food-related tweets can be used to infer census tract--level food desert status. Results: We found associations between a census tract being classified as a food desert and an increase in the number of tweets in a census tract that mentioned unhealthy foods (P=.03), including foods high in cholesterol (P=.02) or low in key nutrients such as potassium (P=.01). We also found an association between a census tract being classified as a food desert and an increase in the proportion of tweets that mentioned healthy foods (P=.03) and fast-food restaurants (P=.01) with positive sentiment. In addition, we found that including food ingestion language derived from tweets in classification models that predict food desert status improves model performance compared with baseline models that only include socioeconomic characteristics. Conclusions: Social media data have been increasingly used to answer questions related to health and well-being. Using Twitter data, we found that food-related tweets can be used to develop models for predicting census tract food desert status with high accuracy and improve over baseline models. Food ingestion language found in tweets, such as census tract--level measures of food sentiment and healthiness, are associated with census tract--level food desert status. ",
doi="10.2196/34285",
url="https://publichealth.jmir.org/2022/7/e34285",
url="http://www.ncbi.nlm.nih.gov/pubmed/35788108"
}


@Article{info:doi/10.2196/35663,
author="Silva, Martha
and Walker, Jonathan
and Portillo, Erin
and Dougherty, Leanne",
title="Strengthening the Merci Mon H{\'e}ros Campaign Through Adaptive Management: Application of Social Listening Methodology",
journal="JMIR Public Health Surveill",
year="2022",
month="Jun",
day="28",
volume="8",
number="6",
pages="e35663",
keywords="social media",
keywords="health communication",
keywords="young people",
keywords="reproductive health",
abstract="Background: Between 2014 and 2018, the penetration of smartphones in sub-Saharan Africa increased from 10\% to 30\%, enabling increased access to the internet, Facebook, Twitter, Pinterest, and YouTube. These platforms engage users in multidirectional communication and provide public health programs with the tools to inform and engage diverse audiences on a range of public health issues, as well as monitor opinions and behaviors on health topics. Objective: This paper details the process used by the U.S. Agency for International Development--funded Breakthrough RESEARCH to apply social media monitoring and social listening techniques in Burkina Faso, C{\^o}te d'Ivoire, Niger, and Togo for the adaptive management of the Merci Mon H{\'e}ros campaign. We documented how these approaches were applied and how the lessons learned can be used to support future public health communication campaigns. Methods: The process involved 6 steps: (1) ensure there is a sufficient volume of topic-specific web-based conversation in the target countries; (2) develop measures to monitor the campaign's social media strategy; (3) identify search terms to assess campaign and related conversations; (4) quantitatively assess campaign audience demographics, campaign reach, and engagement through social media monitoring; (5) qualitatively assess audience attitudes, opinions, and behaviors and understand conversation context through social media listening; and (6) adapt campaign content and approach based on the analysis of social media data. Results: We analyzed posts across social media platforms from November 2019 to October 2020 based on identified key search terms related to family planning, reproductive health, menstruation, sexual activity, and gender. Based on the quantitative and qualitative assessments in steps 4 and 5, there were several adaptive shifts in the campaign's content and approach, of which the following 3 shifts are highlighted. (1) Social media monitoring identified that the Facebook campaign fans were primarily male, which prompted the campaign to target calls to action to the male audience already following the campaign and shift marketing approaches to increase the proportion of female followers. (2) Shorter videos had a higher chance of being viewed in their entirety. In response to this, the campaign shortened video lengths and created screenshot teasers to promote videos. (3) The most negative sentiment related to the campaign videos was associated with beliefs against premarital sex. In response to this finding, the campaign included videos and Facebook Live sessions with religious leaders who promoted talking openly with young people to support intergenerational discussion about reproductive health. Conclusions: Prior to launching health campaigns, programs should test the most relevant social media platforms and their limitations. Inherent biases to internet and social media access are important challenges, and ethical considerations around data privacy must continue to guide the advances in this technology's use for research. However, social listening and social media monitoring can be powerful monitoring and evaluation tools that can be used to aid the adaptive management of health campaigns that engage populations who have a digital presence. ",
doi="10.2196/35663",
url="https://publichealth.jmir.org/2022/6/e35663",
url="http://www.ncbi.nlm.nih.gov/pubmed/35763319"
}


@Article{info:doi/10.2196/38423,
author="Xue, Haoning
and Gong, Xuanjun
and Stevens, Hannah",
title="COVID-19 Vaccine Fact-Checking Posts on Facebook: Observational Study",
journal="J Med Internet Res",
year="2022",
month="Jun",
day="21",
volume="24",
number="6",
pages="e38423",
keywords="COVID-19 vaccine",
keywords="fact checking",
keywords="misinformation correction",
keywords="sentiment analysis",
keywords="social media",
keywords="COVID-19",
keywords="vaccination",
keywords="misinformation",
keywords="health information",
keywords="online information",
keywords="infodemic",
keywords="public sentiment",
abstract="Background: Effective interventions aimed at correcting COVID-19 vaccine misinformation, known as fact-checking messages, are needed to combat the mounting antivaccine infodemic and alleviate vaccine hesitancy. Objective: This work investigates (1) the changes in the public's attitude toward COVID-19 vaccines over time, (2) the effectiveness of COVID-19 vaccine fact-checking information on social media engagement and attitude change, and (3) the emotional and linguistic features of the COVID-19 vaccine fact-checking information ecosystem. Methods: We collected a data set of 12,553 COVID-19 vaccine fact-checking Facebook posts and their associated comments (N=122,362) from January 2020 to March 2022 and conducted a series of natural language processing and statistical analyses to investigate trends in public attitude toward the vaccine in COVID-19 vaccine fact-checking posts and comments, and emotional and linguistic features of the COVID-19 fact-checking information ecosystem. Results: The percentage of fact-checking posts relative to all COVID-19 vaccine posts peaked in May 2020 and then steadily decreased as the pandemic progressed (r=--0.92, df=21, t=--10.94, 95\% CI --0.97 to --0.82, P<.001). The salience of COVID-19 vaccine entities was significantly lower in comments (mean 0.03, SD 0.03, t=39.28, P<.001) than in posts (mean 0.09, SD 0.11). Third-party fact checkers have been playing a more important role in more fact-checking over time (r=0.63, df=25, t=4.06, 95\% CI 0.33-0.82, P<.001). COVID-19 vaccine fact-checking posts continued to be more analytical (r=0.81, df=25, t=6.88, 95\% CI 0.62-0.91, P<.001) and more confident (r=0.59, df=25, t=3.68, 95\% CI 0.27-0.79, P=.001) over time. Although comments did not exhibit a significant increase in confidence over time, tentativeness in comments significantly decreased (r=--0.62, df=25, t=--3.94, 95\% CI --0.81 to --0.31, P=.001). In addition, although hospitals receive less engagement than other information sources, the comments expressed more positive attitudinal valence in comments compared to other information sources (b=0.06, 95\% CI 0.00-0.12, t=2.03, P=.04). Conclusions: The percentage of fact-checking posts relative to all posts about the vaccine steadily decreased after May 2020. As the pandemic progressed, third-party fact checkers played a larger role in posting fact-checking COVID-19 vaccine posts. COVID-19 vaccine fact-checking posts continued to be more analytical and more confident over time, reflecting increased confidence in posts. Similarly, tentativeness in comments decreased; this likewise suggests that public uncertainty diminished over time. COVID-19 fact-checking vaccine posts from hospitals yielded more positive attitudes toward vaccination than other information sources. At the same time, hospitals received less engagement than other information sources. This suggests that hospitals should invest more in generating engaging public health campaigns on social media. ",
doi="10.2196/38423",
url="https://www.jmir.org/2022/6/e38423",
url="http://www.ncbi.nlm.nih.gov/pubmed/35671409"
}


@Article{info:doi/10.2196/37623,
author="Zhao, Yuehua
and Zhu, Sicheng
and Wan, Qiang
and Li, Tianyi
and Zou, Chun
and Wang, Hao
and Deng, Sanhong",
title="Understanding How and by Whom COVID-19 Misinformation is Spread on Social Media: Coding and Network Analyses",
journal="J Med Internet Res",
year="2022",
month="Jun",
day="20",
volume="24",
number="6",
pages="e37623",
keywords="health misinformation",
keywords="COVID-19",
keywords="social media",
keywords="misinformation spread",
keywords="infodemiology",
keywords="global health crisis",
keywords="misinformation",
keywords="theoretical model",
keywords="medical information",
keywords="epidemic",
keywords="pandemic",
abstract="Background: During global health crises such as the COVID-19 pandemic, rapid spread of misinformation on social media has occurred. The misinformation associated with COVID-19 has been analyzed, but little attention has been paid to developing a comprehensive analytical framework to study its spread on social media. Objective: We propose an elaboration likelihood model--based theoretical model to understand the persuasion process of COVID-19--related misinformation on social media. Methods: The proposed model incorporates the central route feature (content feature) and peripheral features (including creator authority, social proof, and emotion). The central-level COVID-19--related misinformation feature includes five topics: medical information, social issues and people's livelihoods, government response, epidemic spread, and international issues. First, we created a data set of COVID-19 pandemic--related misinformation based on fact-checking sources and a data set of posts that contained this misinformation on real-world social media. Based on the collected posts, we analyzed the dissemination patterns. Results: Our data set included 11,450 misinformation posts, with medical misinformation as the largest category (n=5359, 46.80\%). Moreover, the results suggest that both the least (4660/11,301, 41.24\%) and most (2320/11,301, 20.53\%) active users are prone to sharing misinformation. Further, posts related to international topics that have the greatest chance of producing a profound and lasting impact on social media exhibited the highest distribution depth (maximum depth=14) and width (maximum width=2355). Additionally, 97.00\% (2364/2437) of the spread was characterized by radiation dissemination. Conclusions: Our proposed model and findings could help to combat the spread of misinformation by detecting suspicious users and identifying propagation characteristics. ",
doi="10.2196/37623",
url="https://www.jmir.org/2022/6/e37623",
url="http://www.ncbi.nlm.nih.gov/pubmed/35671411"
}


@Article{info:doi/10.2196/38269,
author="Stokes-Parish, Jessica",
title="Navigating the Credibility of Web-Based Information During the COVID-19 Pandemic: Using Mnemonics to Empower the Public to Spot Red Flags in Health Information on the Internet",
journal="J Med Internet Res",
year="2022",
month="Jun",
day="17",
volume="24",
number="6",
pages="e38269",
keywords="science communication",
keywords="critical appraisal",
keywords="social media",
keywords="health literacy",
keywords="digital literacy",
keywords="misinformation",
keywords="COVID-19",
keywords="online health",
keywords="infodemic",
keywords="infodemiology",
doi="10.2196/38269",
url="https://www.jmir.org/2022/6/e38269",
url="http://www.ncbi.nlm.nih.gov/pubmed/35649183"
}


@Article{info:doi/10.2196/32718,
author="Oh, Jimin
and Bonett, Stephen
and Kranzler, C. Elissa
and Saconi, Bruno
and Stevens, Robin",
title="User- and Message-Level Correlates of Endorsement and Engagement for HIV-Related Messages on Twitter: Cross-sectional Study",
journal="JMIR Public Health Surveill",
year="2022",
month="Jun",
day="17",
volume="8",
number="6",
pages="e32718",
keywords="HIV prevention",
keywords="social media",
keywords="public health",
keywords="young adults",
keywords="LASSO",
keywords="HIV",
keywords="Twitter",
keywords="digital health",
abstract="Background: Youth and young adults continue to experience high rates of HIV and are also frequent users of social media. Social media platforms such as Twitter can bolster efforts to promote HIV prevention for these individuals, and while HIV-related messages exist on Twitter, little is known about the impact or reach of these messages for this population. Objective: This study aims to address this gap in the literature by identifying user and message characteristics that are associated with tweet endorsement (favorited) and engagement (retweeted) among youth and young men (aged 13-24 years). Methods: In a secondary analysis of data from a study of HIV-related messages posted by young men on Twitter, we used model selection techniques to examine user and tweet-level factors associated with tweet endorsement and engagement. Results: Tweets from personal user accounts garnered greater endorsement and engagement than tweets from institutional users (aOR 3.27, 95\% CI 2.75-3.89; P<.001). High follower count was associated with increased endorsement and engagement (aOR 1.05, 95\% CI 1.04-1.06; P<.001); tweets that discussed STIs garnered lower endorsement and engagement (aOR 0.59, 95\% CI 0.47-1.74; P<.001). Conclusions: Findings suggest practitioners should partner with youth to design and disseminate HIV prevention messages on social media, incorporate content that resonates with youth audiences, and work to challenge stigma and foster social norms conducive to open conversation about sex, sexuality, and health. ",
doi="10.2196/32718",
url="https://publichealth.jmir.org/2022/6/e32718",
url="http://www.ncbi.nlm.nih.gov/pubmed/35713945"
}


@Article{info:doi/10.2196/35266,
author="Li, Jingwei
and Huang, Wei
and Sia, Ling Choon
and Chen, Zhuo
and Wu, Tailai
and Wang, Qingnan",
title="Enhancing COVID-19 Epidemic Forecasting Accuracy by Combining Real-time and Historical Data From Multiple Internet-Based Sources: Analysis of Social Media Data, Online News Articles, and Search Queries",
journal="JMIR Public Health Surveill",
year="2022",
month="Jun",
day="16",
volume="8",
number="6",
pages="e35266",
keywords="SARS-CoV-2",
keywords="COVID 19",
keywords="epidemic forecasting",
keywords="disease surveillance",
keywords="infectious disease epidemiology",
keywords="social medial",
keywords="online news",
keywords="search query",
keywords="autoregression model",
abstract="Background: The SARS-COV-2 virus and its variants pose extraordinary challenges for public health worldwide. Timely and accurate forecasting of the COVID-19 epidemic is key to sustaining interventions and policies and efficient resource allocation. Internet-based data sources have shown great potential to supplement traditional infectious disease surveillance, and the combination of different Internet-based data sources has shown greater power to enhance epidemic forecasting accuracy than using a single Internet-based data source. However, existing methods incorporating multiple Internet-based data sources only used real-time data from these sources as exogenous inputs but did not take all the historical data into account. Moreover, the predictive power of different Internet-based data sources in providing early warning for COVID-19 outbreaks has not been fully explored. Objective: The main aim of our study is to explore whether combining real-time and historical data from multiple Internet-based sources could improve the COVID-19 forecasting accuracy over the existing baseline models. A secondary aim is to explore the COVID-19 forecasting timeliness based on different Internet-based data sources. Methods: We first used core terms and symptom-related keyword-based methods to extract COVID-19--related Internet-based data from December 21, 2019, to February 29, 2020. The Internet-based data we explored included 90,493,912 online news articles, 37,401,900 microblogs, and all the Baidu search query data during that period. We then proposed an autoregressive model with exogenous inputs, incorporating real-time and historical data from multiple Internet-based sources. Our proposed model was compared with baseline models, and all the models were tested during the first wave of COVID-19 epidemics in Hubei province and the rest of mainland China separately. We also used lagged Pearson correlations for COVID-19 forecasting timeliness analysis. Results: Our proposed model achieved the highest accuracy in all 5 accuracy measures, compared with all the baseline models of both Hubei province and the rest of mainland China. In mainland China, except for Hubei, the COVID-19 epidemic forecasting accuracy differences between our proposed model (model i) and all the other baseline models were statistically significant (model 1, t198=--8.722, P<.001; model 2, t198=--5.000, P<.001, model 3, t198=--1.882, P=.06; model 4, t198=--4.644, P<.001; model 5, t198=--4.488, P<.001). In Hubei province, our proposed model's forecasting accuracy improved significantly compared with the baseline model using historical new confirmed COVID-19 case counts only (model 1, t198=--1.732, P=.09). Our results also showed that Internet-based sources could provide a 2- to 6-day earlier warning for COVID-19 outbreaks. Conclusions: Our approach incorporating real-time and historical data from multiple Internet-based sources could improve forecasting accuracy for epidemics of COVID-19 and its variants, which may help improve public health agencies' interventions and resource allocation in mitigating and controlling new waves of COVID-19 or other relevant epidemics. ",
doi="10.2196/35266",
url="https://publichealth.jmir.org/2022/6/e35266",
url="http://www.ncbi.nlm.nih.gov/pubmed/35507921"
}


@Article{info:doi/10.2196/32912,
author="Gauld, Christophe
and Maquet, Julien
and Micoulaud-Franchi, Jean-Arthur
and Dumas, Guillaume",
title="Popular and Scientific Discourse on Autism: Representational Cross-Cultural Analysis of Epistemic Communities to Inform Policy and Practice",
journal="J Med Internet Res",
year="2022",
month="Jun",
day="15",
volume="24",
number="6",
pages="e32912",
keywords="autism spectrum disorder",
keywords="Twitter",
keywords="natural language processing",
keywords="network analysis",
keywords="popular understanding of illness",
keywords="knowledge translation",
keywords="autism",
keywords="tweets",
keywords="psychiatry",
keywords="text mining",
abstract="Background: Social media provide a window onto the circulation of ideas in everyday folk psychiatry, revealing the themes and issues discussed both by the public and by various scientific communities. Objective: This study explores the trends in health information about autism spectrum disorder within popular and scientific communities through the systematic semantic exploration of big data gathered from Twitter and PubMed. Methods: First, we performed a natural language processing by text-mining analysis and with unsupervised (machine learning) topic modeling on a sample of the last 10,000 tweets in English posted with the term \#autism (January 2021). We built a network of words to visualize the main dimensions representing these data. Second, we performed precisely the same analysis with all the articles using the term ``autism'' in PubMed without time restriction. Lastly, we compared the results of the 2 databases. Results: We retrieved 121,556 terms related to autism in 10,000 tweets and 5.7x109 terms in 57,121 biomedical scientific articles. The 4 main dimensions extracted from Twitter were as follows: integration and social support, understanding and mental health, child welfare, and daily challenges and difficulties. The 4 main dimensions extracted from PubMed were as follows: diagnostic and skills, research challenges, clinical and therapeutical challenges, and neuropsychology and behavior. Conclusions: This study provides the first systematic and rigorous comparison between 2 corpora of interests, in terms of lay representations and scientific research, regarding the significant increase in information available on autism spectrum disorder and of the difficulty to connect fragments of knowledge from the general population. The results suggest a clear distinction between the focus of topics used in the social media and that of scientific communities. This distinction highlights the importance of knowledge mobilization and exchange to better align research priorities with personal concerns and to address dimensions of well-being, adaptation, and resilience. Health care professionals and researchers can use these dimensions as a framework in their consultations to engage in discussions on issues that matter to beneficiaries and develop clinical approaches and research policies in line with these interests. Finally, our study can inform policy makers on the health and social needs and concerns of individuals with autism and their caregivers, especially to define health indicators based on important issues for beneficiaries. ",
doi="10.2196/32912",
url="https://www.jmir.org/2022/6/e32912",
url="http://www.ncbi.nlm.nih.gov/pubmed/35704359"
}


@Article{info:doi/10.2196/35804,
author="Goldberg, M. Elizabeth
and Rosen, K. Rochelle
and Dizon, S. Don
and Langdon, J. Kirsten
and Davoodi, M. Natalie
and Wray, B. Tyler
and Nugent, R. Nicole
and Dunsiger, I. Shira
and Ranney, L. Megan",
title="Using Social Media for Clinical Research: Recommendations and Examples From the Brown-Lifespan Center for Digital Health",
journal="J Med Internet Res",
year="2022",
month="Jun",
day="13",
volume="24",
number="6",
pages="e35804",
keywords="social media",
keywords="Twitter",
keywords="Facebook",
keywords="clinical research",
keywords="privacy",
keywords="institutional review board",
keywords="regulations",
keywords="regulation",
keywords="guideline",
keywords="big data",
doi="10.2196/35804",
url="https://www.jmir.org/2022/6/e35804",
url="http://www.ncbi.nlm.nih.gov/pubmed/35700012"
}


@Article{info:doi/10.2196/34525,
author="Ferrell, DaJuan
and Campos-Castillo, Celeste",
title="Factors Affecting Physicians' Credibility on Twitter When Sharing Health Information: Online Experimental Study",
journal="JMIR Infodemiology",
year="2022",
month="Jun",
day="13",
volume="2",
number="1",
pages="e34525",
keywords="source credibility",
keywords="user engagement",
keywords="social media",
keywords="health communication",
keywords="misinformation",
keywords="Twitter",
abstract="Background: Largely absent from research on how users appraise the credibility of professionals as sources for the information they find on social media is work investigating factors shaping credibility within a specific profession, such as physicians. Objective: We address debates about how physicians can show their credibility on social media depending on whether they employ a formal or casual appearance in their profile picture. Using prominence-interpretation theory, we posit that formal appearance will affect perceived credibility based on users' social context---specifically, whether they have a regular health care provider. Methods: For this experiment, we recruited 205 social media users using Amazon Mechanical Turk. We asked participants if they had a regular health care provider and then randomly assigned them to read 1 of 3 Twitter posts that varied only in the profile picture of the physician offering health advice. Next, we tasked participants with assessing the credibility of the physician and their likelihood of engaging with the tweet and the physician on Twitter. We used path analysis to assess whether participants having a regular health care provider impacted how the profile picture affected their ratings of the physician's credibility and their likelihood to engage with the tweet and physician on Twitter. Results: We found that the profile picture of a physician posting health advice in either formal or casual attire did not elicit significant differences in credibility, with ratings comparable to those having no profile image. Among participants assigned the formal appearance condition, those with a regular provider rated the physician higher on a credibility than those without, which led to stronger intentions to engage with the tweet and physician. Conclusions: The findings add to existing research by showing how the social context of information seeking on social media shapes the credibility of a given professional. Practical implications for professionals engaging with the public on social media and combating false information include moving past debates about casual versus formal appearances and toward identifying ways to segment audiences based on factors like their backgrounds (eg, experiences with health care providers). ",
doi="10.2196/34525",
url="https://infodemiology.jmir.org/2022/1/e34525",
url="http://www.ncbi.nlm.nih.gov/pubmed/37113807"
}


@Article{info:doi/10.2196/35930,
author="Chauhan, Jyoti
and Aasaithambi, Sathyaraj
and M{\'a}rquez-Rodas, Iv{\'a}n
and Formisano, Luigi
and Papa, Sophie
and Meyer, Nicolas
and Forschner, Andrea
and Faust, Guy
and Lau, Mike
and Sagkriotis, Alexandros",
title="Understanding the Lived Experiences of Patients With Melanoma: Real-World Evidence Generated Through a European Social Media Listening Analysis",
journal="JMIR Cancer",
year="2022",
month="Jun",
day="13",
volume="8",
number="2",
pages="e35930",
keywords="melanoma",
keywords="social media",
keywords="social media listening",
keywords="real-world evidence",
keywords="patient journey",
keywords="cancer",
keywords="mortality rate",
keywords="health information",
abstract="Background: Cutaneous melanoma is an aggressive malignancy that is proposed to account for 90\% of skin cancer--related mortality. Individuals with melanoma experience both physical and psychological impacts associated with their diagnosis and treatment. Health-related information is being increasingly accessed and shared by stakeholders on social media platforms. Objective: This study aimed to assess how individuals living with melanoma across 14 European countries use social media to discuss their needs and provide their perceptions of the disease. Methods: Social media sources including Twitter, forums, and blogs were searched using predefined search strings of keywords relating to melanoma. Manual and automated relevancy approaches filtered the extracted data for content that provided patient-centric insights. This contextualized data was then mined for insightful concepts around the symptoms, diagnosis, treatment, impacts, and lived experiences of melanoma. Results: A total of 182,400 posts related to melanoma were identified between November 2018 and November 2020. Following exclusion of irrelevant posts and using random sampling methodology, 864 posts were identified as relevant to the study objectives. Of the social media channels included, Twitter was the most commonly used, followed by forums and blogs. Most posts originated from the United Kingdom (n=328, 38\%) and Spain (n=138, 16\%). Of the relevant posts, 62\% (n=536) were categorized as originating from individuals with melanoma. The most frequently discussed melanoma-related topics were treatment (436/792, 55\%), diagnosis and tests (261/792, 33\%), and remission (190/792, 24\%). The majority of treatment discussions were about surgery (292/436, 67\%), followed by immunotherapy (52/436, 12\%). In total, 255 posts discussed the impacts of melanoma, which included emotional burden (n=179, 70\%), physical impacts (n=61, 24\%), effects on social life (n=43, 17\%), and financial impacts (n=10, 4\%). Conclusions: Findings from this study highlight how melanoma stakeholders discuss key concepts associated with the condition on social media, adding to the conceptual model of the patient journey. This social media listening approach is a powerful tool for exploring melanoma stakeholder perspectives, providing insights that can be used to corroborate existing data and inform future studies. ",
doi="10.2196/35930",
url="https://cancer.jmir.org/2022/2/e35930",
url="http://www.ncbi.nlm.nih.gov/pubmed/35699985"
}


@Article{info:doi/10.2196/33170,
author="Kelly, Jennifer Katherine
and Doucet, Shelley
and Luke, Alison
and Azar, Rima
and Montelpare, William",
title="Exploring the Use of a Facebook-Based Support Group for Caregivers of Children and Youth With Complex Care Needs: Qualitative Descriptive Study",
journal="JMIR Pediatr Parent",
year="2022",
month="Jun",
day="7",
volume="5",
number="2",
pages="e33170",
keywords="peer-to-peer support",
keywords="children",
keywords="youth",
keywords="complex care needs",
keywords="social media",
keywords="social support",
abstract="Background: Caregivers of children and youth with complex care needs (CCN) require substantial support to ensure the well-being of their families. Web-based peer-to-peer (P2P) support groups present an opportunity for caregivers to seek and provide timely informational and emotional support. Despite the widespread use of social media for health-related support across diverse patient and caregiver populations, it is unclear how caregivers of children and youth with CCN use and potentially benefit from these groups. Objective: The aim of this study is to explore the use of a web-based P2P support group for caregivers of children and youth with CCN in New Brunswick, Canada, and investigate factors related to its use by members. Methods: The study sample consisted of individuals who joined a closed Facebook group and an analysis of content published to the group. In phase 1, a Facebook group was developed in consultation with a patient and family advisory council, and members were recruited to the group. Phase 2 of this study consisted of an observation period during which posts and related interactions (ie, likes, loves, and comments) by members were collected. In phase 3, a web-based survey was distributed, and semistructured interviews were conducted with a subsample of group members. Survey and interview data were analyzed using thematic analysis. Results: A total of 108 caregivers joined the Facebook group between October 2020 and March 2021. There were 93 posts with 405 comments and 542 associated interactions (448/542, 82.7\% likes and 94/542, 17.3\% loves). Of these 93 posts, 37 (40\%) were made by group members, and 56 (60\%) were made by moderators. Of the 108 members, a subsample of 39 (36.1\%) completed a web-based survey, and 14 (13\%) participated in the interviews. Content analyses of posts by members revealed that inquiry (17/37, 46\%), informational (15/37, 41\%), and emotional posts (4/37, 11\%) were the most common. Emotional posts received the highest number of interactions (median 24.5). In total, 5 themes emerged from the interviews related to the use of the group and mediating factors of interactions between group members: resource for information, altruistic contribution, varying level of engagement, perceived barriers to and facilitators of group activity, and moderators as contributing members. Conclusions: These findings demonstrate that caregivers of children and youth with CCN seek geography-specific P2P support groups to meet informational and social support needs. This study contributes to the knowledge on how caregivers use Facebook groups to meet their support needs through moderate and passive engagement. ",
doi="10.2196/33170",
url="https://pediatrics.jmir.org/2022/2/e33170",
url="http://www.ncbi.nlm.nih.gov/pubmed/35671082"
}


@Article{info:doi/10.2196/37840,
author="Watanabe, Tomomi
and Yada, Shuntaro
and Aramaki, Eiji
and Yajima, Hiroshi
and Kizaki, Hayato
and Hori, Satoko",
title="Extracting Multiple Worries From Breast Cancer Patient Blogs Using Multilabel Classification With the Natural Language Processing Model Bidirectional Encoder Representations From Transformers: Infodemiology Study of Blogs",
journal="JMIR Cancer",
year="2022",
month="Jun",
day="3",
volume="8",
number="2",
pages="e37840",
keywords="breast neoplasm",
keywords="cancer",
keywords="natural language processing",
keywords="NLP",
keywords="artificial intelligence",
keywords="model",
keywords="machine learning",
keywords="content analysis",
keywords="text mining",
keywords="sentiment analysis",
keywords="oncology",
keywords="quality of life",
keywords="social media",
keywords="social support",
keywords="breast cancer",
keywords="BERT model",
keywords="peer support",
keywords="blog post",
keywords="patient data",
abstract="Background: Patients with breast cancer have a variety of worries and need multifaceted information support. Their accumulated posts on social media contain rich descriptions of their daily worries concerning issues such as treatment, family, and finances. It is important to identify these issues to help patients with breast cancer to resolve their worries and obtain reliable information. Objective: This study aimed to extract and classify multiple worries from text generated by patients with breast cancer using Bidirectional Encoder Representations From Transformers (BERT), a context-aware natural language processing model. Methods: A total of 2272 blog posts by patients with breast cancer in Japan were collected. Five worry labels, ``treatment,'' ``physical,'' ``psychological,'' ``work/financial,'' and ``family/friends,'' were defined and assigned to each post. Multiple labels were allowed. To assess the label criteria, 50 blog posts were randomly selected and annotated by two researchers with medical knowledge. After the interannotator agreement had been assessed by means of Cohen kappa, one researcher annotated all the blogs. A multilabel classifier that simultaneously predicts five worries in a text was developed using BERT. This classifier was fine-tuned by using the posts as input and adding a classification layer to the pretrained BERT. The performance was evaluated for precision using the average of 5-fold cross-validation results. Results: Among the blog posts, 477 included ``treatment,'' 1138 included ``physical,'' 673 included ``psychological,'' 312 included ``work/financial,'' and 283 included ``family/friends.'' The interannotator agreement values were 0.67 for ``treatment,'' 0.76 for ``physical,'' 0.56 for ``psychological,'' 0.73 for ``work/financial,'' and 0.73 for ``family/friends,'' indicating a high degree of agreement. Among all blog posts, 544 contained no label, 892 contained one label, and 836 contained multiple labels. It was found that the worries varied from user to user, and the worries posted by the same user changed over time. The model performed well, though prediction performance differed for each label. The values of precision were 0.59 for ``treatment,'' 0.82 for ``physical,'' 0.64 for ``psychological,'' 0.67 for ``work/financial,'' and 0.58 for ``family/friends.'' The higher the interannotator agreement and the greater the number of posts, the higher the precision tended to be. Conclusions: This study showed that the BERT model can extract multiple worries from text generated from patients with breast cancer. This is the first application of a multilabel classifier using the BERT model to extract multiple worries from patient-generated text. The results will be helpful to identify breast cancer patients' worries and give them timely social support. ",
doi="10.2196/37840",
url="https://cancer.jmir.org/2022/2/e37840",
url="http://www.ncbi.nlm.nih.gov/pubmed/35657664"
}


@Article{info:doi/10.2196/33577,
author="Li, Peiyi
and Chen, Bo
and Deveaux, Genevieve
and Luo, Yunmei
and Tao, Wenjuan
and Li, Weimin
and Wen, Jin
and Zheng, Yuan",
title="Cross-Verification of COVID-19 Information Obtained From Unofficial Social Media Accounts and Associated Changes in Health Behaviors: Web-Based Questionnaire Study Among Chinese Netizens",
journal="JMIR Public Health Surveill",
year="2022",
month="May",
day="31",
volume="8",
number="5",
pages="e33577",
keywords="COVID-19",
keywords="pandemic",
keywords="social media",
keywords="behavior change",
keywords="information cross-verification",
keywords="eHealth literacy",
abstract="Background: As social media platforms have become significant sources of information during the pandemic, a significant volume of both factual and inaccurate information related to the prevention of COVID-19 has been disseminated through social media. Thus, disparities in COVID-19 information verification across populations have the potential to promote the dissemination of misinformation among clustered groups of people with similar characteristics. Objective: This study aimed to identify the characteristics of social media users who obtained COVID-19 information through unofficial social media accounts and were (1) most likely to change their health behaviors according to web-based information and (2) least likely to actively verify the accuracy of COVID-19 information, as these individuals may be susceptible to inaccurate prevention measures and may exacerbate transmission. Methods: An online questionnaire consisting of 17 questions was disseminated by West China Hospital via its official online platforms, between May 18, 2020, and May 31, 2020. The questionnaire collected the sociodemographic information of 14,509 adults, and included questions surveying Chinese netizens' knowledge about COVID-19, personal social media use, health behavioral change tendencies, and cross-verification behaviors for web-based information during the pandemic. Multiple stepwise regression models were used to examine the relationships between social media use, behavior changes, and information cross-verification. Results: Respondents who were most likely to change their health behaviors after obtaining web-based COVID-19 information from celebrity sources had the following characteristics: female sex (P=.004), age ?50 years (P=.009), higher COVID-19 knowledge and health literacy (P=.045 and P=.03, respectively), non--health care professional (P=.02), higher frequency of searching on social media (P<.001), better health conditions (P<.001), and a trust rating score of more than 3 for information released by celebrities on social media (P=.005). Furthermore, among participants who were most likely to change their health behaviors according to social media information released by celebrities, female sex (P<.001), living in a rural residence rather than first-tier city (P<.001), self-reported medium health status and lower health care literacy (P=.007 and P<.001, respectively), less frequent search for COVID-19 information on social media (P<.001), and greater level of trust toward celebrities' social media accounts with a trust rating score greater than 1 (P?.04) were associated with a lack of cross-verification of information. Conclusions: The findings suggest that governments, health care agencies, celebrities, and technicians should combine their efforts to decrease the risk in vulnerable groups that are inclined to change health behaviors according to web-based information but do not perform any fact-check verification of the accuracy of the unofficial information. Specifically, it is necessary to correct the false information related to COVID-19 on social media, appropriately apply celebrities' star power, and increase Chinese netizens' awareness of information cross-verification and eHealth literacy for evaluating the veracity of web-based information. ",
doi="10.2196/33577",
url="https://publichealth.jmir.org/2022/5/e33577",
url="http://www.ncbi.nlm.nih.gov/pubmed/35486529"
}


@Article{info:doi/10.2196/36239,
author="Cirillo, N. Madison
and Halbert, P. Jennifer
and Smith, Gomez Jessica
and Alamiri, Sami Nour
and Ingersoll, S. Karen",
title="\#BingeDrinking---Using Social Media to Understand College Binge Drinking: Qualitative Study",
journal="JMIR Hum Factors",
year="2022",
month="May",
day="30",
volume="9",
number="2",
pages="e36239",
keywords="college students",
keywords="binge drinking",
keywords="social media",
keywords="young adults",
abstract="Background: Hazardous drinking among college students persists, despite ongoing university alcohol education and alcohol intervention programs. College students often post comments or pictures of drinking episodes on social media platforms. Objective: This study aimed to understand one university's student attitudes toward alcohol use by examining student posts about drinking on social media platforms and to identify opportunities to reduce alcohol-related harm and inform novel alcohol interventions. Methods: We analyzed social media posts from 7 social media platforms using qualitative inductive coding based on grounded theory to identify the contexts of student drinking and the attitudes and behaviors of students and peers during drinking episodes. We reviewed publicly available social media posts that referenced alcohol, collaborating with undergraduate students to select their most used platforms and develop locally relevant search terms; all posts in our data set were generated by students associated with a specific university. From the codes, we derived themes about student culture regarding alcohol use. Results: In total, 1151 social media posts were included in this study. These included 809 Twitter tweets, 113 Instagram posts, 100 Greekrank posts, 64 Reddit posts, 34 College Confidential posts, 23 Facebook posts, and 8 YouTube posts. Posts included both implicit and explicit portrayals of alcohol use. Across all types of posts reviewed, positive drinking attitudes were most common, followed by negative and then neutral attitudes, but valence varied by platform. Posts that portrayed drinking positively received positive peer feedback and indicate that drinking is viewed by students as an essential and positive part of university student culture. Conclusions: Social media provide a real-time picture of students' behavior during their own and others' heavy drinking. Posts portray heavy drinking as a normal part of student culture, reinforced by peers' positive feedback on posts. Interventions for college drinking should help students manage alcohol intake in real time, provide safety information during alcohol use episodes, and raise student awareness of web-based privacy concerns and reputation management. Additional interventions for students, alumni, and parents are needed to address positive attitudes about and traditions of drinking. ",
doi="10.2196/36239",
url="https://humanfactors.jmir.org/2022/2/e36239",
url="http://www.ncbi.nlm.nih.gov/pubmed/35635740"
}


@Article{info:doi/10.2196/33291,
author="Clancy, Brigid
and Bonevski, Billie
and English, Coralie
and Baker, L. Amanda
and Turner, Alyna
and Magin, Parker
and Pollack, Michael
and Callister, Robin
and Guillaumier, Ashleigh",
title="Access to and Use of Internet and Social Media by Low-Morbidity Stroke Survivors Participating in a National Web-Based Secondary Stroke Prevention Trial: Cross-sectional Survey",
journal="J Med Internet Res",
year="2022",
month="May",
day="30",
volume="24",
number="5",
pages="e33291",
keywords="stroke",
keywords="stroke survivor",
keywords="recurrent stroke",
keywords="digital health",
keywords="social media",
keywords="internet use",
keywords="eHealth",
keywords="information-seeking behavior",
keywords="web-based",
keywords="mobile phone",
abstract="Background: eHealth applications for stroke are a growing area of research that has yielded promising results. However, little is known about how stroke survivors engage with the internet, social media, and other digital technologies on a day-to-day basis. Objective: This study had three main objectives: to describe the type, frequency, and purpose of technology use among a cohort of low-morbidity stroke survivors; to investigate associations between social media use and participant factors, including sociodemographics, physical function, and independence in activities of daily living; and to investigate associations between stroke-related health risk factors and the use of the internet to search for health and medical information. Methods: This study is a secondary analysis of data obtained during a national randomized controlled trial---Prevent 2nd Stroke. The participants were stroke survivors recruited from 2 Australian stroke registries who completed 2 telephone-administered surveys to collect data on demographics and stroke characteristics; health risk factors (diet quality, physical activity, blood pressure medication, alcohol intake, anxiety and depression, and smoking status); physical functioning; independence in activities of daily living; and questions about what technology they had access to, how often they used it, and for what purposes. Participants were eligible if they had no more than a moderate level of disability (modified Rankin score ?3) and had access to the internet. Multivariable logistic regression was used to assess the associations between social media use and sociodemographics, physical function, and independence in activities of daily living as well as associations between stroke-related health risk factors and the use of the internet to search for health and medical information. Results: Data from 354 participants were included in the analysis. Approximately 79.1\% (280/354) of participants used the internet at least daily, 40.8\% (118/289) accessed social media on their phone or tablet daily, and 46.4\% (134/289) looked up health and medical information at least monthly. Women were 2.7 times more likely to use social media (adjusted odds ratio 2.65, 95\% CI 1.51-4.72), and people aged >75 years were significantly less likely to use social media compared with those aged <55 years (adjusted odds ratio 0.17, 95\% CI 0.07-0.44). Health risk factors were not found to be associated with searching for health- or medical-related information. Conclusions: The internet appears to be a viable platform to engage with stroke survivors who may not be high-morbidity to conduct research and provide information and health interventions. This is important given that they are at high risk of recurrent stroke regardless of their level of disability. Exploring the technology use behaviors and the possibility of eHealth among survivors who experience higher levels of morbidity or disability because of their stroke is an area of research that warrants further study. ",
doi="10.2196/33291",
url="https://www.jmir.org/2022/5/e33291",
url="http://www.ncbi.nlm.nih.gov/pubmed/35635754"
}


@Article{info:doi/10.2196/39450,
author="Perkins, C. Ryan
and Sawicki, S. Gregory",
title="Author Reply to: Empowering Without Misinforming Adolescents and Young Adults with Cystic Fibrosis. Comment on ``Perceptions of Social Media Use to Augment Health Care Among Adolescents and Young Adults With Cystic Fibrosis: Survey Study''",
journal="JMIR Pediatr Parent",
year="2022",
month="May",
day="25",
volume="5",
number="2",
pages="e39450",
keywords="Cystic fibrosis",
keywords="Social media",
keywords="mobile health",
keywords="adherence",
keywords="adolescents",
keywords="young adults",
keywords="Medical misinformation",
doi="10.2196/39450",
url="https://pediatrics.jmir.org/2022/2/e39450",
url="http://www.ncbi.nlm.nih.gov/pubmed/35612884"
}


@Article{info:doi/10.2196/33457,
author="Thumber, Navandeep
and Bhandari, Prerana",
title="Empowering Without Misinforming Adolescents and Young Adults with Cystic Fibrosis. Comment on ``Perceptions of Social Media Use to Augment Health Care Among Adolescents and Young Adults With Cystic Fibrosis: Survey Study''",
journal="JMIR Pediatr Parent",
year="2022",
month="May",
day="25",
volume="5",
number="2",
pages="e33457",
keywords="cystic fibrosis",
keywords="social media",
keywords="mobile health",
keywords="adherence",
keywords="adolescents",
keywords="young adults",
keywords="medical misinformation",
doi="10.2196/33457",
url="https://pediatrics.jmir.org/2022/2/e33457",
url="http://www.ncbi.nlm.nih.gov/pubmed/35612889"
}


@Article{info:doi/10.2196/37415,
author="Ahmed, Fahad
and Ogidi, Princess
and Shareef, Omar
and Lipoff, Jules",
title="Lack of Skin of Color Representation in Dermatology-Related Instagram Posts: Content Analysis",
journal="JMIR Dermatol",
year="2022",
month="May",
day="24",
volume="5",
number="2",
pages="e37415",
keywords="skin of color",
keywords="Instagram",
keywords="dermatology",
keywords="eHealth",
keywords="skin photographs",
keywords="social media",
keywords="skin condition",
keywords="skin",
keywords="health information",
keywords="skin care",
keywords="content",
keywords="information",
keywords="representation",
keywords="photo",
keywords="posts",
doi="10.2196/37415",
url="https://derma.jmir.org/2022/2/e37415",
url="http://www.ncbi.nlm.nih.gov/pubmed/37632868"
}


@Article{info:doi/10.2196/28063,
author="Friedman, J. Vanessa
and Wright, C. Cassandra J.
and Molenaar, Annika
and McCaffrey, Tracy
and Brennan, Linda
and Lim, C. Megan S.",
title="The Use of Social Media as a Persuasive Platform to Facilitate Nutrition and Health Behavior Change in Young Adults: Web-Based Conversation Study",
journal="J Med Internet Res",
year="2022",
month="May",
day="18",
volume="24",
number="5",
pages="e28063",
keywords="young adults",
keywords="nutrition",
keywords="physical activity",
keywords="mental health",
keywords="social media",
keywords="qualitative methods",
keywords="health promotion",
abstract="Background: Globally, suboptimal dietary choices are a leading cause of noncommunicable diseases. Evidence for effective interventions to address these behaviors, particularly in young adults, is limited. Given the substantial time young adults spend in using social media, there is interest in understanding the current and potential role of these platforms in shaping dietary behavior. Objective: This study aims to explore the influence of social media on young adults' dietary behaviors. Methods: We recruited 234 young adults aged 18-24 years and living in Australia, using market and social research panels. We applied a digital ethnography approach to collect data from web-based conversations in a series of forums, where participants responded to different health-themed questions related to health behavior change and persuasion on social media. We conducted a qualitative thematic analysis. Results: Participants described how social media influenced their decisions to change their health behaviors. Access to social support and health information through web-based communities was juxtaposed with exposure to highly persuasive fast-food advertisements. Some participants expressed that exposure to web-based health-focused content induced feelings of guilt about their behavior, which was more prominent among women. Fast-food advertisements were discussed as a contributor to poor health behaviors and indicated as a major barrier to change. Conclusions: Young adults reported that social media is highly persuasive toward dietary behavior through different pathways of social influence. This suggests that social norms on the web are an important aspect of changing young adults' health behaviors. The commercialization of social media also encourages poor health behaviors, largely through fast-food advertisements. Future social media--delivered dietary interventions should acknowledge the social and environmental factors that challenge the ability of young adults to make individual health behavior improvements. Care should also be taken to ensure that future interventions do not further elicit guilt in a way that contributes to poor mental health within this community. ",
doi="10.2196/28063",
url="https://www.jmir.org/2022/5/e28063",
url="http://www.ncbi.nlm.nih.gov/pubmed/35583920"
}


@Article{info:doi/10.2196/35244,
author="Andreou, Andreas
and Dhand, Amar
and Vassilev, Ivaylo
and Griffiths, Chris
and Panzarasa, Pietro
and De Simoni, Anna",
title="Understanding Online and Offline Social Networks in Illness Management of Older Patients With Asthma and Chronic Obstructive Pulmonary Disease: Mixed Methods Study Using Quantitative Social Network Assessment and Qualitative Analysis",
journal="JMIR Form Res",
year="2022",
month="May",
day="17",
volume="6",
number="5",
pages="e35244",
keywords="social networks",
keywords="asthma",
keywords="COPD",
keywords="self-management",
keywords="elderly",
keywords="online health communities",
keywords="online forums",
keywords="digital health",
keywords="mobile phone",
abstract="Background: Individuals' social networks and social support are fundamental determinants of self-management and self-efficacy. In chronic respiratory conditions, social support can be promoted and optimized to facilitate the self-management of breathlessness. Objective: This study aimed to identify how online and offline social networks play a role in the health management of older patients with chronic respiratory conditions, explore the role of support from online peers in patients' self-management, and understand the barriers to and potential benefits of digital social interventions. Methods: We recruited participants from a hospital-run singing group to a workshop in London, the United Kingdom, and adapted PERSNET, a quantitative social network assessment tool. The second workshop was replaced by telephone interviews because of the COVID-19 lockdown. The transcripts were analyzed using thematic analysis. Results: A total of 7 participants (2/7, 29\%, men and 5/7, 71\%, women), with an age range of 64 to 81 years, produced network maps that comprised between 5 and 10 individuals, including family members, health care professionals, colleagues, activity groups, offline and online friends, and peers. The visual maps facilitated reflections and enhanced participants' understanding of the role of offline and online social networks in the management of chronic respiratory conditions. It also highlighted the work undertaken by the networks themselves in the self-management support. Participants with small, close-knit networks received physical, health, and emotional support, whereas those with more diverse and large networks benefited from accessing alternative and complementary sources of information. Participants in the latter type of network tended to communicate more openly and comfortably about their illness, shared the impact of their illness on their day-to-day life, and demonstrated distinct traits in terms of identity and perception of chronic disease. Participants described the potential benefits of expanding their networks to include online peers as sources of novel information, motivation, and access to supportive environments. Lack of technological skills, fear of being scammed, or preference for keeping illness-related problems for themselves and immediate family were reported by some as barriers to engaging with online peer support. Conclusions: In this small-scale study, the social network assessment tool proved feasible and acceptable. These data show the value of using a social network tool as a research tool that can help assess and understand network structure and engagement in the self-management support and could be developed into an intervention to support self-management. Patients' preferences to share illness experiences with their online peers, as well as the contexts in which this can be acceptable, should be considered when developing and offering digital social interventions. Future studies can explore the evolution of the social networks of older people with chronic illnesses to understand whether their willingness to engage with online peers can change over time. ",
doi="10.2196/35244",
url="https://formative.jmir.org/2022/5/e35244",
url="http://www.ncbi.nlm.nih.gov/pubmed/35579933"
}


@Article{info:doi/10.2196/37546,
author="Chidambaram, Swathikan
and Maheswaran, Yathukulan
and Chan, Calvin
and Hanna, Lydia
and Ashrafian, Hutan
and Markar, R. Sheraz
and Sounderajah, Viknesh
and Alverdy, C. John
and Darzi, Ara",
title="Misinformation About the Human Gut Microbiome in YouTube Videos: Cross-sectional Study",
journal="JMIR Form Res",
year="2022",
month="May",
day="16",
volume="6",
number="5",
pages="e37546",
keywords="microbiome",
keywords="social media",
keywords="YouTube",
keywords="misinformation",
keywords="content analysis",
keywords="gut health",
keywords="public",
abstract="Background: Social media platforms such as YouTube are integral tools for disseminating information about health and wellness to the public. However, anecdotal reports have cited that the human gut microbiome has been a particular focus of dubious, misleading, and, on occasion, harmful media content. Despite these claims, there have been no published studies investigating this phenomenon within popular social media platforms. Objective: The aim of this study is to (1) evaluate the accuracy and reliability of the content in YouTube videos related to the human gut microbiome and (2) investigate the correlation between content engagement metrics and video quality, as defined by validated criteria. Methods: In this cross-sectional study, videos about the human gut microbiome were searched for on the United Kingdom version of YouTube on September 20, 2021. The 600 most-viewed videos were extracted and screened for relevance. The contents and characteristics of the videos were extracted and independently rated using the DISCERN quality criteria by 2 researchers. Results: Overall, 319 videos accounting for 62,354,628 views were included. Of the 319 videos, 73.4\% (n=234) were produced in North America and 78.7\% (n=251) were uploaded between 2019 and 2021. A total of 41.1\% (131/319) of videos were produced by nonprofit organizations. Of the videos, 16.3\% (52/319) included an advertisement for a product or promoted a health-related intervention for financial purposes. Videos by nonmedical education creators had the highest total and preferred viewership. Daily viewership was the highest for videos by internet media sources. The average DISCERN and Health on the Net Foundation Code of Conduct scores were 49.5 (SE 0.68) out of 80 and 5.05 (SE 2.52) out of 8, respectively. DISCERN scores for videos by medical professionals (mean 53.2, SE 0.17) were significantly higher than for videos by independent content creators (mean 39.1, SE 5.58; P<.001). Videos including promotional materials had significantly lower DISCERN scores than videos without any advertisements or product promotion (P<.001). There was no correlation between DISCERN scores and total viewership, daily viewership, or preferred viewership (number of likes). Conclusions: The overall quality and reliability of information about the human gut microbiome on YouTube is generally poor. Moreover, there was no correlation between the quality of a video and the level of public engagement. The significant disconnect between reliable sources of information and the public suggests that there is an immediate need for cross-sector initiatives to safeguard vulnerable viewers from the potentially harmful effects of misinformation. ",
doi="10.2196/37546",
url="https://formative.jmir.org/2022/5/e37546",
url="http://www.ncbi.nlm.nih.gov/pubmed/35576578"
}


@Article{info:doi/10.2196/34073,
author="Faust, Guy
and Booth, Alison
and Merinopoulou, Evie
and Halhol, Sonia
and Tosar, Heena
and Nawaz, Amir
and Szlachetka, Magdalena
and Chiu, Gavin",
title="The Experiences of Patients With Adjuvant and Metastatic Melanoma Using Disease-Specific Social Media Communities in the Advent of Novel Therapies (Excite Project): Social Media Listening Study",
journal="JMIR Cancer",
year="2022",
month="May",
day="13",
volume="8",
number="2",
pages="e34073",
keywords="health-related social media",
keywords="patient-centric",
keywords="melanoma",
keywords="adjuvant",
keywords="metastatic",
keywords="immunotherapy",
keywords="targeted therapy",
keywords="natural language processing",
keywords="patient experience",
keywords="cancer",
keywords="cancer therapy",
keywords="patient perspective",
keywords="social media",
keywords="caregiver experience",
abstract="Background: Immunotherapy and targeted therapy treatments are novel treatments available for patients with metastatic and adjuvant melanoma. As recently approved treatments, information surrounding the patients' and caregivers' experience with these therapies, perceptions of treatments, and the effect the treatments have on their day-to-day life are lacking. Such insights would be valuable for any future decision-making with regard to treatment options. Objective: This study aims to use health-related social media data to understand the experience of patients with adjuvant and metastatic melanoma who are receiving either immunotherapy or targeted therapies. This study also included caregivers' perspectives. Methods: Publicly available social media forum posts by patients with self-reported adjuvant or metastatic melanoma (and their caregivers) between January 2014 to October 2019 were programmatically extracted, deidentified, cleaned, and analyzed using a combination of natural language processing and qualitative data analyses. This study identified spontaneously reported symptoms and their impacts, symptom duration, and the impact of treatment for both treatment groups. Results: Overall, 1037 users (9023 posts) and 114 users (442 posts) were included in the metastatic group and adjuvant group, respectively. The most identified symptoms in both groups were fatigue, pain, or exanthema (identified in 5\%-43\% of patients dependent on the treatment group). Symptom impacts reported by both groups were physical impacts, impacts on family, and impacts on work. Positive treatment impacts were reported in both groups and covered the areas of work, social and family life, and general health and quality of life. Conclusions: This study explored health-related social media to better understand the experience and perspectives of patients with melanoma receiving immunotherapy or targeted therapy treatments as well as the experience of their caregivers. This exploratory work uncovered the most discussed concerns among patients and caregivers on the forums including symptoms and their impacts, thus contributing to a deeper understanding of the patient/caregiver experience. ",
doi="10.2196/34073",
url="https://cancer.jmir.org/2022/2/e34073",
url="http://www.ncbi.nlm.nih.gov/pubmed/35559986"
}


@Article{info:doi/10.2196/36858,
author="Douglass, H. Caitlin
and Borthwick, Aidan
and Lim, C. Megan S.
and Erbas, Bircan
and Eren, Senem
and Higgs, Peter",
title="Social Media and Online Digital Technology Use Among Muslim Young People and Parents: Qualitative Focus Group Study",
journal="JMIR Pediatr Parent",
year="2022",
month="May",
day="10",
volume="5",
number="2",
pages="e36858",
keywords="Muslim",
keywords="social media",
keywords="young adult",
keywords="qualitative research",
keywords="social connection",
keywords="parenting",
keywords="pediatrics",
keywords="digital health",
keywords="youth",
keywords="adolescent",
keywords="parent",
keywords="digital technology",
keywords="user experience",
keywords="mental health",
keywords="psychological effect",
keywords="diverse population",
keywords="COVID-19",
abstract="Background: Digital technology and social media use are common among young people in Australia and worldwide. Research suggests that young people have both positive and negative experiences online, but we know little about the experiences of Muslim communities. Objective: This study aims to explore the positive and negative experiences of digital technology and social media use among young people and parents from Muslim backgrounds in Melbourne, Victoria, Australia. Methods: This study involved a partnership between researchers and a not-for-profit organization that work with culturally and linguistically diverse communities. We adopted a participatory and qualitative approach and designed the research in consultation with young people from Muslim backgrounds. Data were collected through in-person and online focus groups with 33 young people aged 16-22 years and 15 parents aged 40-57 years. Data were thematically analyzed. Results: We generated 3 themes: (1) maintaining local and global connections, (2) a paradoxical space: identity, belonging and discrimination, and (3) the digital divide between young Muslims and parents. Results highlighted that social media was an important extension of social and cultural connections, particularly during COVID-19, when people were unable to connect through school or places of worship. Young participants perceived social media as a space where they could establish their identity and feel a sense of belonging. However, participants were also at risk of being exposed to discrimination and unrealistic standards of beauty and success. Although parents and young people shared some similar concerns, there was a large digital divide in online experiences. Both groups implemented strategies to reduce social media use, with young people believing that having short technology-free breaks during prayer and quality family time was beneficial for their mental well-being. Conclusions: Programs that address technology-related harms must acknowledge the benefits of social media for young Muslims across identity, belonging, representation, and social connection. Further research is required to understand how parents and young people can create environments that foster technology-free breaks to support mental well-being. ",
doi="10.2196/36858",
url="https://pediatrics.jmir.org/2022/2/e36858",
url="http://www.ncbi.nlm.nih.gov/pubmed/35536616"
}


@Article{info:doi/10.2196/31739,
author="Kaushal, Aradhna
and Bravo, Caroline
and Duffy, Stephen
and Lewins, Douglas
and M{\"o}hler, Ralph
and Raine, Rosalind
and Vlaev, Ivo
and Waller, Jo
and von Wagner, Christian",
title="Developing Reporting Guidelines for Social Media Research (RESOME) by Using a Modified Delphi Method: Protocol for Guideline Development",
journal="JMIR Res Protoc",
year="2022",
month="May",
day="9",
volume="11",
number="5",
pages="e31739",
keywords="social media",
keywords="research design",
keywords="web-based social networking",
keywords="health behavior",
keywords="health promotion",
keywords="public health",
abstract="Background: Social media platforms, such as Facebook, Twitter, and Instagram, are being increasingly used to deliver public health interventions. Despite the high level of research interest, there is no consensus or guidance on how to report on social media interventions. Reporting guidelines that incorporate elements from behavior change theories and social media engagement frameworks could foster more robust evaluations that capture outcomes that have an impact on behavior change and engagement. Objective: The aim of this project is to develop, publish, and promote a list of items for our Reporting Guidelines for Social Media Research (RESOME) checklist. Methods: RESOME will be developed by using a modified Delphi approach wherein 2 rounds of questionnaires will be sent to experts and stakeholders. The questionnaires will ask them to rate their agreement with a series of statements until a level of consensus is reached. This will be followed by a web-based consensus meeting to finalize the reporting guidelines. After the consensus meeting, the reporting guidelines will be published in the form of a paper outlining the need for the new guidelines and how the guidelines were developed, along with the finalized checklist for reporting. Prior to publication, the guidelines will be piloted to check for understanding and simplify the language used, if necessary. Results: The first draft of RESOME has been developed. Round 1 of the Delphi survey took place between July and December 2021. Round 2 is due to take place in February 2022, and the web-based consensus meeting will be scheduled for the spring of 2022. Conclusions: Developing RESOME has the potential to contribute to improved reporting, and such guidelines will make it easier to assess the effectiveness of social media interventions. Future work will be needed to evaluate our guidelines' usefulness and practicality. International Registered Report Identifier (IRRID): PRR1-10.2196/31739 ",
doi="10.2196/31739",
url="https://www.researchprotocols.org/2022/5/e31739",
url="http://www.ncbi.nlm.nih.gov/pubmed/35532999"
}


@Article{info:doi/10.2196/34302,
author="Dunn, Sheila
and Munro, Sarah
and Devane, Courtney
and Guilbert, Edith
and Jeong, Dahn
and Stroulia, Eleni
and Soon, A. Judith
and Norman, V. Wendy",
title="A Virtual Community of Practice to Support Physician Uptake of a Novel Abortion Practice: Mixed Methods Case Study",
journal="J Med Internet Res",
year="2022",
month="May",
day="5",
volume="24",
number="5",
pages="e34302",
keywords="mifepristone",
keywords="abortion",
keywords="community of practice",
keywords="virtual community of practice",
keywords="diffusion of innovation",
keywords="learning community",
abstract="Background: Virtual communities of practice (VCoPs) have been used to support innovation and quality in clinical care. The drug mifepristone was introduced in Canada in 2017 for medical abortion. We created a VCoP to support implementation of mifepristone abortion practice across Canada. Objective: The aim of this study was to describe the development and use of the Canadian Abortion Providers Support-Communaut{\'e} de pratique canadienne sur l'avortement (CAPS-CPCA) VCoP and explore physicians' experience with CAPS-CPCA and their views on its value in supporting implementation. Methods: This was a mixed methods intrinsic case study of Canadian health care providers' use and physicians' perceptions of the CAPS-CPCA VCoP during the first 2 years of a novel practice. We sampled both physicians who joined the CAPS-CPCA VCoP and those who were interested in providing the novel practice but did not join the VCoP. We designed the VCoP features to address known and discovered barriers to implementation of medication abortion in primary care. Our secure web-based platform allowed asynchronous access to information, practice resources, clinical support, discussion forums, and email notices. We collected data from the platform and through surveys of physician members as well as interviews with physician members and nonmembers. We analyzed descriptive statistics for website metrics, physicians' characteristics and practices, and their use of the VCoP. We used qualitative methods to explore the physicians' experiences and perceptions of the VCoP. Results: From January 1, 2017, to June 30, 2019, a total of 430 physicians representing all provinces and territories in Canada joined the VCoP and 222 (51.6\%) completed a baseline survey. Of these 222 respondents, 156 (70.3\%) were family physicians, 170 (80.2\%) were women, and 78 (35.1\%) had no prior abortion experience. In a survey conducted 12 months after baseline, 77.9\% (120/154) of the respondents stated that they had provided mifepristone abortion and 33.9\% (43/127) said the VCoP had been important or very important. Logging in to the site was burdensome for some, but members valued downloadable resources such as patient information sheets, consent forms, and clinical checklists. They found email announcements helpful for keeping up to date with changing regulations. Few asked clinical questions to the VCoP experts, but physicians felt that this feature was important for isolated or rural providers. Information collected through member polls about health system barriers to implementation was used in the project's knowledge translation activities with policy makers to mitigate these barriers. Conclusions: A VCoP developed to address known and discovered barriers to uptake of a novel medication abortion method engaged physicians from across Canada and supported some, including those with no prior abortion experience, to implement this practice. International Registered Report Identifier (IRRID): RR2-10.1136/bmjopen-2018-028443 ",
doi="10.2196/34302",
url="https://www.jmir.org/2022/5/e34302",
url="http://www.ncbi.nlm.nih.gov/pubmed/35511226"
}


@Article{info:doi/10.2196/35540,
author="Moreno, A. Megan
and Binger, Kole
and Zhao, Qianqian
and Eickhoff, Jens
and Minich, Matt
and Uhls, Tehranian Yalda",
title="Digital Technology and Media Use by Adolescents: Latent Class Analysis",
journal="JMIR Pediatr Parent",
year="2022",
month="May",
day="4",
volume="5",
number="2",
pages="e35540",
keywords="digital technology",
keywords="adolescents",
keywords="latent class analysis",
keywords="social media",
keywords="mobile phone",
abstract="Background: Digital technology and media use is integral to adolescents' lives and has been associated with both positive and negative health consequences. Previous studies have largely focused on understanding technology behaviors and outcomes within adolescent populations, which can promote assumptions about adolescent technology use as homogeneous. Furthermore, many studies on adolescent technology use have focused on risks and negative outcomes. To better understand adolescent digital technology use, we need new approaches that can assess distinct profiles within study populations and take a balanced approach to understanding the risks and benefits of digital technology use. Objective: The purpose of this study was to identify profiles of adolescent technology use within a large study population focusing on four evidence-based constructs: technology ownership and use, parental involvement, health outcomes, and well-being indicators. Methods: Adolescent-parent dyads were recruited for a cross-sectional web-based survey using the Qualtrics (Qualtrics International, Inc) platform and panels. Technology use measures included ownership of devices, social media use frequency, and the Adolescents' Digital Technology Interactions and Importance scale. Parent involvement measures included household media rules, technology-related parenting practices, parent social media use frequency, and the parent-child relationship. Health outcome measures included physical activity, sleep, problematic internet use, and mental health assessments. Well-being indicators included mental wellness, communication, and empathy. We used latent class analysis (LCA) to identify distinct profile groups across the aforementioned 4 critical constructs. Results: Among the 3981 adolescent-parent dyads recruited, adolescent participants had a mean age of 15.0 (SD 1.43) years; a total of 46.3\% (1842/3981) were female, 67.8\% (2701/3981) were White, and 75\% (2986/3981) lived in a household with an income above the poverty line. The LCA identified 2 discrete classes. Class 1 was made up of 62.8\% (2501/3981) of the participants. Class 1 participants were more likely than Class 2 participants to report family-owned devices, have lower technology importance scores, have household technology rules often centered on content, have positive parent relationships and lower parent social media use, and report better health outcomes and well-being indicators. Conclusions: Findings from this national cross-sectional survey using LCA led to 2 distinct profile groups of adolescent media use and their association with technology use and parent involvement as well as health and well-being outcomes. The two classes included a larger Class 1 (Family-Engaged Adolescents) and a smaller Class 2 (At-Risk Adolescents). The findings of this study can inform interventions to reinforce positive technology use and family support. ",
doi="10.2196/35540",
url="https://pediatrics.jmir.org/2022/2/e35540",
url="http://www.ncbi.nlm.nih.gov/pubmed/35507401"
}


@Article{info:doi/10.2196/35788,
author="Golder, Su
and Stevens, Robin
and O'Connor, Karen
and James, Richard
and Gonzalez-Hernandez, Graciela",
title="Methods to Establish Race or Ethnicity of Twitter Users: Scoping Review",
journal="J Med Internet Res",
year="2022",
month="Apr",
day="29",
volume="24",
number="4",
pages="e35788",
keywords="twitter",
keywords="social media",
keywords="race",
keywords="ethnicity",
abstract="Background: A growing amount of health research uses social media data. Those critical of social media research often cite that it may be unrepresentative of the population; however, the suitability of social media data in digital epidemiology is more nuanced. Identifying the demographics of social media users can help establish representativeness. Objective: This study aims to identify the different approaches or combination of approaches to extract race or ethnicity from social media and report on the challenges of using these methods. Methods: We present a scoping review to identify methods used to extract the race or ethnicity of Twitter users from Twitter data sets. We searched 17 electronic databases from the date of inception to May 15, 2021, and carried out reference checking and hand searching to identify relevant studies. Sifting of each record was performed independently by at least two researchers, with any disagreement discussed. Studies were required to extract the race or ethnicity of Twitter users using either manual or computational methods or a combination of both. Results: Of the 1249 records sifted, we identified 67 (5.36\%) that met our inclusion criteria. Most studies (51/67, 76\%) have focused on US-based users and English language tweets (52/67, 78\%). A range of data was used, including Twitter profile metadata, such as names, pictures, information from bios (including self-declarations), or location or content of the tweets. A range of methodologies was used, including manual inference, linkage to census data, commercial software, language or dialect recognition, or machine learning or natural language processing. However, not all studies have evaluated these methods. Those that evaluated these methods found accuracy to vary from 45\% to 93\% with significantly lower accuracy in identifying categories of people of color. The inference of race or ethnicity raises important ethical questions, which can be exacerbated by the data and methods used. The comparative accuracies of the different methods are also largely unknown. Conclusions: There is no standard accepted approach or current guidelines for extracting or inferring the race or ethnicity of Twitter users. Social media researchers must carefully interpret race or ethnicity and not overpromise what can be achieved, as even manual screening is a subjective, imperfect method. Future research should establish the accuracy of methods to inform evidence-based best practice guidelines for social media researchers and be guided by concerns of equity and social justice. ",
doi="10.2196/35788",
url="https://www.jmir.org/2022/4/e35788",
url="http://www.ncbi.nlm.nih.gov/pubmed/35486433"
}


@Article{info:doi/10.2196/30898,
author="Ye, Jiancheng
and Wang, Zidan
and Hai, Jiarui",
title="Social Networking Service, Patient-Generated Health Data, and Population Health Informatics: National Cross-sectional Study of Patterns and Implications of Leveraging Digital Technologies to Support Mental Health and Well-being",
journal="J Med Internet Res",
year="2022",
month="Apr",
day="29",
volume="24",
number="4",
pages="e30898",
keywords="patient-generated health data",
keywords="social network",
keywords="population health informatics",
keywords="mental health",
keywords="social determinants of health",
keywords="health data sharing",
keywords="technology acceptability",
keywords="mobile phone",
keywords="mobile health",
abstract="Background: The emerging health technologies and digital services provide effective ways of collecting health information and gathering patient-generated health data (PGHD), which provide a more holistic view of a patient's health and quality of life over time, increase visibility into a patient's adherence to a treatment plan or study protocol, and enable timely intervention before a costly care episode. Objective: Through a national cross-sectional survey in the United States, we aimed to describe and compare the characteristics of populations with and without mental health issues (depression or anxiety disorders), including physical health, sleep, and alcohol use. We also examined the patterns of social networking service use, PGHD, and attitudes toward health information sharing and activities among the participants, which provided nationally representative estimates. Methods: We drew data from the 2019 Health Information National Trends Survey of the National Cancer Institute. The participants were divided into 2 groups according to mental health status. Then, we described and compared the characteristics of the social determinants of health, health status, sleeping and drinking behaviors, and patterns of social networking service use and health information data sharing between the 2 groups. Multivariable logistic regression models were applied to assess the predictors of mental health. All the analyses were weighted to provide nationally representative estimates. Results: Participants with mental health issues were significantly more likely to be younger, White, female, and lower-income; have a history of chronic diseases; and be less capable of taking care of their own health. Regarding behavioral health, they slept <6 hours on average, had worse sleep quality, and consumed more alcohol. In addition, they were more likely to visit and share health information on social networking sites, write online diary blogs, participate in online forums or support groups, and watch health-related videos. Conclusions: This study illustrates that individuals with mental health issues have inequitable social determinants of health, poor physical health, and poor behavioral health. However, they are more likely to use social networking platforms and services, share their health information, and actively engage with PGHD. Leveraging these digital technologies and services could be beneficial for developing tailored and effective strategies for self-monitoring and self-management. ",
doi="10.2196/30898",
url="https://www.jmir.org/2022/4/e30898",
url="http://www.ncbi.nlm.nih.gov/pubmed/35486428"
}


@Article{info:doi/10.2196/34321,
author="Tahamtan, Iman
and Potnis, Devendra
and Mohammadi, Ehsan
and Singh, Vandana
and Miller, E. Laura",
title="The Mutual Influence of the World Health Organization (WHO) and Twitter Users During COVID-19: Network Agenda-Setting Analysis",
journal="J Med Internet Res",
year="2022",
month="Apr",
day="26",
volume="24",
number="4",
pages="e34321",
keywords="COVID-19",
keywords="agenda setting",
keywords="network agenda setting",
keywords="Twitter",
keywords="social media",
keywords="public opinion",
keywords="content analysis",
keywords="public health",
keywords="WHO",
abstract="Background: Little is known about the role of the World Health Organization (WHO) in communicating with the public on social media during a global health emergency. More specifically, there is no study about the relationship between the agendas of the WHO and Twitter users during the COVID-19 pandemic. Objective: This study utilizes the network agenda-setting model to investigate the mutual relationship between the agenda of the WHO's official Twitter account and the agenda of 7.5 million of its Twitter followers regarding COVID-19. Methods: Content analysis was applied to 7090 tweets posted by the WHO on Twitter from January 1, 2020, to July 31, 2020, to identify the topics of tweets. The quadratic assignment procedure (QAP) was used to investigate the relationship between the WHO agenda network and the agenda network of the 6 Twitter user categories, including ``health care professionals,'' ``academics,'' ``politicians,'' ``print and electronic media,'' ``legal professionals,'' and the ``private sector.'' Additionally, 98 Granger causality statistical tests were performed to determine which topic in the WHO agenda had an effect on the corresponding topic in each Twitter user category and vice versa. Results: Content analysis revealed 7 topics that reflect the WHO agenda related to the COVID-19 pandemic, including ``prevention,'' ``solidarity,'' ``charity,'' ``teamwork,'' ``ill-effect,'' ``surveillance,'' and ``credibility.'' Results of the QAP showed significant and strong correlations between the WHO agenda network and the agenda network of each Twitter user category. These results provide evidence that WHO had an overall effect on different types of Twitter users on the identified topics. For instance, the Granger causality tests indicated that the WHO tweets influenced politicians and print and electronic media about ``surveillance.'' The WHO tweets also influenced academics and the private sector about ``credibility'' and print and electronic media about ``ill-effect.'' Additionally, Twitter users affected some topics in the WHO. For instance, WHO followers affected ``charity'' and ``prevention'' in the WHO. Conclusions: This paper extends theorizing on agenda setting by providing empirical evidence that agenda-setting effects vary by topic and types of Twitter users. Although prior studies showed that network agenda setting is a ``one-way'' model, the novel findings of this research confirm a ``2-way'' or ``multiway'' effect of agenda setting on social media due to the interactions between the content creators and audiences. The WHO can determine which topics should be promoted on social media during different phases of a pandemic and collaborate with other public health gatekeepers to collectively make them salient in the public. ",
doi="10.2196/34321",
url="https://www.jmir.org/2022/4/e34321",
url="http://www.ncbi.nlm.nih.gov/pubmed/35275836"
}


@Article{info:doi/10.2196/32405,
author="Klein, Z. Ari
and Meanley, Steven
and O'Connor, Karen
and Bauermeister, A. Jos{\'e}
and Gonzalez-Hernandez, Graciela",
title="Toward Using Twitter for PrEP-Related Interventions: An Automated Natural Language Processing Pipeline for Identifying Gay or Bisexual Men in the United States",
journal="JMIR Public Health Surveill",
year="2022",
month="Apr",
day="25",
volume="8",
number="4",
pages="e32405",
keywords="natural language processing",
keywords="social media",
keywords="data mining",
keywords="PrEP",
keywords="pre-exposure prophylaxis",
keywords="HIV",
keywords="AIDS",
abstract="Background: Pre-exposure prophylaxis (PrEP) is highly effective at preventing the acquisition of HIV. There is a substantial gap, however, between the number of people in the United States who have indications for PrEP and the number of them who are prescribed PrEP. Although Twitter content has been analyzed as a source of PrEP-related data (eg, barriers), methods have not been developed to enable the use of Twitter as a platform for implementing PrEP-related interventions. Objective: Men who have sex with men (MSM) are the population most affected by HIV in the United States. Therefore, the objectives of this study were to (1) develop an automated natural language processing (NLP) pipeline for identifying men in the United States who have reported on Twitter that they are gay, bisexual, or MSM and (2) assess the extent to which they demographically represent MSM in the United States with new HIV diagnoses. Methods: Between September 2020 and January 2021, we used the Twitter Streaming Application Programming Interface (API) to collect more than 3 million tweets containing keywords that men may include in posts reporting that they are gay, bisexual, or MSM. We deployed handwritten, high-precision regular expressions---designed to filter out noise and identify actual self-reports---on the tweets and their user profile metadata. We identified 10,043 unique users geolocated in the United States and drew upon a validated NLP tool to automatically identify their ages. Results: By manually distinguishing true- and false-positive self-reports in the tweets or profiles of 1000 (10\%) of the 10,043 users identified by our automated pipeline, we established that our pipeline has a precision of 0.85. Among the 8756 users for which a US state--level geolocation was detected, 5096 (58.2\%) were in the 10 states with the highest numbers of new HIV diagnoses. Among the 6240 users for which a county-level geolocation was detected, 4252 (68.1\%) were in counties or states considered priority jurisdictions by the Ending the HIV Epidemic initiative. Furthermore, the age distribution of the users reflected that of MSM in the United States with new HIV diagnoses. Conclusions: Our automated NLP pipeline can be used to identify MSM in the United States who may be at risk of acquiring HIV, laying the groundwork for using Twitter on a large scale to directly target PrEP-related interventions at this population. ",
doi="10.2196/32405",
url="https://publichealth.jmir.org/2022/4/e32405",
url="http://www.ncbi.nlm.nih.gov/pubmed/35468092"
}


@Article{info:doi/10.2196/36218,
author="Hong, Uk Brendan Jae
and Woo, P. Benjamin K.",
title="Investigating Turf Burn--Related Videos on TikTok: Cross-sectional Study",
journal="JMIR Dermatol",
year="2022",
month="Apr",
day="22",
volume="5",
number="2",
pages="e36218",
keywords="turf burn",
keywords="skin",
keywords="burn",
keywords="turf",
keywords="TikTok",
keywords="misinformation",
keywords="dermatologist",
keywords="medical advice",
keywords="peer support",
keywords="companionship",
keywords="web-based platform",
keywords="sports medicine",
keywords="dermatology",
keywords="sports",
keywords="sport",
keywords="social media",
keywords="mental health",
keywords="sports injuries",
keywords="athletic injuries",
keywords="sport injury",
keywords="athletic injury",
keywords="athlete",
keywords="injury",
keywords="injuries",
keywords="web-based video",
keywords="psychiatry",
abstract="Background: Due to the increased use of artificial turf, turf burn has become a common sports injury. Turf burn is caused by exposed skin sliding on artificial turf. Health complications, such as methicillin-resistant Staphylococcus aureus outbreaks, sepsis, and pneumonia, have been linked to untreated turf burns, and many athletes have been turning to social media for advice and companionship regarding their sports injuries. Objective: The goal of this study is to categorize and quantitatively assess the percentage of turf burn--related posts on TikTok based on creator type, content, athletes' experiences, and treatment and prevention methods. With these data, we not only investigate if there is room for health care professionals to assist in the distribution of evidence-based health education to athletes to counteract misinformation but also investigate if there is a potential audience of athletes on TikTok who have the potential to develop problematic responses to injuries. Methods: By using the Discover page on TikTok, we searched for the term turf burn on October 17, 2021. In total, 100 videos were analyzed. Videos were categorized and analyzed based on creator type, content, experiences of the athletes, and treatment and prevention methods. The number of likes and comments was recorded. Results: Most videos (98/100, 98\%) were created by athletes. A small number of videos (2/100, 2\%) were created by health care professionals. In terms of content, most videos (67/100, 67\%) displayed turf burns. A small amount of videos (15/100, 15\%) showed the incidents when turf burns were acquired, while around one-quarter of the videos (23/100, 23\%) demonstrated the treatment and prevention of turf burns. Of the 23 treatment and prevention videos, a minority (4/23, 17\%) showed the preferred treatment of turf burns, while most videos (19/23, 83\%) showed nonpreferred treatments. The smallest amount of videos (2/100, 2\%) were about turf burn education. Most of the videos created by athletes (56/98, 57\%) depicted the negative experiences that patients had with turf burns. Some videos (37/98, 38\%) depicted neutral experiences, while the smallest amount of videos (5/98, 5\%) depicted positive experiences. Conclusions: Our study suggests that there is a potential audience of athletes on TikTok who could develop problematic responses to sports injuries, such as turf burns, as most of the people who post videos are athletes, and many of the posts demonstrate negative experiences associated with turf burns. TikTok is a growing social media platform that should be studied to determine if it can be used to create a social support group for injured athletes to prevent the progression of negative emotional responses into problematic responses. Physicians should also have a role in establishing their social media presence on TikTok and offering evidence-based advice to athletes while disproving misinformation on TikTok. ",
doi="10.2196/36218",
url="https://derma.jmir.org/2022/2/e36218",
url="http://www.ncbi.nlm.nih.gov/pubmed/37632852"
}


@Article{info:doi/10.2196/34111,
author="Mark, Erica
and Sridharan, Mira
and Florenzo, Brian
and Schenck, L. Olivia
and Noland, B. Mary-Margaret
and Barbieri, S. John
and Lipoff, B. Jules",
title="Crowdsourcing Medical Costs in Dermatology: Cross-sectional Study Analyzing Dermatologic GoFundMe Campaigns",
journal="JMIR Dermatol",
year="2022",
month="Apr",
day="22",
volume="5",
number="2",
pages="e34111",
keywords="crowdfunding",
keywords="crowdsourcing",
keywords="fundraising",
keywords="GoFundMe",
keywords="social media",
keywords="medical expenses",
keywords="financial burden",
keywords="health equity",
abstract="Background: Crowdfunding for medical costs is becoming increasingly popular. Few previous studies have described the fundraising characteristics and qualities associated with success. Objective: This study aimed to characterize and investigate the qualities associated with successful dermatological fundraisers. Methods: This cross-sectional study of dermatological GoFundMe campaigns collected data, including demographic variables, thematic variables using an inductive qualitative method, and quantitative information. Linear regression examined the qualities associated with success, which are defined based on funds raised when controlling for campaign goals. Logistic regression was used to examine qualities associated with extremely successful campaigns, defined as those raising >1.5 times the IQR. Statistical significance was set at P<.05. Results: A total of 2008 publicly available campaigns at the time of data collection were evaluated. Nonmodifiable factors associated with greater success included male gender, age 20-40 years, and White race. Modifiable factors associated with success included more updates posted to the campaign page, non--self-identity of the campaign creator, mention of a chronic condition, and smiling in campaign profile photographs. Conclusions: Understanding the modifiable factors of medical crowdfunding may inform future campaigns, and nonmodifiable factors may have policy implications for improving health care equity and financing. Crowdfunding for medical disease treatment may have potential implications for medical privacy and exacerbation of existing health care disparities. This study was limited to publicly available GoFundMe campaigns. Potential limitations for this study include intercoder variability, misclassification bias because of the data abstraction process, and prioritization of campaigns based on the proprietary GoFundMe algorithm. ",
doi="10.2196/34111",
url="https://derma.jmir.org/2022/2/e34111",
url="http://www.ncbi.nlm.nih.gov/pubmed/37632862"
}


@Article{info:doi/10.2196/35356,
author="Rovetta, Alessandro",
title="Google Trends as a Predictive Tool for COVID-19 Vaccinations in Italy: Retrospective Infodemiological Analysis",
journal="JMIRx Med",
year="2022",
month="Apr",
day="19",
volume="3",
number="2",
pages="e35356",
keywords="COVID-19",
keywords="epidemiology",
keywords="Google Trends",
keywords="infodemiology",
keywords="infoveillance",
keywords="Italy",
keywords="public health",
keywords="SARS-CoV-2",
keywords="vaccinations",
keywords="vaccines",
keywords="social media analysis",
keywords="social media",
abstract="Background: Google Trends is an infoveillance tool widely used by the scientific community to investigate different user behaviors related to COVID-19. However, several limitations regarding its adoption are reported in the literature. Objective: This paper aims to provide an effective and efficient approach to investigating vaccine adherence against COVID-19 via Google Trends. Methods: Through the cross-correlational analysis of well-targeted hypotheses, we investigate the predictive capacity of web searches related to COVID-19 toward vaccinations in Italy from November 2020 to November 2021. The keyword ``vaccine reservation'' query (VRQ) was chosen as it reflects a real intention of being vaccinated (V). Furthermore, the impact of the second most read Italian newspaper (vaccine-related headlines [VRH]) on vaccine-related web searches was investigated to evaluate the role of the mass media as a confounding factor. Fisher r-to-z transformation (z) and percentage difference ($\delta$) were used to compare Spearman coefficients. A regression model V=f(VRH, VRQ) was built to validate the results found. The Holm-Bonferroni correction was adopted (P*). SEs are reported. Results: Simple and generic keywords are more likely to identify the actual web interest in COVID-19 vaccines than specific and elaborated keywords. Cross-correlations between VRQ and V were very strong and significant (min r{\texttwosuperior}=0.460, P*<.001, lag 0 weeks; max r{\texttwosuperior}=0.903, P*<.001, lag 6 weeks). The remaining cross-correlations have been markedly lower ($\delta$>55.8\%; z>5.8; P*<.001). The regression model confirmed the greater significance of VRQ versus VRH (P*<.001 vs P=.03, P*=.29). Conclusions: This research provides preliminary evidence in favor of using Google Trends as a surveillance and prediction tool for vaccine adherence against COVID-19 in Italy. Further research is needed to establish the appropriate use and limits of Google Trends for vaccination tracking. However, these findings prove that the search for suitable keywords is a fundamental step to reduce confounding factors. Additionally, targeting hypotheses helps diminish the likelihood of spurious correlations. It is recommended that Google Trends be leveraged as a complementary infoveillance tool by government agencies to monitor and predict vaccine adherence in this and future crises by following the methods proposed in this paper. ",
doi="10.2196/35356",
url="https://med.jmirx.org/2022/2/e35356",
url="http://www.ncbi.nlm.nih.gov/pubmed/35481982"
}


@Article{info:doi/10.2196/33450,
author="Shannon, Holly
and Bush, Katie
and Villeneuve, J. Paul
and Hellemans, GC Kim
and Guimond, Synthia",
title="Problematic Social Media Use in Adolescents and Young Adults: Systematic Review and Meta-analysis",
journal="JMIR Ment Health",
year="2022",
month="Apr",
day="14",
volume="9",
number="4",
pages="e33450",
keywords="problematic social media use",
keywords="depression",
keywords="anxiety",
keywords="stress",
abstract="Background: Technology is ever evolving, with more and more diverse activities becoming possible on screen-based devices. However, participating in a heavy screen-based lifestyle may come at a cost. Our hypothesis was that problematic social media use increased the prevalence of mental health outcomes. Objective: This study seeks to systematically examine problematic social media use in youth and its association with symptoms of depression, anxiety, and stress. Methods: A systematic search was conducted to identify studies in adolescents and young adults, using the databases Engineering Village, Psycinfo, Pubmed, and Web of Science. A total of 18 studies were identified, with a total of 9269 participants in our review and included in the meta-analysis. Results: Our metaregression shows moderate but statistically significant correlations between problematic social media use and depression (r=0.273, P<.001), anxiety (r=0.348, P<.001), and stress (r=0.313, P<.001). We did not find evidence of heterogeneity of these summary correlations by age, gender, or year of publication. Conclusions: This study provides further evidence of the association between problematic social media use and negative mental health among adolescents and young adults and supports future research to focus on the underlying mechanisms of problematic use of social media. Trial Registration: PROSPERO CRD42021222309; https://tinyurl.com/2p9y4bjx ",
doi="10.2196/33450",
url="https://mental.jmir.org/2022/4/e33450",
url="http://www.ncbi.nlm.nih.gov/pubmed/35436240"
}


@Article{info:doi/10.2196/33680,
author="Gunasekeran, Visva Dinesh
and Chew, Alton
and Chandrasekar, K. Eeshwar
and Rajendram, Priyanka
and Kandarpa, Vasundhara
and Rajendram, Mallika
and Chia, Audrey
and Smith, Helen
and Leong, Kit Choon",
title="The Impact and Applications of Social Media Platforms for Public Health Responses Before and During the COVID-19 Pandemic: Systematic Literature Review",
journal="J Med Internet Res",
year="2022",
month="Apr",
day="11",
volume="24",
number="4",
pages="e33680",
keywords="digital health",
keywords="social media",
keywords="big data",
keywords="population health",
keywords="blockchain",
keywords="COVID-19",
keywords="review",
keywords="benefit",
keywords="challenge",
keywords="public health",
abstract="Background: ?Social media platforms have numerous potential benefits and drawbacks on public health, which have been described in the literature. The COVID-19 pandemic has exposed our limited knowledge regarding the potential health impact of these platforms, which have been detrimental to public health responses in many regions. Objective: This review aims to highlight a brief history of social media in health care and report its potential negative and positive public health impacts, which have been characterized in the literature. Methods: ?We searched electronic bibliographic databases including PubMed, including Medline and Institute of Electrical and Electronics Engineers Xplore, from December 10, 2015, to December 10, 2020. We screened the title and abstracts and selected relevant reports for review of full text and reference lists. These were analyzed thematically and consolidated into applications of social media platforms for public health. Results: ?The positive and negative impact of social media platforms on public health are catalogued on the basis of recent research in this report. These findings are discussed in the context of improving future public health responses and incorporating other emerging digital technology domains such as artificial intelligence. However, there is a need for more research with pragmatic methodology that evaluates the impact of specific digital interventions to inform future health policy. Conclusions: ?Recent research has highlighted the potential negative impact of social media platforms on population health, as well as potentially useful applications for public health communication, monitoring, and predictions. More research is needed to objectively investigate measures to mitigate against its negative impact while harnessing effective applications for the benefit of public health. ",
doi="10.2196/33680",
url="https://www.jmir.org/2022/4/e33680",
url="http://www.ncbi.nlm.nih.gov/pubmed/35129456"
}


@Article{info:doi/10.2196/35677,
author="Bacsu, Juanita-Dawne
and Fraser, Sarah
and Chasteen, L. Alison
and Cammer, Allison
and Grewal, S. Karl
and Bechard, E. Lauren
and Bethell, Jennifer
and Green, Shoshana
and McGilton, S. Katherine
and Morgan, Debra
and O'Rourke, M. Hannah
and Poole, Lisa
and Spiteri, J. Raymond
and O'Connell, E. Megan",
title="Using Twitter to Examine Stigma Against People With Dementia During COVID-19: Infodemiology Study",
journal="JMIR Aging",
year="2022",
month="Mar",
day="31",
volume="5",
number="1",
pages="e35677",
keywords="coronavirus 2019",
keywords="social media",
keywords="stigma",
keywords="dementia",
keywords="ageism",
keywords="COVID-19",
keywords="Twitter",
keywords="bias",
keywords="infodemiology",
keywords="attention",
keywords="risk",
keywords="impact",
keywords="misinformation",
keywords="belief",
keywords="cognition",
keywords="cognitive impairment",
abstract="Background: During the pandemic, there has been significant social media attention focused on the increased COVID-19 risks and impacts for people with dementia and their care partners. However, these messages can perpetuate misconceptions, false information, and stigma. Objective: This study used Twitter data to understand stigma against people with dementia propagated during the COVID-19 pandemic. Methods: We collected 1743 stigma-related tweets using the GetOldTweets application in Python from February 15 to September 7, 2020. Thematic analysis was used to analyze the tweets. Results: Based on our analysis, 4 main themes were identified: (1) ageism and devaluing the lives of people with dementia, (2) misinformation and false beliefs about dementia and COVID-19, (3) dementia used as an insult for political ridicule, and (4) challenging stigma against dementia. Social media has been used to spread stigma, but it can also be used to challenge negative beliefs, stereotypes, and false information. Conclusions: Dementia education and awareness campaigns are urgently needed on social media to address COVID-19-related stigma. When stigmatizing discourse on dementia is widely shared and consumed amongst the public, it has public health implications. How we talk about dementia shapes how policymakers, clinicians, and the public value the lives of people with dementia. Stigma perpetuates misinformation, pejorative language, and patronizing attitudes that can lead to discriminatory actions, such as the limited provision of lifesaving supports and health services for people with dementia during the pandemic. COVID-19 policies and public health messages should focus on precautions and preventive measures rather than labeling specific population groups. ",
doi="10.2196/35677",
url="https://aging.jmir.org/2022/1/e35677",
url="http://www.ncbi.nlm.nih.gov/pubmed/35290197"
}


@Article{info:doi/10.2196/34050,
author="Purushothaman, Vidya
and McMann, Tiana
and Nali, Matthew
and Li, Zhuoran
and Cuomo, Raphael
and Mackey, K. Tim",
title="Content Analysis of Nicotine Poisoning (Nic Sick) Videos on TikTok: Retrospective Observational Infodemiology Study",
journal="J Med Internet Res",
year="2022",
month="Mar",
day="30",
volume="24",
number="3",
pages="e34050",
keywords="nic sick",
keywords="vaping",
keywords="tobacco",
keywords="social media",
keywords="TikTok",
keywords="content analysis",
keywords="smoking",
keywords="nicotine",
keywords="e-cigarette",
keywords="adverse effects",
keywords="public health",
keywords="infodemiology",
abstract="Background: TikTok is a microvideo social media platform currently experiencing rapid growth and with 60\% of its monthly users between the ages of 16 and 24 years. Increased exposure to e-cigarette content on social media may influence patterns of use, including the risk of overconsumption and possible nicotine poisoning, when users engage in trending challenges online. However, there is limited research assessing the characteristics of nicotine poisoning--related content posted on social media. Objective: We aimed to assess the characteristics of content on TikTok that is associated with a popular nicotine poisoning--related hashtag. Methods: We collected TikTok posts associated with the hashtag \#nicsick, using a Python programming package (Selenium) and used an inductive coding approach to analyze video content and characteristics of interest. Videos were manually annotated to generate a codebook of the nicotine sickness--related themes. Statistical analysis was used to compare user engagement characteristics and video length in content with and without active nicotine sickness TikTok topics. Results: A total of 132 TikTok videos associated with the hashtag \#nicsick were manually coded, with 52.3\% (69/132) identified as discussing firsthand and secondhand reports of suspected nicotine poisoning symptoms and experiences. More than one-third of nicotine poisoning--related content (26/69, 37.68\%) portrayed active vaping by users, which included content with vaping behavior such as vaping tricks and overconsumption, and 43\% (30/69) of recorded users self-reported experiencing nicotine sickness, poisoning, or adverse events such as vomiting following nicotine consumption. The average follower count of users posting content related to nicotine sickness was significantly higher than that for users posting content unrelated to nicotine sickness (W=2350.5, P=.03). Conclusions: TikTok users openly discuss experiences, both firsthand and secondhand, with nicotine adverse events via the \#nicsick hashtag including reports of overconsumption resulting in sickness. These study results suggest that there is a need to assess the utility of digital surveillance on emerging social media platforms for vaping adverse events, particularly on sites popular among youth and young adults. As vaping product use-patterns continue to evolve, digital adverse event detection likely represents an important tool to supplement traditional methods of public health surveillance (such as poison control center prevalence numbers). ",
doi="10.2196/34050",
url="https://www.jmir.org/2022/3/e34050",
url="http://www.ncbi.nlm.nih.gov/pubmed/35353056"
}


@Article{info:doi/10.2196/33685,
author="Stupinski, Marie Anne
and Alshaabi, Thayer
and Arnold, V. Michael
and Adams, Lydia Jane
and Minot, R. Joshua
and Price, Matthew
and Dodds, Sheridan Peter
and Danforth, M. Christopher",
title="Quantifying Changes in the Language Used Around Mental Health on Twitter Over 10 Years: Observational Study",
journal="JMIR Ment Health",
year="2022",
month="Mar",
day="30",
volume="9",
number="3",
pages="e33685",
keywords="mental health",
keywords="stigma",
keywords="natural language processing",
abstract="Background: Mental health challenges are thought to affect approximately 10\% of the global population each year, with many of those affected going untreated because of the stigma and limited access to services. As social media lowers the barrier for joining difficult conversations and finding supportive groups, Twitter is an open source of language data describing the changing experience of a stigmatized group. Objective: By measuring changes in the conversation around mental health on Twitter, we aim to quantify the hypothesized increase in discussions and awareness of the topic as well as the corresponding reduction in stigma around mental health. Methods: We explored trends in words and phrases related to mental health through a collection of 1-, 2-, and 3-grams parsed from a data stream of approximately 10\% of all English tweets from 2010 to 2021. We examined temporal dynamics of mental health language and measured levels of positivity of the messages. Finally, we used the ratio of original tweets to retweets to quantify the fraction of appearances of mental health language that was due to social amplification. Results: We found that the popularity of the phrase mental health increased by nearly two orders of magnitude between 2012 and 2018. We observed that mentions of mental health spiked annually and reliably because of mental health awareness campaigns as well as unpredictably in response to mass shootings, celebrities dying by suicide, and popular fictional television stories portraying suicide. We found that the level of positivity of messages containing mental health, while stable through the growth period, has declined recently. Finally, we observed that since 2015, mentions of mental health have become increasingly due to retweets, suggesting that the stigma associated with the discussion of mental health on Twitter has diminished with time. Conclusions: These results provide useful texture regarding the growing conversation around mental health on Twitter and suggest that more awareness and acceptance has been brought to the topic compared with past years. ",
doi="10.2196/33685",
url="https://mental.jmir.org/2022/3/e33685",
url="http://www.ncbi.nlm.nih.gov/pubmed/35353049"
}


@Article{info:doi/10.2196/33934,
author="Sukhera, Javeed
and Ahmed, Hasan",
title="Leveraging Machine Learning to Understand How Emotions Influence Equity Related Education: Quasi-Experimental Study",
journal="JMIR Med Educ",
year="2022",
month="Mar",
day="30",
volume="8",
number="1",
pages="e33934",
keywords="bias",
keywords="equity",
keywords="sentiment analysis",
keywords="medical education",
keywords="emotion",
keywords="education",
abstract="Background: Teaching and learning about topics such as bias are challenging due to the emotional nature of bias-related discourse. However, emotions can be challenging to study in health professions education for numerous reasons. With the emergence of machine learning and natural language processing, sentiment analysis (SA) has the potential to bridge the gap. Objective: To improve our understanding of the role of emotions in bias-related discourse, we developed and conducted a SA of bias-related discourse among health professionals. Methods: We conducted a 2-stage quasi-experimental study. First, we developed a SA (algorithm) within an existing archive of interviews with health professionals about bias. SA refers to a mechanism of analysis that evaluates the sentiment of textual data by assigning scores to textual components and calculating and assigning a sentiment value to the text. Next, we applied our SA algorithm to an archive of social media discourse on Twitter that contained equity-related hashtags to compare sentiment among health professionals and the general population. Results: When tested on the initial archive, our SA algorithm was highly accurate compared to human scoring of sentiment. An analysis of bias-related social media discourse demonstrated that health professional tweets (n=555) were less neutral than the general population (n=6680) when discussing social issues on professionally associated accounts ($\chi$2 [2, n=555)]=35.455; P<.001), suggesting that health professionals attach more sentiment to their posts on Twitter than seen in the general population. Conclusions: The finding that health professionals are more likely to show and convey emotions regarding equity-related issues on social media has implications for teaching and learning about sensitive topics related to health professions education. Such emotions must therefore be considered in the design, delivery, and evaluation of equity and bias-related education. ",
doi="10.2196/33934",
url="https://mededu.jmir.org/2022/1/e33934",
url="http://www.ncbi.nlm.nih.gov/pubmed/35353048"
}


@Article{info:doi/10.2196/34935,
author="Ranpariya, K. Varun
and Fathy, Ramie
and Chu, Brian
and Wang, Sonia
and Lipoff, B. Jules",
title="Patterns of Promotional Content by Dermatology Influencers on TikTok",
journal="JMIR Dermatol",
year="2022",
month="Mar",
day="30",
volume="5",
number="1",
pages="e34935",
keywords="social media",
keywords="TikTok",
keywords="Instagram",
keywords="promotion",
keywords="conflicts of interest",
keywords="influencer",
keywords="dermatology",
keywords="dermatologist",
doi="10.2196/34935",
url="https://derma.jmir.org/2022/1/e34935",
url="http://www.ncbi.nlm.nih.gov/pubmed/37632857"
}


@Article{info:doi/10.2196/35358,
author="Tanaka, Hiroki
and Nakamura, Satoshi",
title="The Acceptability of Virtual Characters as Social Skills Trainers: Usability Study",
journal="JMIR Hum Factors",
year="2022",
month="Mar",
day="29",
volume="9",
number="1",
pages="e35358",
keywords="social skills training",
keywords="virtual agent design",
keywords="virtual assistant",
keywords="virtual trainer",
keywords="chatbot",
keywords="acceptability",
keywords="realism",
keywords="virtual agent",
keywords="simulation",
keywords="social skill",
keywords="social interaction",
keywords="design",
keywords="training",
keywords="crowdsourcing",
abstract="Background: Social skills training by human trainers is a well-established method to provide appropriate social interaction skills and strengthen social self-efficacy. In our previous work, we attempted to automate social skills training by developing a virtual agent that taught social skills through interaction. Previous research has not investigated the visual design of virtual agents for social skills training. Thus, we investigated the effect of virtual agent visual design on automated social skills training. Objective: The 3 main purposes of this research were to investigate the effect of virtual agent appearance on automated social skills training, the relationship between acceptability and other measures (eg, likeability, realism, and familiarity), and the relationship between likeability and individual user characteristics (eg, gender, age, and autistic traits). Methods: We prepared images and videos of a virtual agent, and 1218 crowdsourced workers rated the virtual agents through a questionnaire. In designing personalized virtual agents, we investigated the acceptability, likeability, and other impressions of the virtual agents and their relationship to individual characteristics. Results: We found that there were differences between the virtual agents in all measures (P<.001). A female anime-type virtual agent was rated as the most likeable. We also confirmed that participants' gender, age, and autistic traits were related to their ratings. Conclusions: We confirmed the effect of virtual agent design on automated social skills training. Our findings are important in designing the appearance of an agent for use in personalized automated social skills training. ",
doi="10.2196/35358",
url="https://humanfactors.jmir.org/2022/1/e35358",
url="http://www.ncbi.nlm.nih.gov/pubmed/35348468"
}


@Article{info:doi/10.2196/35016,
author="Jang, Hyeju
and Rempel, Emily
and Roe, Ian
and Adu, Prince
and Carenini, Giuseppe
and Janjua, Zafar Naveed",
title="Tracking Public Attitudes Toward COVID-19 Vaccination on Tweets in Canada: Using Aspect-Based Sentiment Analysis",
journal="J Med Internet Res",
year="2022",
month="Mar",
day="29",
volume="24",
number="3",
pages="e35016",
keywords="COVID-19",
keywords="vaccination",
keywords="Twitter",
keywords="aspect-based sentiment analysis",
keywords="Canada",
keywords="social media",
keywords="pandemic",
keywords="content analysis",
keywords="vaccine rollout",
keywords="sentiment analysis",
keywords="public sentiment",
keywords="public health",
keywords="health promotion",
keywords="vaccination promotion",
abstract="Background: The development and approval of COVID-19 vaccines have generated optimism for the end of the COVID-19 pandemic and a return to normalcy. However, vaccine hesitancy, often fueled by misinformation, poses a major barrier to achieving herd immunity. Objective: We aim to investigate Twitter users' attitudes toward COVID-19 vaccination in Canada after vaccine rollout. Methods: We applied a weakly supervised aspect-based sentiment analysis (ABSA) technique, which involves the human-in-the-loop system, on COVID-19 vaccination--related tweets in Canada. Automatically generated aspect and opinion terms were manually corrected by public health experts to ensure the accuracy of the terms and make them more domain-specific. Then, based on these manually corrected terms, the system inferred sentiments toward the aspects. We observed sentiments toward key aspects related to COVID-19 vaccination, and investigated how sentiments toward ``vaccination'' changed over time. In addition, we analyzed the most retweeted or liked tweets by observing most frequent nouns and sentiments toward key aspects. Results: After applying the ABSA system, we obtained 170 aspect terms (eg, ``immunity'' and ``pfizer'') and 6775 opinion terms (eg, ``trustworthy'' for the positive sentiment and ``jeopardize'' for the negative sentiment). While manually verifying or editing these terms, our public health experts selected 20 key aspects related to COVID-19 vaccination for analysis. The sentiment analysis results for the 20 key aspects revealed negative sentiments related to ``vaccine distribution,'' ``side effects,'' ``allergy,'' ``reactions,'' and ``anti-vaxxer,'' and positive sentiments related to ``vaccine campaign,'' ``vaccine candidates,'' and ``immune response.'' These results indicate that the Twitter users express concerns about the safety of vaccines but still consider vaccines as the option to end the pandemic. In addition, compared to the sentiment of the remaining tweets, the most retweeted or liked tweets showed more positive sentiment overall toward key aspects (P<.001), especially vaccines (P<.001) and vaccination (P=.009). Further investigation of the most retweeted or liked tweets revealed two opposing trends in Twitter users who showed negative sentiments toward vaccines: the ``anti-vaxxer'' population that used negative sentiments as a means to discourage vaccination and the ``Covid Zero'' population that used negative sentiments to encourage vaccinations while critiquing the public health response. Conclusions: Our study examined public sentiments toward COVID-19 vaccination on tweets over an extended period in Canada. Our findings could inform public health agencies to design and implement interventions to promote vaccination. ",
doi="10.2196/35016",
url="https://www.jmir.org/2022/3/e35016",
url="http://www.ncbi.nlm.nih.gov/pubmed/35275835"
}


@Article{info:doi/10.2196/34421,
author="Cresswell, Liam
and Espin-Noboa, Lisette
and Murphy, Q. Malia S.
and Ramlawi, Serine
and Walker, C. Mark
and Karsai, M{\'a}rton
and Corsi, J. Daniel",
title="The Volume and Tone of Twitter Posts About Cannabis Use During Pregnancy: Protocol for a Scoping Review",
journal="JMIR Res Protoc",
year="2022",
month="Mar",
day="29",
volume="11",
number="3",
pages="e34421",
keywords="cannabis",
keywords="pregnancy",
keywords="health information",
keywords="social media",
keywords="Twitter",
abstract="Background: Cannabis use has increased in Canada since its legalization in 2018, including among pregnant women who may be motivated to use cannabis to reduce symptoms of nausea and vomiting. However, a growing body of research suggests that cannabis use during pregnancy may harm the developing fetus. As a result, patients increasingly seek medical advice from online sources, but these platforms may also spread anecdotal descriptions or misinformation. Given the possible disconnect between online messaging and evidence-based research about the effects of cannabis use during pregnancy, there is a potential for advice taken from social media to affect the health of mothers and their babies. Objective: This study aims to quantify the volume and tone of English language posts related to cannabis use in pregnancy from January 2012 to December 2021. Methods: Modeling published frameworks for scoping reviews, we will collect publicly available posts from Twitter that mention cannabis use during pregnancy and use the Twitter Application Programming Interface for Academic Research to extract data from tweets, including public metrics such as the number of likes, retweets, and quotes, as well as health effect mentions, sentiment, location, and users' interests. These data will be used to quantify how cannabis use during pregnancy is discussed on Twitter and to build a qualitative profile of supportive and opposing posters. Results: The CHEO Research Ethics Board reviewed our project and granted an exemption in May 2021. As of December 2021, we have gained approval to use the Twitter Application Programming Interface for Academic Research and have developed a preliminary search strategy that returns over 3 million unique tweets posted between 2012 and 2021. Conclusions: Understanding how Twitter is being used to discuss cannabis use during pregnancy will help public health agencies and health care providers assess the messaging patients may be receiving and develop communication strategies to counter misinformation, especially in geographical regions where legalization is recent or imminent. Most importantly, we foresee that our findings will assist expecting families in making informed choices about where they choose to access advice about using cannabis during pregnancy. Trial Registration: Open Science Framework 10.17605/OSF.IO/BW8DA; www.osf.io/6fb2e International Registered Report Identifier (IRRID): PRR1-10.2196/34421 ",
doi="10.2196/34421",
url="https://www.researchprotocols.org/2022/3/e34421",
url="http://www.ncbi.nlm.nih.gov/pubmed/35348465"
}


@Article{info:doi/10.2196/27894,
author="Chu, Kar-Hai
and Hershey, B. Tina
and Hoffman, L. Beth
and Wolynn, Riley
and Colditz, B. Jason
and Sidani, E. Jaime
and Primack, A. Brian",
title="Puff Bars, Tobacco Policy Evasion, and Nicotine Dependence: Content Analysis of Tweets",
journal="J Med Internet Res",
year="2022",
month="Mar",
day="25",
volume="24",
number="3",
pages="e27894",
keywords="tobacco",
keywords="policy",
keywords="social media",
keywords="e-cigarette",
keywords="twitter",
keywords="mHealth",
keywords="dependence",
keywords="addiction",
keywords="nicotine",
abstract="Background: Puff Bars are e-cigarettes that continued marketing flavored products by exploiting the US Food and Drug Administration exemption for disposable devices. Objective: This study aimed to examine discussions related to Puff Bar on Twitter to identify tobacco regulation and policy themes as well as unanticipated outcomes of regulatory loopholes. Methods: Of 8519 original tweets related to Puff Bar collected from July 13, 2020, to August 13, 2020, a random 20\% subsample (n=2661) was selected for qualitative coding of topics related to nicotine dependence and tobacco policy. Results: Of the human-coded tweets, 2123 (80.2\%) were coded as relevant to Puff Bar as the main topic. Of those tweets, 698 (32.9\%) discussed tobacco policy, including flavors (n=320, 45.9\%), regulations (n=124, 17.8\%), purchases (n=117, 16.8\%), and other products (n=110, 15.8\%). Approximately 22\% (n=480) of the tweets referenced dependence, including lack of access (n=273, 56.9\%), appetite suppression (n=59, 12.3\%), frequent use (n=47, 9.8\%), and self-reported dependence (n=110, 22.9\%). Conclusions: This study adds to the growing evidence base that the US Food and Drug Administration ban of e-cigarette flavors did not reduce interest, but rather shifted the discussion to brands utilizing a loophole that allowed flavored products to continue to be sold in disposable devices. Until comprehensive tobacco policy legislation is developed, new products or loopholes will continue to supply nicotine demand. ",
doi="10.2196/27894",
url="https://www.jmir.org/2022/3/e27894",
url="http://www.ncbi.nlm.nih.gov/pubmed/35333188"
}


@Article{info:doi/10.2196/34544,
author="Elgersma, Hess Ingeborg
and Fretheim, Atle
and Indseth, Thor
and Munch, Thorolvsen Anita
and Johannessen, B{\o}e Live
and Hansen, Engh Christine",
title="The Evaluation of a Social Media Campaign to Increase COVID-19 Testing in Migrant Groups: Cluster Randomized Trial",
journal="J Med Internet Res",
year="2022",
month="Mar",
day="24",
volume="24",
number="3",
pages="e34544",
keywords="COVID-19",
keywords="SARS-CoV-2",
keywords="social media",
keywords="campaign",
keywords="cluster randomized trial",
keywords="nonpharmaceutical interventions",
keywords="migrant",
keywords="intervention",
keywords="testing",
keywords="strategy",
keywords="public health",
keywords="Facebook",
keywords="communication",
abstract="Background: A low test positivity rate is key to keeping the COVID-19 pandemic under control. Throughout the pandemic, several migrant groups in Norway have seen higher rates of confirmed COVID-19 and related hospitalizations, while test positivity has remained high in the same groups. The Norwegian government has used several platforms for communication, and targeted social media advertisements have in particular been an important part of the communication strategy to reach these groups. Objective: In this study, we aimed to investigate whether such a targeted Facebook campaign increased the rate of COVID-19 tests performed in certain migrant groups. Methods: We randomly assigned 386 Norwegian municipalities and city districts to intervention or control groups. Individuals born in Eritrea, Iraq, Pakistan, Poland, Russia, Somalia, Syria, and Turkey residing in intervention areas were targeted with a social media campaign aiming at increasing the COVID-19 test rate. The campaign message was in a simple language and conveyed in the users' main language or in English. Results: During the 2-week follow-up period, the predicted probability of having a COVID-19 test taken was 4.82\% (95\% CI 4.47\%-5.18\%) in the control group, and 5.58\% (95\% CI 5.20\%-5.99\%) in the intervention group (P=.004). Conclusions: Our targeted social media intervention led to a modest increase in test rates among certain migrant groups in Norway. Trial Registration: ClinicalTrials.gov NCT04866589; https://clinicaltrials.gov/ct2/show/NCT04866589 ",
doi="10.2196/34544",
url="https://www.jmir.org/2022/3/e34544",
url="http://www.ncbi.nlm.nih.gov/pubmed/35285811"
}


@Article{info:doi/10.2196/31135,
author="Metzler, Matthias Julian
and Kalaitzopoulos, Rafail Dimitrios
and Burla, Laurin
and Schaer, Gabriel
and Imesch, Patrick",
title="Examining the Influence on Perceptions of Endometriosis via Analysis of Social Media Posts: Cross-sectional Study",
journal="JMIR Form Res",
year="2022",
month="Mar",
day="18",
volume="6",
number="3",
pages="e31135",
keywords="endometriosis",
keywords="social media",
keywords="Facebook",
keywords="Instagram",
keywords="influencer",
keywords="engagement",
abstract="Background: Social media platforms, such as Facebook and Instagram, are increasingly being used to share health-related information by ``influencers,'' regular users, and institutions alike. While patients may benefit in various ways from these interactions, little is known about the types of endometriosis-related information published on social media. As digital opinion leaders influence the perceptions of their followers, physicians need to be aware about ideas and beliefs that are available online, in order to address possible misconceptions and provide optimal patient care. Objective: The aim of this study was to identify and analyze frequent endometriosis-related discussion topics on social media in order to offer caregivers insight into commonly discussed subject matter and aspects. Methods: We performed a systematic search using predefined parameters. Using the term ``endometriosis'' in Facebook's search function and a social media search engine, a list of Facebook pages was generated. A list of Instagram accounts was generated using the terms ``endometriosis'' and ``endo'' in Instagram's search function. Pages and accounts in English with 5000 or more followers or likes were included. Nonpublic, unrelated, or inactive pages and accounts were excluded. For each account, the most recent 10 posts were identified and categorized by two independent examiners using qualitative content analysis. User engagement was calculated using the numbers of interactions (ie, shares, likes, and comments) for each post, stratified by the number of followers. Results: A total of 39 Facebook pages and 43 Instagram accounts with approximately 1.4 million followers were identified. Hospitals and medical centers made up 15\% (6/39) of the Facebook pages and 5\% (2/43) of the Instagram accounts. Top accounts had up to 111,600 (Facebook) and 41,400 (Instagram) followers. A total of 820 posts were analyzed. On Facebook, most posts were categorized as ``awareness'' (101/390, 25.9\% of posts), ``education and research'' (71/390, 18.2\%), and ``promotion'' (64/390, 16.4\%). On Instagram, the top categories were ``inspiration and support'' (120/430, 27.9\% of posts), ``awareness'' (72/430, 16.7\%), and ``personal story'' (72/430, 16.7\%). The frequency of most categories differed significantly between platforms. User engagement was higher on Instagram than on Facebook (3.20\% vs 0.97\% of followers per post). On Instagram, the highest percentage of users engaged with posts categorized as ``humor'' (mean 4.19\%, SD 4.53\%), ``personal story'' (mean 3.02\%, SD 4.95\%), and ``inspiration and support'' (mean 2.83\%, SD 3.08\%). On Facebook, posts in the categories ``awareness'' (mean 2.05\%, SD 15.56\%), ``humor'' (mean 0.91\%, SD 1.07\%), and ``inspiration and support'' (mean 0.56\%, SD 1.37\%) induced the most user engagement. Posts made by hospitals and medical centers generated higher user engagement than posts by regular accounts on Facebook (mean 1.44\%, SD 1.11\% vs mean 0.88\%, SD  2.71\% of followers per post) and Instagram (mean 3.33\%, SD 1.21\% vs mean 3.19\%, SD 2.52\% of followers per post). Conclusions: Facebook and Instagram are widely used to share endometriosis-related information among a large number of users. Most posts offer inspiration or support, spread awareness about the disease, or cover personal issues. Followers mostly engage with posts with a humoristic, supportive, and awareness-generating nature. Health care providers should be aware about the topics discussed online, as this may lead to an increased understanding of the needs and demands of digitally proficient patients with endometriosis. ",
doi="10.2196/31135",
url="https://formative.jmir.org/2022/3/e31135",
url="http://www.ncbi.nlm.nih.gov/pubmed/35302501"
}


@Article{info:doi/10.2196/31687,
author="Ni, Congning
and Wan, Zhiyu
and Yan, Chao
and Liu, Yongtai
and Clayton, Wright Ellen
and Malin, Bradley
and Yin, Zhijun",
title="The Public Perception of the \#GeneEditedBabies Event Across Multiple Social Media Platforms: Observational Study",
journal="J Med Internet Res",
year="2022",
month="Mar",
day="11",
volume="24",
number="3",
pages="e31687",
keywords="CRISPR/Cas9",
keywords="gene-edited babies",
keywords="social media",
keywords="stance learning",
keywords="text mining",
keywords="content analysis",
abstract="Background: In November 2018, a Chinese researcher reported that his team had applied clustered regularly interspaced palindromic repeats or associated protein 9 to delete the gene C-C chemokine receptor type 5 from embryos and claimed that the 2 newborns would have lifetime immunity from HIV infection, an event referred to as \#GeneEditedBabies on social media platforms. Although this event stirred a worldwide debate on ethical and legal issues regarding clinical trials with embryonic gene sequences, the focus has mainly been on academics and professionals. However, how the public, especially stratified by geographic region and culture, reacted to these issues is not yet well-understood. Objective: The aim of this study is to examine web-based posts about the \#GeneEditedBabies event and characterize and compare the public's stance across social media platforms with different user bases. Methods: We used a set of relevant keywords to search for web-based posts in 4 worldwide or regional mainstream social media platforms: Sina Weibo (China), Twitter, Reddit, and YouTube. We applied structural topic modeling to analyze the main discussed topics and their temporal trends. On the basis of the topics we found, we designed an annotation codebook to label 2000 randomly sampled posts from each platform on whether a supporting, opposing, or neutral stance toward this event was expressed and what the major considerations of those posts were if a stance was described. The annotated data were used to compare stances and the language used across the 4 web-based platforms. Results: We collected >220,000 posts published by approximately 130,000 users regarding the \#GeneEditedBabies event. Our results indicated that users discussed a wide range of topics, some of which had clear temporal trends. Our results further showed that although almost all experts opposed this event, many web-based posts supported this event. In particular, Twitter exhibited the largest number of posts in opposition (701/816, 85.9\%), followed by Sina Weibo (968/1140, 84.91\%), Reddit (550/898, 61.2\%), and YouTube (567/1078, 52.6\%). The primary opposing reason was rooted in ethical concerns, whereas the primary supporting reason was based on the expectation that such technology could prevent the occurrence of diseases in the future. Posts from these 4 platforms had different language uses and patterns when they expressed stances on the \#GeneEditedBabies event. Conclusions: This research provides evidence that posts on web-based platforms can offer insights into the public's stance on gene editing techniques. However, these stances vary across web-based platforms and often differ from those raised by academics and policy makers. ",
doi="10.2196/31687",
url="https://www.jmir.org/2022/3/e31687",
url="http://www.ncbi.nlm.nih.gov/pubmed/35275077"
}


@Article{info:doi/10.2196/25614,
author="Tian, Hao
and Gaines, Christy
and Launi, Lori
and Pomales, Ana
and Vazquez, Germaine
and Goharian, Amanda
and Goodnight, Bradley
and Haney, Erica
and Reh, M. Christopher
and Rogers, D. Rachel",
title="Understanding Public Perceptions of Per- and Polyfluoroalkyl Substances: Infodemiology Study of Social Media",
journal="J Med Internet Res",
year="2022",
month="Mar",
day="11",
volume="24",
number="3",
pages="e25614",
keywords="PFAS",
keywords="per- and polyfluoroalkyl substances",
keywords="social media",
keywords="public perceptions",
abstract="Background: Per- and polyfluoroalkyl substances (PFAS) are environmental contaminants that have received significant public attention. PFAS are a large group of human-made chemicals that have been used in industry and consumer products worldwide since the 1950s. Human exposure to PFAS is a growing public health concern. Studies suggest that exposure to PFAS may increase the risk of some cancers and have negative health impacts on the endocrine, metabolic, and immune systems. Federal and state health partners are investigating the exposure to and possible health effects associated with PFAS. Government agencies can observe social media discourse on PFAS to better understand public concerns and develop targeted communication and outreach efforts. Objective: The primary objective of this study is to understand how social media is used to share, disseminate, and engage in public discussions of PFAS-related information in the United States. Methods: We investigated PFAS-related content across 2 social media platforms between May 1, 2017, and April 30, 2019, to identify how social media is used in the United States to seek and disseminate PFAS-related information. Our key variable of interest was posts that mentioned ``PFAS,'' ``PFOA,'' ``PFOS,'' and their hashtag variations across social media platforms. Additional variables included post type, time, PFAS event, and geographic location. We examined term use and post type differences across platforms. We used descriptive statistics and regression analysis to assess the incidence of PFAS discussions and to identify the date, event, and geographic patterns. We qualitatively analyzed social media content to determine the most prevalent themes discussed on social media platforms. Results: Our analysis revealed that Twitter had a significantly greater volume of PFAS-related posts compared with Reddit (98,264 vs 3126 posts). PFAS-related social media posts increased by 670\% over 2 years, indicating a marked increase in social media users' interest in and awareness of PFAS. Active engagement varied across platforms, with Reddit posts demonstrating more in-depth discussions compared with passive likes and reposts among Twitter users. Spikes in PFAS discussions were evident and connected to the discovery of contamination events, media coverage, and scientific publications. Thematic analysis revealed that social media users see PFAS as a significant public health concern and seek a trusted source of information about PFAS-related public health efforts. Conclusions: The analysis identified a prevalent theme---on social media, PFAS are perceived as an immediate public health concern, which demonstrates a growing sense of urgency to understand this emerging contaminant and its potential health impacts. Government agencies can continue using social media research to better understand the changing community sentiment on PFAS and disseminate targeted information and then use social media as a forum for dispelling misinformation, communicating scientific findings, and providing resources for relevant public health services. ",
doi="10.2196/25614",
url="https://www.jmir.org/2022/3/e25614",
url="http://www.ncbi.nlm.nih.gov/pubmed/35275066"
}


@Article{info:doi/10.2196/34040,
author="Blane, T. Janice
and Bellutta, Daniele
and Carley, M. Kathleen",
title="Social-Cyber Maneuvers During the COVID-19 Vaccine Initial Rollout: Content Analysis of Tweets",
journal="J Med Internet Res",
year="2022",
month="Mar",
day="7",
volume="24",
number="3",
pages="e34040",
keywords="social cybersecurity",
keywords="social-cyber maneuvers",
keywords="social network analysis",
keywords="disinformation",
keywords="BEND maneuvers",
keywords="COVID-19",
keywords="coronavirus",
keywords="social media",
keywords="vaccine",
keywords="anti-vaccine",
keywords="pro-vaccine",
keywords="ORA-PRO",
keywords="cybersecurity",
keywords="security",
keywords="Twitter",
keywords="community",
keywords="communication",
keywords="health information",
keywords="manipulation",
keywords="belief",
abstract="Background: During the time surrounding the approval and initial distribution of Pfizer-BioNTech's COVID-19 vaccine, large numbers of social media users took to using their platforms to voice opinions on the vaccine. They formed pro- and anti-vaccination groups toward the purpose of influencing behaviors to vaccinate or not to vaccinate. The methods of persuasion and manipulation for convincing audiences online can be characterized under a framework for social-cyber maneuvers known as the BEND maneuvers. Previous studies have been conducted on the spread of COVID-19 vaccine disinformation. However, these previous studies lacked comparative analyses over time on both community stances and the competing techniques of manipulating both the narrative and network structure to persuade target audiences. Objective: This study aimed to understand community response to vaccination by dividing Twitter data from the initial Pfizer-BioNTech COVID-19 vaccine rollout into pro-vaccine and anti-vaccine stances, identifying key actors and groups, and evaluating how the different communities use social-cyber maneuvers, or BEND maneuvers, to influence their target audiences and the network as a whole. Methods: COVID-19 Twitter vaccine data were collected using the Twitter application programming interface (API) for 1-week periods before, during, and 6 weeks after the initial Pfizer-BioNTech rollout (December 2020 to January 2021). Bot identifications and linguistic cues were derived for users and tweets, respectively, to use as metrics for evaluating social-cyber maneuvers. Organization Risk Analyzer (ORA)-PRO software was then used to separate the vaccine data into pro-vaccine and anti-vaccine communities and to facilitate identification of key actors, groups, and BEND maneuvers for a comparative analysis between each community and the entire network. Results: Both the pro-vaccine and anti-vaccine communities used combinations of the 16 BEND maneuvers to persuade their target audiences of their particular stances. Our analysis showed how each side attempted to build its own community while simultaneously narrowing and neglecting the opposing community. Pro-vaccine users primarily used positive maneuvers such as excite and explain messages to encourage vaccination and backed leaders within their group. In contrast, anti-vaccine users relied on negative maneuvers to dismay and distort messages with narratives on side effects and death and attempted to neutralize the effectiveness of the leaders within the pro-vaccine community. Furthermore, nuking through platform policies showed to be effective in reducing the size of the anti-vaccine online community and the quantity of anti-vaccine messages. Conclusions: Social media continues to be a domain for manipulating beliefs and ideas. These conversations can ultimately lead to real-world actions such as to vaccinate or not to vaccinate against COVID-19. Moreover, social media policies should be further explored as an effective means for curbing disinformation and misinformation online. ",
doi="10.2196/34040",
url="https://www.jmir.org/2022/3/e34040",
url="http://www.ncbi.nlm.nih.gov/pubmed/35044302"
}


@Article{info:doi/10.2196/34831,
author="Mourali, Mehdi
and Drake, Carly",
title="The Challenge of Debunking Health Misinformation in Dynamic Social Media Conversations: Online Randomized Study of Public Masking During COVID-19",
journal="J Med Internet Res",
year="2022",
month="Mar",
day="2",
volume="24",
number="3",
pages="e34831",
keywords="misinformation",
keywords="debunking",
keywords="correction",
keywords="social media",
keywords="truth objectivity",
keywords="COVID-19",
keywords="infodemiology",
keywords="health information",
keywords="digital health",
keywords="public health",
keywords="health professional",
abstract="Background: The spread of false and misleading health information on social media can cause individual and social harm. Research on debunking has shown that properly designed corrections can mitigate the impact of misinformation, but little is known about the impact of correction in the context of prolonged social media debates. For example, when a social media user takes to Facebook to make a false claim about a health-related practice and a health expert subsequently refutes the claim, the conversation rarely ends there. Often, the social media user proceeds by rebuking the critic and doubling down on the claim. Objective: The aim of this study was to examine the impact of such extended back and forth between false claims and debunking attempts on observers' dispositions toward behavior that science favors. We tested competing predictions about the effect of extended exposure on people's attitudes and intentions toward masking in public during the early days of the COVID-19 pandemic and explored several psychological processes potentially underlying this effect. Methods: A total of 500 US residents took part in an online experiment in October 2020. They reported on their attitudes and intentions toward wearing masks in public. They were then randomly assigned to one of four social media exposure conditions (misinformation only vs misinformation+correction vs misinformation+correction+rebuke vs misinformation+correction+rebuke+second correction), and reported their attitudes and intentions for a second time. They also indicated whether they would consider sharing the thread if they were to see it on social media and answered questions on potential mediators and covariates. Results: Exposure to misinformation had a negative impact on attitudes and intentions toward masking ($\beta$=--.35, 95\% CI --.42 to --.29; P<.001). Moreover, initial debunking of a false claim generally improved attitudes and intentions toward masking ($\beta$=.35, 95\% CI .16 to .54; P<.001). However, this improvement was washed out by further exposure to false claims and debunking attempts ($\beta$=--.53, 95\% CI --.72 to --.34; P<.001). The latter result is partially explained by a decrease in the perceived objectivity of truth. That is, extended exposure to false claims and debunking attempts appear to weaken the belief that there is an objectively correct answer to how people ought to behave in this situation, which in turn leads to less positive reactions toward masking as the prescribed behavior. Conclusions: Health professionals and science advocates face an underappreciated challenge in attempting to debunk misinformation on social media. Although engaging in extended debates with science deniers and other purveyors of bunk appears necessary, more research is needed to address the unintended consequences of such engagement. ",
doi="10.2196/34831",
url="https://www.jmir.org/2022/3/e34831",
url="http://www.ncbi.nlm.nih.gov/pubmed/35156933"
}


@Article{info:doi/10.2196/34870,
author="MacLeod, Spencer
and Singh, Paul Nikhi
and Boyd, Joseph Carter",
title="The Unclear Role of the Physician on Social Media During the COVID-19 Pandemic. Comment on ``Emergency Physician Twitter Use in the COVID-19 Pandemic as a Potential Predictor of Impending Surge: Retrospective Observational Study''",
journal="J Med Internet Res",
year="2022",
month="Mar",
day="2",
volume="24",
number="3",
pages="e34870",
keywords="COVID-19 pandemic",
keywords="emergency medicine",
keywords="disaster medicine",
keywords="crisis standards of care",
keywords="latent Dirichlet allocation",
keywords="topic modeling",
keywords="Twitter",
keywords="sentiment analysis",
keywords="surge capacity",
keywords="physician wellness",
keywords="social media",
keywords="internet",
keywords="infodemiology",
keywords="COVID-19",
doi="10.2196/34870",
url="https://www.jmir.org/2022/3/e34870",
url="http://www.ncbi.nlm.nih.gov/pubmed/35120018"
}


@Article{info:doi/10.2196/29422,
author="Willis, Erin
and Delbaere, Marjorie",
title="Patient Influencers: The Next Frontier in Direct-to-Consumer Pharmaceutical Marketing",
journal="J Med Internet Res",
year="2022",
month="Mar",
day="1",
volume="24",
number="3",
pages="e29422",
keywords="social media",
keywords="influencers",
keywords="health",
keywords="pharmaceutical marketing",
keywords="direct-to-consumer advertising",
keywords="relationship marketing",
keywords="marketing",
keywords="advertising",
keywords="pharmaceuticals",
keywords="ethics",
doi="10.2196/29422",
url="https://www.jmir.org/2022/3/e29422",
url="http://www.ncbi.nlm.nih.gov/pubmed/35230241"
}


@Article{info:doi/10.2196/27244,
author="Liu, Danxia
and Feng, Lin Xing
and Ahmed, Farooq
and Shahid, Muhammad
and Guo, Jing",
title="Detecting and Measuring Depression on Social Media Using a Machine Learning Approach: Systematic Review",
journal="JMIR Ment Health",
year="2022",
month="Mar",
day="1",
volume="9",
number="3",
pages="e27244",
keywords="depression",
keywords="machine learning",
keywords="social media",
abstract="Background: Detection of depression gained prominence soon after this troublesome disease emerged as a serious public health concern worldwide. Objective: This systematic review aims to summarize the findings of previous studies concerning applying machine learning (ML) methods to text data from social media to detect depressive symptoms and to suggest directions for future research in this area. Methods: A bibliographic search was conducted for the period of January 1990 to December 2020 in Google Scholar, PubMed, Medline, ERIC, PsycINFO, and BioMed. Two reviewers retrieved and independently assessed the 418 studies consisting of 322 articles identified through database searching and 96 articles identified through other sources; 17 of the studies met the criteria for inclusion. Results: Of the 17 studies, 10 had identified depression based on researcher-inferred mental status, 5 had identified it based on users' own descriptions of their mental status, and 2 were identified based on community membership. The ML approaches of 13 of the 17 studies were supervised learning approaches, while 3 used unsupervised learning approaches; the remaining 1 study did not describe its ML approach. Challenges in areas such as sampling, optimization of approaches to prediction and their features, generalizability, privacy, and other ethical issues call for further research. Conclusions: ML approaches applied to text data from users on social media can work effectively in depression detection and could serve as complementary tools in public mental health practice. ",
doi="10.2196/27244",
url="https://mental.jmir.org/2022/3/e27244",
url="http://www.ncbi.nlm.nih.gov/pubmed/35230252"
}


@Article{info:doi/10.2196/33340,
author="Pulsipher, J. Kayd
and Concilla, Anthony
and Presley, L. Colby
and Laughter, R. Melissa
and Anderson, Jaclyn
and Chea, Emily
and Lim, Kristina
and Rundle, W. Chandler
and Szeto, D. Mindy
and Dellavalle, Robert",
title="An Analysis of Skin of Color Content on TikTok",
journal="JMIR Dermatol",
year="2022",
month="Mar",
day="1",
volume="5",
number="1",
pages="e33340",
keywords="internet",
keywords="social media",
keywords="TikTok",
keywords="skin of color",
keywords="SoC",
keywords="influencer",
keywords="user engagement",
keywords="hashtag",
keywords="dermatologist",
doi="10.2196/33340",
url="https://derma.jmir.org/2022/1/e33340"
}


@Article{info:doi/10.2196/30397,
author="Hasan, Abul
and Levene, Mark
and Weston, David
and Fromson, Renate
and Koslover, Nicolas
and Levene, Tamara",
title="Monitoring COVID-19 on Social Media: Development of an End-to-End Natural Language Processing Pipeline Using a Novel Triage and Diagnosis Approach",
journal="J Med Internet Res",
year="2022",
month="Feb",
day="28",
volume="24",
number="2",
pages="e30397",
keywords="COVID-19",
keywords="conditional random fields",
keywords="disease detection and surveillance",
keywords="medical social media",
keywords="natural language processing",
keywords="severity and prevalence",
keywords="support vector machines",
keywords="triage and diagnosis",
abstract="Background: The COVID-19 pandemic has created a pressing need for integrating information from disparate sources in order to assist decision makers. Social media is important in this respect; however, to make sense of the textual information it provides and be able to automate the processing of large amounts of data, natural language processing methods are needed. Social media posts are often noisy, yet they may provide valuable insights regarding the severity and prevalence of the disease in the population. Here, we adopt a triage and diagnosis approach to analyzing social media posts using machine learning techniques for the purpose of disease detection and surveillance. We thus obtain useful prevalence and incidence statistics to identify disease symptoms and their severities, motivated by public health concerns. Objective: This study aims to develop an end-to-end natural language processing pipeline for triage and diagnosis of COVID-19 from patient-authored social media posts in order to provide researchers and public health practitioners with additional information on the symptoms, severity, and prevalence of the disease rather than to provide an actionable decision at the individual level. Methods: The text processing pipeline first extracted COVID-19 symptoms and related concepts, such as severity, duration, negations, and body parts, from patients' posts using conditional random fields. An unsupervised rule-based algorithm was then applied to establish relations between concepts in the next step of the pipeline. The extracted concepts and relations were subsequently used to construct 2 different vector representations of each post. These vectors were separately applied to build support vector machine learning models to triage patients into 3 categories and diagnose them for COVID-19. Results: We reported macro- and microaveraged F1 scores in the range of 71\%-96\% and 61\%-87\%, respectively, for the triage and diagnosis of COVID-19 when the models were trained on human-labeled data. Our experimental results indicated that similar performance can be achieved when the models are trained using predicted labels from concept extraction and rule-based classifiers, thus yielding end-to-end machine learning. In addition, we highlighted important features uncovered by our diagnostic machine learning models and compared them with the most frequent symptoms revealed in another COVID-19 data set. In particular, we found that the most important features are not always the most frequent ones. Conclusions: Our preliminary results show that it is possible to automatically triage and diagnose patients for COVID-19 from social media natural language narratives, using a machine learning pipeline in order to provide information on the severity and prevalence of the disease for use within health surveillance systems. ",
doi="10.2196/30397",
url="https://www.jmir.org/2022/2/e30397",
url="http://www.ncbi.nlm.nih.gov/pubmed/35142636"
}


@Article{info:doi/10.2196/33058,
author="Teague, J. Samantha
and Shatte, R. Adrian B.
and Weller, Emmelyn
and Fuller-Tyszkiewicz, Matthew
and Hutchinson, M. Delyse",
title="Methods and Applications of Social Media Monitoring of Mental Health During Disasters: Scoping Review",
journal="JMIR Ment Health",
year="2022",
month="Feb",
day="28",
volume="9",
number="2",
pages="e33058",
keywords="social media",
keywords="SNS",
keywords="mental health",
keywords="disaster",
keywords="big data",
keywords="digital psychiatry",
abstract="Background: With the increasing frequency and magnitude of disasters internationally, there is growing research and clinical interest in the application of social media sites for disaster mental health surveillance. However, important questions remain regarding the extent to which unstructured social media data can be harnessed for clinically meaningful decision-making. Objective: This comprehensive scoping review synthesizes interdisciplinary literature with a particular focus on research methods and applications. Methods: A total of 6 health and computer science databases were searched for studies published before April 20, 2021, resulting in the identification of 47 studies. Included studies were published in peer-reviewed outlets and examined mental health during disasters or crises by using social media data. Results: Applications across 31 mental health issues were identified, which were grouped into the following three broader themes: estimating mental health burden, planning or evaluating interventions and policies, and knowledge discovery. Mental health assessments were completed by primarily using lexical dictionaries and human annotations. The analyses included a range of supervised and unsupervised machine learning, statistical modeling, and qualitative techniques. The overall reporting quality was poor, with key details such as the total number of users and data features often not being reported. Further, biases in sample selection and related limitations in generalizability were often overlooked. Conclusions: The application of social media monitoring has considerable potential for measuring mental health impacts on populations during disasters. Studies have primarily conceptualized mental health in broad terms, such as distress or negative affect, but greater focus is required on validating mental health assessments. There was little evidence for the clinical integration of social media--based disaster mental health monitoring, such as combining surveillance with social media--based interventions or developing and testing real-world disaster management tools. To address issues with study quality, a structured set of reporting guidelines is recommended to improve the methodological quality, replicability, and clinical relevance of future research on the social media monitoring of mental health during disasters. ",
doi="10.2196/33058",
url="https://mental.jmir.org/2022/2/e33058",
url="http://www.ncbi.nlm.nih.gov/pubmed/35225815"
}


@Article{info:doi/10.2196/31943,
author="Concilla, Anthony
and Laughter, R. Melissa
and Presley, L. Colby
and Anderson, Jaclyn
and Rundle, W. Chandler",
title="The Dermatologist on Social Media: When the Pros Outweigh the Cons. Comment on ``Risks and Benefits of Using Social Media in Dermatology: Cross-sectional Questionnaire Study''",
journal="JMIR Dermatol",
year="2022",
month="Feb",
day="25",
volume="5",
number="1",
pages="e31943",
keywords="Instagram",
keywords="Twitter",
keywords="TikTok",
keywords="Facebook",
keywords="internet",
keywords="social media",
keywords="dermatologist",
keywords="generational differences",
keywords="information quality",
keywords="patient education",
keywords="online content",
keywords="risk",
keywords="benefit",
keywords="dermatology",
keywords="cross-sectional",
keywords="survey",
keywords="online health information",
doi="10.2196/31943",
url="https://derma.jmir.org/2022/1/e31943",
url="http://www.ncbi.nlm.nih.gov/pubmed/37632875"
}


@Article{info:doi/10.2196/31978,
author="Cummins, Alexander Jack",
title="Getting a Vaccine, Jab, or Vax Is More Than a Regular Expression. Comment on ``COVID-19 Vaccine-Related Discussion on Twitter: Topic Modeling and Sentiment Analysis''",
journal="J Med Internet Res",
year="2022",
month="Feb",
day="23",
volume="24",
number="2",
pages="e31978",
keywords="COVID-19",
keywords="vaccine",
keywords="vaccination",
keywords="Twitter",
keywords="infodemiology",
keywords="infoveillance",
keywords="topic",
keywords="sentiment",
keywords="opinion",
keywords="discussion",
keywords="communication",
keywords="social media",
keywords="perception",
keywords="concern",
keywords="emotion",
keywords="natural language processing",
doi="10.2196/31978",
url="https://www.jmir.org/2022/2/e31978",
url="http://www.ncbi.nlm.nih.gov/pubmed/35195531"
}


@Article{info:doi/10.2196/28704,
author="Sinicrope, S. Pamela
and Young, D. Colleen
and Resnicow, Ken
and Merritt, T. Zoe
and McConnell, R. Clara
and Hughes, A. Christine
and Koller, R. Kathryn
and Bock, J. Martha
and Decker, A. Paul
and Flanagan, A. Christie
and Meade, D. Crystal
and Thomas, K. Timothy
and Prochaska, J. Judith
and Patten, A. Christi",
title="Lessons Learned From Beta-Testing a Facebook Group Prototype to Promote Treatment Use in the ``Connecting Alaska Native People to Quit Smoking'' (CAN Quit) Study",
journal="J Med Internet Res",
year="2022",
month="Feb",
day="17",
volume="24",
number="2",
pages="e28704",
keywords="Web 2.0",
keywords="social media",
keywords="Facebook",
keywords="Alaska Native",
keywords="American Indian",
keywords="Alaska",
keywords="smoking",
keywords="cessation",
keywords="cancer prevention",
keywords="Quitline",
keywords="mobile phone",
doi="10.2196/28704",
url="https://www.jmir.org/2022/2/e28704",
url="http://www.ncbi.nlm.nih.gov/pubmed/35175208"
}


@Article{info:doi/10.2196/23354,
author="Luo, Aijing
and Qin, Lu
and Yuan, Yifeng
and Yang, Zhengzijin
and Liu, Fei
and Huang, Panhao
and Xie, Wenzhao",
title="The Effect of Online Health Information Seeking on Physician-Patient Relationships: Systematic Review",
journal="J Med Internet Res",
year="2022",
month="Feb",
day="10",
volume="24",
number="2",
pages="e23354",
keywords="online health information",
keywords="search behavior",
keywords="physician-patient relationship",
keywords="physician-patient consultation.",
abstract="Background: The internet has now become part of human life and is constantly changing people's way of life. With the increasing popularity of online health information (OHI), it has been found that OHI can affect the physician-patient relationship by influencing patient behaviors. Objective: This study aims to systematically investigate the impact of OHI-seeking behavior on the physician-patient relationship. Methods: Literature retrieval was conducted on 4 databases (Web of Science, PubMed, China National Knowledge Infrastructure, SinoMed), and the time limit for literature publication was before August 1, 2021. Results: We selected 53 target papers (42 [79\%] English papers and 11 [21\%] Chinese papers) that met the inclusion criteria. Of these, 31 (58\%) papers believe that patients' OHI behavior can enable them to participate in their own medical care, improve patient compliance, and improve the physician-patient relationship. In addition, 14 (26\%) papers maintain a neutral attitude, some believing that OHI behavior has no significant effect on doctors and patients and others believing that due to changes in the factors affecting OHI behavior, they will have a negative or a positive impact. Furthermore, 8 (15\%) papers believe that OHI search behavior has a negative impact on doctors and patients, while 6 (11\%) papers show that OHI reduces Chinese patients' trust in doctors. Conclusions: Our main findings showed that (1) OHI-seeking behavior has an impact on patients' psychology, behavior, and evaluation of doctors; (2) whether patients choose to discuss OHI with doctors has different effects on the physician-patient relationship; and (3) the negative impact of OHI on China's internet users is worthy of attention. Due to the low quality of OHI, poor health information literacy, short physician-patient communication time, and various types of negative news, patients' trust in doctors has declined, thus affecting the physician-patient relationship. Improvement of people's health information literacy and the quality of OHI are important factors that promote the positive impact of OHI on the physician-patient relationship. ",
doi="10.2196/23354",
url="https://www.jmir.org/2022/2/e23354",
url="http://www.ncbi.nlm.nih.gov/pubmed/35142620"
}


@Article{info:doi/10.2196/31569,
author="Neely, Stephen
and Eldredge, Christina
and Sanders, Ronald",
title="Authors' Reply: Understanding the Impact of Social Media Information and Misinformation Producers on Health Information Seeking. Comment on ``Health Information Seeking Behaviors on Social Media During the COVID-19 Pandemic Among American Social Networking Site Users: Survey Study''",
journal="J Med Internet Res",
year="2022",
month="Feb",
day="4",
volume="24",
number="2",
pages="e31569",
keywords="social media",
keywords="internet",
keywords="communication",
keywords="public health",
keywords="COVID-19",
keywords="usage",
keywords="United States",
keywords="information seeking",
keywords="web-based health information",
keywords="online health information",
keywords="survey",
keywords="mistrust",
keywords="vaccination",
keywords="misinformation",
doi="10.2196/31569",
url="https://www.jmir.org/2022/2/e31569",
url="http://www.ncbi.nlm.nih.gov/pubmed/35119376"
}


@Article{info:doi/10.2196/31415,
author="Boudreau, Hunter
and Singh, Nikhi
and Boyd, J. Carter",
title="Understanding the Impact of Social Media Information and Misinformation Producers on Health Information Seeking. Comment on ``Health Information Seeking Behaviors on Social Media During the COVID-19 Pandemic Among American Social Networking Site Users: Survey Study''",
journal="J Med Internet Res",
year="2022",
month="Feb",
day="4",
volume="24",
number="2",
pages="e31415",
keywords="social media",
keywords="internet",
keywords="communication",
keywords="public health",
keywords="COVID-19",
keywords="usage",
keywords="United States",
keywords="information seeking",
keywords="web-based health information",
keywords="online health information",
keywords="survey",
keywords="mistrust",
keywords="vaccination",
keywords="misinformation",
doi="10.2196/31415",
url="https://www.jmir.org/2022/2/e31415",
url="http://www.ncbi.nlm.nih.gov/pubmed/35076408"
}


@Article{info:doi/10.2196/35552,
author="Gisondi, A. Michael
and Barber, Rachel
and Faust, Samuel Jemery
and Raja, Ali
and Strehlow, C. Matthew
and Westafer, M. Lauren
and Gottlieb, Michael",
title="A Deadly Infodemic: Social Media and the Power of COVID-19 Misinformation",
journal="J Med Internet Res",
year="2022",
month="Feb",
day="1",
volume="24",
number="2",
pages="e35552",
keywords="COVID-19",
keywords="social media",
keywords="misinformation",
keywords="disinformation",
keywords="infodemic",
keywords="ethics",
keywords="vaccination",
keywords="vaccine hesitancy",
keywords="infoveillance",
keywords="vaccine",
doi="10.2196/35552",
url="https://www.jmir.org/2022/2/e35552",
url="http://www.ncbi.nlm.nih.gov/pubmed/35007204"
}


@Article{info:doi/10.2196/31911,
author="Nizam, Zayan Mohammed
and Powell, Leigh
and Zary, Nabil",
title="Elements That Underpin the Design, Development, and Evaluation of Social Media Health Interventions: Protocol for a Scoping Review",
journal="JMIR Res Protoc",
year="2022",
month="Feb",
day="1",
volume="11",
number="2",
pages="e31911",
keywords="social media",
keywords="health intervention",
keywords="behavior change models",
keywords="health improvement",
keywords="intervention design",
keywords="models of design",
keywords="evaluating interventions",
abstract="Background: Social media use has grown tremendously over the years. Given the volume and diversity of people on social media and the amount of information being exchanged, it is perhaps unsurprising that social media is being used as an avenue to disseminate and deliver health interventions. There exists an opportunity for social media health interventions to make a positive impact on health. However, there is a need to understand more about the ways in which these interventions are designed, developed, and evaluated. This scoping protocol will review the current state of this field by charting the elements that drive the design, development, and evaluation of these interventions. This includes charting models, frameworks, and rationales for the interventions, as well as the platforms being used, and the health behaviors being targeted. This intention of this scoping review is to help inform those who wish to develop effective social media health interventions. Objective: The objective of this review is to map the elements that drive the design, development, and evaluation of social media health interventions. We define ``social media health intervention'' as interventions that make use of social media platforms to disseminate or deliver health-related information and educational initiatives to the public. We will seek to chart the elements that drive the design, development, and delivery of such interventions, including their platforms and targeted health behaviors. Methods: The methodological framework for this review is guided by Arksey and O'Malley and enhancements by later studies. We will search relevant literature from 9 databases: (1) PubMed, (2) PsycINFO, (3) EMBASE, (4) Web of Science, (5) Scopus, (6) CINAHL, (7) ERIC, (8) MEDLINE, and (9) Google Scholar. The literature will be screened by at least two reviewers in 2 stages: (1) title/abstract screening against the eligibility criteria; and (2) eligible articles will then undergo a full-text screening. Data will be charted using the data charting tool developed by the authors. Results: The results of this study will be presented in a final scoping review paper, divided into 2 sections. The first section will describe the search strategy and study selection process and will contain the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flowchart. The second section will provide key details pertaining to the review objective and question. Conclusions: This review will help guide scholars looking to build social media health interventions toward evidence-based practices in design and evaluation. International Registered Report Identifier (IRRID): PRR1-10.2196/31911 ",
doi="10.2196/31911",
url="https://www.researchprotocols.org/2022/2/e31911",
url="http://www.ncbi.nlm.nih.gov/pubmed/34848388"
}


@Article{info:doi/10.2196/31528,
author="Renner, Simon
and Marty, Tom
and Khadhar, Micka{\"i}l
and Foulqui{\'e}, Pierre
and Voillot, Pam{\'e}la
and Mebarki, Adel
and Montagni, Ilaria
and Texier, Nathalie
and Sch{\"u}ck, St{\'e}phane",
title="A New Method to Extract Health-Related Quality of Life Data From Social Media Testimonies: Algorithm Development and Validation",
journal="J Med Internet Res",
year="2022",
month="Jan",
day="28",
volume="24",
number="1",
pages="e31528",
keywords="health-related quality of life",
keywords="social media use",
keywords="measures",
keywords="real world",
keywords="natural language processing",
keywords="social media",
keywords="NLP",
keywords="infoveillance",
keywords="quality of life",
keywords="digital health",
keywords="social listening",
abstract="Background: Monitoring social media has been shown to be a useful means to capture patients' opinions and feelings about medical issues, ranging from diseases to treatments. Health-related quality of life (HRQoL) is a useful indicator of overall patients' health, which can be captured online. Objective: This study aimed to describe a social media listening algorithm able to detect the impact of diseases or treatments on specific dimensions of HRQoL based on posts written by patients in social media and forums. Methods: Using a web crawler, 19 forums in France were harvested, and messages related to patients' experience with disease or treatment were specifically collected. The SF-36 (Short Form Health Survey) and EQ-5D (Euro Quality of Life 5 Dimensions) HRQoL surveys were mixed and adapted for a tailored social media listening system. This was carried out to better capture the variety of expression on social media, resulting in 5 dimensions of the HRQoL, which are physical, psychological, activity-based, social, and financial. Models were trained using cross-validation and hyperparameter optimization. Oversampling was used to increase the infrequent dimension: after annotation, SMOTE (synthetic minority oversampling technique) was used to balance the proportions of the dimensions among messages. Results: The training set was composed of 1399 messages, randomly taken from a batch of 20,000 health-related messages coming from forums. The algorithm was able to detect a general impact on HRQoL (sensitivity of 0.83 and specificity of 0.74), a physical impact (0.67 and 0.76), a psychic impact (0.82 and 0.60), an activity-related impact (0.73 and 0.78), a relational impact (0.73 and 0.70), and a financial impact (0.79 and 0.74). Conclusions: The development of an innovative method to extract health data from social media as real time assessment of patients' HRQoL is useful to a patient-centered medical care. As a source of real-world data, social media provide a complementary point of view to understand patients' concerns and unmet needs, as well as shedding light on how diseases and treatments can be a burden in their daily lives. ",
doi="10.2196/31528",
url="https://www.jmir.org/2022/1/e31528",
url="http://www.ncbi.nlm.nih.gov/pubmed/35089152"
}


@Article{info:doi/10.2196/31140,
author="Voillot, Pam{\'e}la
and Riche, Brigitte
and Portafax, Michel
and Foulqui{\'e}, Pierre
and Gedik, Ana{\"i}s
and Barbarot, S{\'e}bastien
and Misery, Laurent
and H{\'e}as, St{\'e}phane
and Mebarki, Adel
and Texier, Nathalie
and Sch{\"u}ck, St{\'e}phane",
title="Social Media Platforms Listening Study on Atopic Dermatitis: Quantitative and Qualitative Findings",
journal="J Med Internet Res",
year="2022",
month="Jan",
day="28",
volume="24",
number="1",
pages="e31140",
keywords="atopic dermatitis",
keywords="Atopic Dermatitis Control Tool",
keywords="health-related quality of life",
keywords="social media use",
keywords="real world",
keywords="dermatology",
keywords="skin disease",
keywords="social media",
keywords="online health information",
keywords="online health",
keywords="health care",
abstract="Background: Atopic dermatitis (AD) is a chronic, pruritic, inflammatory disease that occurs most frequently in children but also affects many adults. Social media have become key tools for finding and disseminating medical information. Objective: The aims of this study were to identify the main themes of discussion, the difficulties encountered by patients with respect to AD, the impact of the pathology on quality of life (QoL; physical, psychological, social, or financial), and to study the perception of patients regarding their treatment. Methods: A retrospective study was carried out by collecting social media posts in French language written by internet users mentioning their experience with AD, their QoL, and their treatments. Messages related to AD discomfort posted between July 1, 2010, and October 23, 2020, were extracted from French-speaking publicly available online forums. Automatic and manual extractions were implemented to create a general corpus and 2 subcorpuses depending on the level of control of the disease. Results: A total of 33,115 messages associated with AD were included in the analysis corpus after extraction and cleaning. These messages were posted by 15,857 separate web users, most of them being women younger than 40 years. Tips to manage AD and everyday hygiene/treatments were among the most discussed topics for controlled AD subcorpus, while baby-related topics and therapeutic failure were among the most discussed topics for insufficiently controlled AD subcorpus. QoL was discussed in both subcorpuses with a higher proportion in the controlled AD subcorpus. Treatments and their perception were also discussed by web users. Conclusions: More than just emotional or peer support, patients with AD turn to online forums to discuss their health. Our findings show the need for an intersection between social media and health care and the importance of developing new approaches such as the Atopic Dermatitis Control Tool, which is a patient-related disease severity assessment tool focused on patients with AD. ",
doi="10.2196/31140",
url="https://www.jmir.org/2022/1/e31140",
url="http://www.ncbi.nlm.nih.gov/pubmed/35089160"
}


@Article{info:doi/10.2196/23762,
author="Yen, Tso-Jung
and Chan, Ta-Chien
and Fu, Yang-Chih
and Hwang, Jing-Shiang",
title="Quality of Life and Multilevel Contact Network Structures Among Healthy Adults in Taiwan: Online Participatory Cohort Study",
journal="J Med Internet Res",
year="2022",
month="Jan",
day="28",
volume="24",
number="1",
pages="e23762",
keywords="contact diary",
keywords="egocentric networks",
keywords="social support",
keywords="weak ties",
keywords="World Health Organization Quality of Life Survey",
keywords="quality of life",
keywords="networks",
keywords="demography",
keywords="society",
abstract="Background: People's quality of life diverges on their demographics, socioeconomic status, and social connections. Objective: By taking both demographic and socioeconomic features into account, we investigated how quality of life varied on social networks using data from both longitudinal surveys and contact diaries in a year-long (2015-2016) study. Methods: Our 4-wave, repeated measures of quality of life followed the brief version of the World Health Organization Quality of Life scale (WHOQOL-BREF). In our regression analysis, we integrated these survey measures with key time-varying and multilevel network indices based on contact diaries. Results: People's quality of life may decrease if their daily contacts contain high proportions of weak ties. In addition, people tend to perceive a better quality of life when their daily contacts are face-to-face or initiated by others or when they contact someone who is in a good mood or someone with whom they can discuss important life issues. Conclusions: Our findings imply that both functional and structural aspects of the social network play important but different roles in shaping people's quality of life. ",
doi="10.2196/23762",
url="https://www.jmir.org/2022/1/e23762",
url="http://www.ncbi.nlm.nih.gov/pubmed/35089142"
}


@Article{info:doi/10.2196/35286,
author="Girardi, Abdias
and Singh, Paul Nikhi
and Boyd, Joseph Carter",
title="Using Social Media in Health Care Research Should Proceed With Caution. Comment on ``The Use of Social Media for Health Research Purposes: Scoping Review''",
journal="J Med Internet Res",
year="2022",
month="Jan",
day="28",
volume="24",
number="1",
pages="e35286",
keywords="public health",
keywords="epidemiology",
keywords="research",
keywords="health",
keywords="medical",
keywords="social networking",
keywords="infodemiology",
keywords="eHealth",
keywords="text mining",
keywords="medical education",
keywords="social media",
keywords="information technology",
keywords="health care",
keywords="HIPAA",
keywords="education",
doi="10.2196/35286",
url="https://www.jmir.org/2022/1/e35286",
url="http://www.ncbi.nlm.nih.gov/pubmed/35089149"
}


@Article{info:doi/10.2196/28152,
author="Yeung, Kan Andy Wai
and Tosevska, Anela
and Klager, Elisabeth
and Eibensteiner, Fabian
and Tsagkaris, Christos
and Parvanov, D. Emil
and Nawaz, A. Faisal
and V{\"o}lkl-Kernstock, Sabine
and Schaden, Eva
and Kletecka-Pulker, Maria
and Willschke, Harald
and Atanasov, G. Atanas",
title="Medical and Health-Related Misinformation on Social Media: Bibliometric Study of the Scientific Literature",
journal="J Med Internet Res",
year="2022",
month="Jan",
day="25",
volume="24",
number="1",
pages="e28152",
keywords="COVID-19",
keywords="Twitter",
keywords="health",
keywords="social media",
keywords="bibliometric",
keywords="dissemination",
keywords="knowledge exchange",
abstract="Background: Social media has been extensively used for the communication of health-related information and consecutively for the potential spread of medical misinformation. Conventional systematic reviews have been published on this topic to identify original articles and to summarize their methodological approaches and themes. A bibliometric study could complement their findings, for instance, by evaluating the geographical distribution of the publications and determining if they were well cited and disseminated in high-impact journals. Objective: The aim of this study was to perform a bibliometric analysis of the current literature to discover the prevalent trends and topics related to medical misinformation on social media. Methods: The Web of Science Core Collection electronic database was accessed to identify relevant papers with the following search string: ALL=(misinformati* OR ``wrong informati*'' OR disinformati* OR ``misleading informati*'' OR ``fake news*'') AND ALL=(medic* OR illness* OR disease* OR health* OR pharma* OR drug* OR therap*) AND ALL=(``social media*'' OR Facebook* OR Twitter* OR Instagram* OR YouTube* OR Weibo* OR Whatsapp* OR Reddit* OR TikTok* OR WeChat*). Full records were exported to a bibliometric software, VOSviewer, to link bibliographic information with citation data. Term and keyword maps were created to illustrate recurring terms and keywords. Results: Based on an analysis of 529 papers on medical and health-related misinformation on social media, we found that the most popularly investigated social media platforms were Twitter (n=90), YouTube (n=67), and Facebook (n=57). Articles targeting these 3 platforms had higher citations per paper (>13.7) than articles covering other social media platforms (Instagram, Weibo, WhatsApp, Reddit, and WeChat; citations per paper <8.7). Moreover, social media platform--specific papers accounted for 44.1\% (233/529) of all identified publications. Investigations on these platforms had different foci. Twitter-based research explored cyberchondria and hypochondriasis, YouTube-based research explored tobacco smoking, and Facebook-based research studied vaccine hesitancy related to autism. COVID-19 was a common topic investigated across all platforms. Overall, the United States contributed to half of all identified papers, and 80\% of the top 10 most productive institutions were based in this country. The identified papers were mostly published in journals of the categories public environmental and occupational health, communication, health care sciences services, medical informatics, and medicine general internal, with the top journal being the Journal of Medical Internet Research. Conclusions: There is a significant platform-specific topic preference for social media investigations on medical misinformation. With a large population of internet users from China, it may be reasonably expected that Weibo, WeChat, and TikTok (and its Chinese version Douyin) would be more investigated in future studies. Currently, these platforms present research gaps that leave their usage and information dissemination warranting further evaluation. Future studies should also include social platforms targeting non-English users to provide a wider global perspective. ",
doi="10.2196/28152",
url="https://www.jmir.org/2022/1/e28152",
url="http://www.ncbi.nlm.nih.gov/pubmed/34951864"
}


@Article{info:doi/10.2196/30388,
author="Hudson, Georgie
and Jansli, M. Sonja
and Erturk, Sinan
and Morris, Daniel
and Odoi, M. Clarissa
and Clayton-Turner, Angela
and Bray, Vanessa
and Yourston, Gill
and Clouden, Doreen
and Proudfoot, David
and Cornwall, Andrew
and Waldron, Claire
and Wykes, Til
and Jilka, Sagar",
title="Investigation of Carers' Perspectives of Dementia Misconceptions on Twitter: Focus Group Study",
journal="JMIR Aging",
year="2022",
month="Jan",
day="24",
volume="5",
number="1",
pages="e30388",
keywords="patient and public involvement",
keywords="dementia",
keywords="co-production",
keywords="misconceptions",
keywords="stigma",
keywords="Twitter",
keywords="social media",
keywords="Alzheimer's Disease",
abstract="Background: Dementia misconceptions on social media are common, with negative effects on people with the condition, their carers, and those who know them. This study codeveloped a thematic framework with carers to understand the forms these misconceptions take on Twitter. Objective: The aim of this study is to identify and analyze types of dementia conversations on Twitter using participatory methods. Methods: A total of 3 focus groups with dementia carers were held to develop a framework of dementia misconceptions based on their experiences. Dementia-related tweets were collected from Twitter's official application programming interface using neutral and negative search terms defined by the literature and by carers (N=48,211). A sample of these tweets was selected with equal numbers of neutral and negative words (n=1497), which was validated in individual ratings by carers. We then used the framework to analyze, in detail, a sample of carer-rated negative tweets (n=863). Results: A total of 25.94\% (12,507/48,211) of our tweet corpus contained negative search terms about dementia. The carers' framework had 3 negative and 3 neutral categories. Our thematic analysis of carer-rated negative tweets found 9 themes, including the use of weaponizing language to insult politicians (469/863, 54.3\%), using dehumanizing or outdated words or statements about members of the public (n=143, 16.6\%), unfounded claims about the cures or causes of dementia (n=11, 1.3\%), or providing armchair diagnoses of dementia (n=21, 2.4\%). Conclusions: This is the first study to use participatory methods to develop a framework that identifies dementia misconceptions on Twitter. We show that misconceptions and stigmatizing language are not rare. They manifest through minimizing and underestimating language. Web-based campaigns aiming to reduce discrimination and stigma about dementia could target those who use negative vocabulary and reduce the misconceptions that are being propagated, thus improving general awareness. ",
doi="10.2196/30388",
url="https://aging.jmir.org/2022/1/e30388",
url="http://www.ncbi.nlm.nih.gov/pubmed/35072637"
}


@Article{info:doi/10.2196/32394,
author="Zhang, Chunyan
and Xu, Songhua
and Li, Zongfang
and Liu, Ge
and Dai, Duwei
and Dong, Caixia",
title="The Evolution and Disparities of Online Attitudes Toward COVID-19 Vaccines: Year-long Longitudinal and Cross-sectional Study",
journal="J Med Internet Res",
year="2022",
month="Jan",
day="21",
volume="24",
number="1",
pages="e32394",
keywords="COVID-19",
keywords="vaccine",
keywords="attitude",
keywords="Twitter",
keywords="data mining",
keywords="pandemic",
keywords="population group",
keywords="evolution",
keywords="disparity",
abstract="Background: Due to the urgency caused by the COVID-19 pandemic worldwide, vaccine manufacturers have to shorten and parallel the development steps to accelerate COVID-19 vaccine production. Although all usual safety and efficacy monitoring mechanisms remain in place, varied attitudes toward the new vaccines have arisen among different population groups. Objective: This study aimed to discern the evolution and disparities of attitudes toward COVID-19 vaccines among various population groups through the study of large-scale tweets spanning over a whole year. Methods: We collected over 1.4 billion tweets from June 2020 to July 2021, which cover some critical phases concerning the development and inoculation of COVID-19 vaccines worldwide. We first developed a data mining model that incorporates a series of deep learning algorithms for inferring a range of individual characteristics, both in reality and in cyberspace, as well as sentiments and emotions expressed in tweets. We further conducted an observational study, including an overall analysis, a longitudinal study, and a cross-sectional study, to collectively explore the attitudes of major population groups. Results: Our study derived 3 main findings. First, the whole population's attentiveness toward vaccines was strongly correlated (Pearson r=0.9512) with official COVID-19 statistics, including confirmed cases and deaths. Such attentiveness was also noticeably influenced by major vaccine-related events. Second, after the beginning of large-scale vaccine inoculation, the sentiments of all population groups stabilized, followed by a considerably pessimistic trend after June 2021. Third, attitude disparities toward vaccines existed among population groups defined by 8 different demographic characteristics. By crossing the 2 dimensions of attitude, we found that among population groups carrying low sentiments, some had high attentiveness ratios, such as males and individuals aged ?40 years, while some had low attentiveness ratios, such as individuals aged ?18 years, those with occupations of the 3rd category, those with account age <5 years, and those with follower number <500. These findings can be used as a guide in deciding who should be given more attention and what kinds of help to give to alleviate the concerns about vaccines. Conclusions: This study tracked the year-long evolution of attitudes toward COVID-19 vaccines among various population groups defined by 8 demographic characteristics, through which significant disparities in attitudes along multiple dimensions were revealed. According to these findings, it is suggested that governments and public health organizations should provide targeted interventions to address different concerns, especially among males, older people, and other individuals with low levels of education, low awareness of news, low income, and light use of social media. Moreover, public health authorities may consider cooperating with Twitter users having high levels of social influence to promote the acceptance of COVID-19 vaccines among all population groups. ",
doi="10.2196/32394",
url="https://www.jmir.org/2022/1/e32394",
url="http://www.ncbi.nlm.nih.gov/pubmed/34878410"
}


@Article{info:doi/10.2196/32125,
author="Masselot, Camille
and Greshake Tzovaras, Bastian
and Graham, B. Chris L.
and Finnegan, Gary
and Jeyaram, Rathin
and Vitali, Isabelle
and Landrain, Thomas
and Santolini, Marc",
title="Implementing the Co-Immune Open Innovation Program to Address Vaccination Hesitancy and Access to Vaccines: Retrospective Study",
journal="J Particip Med",
year="2022",
month="Jan",
day="21",
volume="14",
number="1",
pages="e32125",
keywords="open science",
keywords="open innovation",
keywords="programmatic research",
keywords="collective intelligence",
keywords="web based",
keywords="immunization",
keywords="vaccination access",
keywords="vaccine hesitancy",
keywords="innovation",
keywords="vaccine",
keywords="public health",
keywords="access",
keywords="framework",
keywords="participatory",
keywords="design",
keywords="implementation",
abstract="Background: The rise of major complex public health problems, such as vaccination hesitancy and access to vaccination, requires innovative, open, and transdisciplinary approaches. Yet, institutional silos and lack of participation on the part of nonacademic citizens in the design of solutions hamper efforts to meet these challenges. Against this background, new solutions have been explored, with participatory research, citizen science, hackathons, and challenge-based approaches being applied in the context of public health. Objective: Our aim was to develop a program for creating citizen science and open innovation projects that address the contemporary challenges of vaccination in France and around the globe. Methods: We designed and implemented Co-Immune, a program created to tackle the question of vaccination hesitancy and access to vaccination through an online and offline challenge-based open innovation approach. The program was run on the open science platform Just One Giant Lab. Results: Over a 6-month period, the Co-Immune program gathered 234 participants of diverse backgrounds and 13 partners from the public and private sectors. The program comprised 10 events to facilitate the creation of 20 new projects, as well as the continuation of two existing projects, to address the issues of vaccination hesitancy and access, ranging from app development and data mining to analysis and game design. In an open framework, the projects made their data, code, and solutions publicly available. Conclusions: Co-Immune highlights how open innovation approaches and online platforms can help to gather and coordinate noninstitutional communities in a rapid, distributed, and global way toward solving public health issues. Such initiatives can lead to the production and transfer of knowledge, creating novel solutions in the public health sector. The example of Co-Immune contributes to paving the way for organizations and individuals to collaboratively tackle future global challenges. ",
doi="10.2196/32125",
url="https://jopm.jmir.org/2022/1/e32125",
url="http://www.ncbi.nlm.nih.gov/pubmed/35060917"
}


@Article{info:doi/10.2196/26868,
author="Singh, Kumar Asmit
and Mehan, Paras
and Sharma, Divyanshu
and Pandey, Rohan
and Sethi, Tavpritesh
and Kumaraguru, Ponnurangam",
title="COVID-19 Mask Usage and Social Distancing in Social Media Images: Large-scale Deep Learning Analysis",
journal="JMIR Public Health Surveill",
year="2022",
month="Jan",
day="18",
volume="8",
number="1",
pages="e26868",
keywords="COVID-19",
keywords="mask detection",
keywords="deep learning",
keywords="classification",
keywords="segmentation",
keywords="social media analysis",
abstract="Background: The adoption of nonpharmaceutical interventions and their surveillance are critical for detecting and stopping possible transmission routes of COVID-19. A study of the effects of these interventions can help shape public health decisions. The efficacy of nonpharmaceutical interventions can be affected by public behaviors in events, such as protests. We examined mask use and mask fit in the United States, from social media images, especially during the Black Lives Matter (BLM) protests, representing the first large-scale public gatherings in the pandemic. Objective: This study assessed the use and fit of face masks and social distancing in the United States and events of large physical gatherings through public social media images from 6 cities and BLM protests. Methods: We collected and analyzed 2.04 million public social media images from New York City, Dallas, Seattle, New Orleans, Boston, and Minneapolis between February 1, 2020, and May 31, 2020. We evaluated correlations between online mask usage trends and COVID-19 cases. We looked for significant changes in mask use patterns and group posting around important policy decisions. For BLM protests, we analyzed 195,452 posts from New York and Minneapolis from May 25, 2020, to July 15, 2020. We looked at differences in adopting the preventive measures in the BLM protests through the mask fit score. Results: The average percentage of group pictures dropped from 8.05\% to 4.65\% after the lockdown week. New York City, Dallas, Seattle, New Orleans, Boston, and Minneapolis observed increases of 5.0\%, 7.4\%, 7.4\%, 6.5\%, 5.6\%, and 7.1\%, respectively, in mask use between February 2020 and May 2020. Boston and Minneapolis observed significant increases of 3.0\% and 7.4\%, respectively, in mask use after the mask mandates. Differences of 6.2\% and 8.3\% were found in group pictures between BLM posts and non-BLM posts for New York City and Minneapolis, respectively. In contrast, the differences in the percentage of masked faces in group pictures between BLM and non-BLM posts were 29.0\% and 20.1\% for New York City and Minneapolis, respectively. Across protests, 35\% of individuals wore a mask with a fit score greater than 80\%. Conclusions: The study found a significant drop in group posting when the stay-at-home laws were applied and a significant increase in mask use for 2 of 3 cities where masks were mandated. Although a positive trend toward mask use and social distancing was observed, a high percentage of posts showed disregard for the guidelines. BLM-related posts captured the lack of seriousness to safety measures, with a high percentage of group pictures and low mask fit scores. Thus, the methodology provides a directional indication of how government policies can be indirectly monitored through social media. ",
doi="10.2196/26868",
url="https://publichealth.jmir.org/2022/1/e26868",
url="http://www.ncbi.nlm.nih.gov/pubmed/34479183"
}


@Article{info:doi/10.2196/28858,
author="Schm{\"a}lzle, Ralf
and Wilcox, Shelby",
title="Harnessing Artificial Intelligence for Health Message Generation: The Folic Acid Message Engine",
journal="J Med Internet Res",
year="2022",
month="Jan",
day="18",
volume="24",
number="1",
pages="e28858",
keywords="human-centered AI",
keywords="campaigns",
keywords="health communication",
keywords="NLP",
keywords="health promotion",
abstract="Background: Communication campaigns using social media can raise public awareness; however, they are difficult to sustain. A barrier is the need to generate and constantly post novel but on-topic messages, which creates a resource-intensive bottleneck. Objective: In this study, we aim to harness the latest advances in artificial intelligence (AI) to build a pilot system that can generate many candidate messages, which could be used for a campaign to suggest novel, on-topic candidate messages. The issue of folic acid, a B-vitamin that helps prevent major birth defects, serves as an example; however, the system can work with other issues that could benefit from higher levels of public awareness. Methods: We used the Generative Pretrained Transformer-2 architecture, a machine learning model trained on a large natural language corpus, and fine-tuned it using a data set of autodownloaded tweets about \#folicacid. The fine-tuned model was then used as a message engine, that is, to create new messages about this topic. We conducted a web-based study to gauge how human raters evaluate AI-generated tweet messages compared with original, human-crafted messages. Results: We found that the Folic Acid Message Engine can easily create several hundreds of new messages that appear natural to humans. Web-based raters evaluated the clarity and quality of a human-curated sample of AI-generated messages as on par with human-generated ones. Overall, these results showed that it is feasible to use such a message engine to suggest messages for web-based campaigns that focus on promoting awareness. Conclusions: The message engine can serve as a starting point for more sophisticated AI-guided message creation systems for health communication. Beyond the practical potential of such systems for campaigns in the age of social media, they also hold great scientific potential for the quantitative analysis of message characteristics that promote successful communication. We discuss future developments and obvious ethical challenges that need to be addressed as AI technologies for health persuasion enter the stage. ",
doi="10.2196/28858",
url="https://www.jmir.org/2022/1/e28858",
url="http://www.ncbi.nlm.nih.gov/pubmed/35040800"
}


@Article{info:doi/10.2196/23656,
author="Lim, C. Megan S.
and Molenaar, Annika
and Brennan, Linda
and Reid, Mike
and McCaffrey, Tracy",
title="Young Adults' Use of Different Social Media Platforms for Health Information: Insights From Web-Based Conversations",
journal="J Med Internet Res",
year="2022",
month="Jan",
day="18",
volume="24",
number="1",
pages="e23656",
keywords="social media",
keywords="Facebook",
keywords="Instagram",
keywords="YouTube",
keywords="health information",
keywords="health communication",
keywords="young adults",
abstract="Background: Social media--delivered health promotion has demonstrated limited uptake and effectiveness among young adults. Understanding how young adults interact with existing social media platforms for health might provide insight for future health promotion interventions. Objective: The aim of this study is to describe how young adults interact with different social media platforms for health and health information. Methods: We used a web-based conversation methodology to collect data from 165 young adults aged 18 to 24 years. Participants participated in an extended conversation with moderators and other participants about health and social media. They were prompted to discuss how they find health information, how they use different social media platforms, and how they evaluate the trustworthiness of information. A thematic qualitative analysis was applied to the data. Results: Young adults spent a lot of time scrolling through Facebook newsfeeds, which often resulted in seeing health-related content either from their friends, news sources, or advertisements. Some actively sought out information about specific health areas by joining groups or following relevant pages. YouTube was considered a useful source for learning about everything and was often the go-to when searching for information or advice (after Google). Young adults found the video format easy to learn from. They stated that they could identify accurate YouTube health content by cross-checking multiple videos, by feeling that the presenter was real and relatable, or just through instinctively judging a video's credibility. Instagram was a source of inspiration for health and wellness from those whose lives were dedicated to healthy lifestyles and fitness. Twitter, Tumblr, and Snapchat were rarely used for health information. Conclusions: Most young adults obtain health information from social media, both actively and through passive exposure. Participants indicated looking to social media influencers for health and lifestyle inspiration and judged the credibility of sources by appearance and instinct. Health experts should try to use the channels in the way that young adults already use them; use relatable role models on Instagram and YouTube, eye-catching headlines and support groups on Facebook, and easy to follow instruction videos via YouTube. International Registered Report Identifier (IRRID): RR2-10.1111/1747-0080.12448 ",
doi="10.2196/23656",
url="https://www.jmir.org/2022/1/e23656",
url="http://www.ncbi.nlm.nih.gov/pubmed/35040796"
}


@Article{info:doi/10.2196/35274,
author="Yalamanchili, Bhavya
and Donelle, Lorie
and Jurado, Leo-Felix
and Fera, Joseph
and Basch, H. Corey",
title="Investigating \#covidnurse Messages on TikTok: Descriptive Study",
journal="JMIR Nursing",
year="2022",
month="Jan",
day="14",
volume="5",
number="1",
pages="e35274",
keywords="COVID-19 pandemic",
keywords="nurse",
keywords="burnout",
keywords="social media",
keywords="stress",
keywords="TikTok",
keywords="nursing",
keywords="COVID-19",
keywords="pandemic",
keywords="social support",
keywords="digital peer support",
keywords="health communication",
keywords="peer support",
abstract="Background: During a time of high stress and decreased social interaction, nurses have turned to social media platforms like TikTok as an outlet for expression, entertainment, and communication. Objective: The purpose of this cross-sectional content analysis study is to describe the content of videos with the hashtag \#covidnurse on TikTok, which included 100 videos in the English language. Methods: At the time of the study, this hashtag had 116.9 million views. Each video was coded for content-related to what nurses encountered and were feeling during the COVID-19 pandemic. Results: Combined, the 100 videos sampled received 47,056,700 views; 76,856 comments; and 5,996,676 likes. There were 4 content categories that appeared in a majority (>50) of the videos: 83 showed the individual as a nurse, 72 showed the individual in professional attire, 58 mentioned/suggested stress, 55 used music, and 53 mentioned/suggested frustration. Those that mentioned stress and those that mentioned frustration received less than 50\% of the total views (n=21,726,800, 46.17\% and n=16,326,300,  34.69\%, respectively). Although not a majority, 49 of the 100 videos mentioned the importance of nursing. These videos garnered 37.41\% (n=17,606,000) of the total views, 34.82\% (n=26,759) of the total comments, and 23.85\% (n=1,430,213) of the total likes. So, despite nearly half of the total videos mentioning how important nurses are, these videos received less than half of the total views, comments, and likes. Conclusions: Social media and increasingly video-related online messaging such as TikTok are important platforms for social networking, social support, entertainment, and education on diverse topics, including health in general and COVID-19 specifically. This presents an opportunity for future research to assess the utility of the TikTok platform for meaningful engagement and health communication on important public health issues. ",
doi="10.2196/35274",
url="https://nursing.jmir.org/2022/1/e35274",
url="http://www.ncbi.nlm.nih.gov/pubmed/35029536"
}


@Article{info:doi/10.2196/24086,
author="Wang, Xiaohui
and Shi, Jingyuan
and Lee, Min Kwan",
title="The Digital Divide and Seeking Health Information on Smartphones in Asia: Survey Study of Ten Countries",
journal="J Med Internet Res",
year="2022",
month="Jan",
day="13",
volume="24",
number="1",
pages="e24086",
keywords="smartphone",
keywords="health information seeking",
keywords="Asia",
keywords="user profile",
keywords="digital divide",
abstract="Background: Although recent developments in mobile health have elevated the importance of how smartphones empower individuals to seek health information, research investigating this phenomenon in Asian countries has been rare. Objective: The goal of our study was to provide a comprehensive profile of mobile health information seekers and to examine the individual- and country-level digital divide in Asia. Methods: With survey data from 10 Asian countries (N=9086), we ran multilevel regression models to assess the effect of sociodemographic factors, technological factors, and country-level disparities on using smartphones to seek health information. Results: Respondents who were women ($\beta$=.13, P<.001), parents ($\beta$=.16, P<.001), employed ($\beta$=.08, P=.002), of higher social status ($\beta$=.08, P<.001), and/or from countries with low health expenditures ($\beta$=.19, P=.02) were more likely to use smartphones to seek health information. In terms of technological factors, technology innovativeness ($\beta$=.10, P<.001) and frequency of smartphone use ($\beta$=.42, P<.001) were important factors of health information seeking, whereas the effect of online information quality was marginal ($\beta$=--.04, P<.001). Conclusions: Among smartphone users in Asia, health information seeking varies according to individuals' socioeconomic status, their innovativeness toward technology, and their frequency of smartphone use. Although smartphones widen the digital divide among individuals with different socioeconomic status, they also bridge the divide between countries with varying health expenditures. Smartphones appear to be a particularly useful complement to manage health in developing countries. ",
doi="10.2196/24086",
url="https://www.jmir.org/2022/1/e24086",
url="http://www.ncbi.nlm.nih.gov/pubmed/35023845"
}


@Article{info:doi/10.2196/31175,
author="Pereira-Sanchez, Victor
and Alvarez-Mon, Angel Miguel
and Horinouchi, Toru
and Kawagishi, Ryo
and Tan, J. Marcus P.
and Hooker, R. Elizabeth
and Alvarez-Mon, Melchor
and Teo, R. Alan",
title="Examining Tweet Content and Engagement of Users With Tweets About Hikikomori in Japanese: Mixed Methods Study of Social Withdrawal",
journal="J Med Internet Res",
year="2022",
month="Jan",
day="11",
volume="24",
number="1",
pages="e31175",
keywords="hikikomori",
keywords="loneliness",
keywords="social isolation",
keywords="social withdrawal",
keywords="Twitter",
keywords="hidden youth",
keywords="mobile phone",
abstract="Background: Hikikomori is a form of severe social withdrawal that is particularly prevalent in Japan. Social media posts offer insight into public perceptions of mental health conditions and may also inform strategies to identify, engage, and support hard-to-reach patient populations such as individuals affected by hikikomori. Objective: In this study, we seek to identify the types of content on Twitter related to hikikomori in the Japanese language and to assess Twitter users' engagement with that content. Methods: We conducted a mixed methods analysis of a random sample of 4940 Japanese tweets from February to August 2018 using a hashtag (\#hikikomori). Qualitative content analysis included examination of the text of each tweet, development of a codebook, and categorization of tweets into relevant codes. For quantitative analysis (n=4859 tweets), we used bivariate and multivariate logistic regression models, adjusted for multiple comparisons, and estimated the predicted probabilities of tweets receiving engagement (likes or retweets). Results: Our content analysis identified 9 codes relevant to tweets about hikikomori: personal anecdotes, social support, marketing, advice, stigma, educational opportunities, refuge (ibasho), employment opportunities, and medicine and science. Tweets about personal anecdotes were the most common (present in 2747/4859, 56.53\% of the tweets), followed by social support (902/4859, 18.56\%) and marketing (624/4859, 12.84\%). In the adjusted models, tweets coded as stigma had a lower predicted probability of likes (?33 percentage points, 95\% CI ?42 to ?23 percentage points; P<.001) and retweets (?11 percentage points, 95\% CI ?18 to ?4 percentage points; P<.001), personal anecdotes had a lower predicted probability of retweets (?8 percentage points, 95\% CI ?14 to ?3 percentage points; P=.002), marketing had a lower predicted probability of likes (?13 percentage points, 95\% CI ?21 to ?6 percentage points; P<.001), and social support had a higher predicted probability of retweets (+15 percentage points, 95\% CI 6-24 percentage points; P=.001), compared with all tweets without each of these codes. Conclusions: Japanese tweets about hikikomori reflect a unique array of topics, many of which have not been identified in prior research and vary in their likelihood of receiving engagement. Tweets often contain personal stories of hikikomori, suggesting the potential to identify individuals with hikikomori through Twitter. ",
doi="10.2196/31175",
url="https://www.jmir.org/2022/1/e31175",
url="http://www.ncbi.nlm.nih.gov/pubmed/35014971"
}


@Article{info:doi/10.2196/25792,
author="Wilczynski, Oph{\'e}lie
and Boisbouvier, Anthony
and Radoszycki, Lise
and Cott{\'e}, Fran{\c{c}}ois-Emery
and Gaudin, Anne-Fran{\c{c}}oise
and Lemasson, Herv{\'e}",
title="Integrating Quality of Life in the Care Pathway of Cancer Patients Undergoing Immunotherapy Treatment: Descriptive, Cross-sectional Survey of an Online Patient Community's Experiences and Expectations",
journal="J Med Internet Res",
year="2022",
month="Jan",
day="11",
volume="24",
number="1",
pages="e25792",
keywords="cancer",
keywords="quality of life",
keywords="immunotherapy",
keywords="patient community",
keywords="patient satisfaction",
abstract="Background: New cancer treatments, such as immune checkpoint inhibitors (ICIs), can improve survival and health-related quality of life (HRQoL) in patients with cancer. Although long-term monitoring of HRQoL has been shown to improve survival, integration of HRQoL into everyday practice remains poorly documented. Objective: This study describes experiences and expectations of patients treated with ICIs regarding a discussion of HRQoL with health care professionals (HCPs) in cancer management. Methods: This cross-sectional study was conducted in an online patient community (Carenity) in France. Patients treated with ICIs for cancer, included between September 2018 and January 2019, completed a questionnaire to assess the involvement of HCP in a discussion of HRQoL and when and what was discussed. Results: Of 82 patients included (mean age: 56.9 years, 95\% CI 54.2-59.6; 46 [56\%] male; 34 [41\%] with lung cancer), 62 (76\%) reported discussing HRQoL at least once with HCPs, mainly general practitioners (54/82, 66\%), oncologists (53/82, 65\%), and hospital nurses (50/82, 61\%). Around half (45/82, 55\%) of the patients were satisfied with these discussions. Discussions with the oncologist were at the patient's initiative (34/53, 64\%). Discussions occurred primarily during follow-up visits (40/62, 65\%), when adverse events occurred (30/62, 48\%), and at treatment initiation (27/62, 32\%). The most discussed dimensions were symptoms (48/62, 77\%) and physical well-being (43/62, 69\%). With respect to expectations, 54/82 (66\%) patients considered oncologists as the most important HCPs for discussing HRQoL. These discussions were desirable throughout the care pathway, particularly at diagnosis (63/82, 77\%) and when treatment was initiated (75/82, 92\%) or changed (68/82, 83\%). All HRQoL dimensions were considered important to discuss. Conclusions: With only around half of the patients satisfied with HRQoL discussions, impactful HRQoL integration in clinical practice is critical. According to patients, this integration should involve mainly oncologists and general practitioners, should happen at every step of the care pathway, and should be extended to dimensions that are currently rarely addressed. ",
doi="10.2196/25792",
url="https://www.jmir.org/2022/1/e25792",
url="http://www.ncbi.nlm.nih.gov/pubmed/35014969"
}


@Article{info:doi/10.2196/27000,
author="Cheng, Cecilia
and Ebrahimi, V. Omid
and Luk, W. Jeremy",
title="Heterogeneity of Prevalence of Social Media Addiction Across Multiple Classification Schemes: Latent Profile Analysis",
journal="J Med Internet Res",
year="2022",
month="Jan",
day="10",
volume="24",
number="1",
pages="e27000",
keywords="behavioral addiction",
keywords="compulsive social media use",
keywords="information technology addiction",
keywords="mental health",
keywords="psychological assessment",
keywords="sensitivity",
keywords="social network site",
keywords="social networking",
keywords="well-being",
abstract="Background: As social media is a major channel of interpersonal communication in the digital age, social media addiction has emerged as a novel mental health issue that has raised considerable concerns among researchers, health professionals, policy makers, mass media, and the general public. Objective: The aim of this study is to examine the prevalence of social media addiction derived from 4 major classification schemes (strict monothetic, strict polythetic, monothetic, and polythetic), with latent profiles embedded in the empirical data adopted as the benchmark for comparison. The extent of matching between the classification of each scheme and the actual data pattern was evaluated using sensitivity and specificity analyses. The associations between social media addiction and 2 comorbid mental health conditions---depression and anxiety---were investigated. Methods: A cross-sectional web-based survey was conducted, and the replicability of findings was assessed in 2 independent samples comprising 573 adults from the United Kingdom (261/573, 45.6\% men; mean age 43.62 years, SD 12.24 years) and 474 adults from the United States (224/474, 47.4\% men; mean age 44.67 years, SD 12.99 years). The demographic characteristics of both samples were similar to those of their respective populations. Results: The prevalence estimates of social media addiction varied across the classification schemes, ranging from 1\% to 15\% for the UK sample and 0\% to 11\% for the US sample. The latent profile analysis identified 3 latent groups for both samples: low-risk, at-risk, and high-risk. The sensitivity, specificity, and negative predictive values were high (83\%-100\%) for all classification schemes, except for the relatively lower sensitivity (73\%-74\%) for the polythetic scheme. However, the polythetic scheme had high positive predictive values (88\%-94\%), whereas such values were low (2\%-43\%) for the other 3 classification schemes. The group membership yielded by the polythetic scheme was largely consistent (95\%-96\%) with that of the benchmark. Conclusions: Among the classification schemes, the polythetic scheme is more well-balanced across all 4 indices. ",
doi="10.2196/27000",
url="https://www.jmir.org/2022/1/e27000",
url="http://www.ncbi.nlm.nih.gov/pubmed/35006084"
}


@Article{info:doi/10.2196/35080,
author="Miao, Melissa
and Power, Emma
and Rietdijk, Rachael
and Debono, Deborah
and Brunner, Melissa
and Salomon, Alexander
and Mcculloch, Ben
and Wright, Rebecca Meg
and Welsh, Monica
and Tremblay, Bastian
and Rixon, Caleb
and Williams, Liz
and Morrow, Rosemary
and Evain, Jean-Christophe
and Togher, Leanne",
title="Coproducing Knowledge of the Implementation of Complex Digital Health Interventions for Adults with Acquired Brain Injury and their Communication Partners: Protocol for a Mixed Methods Study",
journal="JMIR Res Protoc",
year="2022",
month="Jan",
day="10",
volume="11",
number="1",
pages="e35080",
keywords="priority setting",
keywords="public involvement",
keywords="implementation science",
keywords="internet interventions",
keywords="acquired brain injury",
keywords="delivery of health care",
keywords="caregivers",
keywords="speech-language pathology",
keywords="brain injury",
keywords="mobile phone",
abstract="Background: The Social Brain Toolkit, conceived and developed in partnership with stakeholders, is a novel suite of web-based communication interventions for people with brain injury and their communication partners. To support effective implementation, the developers of the Social Brain Toolkit have collaborated with people with brain injury, communication partners, clinicians, and individuals with digital health implementation experience to coproduce new implementation knowledge. In recognition of the equal value of experiential and academic knowledge, both types of knowledge are included in this study protocol, with input from stakeholder coauthors. Objective: This study aims to collaborate with stakeholders to prioritize theoretically based implementation targets for the Social Brain Toolkit, understand the nature of these priorities, and develop targeted implementation strategies to address these priorities, in order to support the Social Brain Toolkit's implementation. Methods: Theoretically underpinned by the Nonadoption, Abandonment, Scale-up, Spread, and Sustainability (NASSS) framework of digital health implementation, a maximum variation sample (N=35) of stakeholders coproduced knowledge of the implementation of the Social Brain Toolkit. People with brain injury (n=10), communication partners (n=11), and clinicians (n=5) participated in an initial web-based prioritization survey based on the NASSS framework. Survey completion was facilitated by plain English explanations and accessible captioned videos developed through 3 rounds of piloting. A speech-language pathologist also assisted stakeholders with brain injury to participate in the survey via video teleconference. Participants subsequently elaborated on their identified priorities via 7 web-based focus groups, in which researchers and stakeholders exchanged stakeholder perspectives and research evidence from a concurrent systematic review. Stakeholders were supported to engage in focus groups through the use of visual supports and plain English explanations. Additionally, individuals with experience in digital health implementation (n=9) responded to the prioritization survey questions via individual interview. The results will be deductively analyzed in relation to the NASSS framework in a coauthorship process with people with brain injury, communication partners, and clinicians. Results: Ethical approval was received from the University of Technology Sydney Health and Medical Research Ethics Committee (ETH20-5466) on December 15, 2020. Data were collected from April 13 to November 18, 2021. Data analysis is currently underway, with results expected for publication in mid-2022. Conclusions: In this study, researchers supported individuals with living experience of acquired brain injury, of communicating with or clinically supporting someone post injury, and of digital health implementation, to directly access and leverage the latest implementation research evidence and theory. With this support, stakeholders were able to prioritize implementation research targets, develop targeted implementation solutions, and coauthor and publish new implementation findings. The results will be used to optimize the implementation of 3 real-world, evidence-based interventions and thus improve the outcomes of people with brain injury and their communication partners. International Registered Report Identifier (IRRID): DERR1-10.2196/35080 ",
doi="10.2196/35080",
url="https://www.researchprotocols.org/2022/1/e35080",
url="http://www.ncbi.nlm.nih.gov/pubmed/35006082"
}


@Article{info:doi/10.2196/30379,
author="Farsi, Deema
and Martinez-Menchaca, R. Hector
and Ahmed, Mohammad
and Farsi, Nada",
title="Social Media and Health Care (Part II): Narrative Review of Social Media Use by Patients",
journal="J Med Internet Res",
year="2022",
month="Jan",
day="7",
volume="24",
number="1",
pages="e30379",
keywords="social media",
keywords="social networking",
keywords="internet",
keywords="health care",
keywords="COVID-19",
keywords="patient",
keywords="telemedicine",
keywords="mobile phone",
abstract="Background: People are now connected in a borderless web-based world. The modern public, especially the younger generation, relies heavily on the internet as the main source of health-related information. In health care, patients can use social media for more tailored uses such as telemedicine, finding a provider, and for peer support. Objective: The aim of this narrative review is to discuss how social media has been used in the health care industry from the perspective of patients and describe the main issues surrounding its use in health care. Methods: Between March and June 2020, a review of the literature was conducted on PubMed, Google Scholar, and Web of Science for English studies that were published since 2007 and discussed the use of social media in health care. In addition to only English publications that discussed the use of social media by patients, publications pertaining to ethical and legal considerations in the use of social media were included. The studies were then categorized as health information, telemedicine, finding a health care provider, peer support and sharing experiences, and influencing positive health behavior. In addition, two more sections were added to the review: issues pertaining to social media use in health care and ethical considerations. Results: Initially, 75 studies were included. As the study proceeded, more studies were included, and a total of 91 studies were reviewed, complemented by 1 textbook chapter and 13 web references. Approximately half of the studies were reviews. The first study was published in 2009, and the last was published in 2021, with more than half of the studies published in the last 5 years. The studies were mostly from the United States (n=40), followed by Europe (n=13), and the least from India (n=1). WhatsApp or WeChat was the most investigated social media platform. Conclusions: Social media can be used by the public and patients to improve their health and knowledge. However, due diligence must be practiced to assess the credibility of the information obtained and its source. Health care providers, patients, and the public need not forget the risks associated with the use of social media. The limitations and shortcomings of the use of social media by patients should be understood. ",
doi="10.2196/30379",
url="https://www.jmir.org/2022/1/e30379",
url="http://www.ncbi.nlm.nih.gov/pubmed/34994706"
}


@Article{info:doi/10.2196/31411,
author="Titgemeyer, Catrin Sarah
and Schaaf, P. Christian",
title="Facebook Support Groups for Pediatric Rare Diseases: Cross-Sectional Study to Investigate Opportunities, Limitations, and Privacy Concerns",
journal="JMIR Pediatr Parent",
year="2022",
month="Jan",
day="6",
volume="5",
number="1",
pages="e31411",
keywords="Facebook",
keywords="support group",
keywords="parental support",
keywords="pediatric rare diseases",
keywords="privacy paradox",
keywords="children's privacy",
abstract="Background: Because of the nature of rare diseases with affected individuals being widely geographically dispersed, finding an in-person/offline support group itself can be a challenge. Affected individuals therefore turn to social networking platforms such as Facebook for online support groups. Objective: We aim to put into perspective the opportunities Facebook offers as a tool for pediatric rare disease support groups by investigating its use, advantages, and limitations including privacy concerns. We analyze group accessibility and usage, advantages specific to rare diseases, perceived privacy, and views on using Facebook for communication between health professionals and parents, pharmaceutical companies, and study recruitment. Methods: We contacted 12 Facebook support groups for 12 respective rare diseases with pediatric onset and invited group members to participate in a cross-sectional online survey. Results: Of 231 respondents, 87.0\% (n=201) of respondents were female, 12.6\% (n=29) were male, and 0.4\% reported another sex (n=1). Respondents' mean age was 41.56 years (SD 9.375); 91.3\% (n=211) of respondents were parents (183 mothers, 27 fathers, 1 other sex); 59.7\% (n=138) reported a self-initiated search for the Facebook group, 24.2\% (n=56) received recommendations from their health professionals, and 12.6\% (n=29) recommendations from someone else affected by the disease. On average, support group members visited Facebook at least once a day, visited and passively participated (read/liked posts) several times a week, and participated actively (commented/posted) once a month. As much as 79.2\% (183/231) agreed that they would like to have health professionals as members of the respective Facebook group. Group members expressed more concern about privacy issues on Facebook in general than in their respective Facebook support groups, with concerns mostly related to Facebook itself and nongroup members. Conclusions: Our study confirmed that Facebook enhances support group accessibility for parents of children with rare diseases. Group participants perceive a reduction and elimination of distance, a common challenge in rare disease, and Facebook support groups create an environment of perceived privacy. The group's privacy setting can be a critical factor for active support group participation. Sharing personal information and pictures on Facebook is very common among group participants, which shows the importance of discussing and protecting children's privacy rights in this context. Trial Registration: German Clinical Trials Register DRKS00016067; https://www.drks.de/drks\_web/navigate.do?navigationId=trial.HTML\&TRIAL\_ID=DRKS00016067 ",
doi="10.2196/31411",
url="https://pediatrics.jmir.org/2022/1/e31411",
url="http://www.ncbi.nlm.nih.gov/pubmed/34989690"
}


@Article{info:doi/10.2196/33792,
author="Klein, Z. Ari
and O'Connor, Karen
and Gonzalez-Hernandez, Graciela",
title="Toward Using Twitter Data to Monitor COVID-19 Vaccine Safety in Pregnancy: Proof-of-Concept Study of Cohort Identification",
journal="JMIR Form Res",
year="2022",
month="Jan",
day="6",
volume="6",
number="1",
pages="e33792",
keywords="natural language processing",
keywords="social media",
keywords="COVID-19",
keywords="data mining",
keywords="COVID-19 vaccine",
keywords="pregnancy outcomes",
abstract="Background: COVID-19 during pregnancy is associated with an increased risk of maternal death, intensive care unit admission, and preterm birth; however, many people who are pregnant refuse to receive COVID-19 vaccination because of a lack of safety data. Objective: The objective of this preliminary study was to assess whether Twitter data could be used to identify a cohort for epidemiologic studies of COVID-19 vaccination in pregnancy. Specifically, we examined whether it is possible to identify users who have reported (1) that they received COVID-19 vaccination during pregnancy or the periconception period, and (2) their pregnancy outcomes. Methods: We developed regular expressions to search for reports of COVID-19 vaccination in a large collection of tweets posted through the beginning of July 2021 by users who have announced their pregnancy on Twitter. To help determine if users were vaccinated during pregnancy, we drew upon a natural language processing (NLP) tool that estimates the timeframe of the prenatal period. For users who posted tweets with a timestamp indicating they were vaccinated during pregnancy, we drew upon additional NLP tools to help identify tweets that reported their pregnancy outcomes. Results: We manually verified the content of tweets detected automatically, identifying 150 users who reported on Twitter that they received at least one dose of COVID-19 vaccination during pregnancy or the periconception period. We manually verified at least one reported outcome for 45 of the 60 (75\%) completed pregnancies. Conclusions: Given the limited availability of data on COVID-19 vaccine safety in pregnancy, Twitter can be a complementary resource for potentially increasing the acceptance of COVID-19 vaccination in pregnant populations. The results of this preliminary study justify the development of scalable methods to identify a larger cohort for epidemiologic studies. ",
doi="10.2196/33792",
url="https://formative.jmir.org/2022/1/e33792",
url="http://www.ncbi.nlm.nih.gov/pubmed/34870607"
}


@Article{info:doi/10.2196/30286,
author="Ademiluyi, Adesoji
and Li, Chuqin
and Park, Albert",
title="Implications and Preventions of Cyberbullying and Social Exclusion in Social Media: Systematic Review",
journal="JMIR Form Res",
year="2022",
month="Jan",
day="4",
volume="6",
number="1",
pages="e30286",
keywords="cyberbullying",
keywords="cybervictimization",
keywords="cyberaggression",
keywords="bullying",
keywords="mental health",
keywords="social isolation",
keywords="social media",
keywords="mobile phone",
abstract="Background: The growth of social networking has created a paradigm in which many forms of personal communication are being replaced by internet communication technologies, such as social media. This has led to social issues, such as cyberbullying. In response, researchers are investigating cyberbullying to determine its implications in various life sectors. Objective: This manuscript reviews the methods, results, and limitations of the current cyberbullying research and discusses the physical and mental repercussions of cyberbullying and social exclusion as well as methods of predicting and counteracting these events. On the basis of the findings, we discuss future research directions. Methods: Using ScienceDirect, ACM Digital Library, and PubMed, 34 research articles were used in this review. A review was conducted using the selected articles with the goal of understanding the current landscape of cyberbullying research. Results: Studies have analyzed correlations between depressive and suicidal ideations in subjects as well as relationships in the social, educational, and financial status of the perpetrators. Studies have explored detection methods for monitoring cyberbullying. Automated detection has yet to become effective and accurate; however, several factors, such as personal background and physical appearance, have been identified to correlate with the likelihood that a person becomes a survivor or perpetrator of web-based cybervictimization. Social support is currently common in recovery efforts but may require diversification for specific applications in web-based incidents. Conclusions: Relations between social status, age, gender, and behaviors have been discovered that offer new insights into the origins and likeliness of cyberbullying events. Rehabilitation from such events is possible; however, automatic detection is not yet a viable solution for prevention of cyberbullying incidents. Effects such as social exclusion and suicidal ideations are closely tied to incidents of cyberbullying and require further study across various social and demographical populations. New studies should be conducted to explore the experiences of survivors and perpetrators and identify causal links. The breadth of research includes demographics from China, Canada, Taiwan, Iran, the United States, and Namibia. Wider ranges of national populations should be considered in future studies for accurate assessments, given global internet communication technology activity. The studies emphasize the need for formal classification terminology. With formal classification, researchers will have a more definite scope, allowing specific research on a single definable topic rather than on general bullying events and symptoms. Of all the studies, 2 used a longitudinal design for their research methodology. The low number of longitudinal studies leaves gaps between causation and correlation, and further research is required to understand the effects of cyberbullying. Research addressing ongoing victimization is required for the various forms of cyberbullying; social support offers the most effective current standard for prevention. ",
doi="10.2196/30286",
url="https://formative.jmir.org/2022/1/e30286",
url="http://www.ncbi.nlm.nih.gov/pubmed/34982712"
}


@Article{info:doi/10.2196/31671,
author="Kahanek, Alexander
and Yu, Xinchen
and Hong, Lingzi
and Cleveland, Ana
and Philbrick, Jodi",
title="Temporal Variations and Spatial Disparities in Public Sentiment Toward COVID-19 and Preventive Practices in the United States: Infodemiology Study of Tweets",
journal="JMIR Infodemiology",
year="2021",
month="Dec",
day="30",
volume="1",
number="1",
pages="e31671",
keywords="COVID-19",
keywords="preventive practices",
keywords="temporal variations",
keywords="spatial disparities",
keywords="Twitter",
keywords="public sentiment",
keywords="socioeconomic factors",
abstract="Background: During the COVID-19 pandemic, US public health authorities and county, state, and federal governments recommended or ordered certain preventative practices, such as wearing masks, to reduce the spread of the disease. However, individuals had divergent reactions to these preventive practices. Objective: The purpose of this study was to understand the variations in public sentiment toward COVID-19 and the recommended or ordered preventive practices from the temporal and spatial perspectives, as well as how the variations in public sentiment are related to geographical and socioeconomic factors. Methods: The authors leveraged machine learning methods to investigate public sentiment polarity in COVID-19--related tweets from January 21, 2020 to June 12, 2020. The study measured the temporal variations and spatial disparities in public sentiment toward both general COVID-19 topics and preventive practices in the United States. Results: In the temporal analysis, we found a 4-stage pattern from high negative sentiment in the initial stage to decreasing and low negative sentiment in the second and third stages, to the rebound and increase in negative sentiment in the last stage. We also identified that public sentiment to preventive practices was significantly different in urban and rural areas, while poverty rate and unemployment rate were positively associated with negative sentiment to COVID-19 issues. Conclusions: The differences between public sentiment toward COVID-19 and the preventive practices imply that actions need to be taken to manage the initial and rebound stages in future pandemics. The urban and rural differences should be considered in terms of the communication strategies and decision making during a pandemic. This research also presents a framework to investigate time-sensitive public sentiment at the county and state levels, which could guide local and state governments and regional communities in making decisions and developing policies in crises. ",
doi="10.2196/31671",
url="https://infodemiology.jmir.org/2021/1/e31671",
url="http://www.ncbi.nlm.nih.gov/pubmed/35013722"
}


@Article{info:doi/10.2196/28042,
author="Lu, Jiahui
and Lee, J. Edmund W.",
title="Examining Twitter Discourse on Electronic Cigarette and Tobacco Consumption During National Cancer Prevention Month in 2018: Topic Modeling and Geospatial Analysis",
journal="J Med Internet Res",
year="2021",
month="Dec",
day="29",
volume="23",
number="12",
pages="e28042",
keywords="electronic cigarette",
keywords="smoking",
keywords="lung cancer",
keywords="Twitter",
keywords="national cancer prevention month",
keywords="policy",
keywords="topic modeling",
keywords="cessation",
keywords="e-cigarette",
keywords="cancer",
keywords="social media",
keywords="eHealth",
keywords="cancer prevention",
keywords="tweets",
keywords="public health",
abstract="Background: Examining public perception of tobacco products is critical for effective tobacco policy making and public education outreach. While the link between traditional tobacco products and lung cancer is well established, it is not known how the public perceives the association between electronic cigarettes (e-cigarettes) and lung cancer. In addition, it is unclear how members of the public interact with official messages during cancer campaigns on tobacco consumption and lung cancer. Objective: In this study, we aimed to analyze e-cigarette and smoking tweets in the context of lung cancer during National Cancer Prevention Month in 2018 and examine how e-cigarette and traditional tobacco product discussions relate to implementation of tobacco control policies across different states in the United States. Methods: We mined tweets that contained the term ``lung cancer'' on Twitter from February to March 2018. The data set contained 13,946 publicly available tweets that occurred during National Cancer Prevention Month (February 2018), and 10,153 tweets that occurred during March 2018. E-cigarette--related and smoking-related tweets were retrieved, using topic modeling and geospatial analysis. Results: Debates on harmfulness (454/915, 49.7\%), personal experiences (316/915, 34.5\%), and e-cigarette risks (145/915, 15.8\%) were the major themes of e-cigarette tweets related to lung cancer. Policy discussions (2251/3870, 58.1\%), smoking risks (843/3870, 21.8\%), and personal experiences (776/3870, 20.1\%) were the major themes of smoking tweets related to lung cancer. Geospatial analysis showed that discussion on e-cigarette risks was positively correlated with the number of state-level smoke-free policies enacted for e-cigarettes. In particular, the number of indoor and on campus smoke-free policies was related to the number of tweets on e-cigarette risks (smoke-free indoor, r49=0.33, P=.02; smoke-free campus, r49=0.32, P=.02). The total number of e-cigarette policies was also positively related to the number of tweets on e-cigarette risks (r49=0.32, P=.02). In contrast, the number of smoking policies was not significantly associated with any of the smoking themes in the lung cancer discourse (P>.13). Conclusions: Though people recognized the importance of traditional tobacco control policies in reducing lung cancer incidences, their views on e-cigarette risks were divided, and discussions on the importance of e-cigarette policy control were missing from public discourse. Findings suggest the need for health organizations to continuously engage the public in discussions on the potential health risks of e-cigarettes and raise awareness of the insidious lobbying efforts from the tobacco industry. ",
doi="10.2196/28042",
url="https://www.jmir.org/2021/12/e28042",
url="http://www.ncbi.nlm.nih.gov/pubmed/34964716"
}


@Article{info:doi/10.2196/25230,
author="Forgie, E. Ella M.
and Lai, Hollis
and Cao, Bo
and Stroulia, Eleni
and Greenshaw, J. Andrew
and Goez, Helly",
title="Social Media and the Transformation of the Physician-Patient Relationship: Viewpoint",
journal="J Med Internet Res",
year="2021",
month="Dec",
day="24",
volume="23",
number="12",
pages="e25230",
keywords="social media",
keywords="social determinants of health",
keywords="precision medicine",
keywords="patient care",
doi="10.2196/25230",
url="https://www.jmir.org/2021/12/e25230",
url="http://www.ncbi.nlm.nih.gov/pubmed/34951596"
}


@Article{info:doi/10.2196/31540,
author="Beliga, Slobodan
and Martin{\v c}i{\'c}-Ip{\vs}i{\'c}, Sanda
and Mate{\vs}i{\'c}, Mihaela
and Petrijev{\v c}anin Vuksanovi{\'c}, Irena
and Me{\vs}trovi{\'c}, Ana",
title="Infoveillance of the Croatian Online Media During the COVID-19 Pandemic: One-Year Longitudinal Study Using Natural Language Processing",
journal="JMIR Public Health Surveill",
year="2021",
month="Dec",
day="24",
volume="7",
number="12",
pages="e31540",
keywords="COVID-19",
keywords="pandemic",
keywords="online media",
keywords="news coverage",
keywords="infoveillance",
keywords="infodemic",
keywords="infodemiology",
keywords="natural language processing",
keywords="name entity recognition",
keywords="longitudinal study",
abstract="Background: Online media play an important role in public health emergencies and serve as essential communication platforms. Infoveillance of online media during the COVID-19 pandemic is an important step toward gaining a better understanding of crisis communication. Objective: The goal of this study was to perform a longitudinal analysis of the COVID-19--related content on online media based on natural language processing. Methods: We collected a data set of news articles published by Croatian online media during the first 13 months of the pandemic. First, we tested the correlations between the number of articles and the number of new daily COVID-19 cases. Second, we analyzed the content by extracting the most frequent terms and applied the Jaccard similarity coefficient. Third, we compared the occurrence of the pandemic-related terms during the two waves of the pandemic. Finally, we applied named entity recognition to extract the most frequent entities and tracked the dynamics of changes during the observation period. Results: The results showed no significant correlation between the number of articles and the number of new daily COVID-19 cases. Furthermore, there were high overlaps in the terminology used in all articles published during the pandemic with a slight shift in the pandemic-related terms between the first and the second waves. Finally, the findings indicate that the most influential entities have lower overlaps for the identified people and higher overlaps for locations and institutions. Conclusions: Our study shows that online media have a prompt response to the pandemic with a large number of COVID-19--related articles. There was a high overlap in the frequently used terms across the first 13 months, which may indicate the narrow focus of reporting in certain periods. However, the pandemic-related terminology is well-covered. ",
doi="10.2196/31540",
url="https://publichealth.jmir.org/2021/12/e31540",
url="http://www.ncbi.nlm.nih.gov/pubmed/34739388"
}


@Article{info:doi/10.2196/33331,
author="Yang, S. Joshua
and Cuomo, E. Raphael
and Purushothaman, Vidya
and Nali, Matthew
and Shah, Neal
and Bardier, Cortni
and Obradovich, Nick
and Mackey, Tim",
title="Campus Smoking Policies and Smoking-Related Twitter Posts Originating From California Public Universities: Retrospective Study",
journal="JMIR Form Res",
year="2021",
month="Dec",
day="24",
volume="5",
number="12",
pages="e33331",
keywords="tobacco-free policies",
keywords="social media",
keywords="colleges and universities",
keywords="smoking",
keywords="smoking policy",
keywords="campus policy",
keywords="tobacco use",
keywords="Twitter analysis",
keywords="smoke-free",
keywords="tobacco-free",
keywords="Twitter",
keywords="college students",
keywords="students",
keywords="campus",
keywords="health policy",
abstract="Background: The number of colleges and universities with smoke- or tobacco-free campus policies has been increasing. The effects of campus smoking policies on overall sentiment, particularly among young adult populations, are more difficult to assess owing to the changing tobacco and e-cigarette product landscape and differential attitudes toward policy implementation and enforcement. Objective: The goal of the study was to retrospectively assess the campus climate toward tobacco use by comparing tweets from California universities with and those without smoke- or tobacco-free campus policies. Methods: Geolocated Twitter posts from 2015 were collected using the Twitter public application programming interface in combination with cloud computing services on Amazon Web Services. Posts were filtered for tobacco products and behavior-related keywords. A total of 42,877,339 posts were collected from 2015, with 2837 originating from a University of California or California State University system campus, and 758 of these manually verified as being about smoking. Chi-square tests were conducted to determine if there were significant differences in tweet user sentiments between campuses that were smoke- or tobacco-free (all University of California campuses and California State University, Fullerton) compared to those that were not. A separate content analysis of tweets included in chi-square tests was conducted to identify major themes by campus smoking policy status. Results: The percentage of positive sentiment tweets toward tobacco use was higher on campuses without a smoke- or tobacco-free campus policy than on campuses with a smoke- or tobacco-free campus policy (76.7\% vs 66.4\%, P=.03). Higher positive sentiment on campuses without a smoke- or tobacco-free campus policy may have been driven by general comments about one's own smoking behavior and comments about smoking as a general behavior. Positive sentiment tweets originating from campuses without a smoke- or tobacco-free policy had greater variation in tweet type, which may have also contributed to differences in sentiment among universities. Conclusions: Our study introduces preliminary data suggesting that campus smoke- and tobacco-free policies are associated with a reduction in positive sentiment toward smoking. However, continued expressions and intentions to smoke and reports of one's own smoking among Twitter users suggest a need for more research to better understand the dynamics between implementation of smoke- and tobacco-free policies and resulting tobacco behavioral sentiment. ",
doi="10.2196/33331",
url="https://formative.jmir.org/2021/12/e33331",
url="http://www.ncbi.nlm.nih.gov/pubmed/34951597"
}


@Article{info:doi/10.2196/27339,
author="Ning, Peishan
and Cheng, Peixia
and Li, Jie
and Zheng, Ming
and Schwebel, C. David
and Yang, Yang
and Lu, Peng
and Mengdi, Li
and Zhang, Zhuo
and Hu, Guoqing",
title="COVID-19--Related Rumor Content, Transmission, and Clarification Strategies in China: Descriptive Study",
journal="J Med Internet Res",
year="2021",
month="Dec",
day="23",
volume="23",
number="12",
pages="e27339",
keywords="COVID-19",
keywords="rumor",
keywords="strategy",
keywords="China",
keywords="social media",
abstract="Background: Given the permeation of social media throughout society, rumors spread faster than ever before, which significantly complicates government responses to public health emergencies such as the COVID-19 pandemic. Objective: We aimed to examine the characteristics and propagation of rumors during the early months of the COVID-19 pandemic in China and evaluated the effectiveness of health authorities' release of correction announcements. Methods: We retrieved rumors widely circulating on social media in China during the early stages of the COVID-19 pandemic and assessed the effectiveness of official government clarifications and popular science articles refuting those rumors. Results: We show that the number of rumors related to the COVID-19 pandemic fluctuated widely in China between December 1, 2019 and April 15, 2020. Rumors mainly occurred in 3 provinces: Hubei, Zhejiang, and Guangxi. Personal social media accounts constituted the major source of media reports of the 4 most widely distributed rumors (the novel coronavirus can be prevented with ``Shuanghuanglian'': 7648/10,664, 71.7\%; the novel coronavirus is the SARS coronavirus: 14,696/15,902, 92.4\%; medical supplies intended for assisting Hubei were detained by the local government: 3911/3943, 99.2\%; asymptomatically infected persons were regarded as diagnosed COVID-19 patients with symptoms in official counts: 322/323, 99.7\%). The number of rumors circulating was positively associated with the severity of the COVID-19 epidemic ($\rho$=0.88, 95\% CI 0.81-0.93). The release of correction articles was associated with a substantial decrease in the proportion of rumor reports compared to accurate reports. The proportions of negative sentiments appearing among comments by citizens in response to media articles disseminating rumors and disseminating correct information differ insignificantly (both correct reports: $\chi$12=0.315, P=.58; both rumors: $\chi$12=0.025, P=.88; first rumor and last correct report: $\chi$12=1.287, P=.26; first correct report and last rumor: $\chi$12=0.033, P=.86). Conclusions: Our results highlight the importance and urgency of monitoring and correcting false or misleading reports on websites and personal social media accounts. The circulation of rumors can influence public health, and government bodies should establish guidelines to monitor and mitigate the negative impact of such rumors. ",
doi="10.2196/27339",
url="https://www.jmir.org/2021/12/e27339",
url="http://www.ncbi.nlm.nih.gov/pubmed/34806992"
}


@Article{info:doi/10.2196/26093,
author="
and Delir Haghighi, Pari
and Burstein, Frada
and Urquhart, Donna
and Cicuttini, Flavia",
title="Investigating Individuals' Perceptions Regarding the Context Around the Low Back Pain Experience: Topic Modeling Analysis of Twitter Data",
journal="J Med Internet Res",
year="2021",
month="Dec",
day="23",
volume="23",
number="12",
pages="e26093",
keywords="low back pain",
keywords="Twitter",
keywords="content analysis",
keywords="social media",
keywords="topic modeling",
keywords="patient-centered approach",
keywords="pain experience",
keywords="context of pain",
abstract="Background: Low back pain (LBP) remains the leading cause of disability worldwide. A better understanding of the beliefs regarding LBP and impact of LBP on the individual is important in order to improve outcomes. Although personal experiences of LBP have traditionally been explored through qualitative studies, social media allows access to data from a large, heterogonous, and geographically distributed population, which is not possible using traditional qualitative or quantitative methods. As data on social media sites are collected in an unsolicited manner, individuals are more likely to express their views and emotions freely and in an unconstrained manner as compared to traditional data collection methods. Thus, content analysis of social media provides a novel approach to understanding how problems such as LBP are perceived by those who experience it and its impact. Objective: The objective of this study was to identify contextual variables of the LBP experience from a first-person perspective to provide insights into individuals' beliefs and perceptions. Methods: We analyzed 896,867 cleaned tweets about  LBP between January 1, 2014, and December 31, 2018. We tested and compared latent Dirichlet allocation (LDA), Dirichlet multinomial mixture (DMM), GPU-DMM, biterm topic model, and nonnegative matrix factorization for identifying topics associated with tweets. A coherence score was determined to identify the best model. Two domain experts independently performed qualitative content analysis of the topics with the strongest coherence score and grouped them into contextual categories. The experts met and reconciled any differences and developed the final labels. Results: LDA outperformed all other algorithms, resulting in the highest coherence score. The best model was LDA with 60 topics, with a coherence score of 0.562. The 60 topics were grouped into 19 contextual categories. ``Emotion and beliefs'' had the largest proportion of total tweets (157,563/896,867, 17.6\%), followed by ``physical activity'' (124,251/896,867, 13.85\%) and ``daily life'' (80,730/896,867, 9\%), while ``food and drink,'' ``weather,'' and ``not being understood'' had the smallest proportions (11,551/896,867, 1.29\%; 10,109/896,867, 1.13\%; and 9180/896,867, 1.02\%, respectively). Of the 11 topics within ``emotion and beliefs,'' 113,562/157,563 (72\%) had negative sentiment. Conclusions: The content analysis of tweets in the area of LBP identified common themes that are consistent with findings from conventional qualitative studies but provide a more granular view of individuals' perspectives related to LBP. This understanding has the potential to assist with developing more effective and personalized models of care to improve outcomes in those with LBP. ",
doi="10.2196/26093",
url="https://www.jmir.org/2021/12/e26093",
url="http://www.ncbi.nlm.nih.gov/pubmed/36260398"
}


@Article{info:doi/10.2196/34218,
author="Tan, YQ Edina
and Wee, RE Russell
and Saw, Ern Young
and Heng, JQ Kylie
and Chin, WE Joseph
and Tong, MW Eddie
and Liu, CJ Jean",
title="Tracking Private WhatsApp Discourse About COVID-19 in Singapore: Longitudinal Infodemiology Study",
journal="J Med Internet Res",
year="2021",
month="Dec",
day="23",
volume="23",
number="12",
pages="e34218",
keywords="social media",
keywords="WhatsApp",
keywords="infodemiology",
keywords="misinformation",
keywords="COVID-19",
keywords="tracking",
keywords="surveillance",
keywords="app",
keywords="longitudinal",
keywords="Singapore",
keywords="characteristic",
keywords="usage",
keywords="pattern",
keywords="well-being",
keywords="communication",
keywords="risk",
abstract="Background: Worldwide, social media traffic increased following the onset of the COVID-19 pandemic. Although the spread of COVID-19 content has been described for several social media platforms (eg, Twitter and Facebook), little is known about how such content is spread via private messaging platforms, such as WhatsApp (WhatsApp LLC). Objective: In this study, we documented (1) how WhatsApp is used to transmit COVID-19 content, (2) the characteristics of WhatsApp users based on their usage patterns, and (3) how usage patterns link to COVID-19 concerns. Methods: We used the experience sampling method to track day-to-day WhatsApp usage during the COVID-19 pandemic. For 1 week, participants reported each day the extent to which they had received, forwarded, or discussed COVID-19 content. The final data set comprised 924 data points, which were collected from 151 participants. Results: During the weeklong monitoring process, most participants (143/151, 94.7\%) reported at least 1 COVID-19--related use of WhatsApp. When a taxonomy was generated based on usage patterns, around 1 in 10 participants (21/151, 13.9\%) were found to have received and shared a high volume of forwarded COVID-19 content, akin to super-spreaders identified on other social media platforms. Finally, those who engaged with more COVID-19 content in their personal chats were more likely to report having COVID-19--related thoughts throughout the day. Conclusions: Our findings provide a rare window into discourse on private messaging platforms. Such data can be used to inform risk communication strategies during the pandemic. Trial Registration: ClinicalTrials.gov NCT04367363; https://clinicaltrials.gov/ct2/show/NCT04367363 ",
doi="10.2196/34218",
url="https://www.jmir.org/2021/12/e34218",
url="http://www.ncbi.nlm.nih.gov/pubmed/34881720"
}


@Article{info:doi/10.2196/30753,
author="ElSherief, Mai
and Sumner, A. Steven
and Jones, M. Christopher
and Law, K. Royal
and Kacha-Ochana, Akadia
and Shieber, Lyna
and Cordier, LeShaundra
and Holton, Kelly
and De Choudhury, Munmun",
title="Characterizing and Identifying the Prevalence of Web-Based Misinformation Relating to Medication for Opioid Use Disorder: Machine Learning Approach",
journal="J Med Internet Res",
year="2021",
month="Dec",
day="22",
volume="23",
number="12",
pages="e30753",
keywords="opioid use disorder",
keywords="substance use",
keywords="addiction treatment",
keywords="misinformation",
keywords="social media",
keywords="machine learning",
keywords="natural language processing",
abstract="Background: Expanding access to and use of medication for opioid use disorder (MOUD) is a key component of overdose prevention. An important barrier to the uptake of MOUD is exposure to inaccurate and potentially harmful health misinformation on social media or web-based forums where individuals commonly seek information. There is a significant need to devise computational techniques to describe the prevalence of web-based health misinformation related to MOUD to facilitate mitigation efforts. Objective: By adopting a multidisciplinary, mixed methods strategy, this paper aims to present machine learning and natural language analysis approaches to identify the characteristics and prevalence of web-based misinformation related to MOUD to inform future prevention, treatment, and response efforts. Methods: The team harnessed public social media posts and comments in the English language from Twitter (6,365,245 posts), YouTube (99,386 posts), Reddit (13,483,419 posts), and Drugs-Forum (5549 posts). Leveraging public health expert annotations on a sample of 2400 of these social media posts that were found to be semantically most similar to a variety of prevailing opioid use disorder--related myths based on representational learning, the team developed a supervised machine learning classifier. This classifier identified whether a post's language promoted one of the leading myths challenging addiction treatment: that the use of agonist therapy for MOUD is simply replacing one drug with another. Platform-level prevalence was calculated thereafter by machine labeling all unannotated posts with the classifier and noting the proportion of myth-indicative posts over all posts. Results: Our results demonstrate promise in identifying social media postings that center on treatment myths about opioid use disorder with an accuracy of 91\% and an area under the curve of 0.9, including how these discussions vary across platforms in terms of prevalence and linguistic characteristics, with the lowest prevalence on web-based health communities such as Reddit and Drugs-Forum and the highest on Twitter. Specifically, the prevalence of the stated MOUD myth ranged from 0.4\% on web-based health communities to 0.9\% on Twitter. Conclusions: This work provides one of the first large-scale assessments of a key MOUD-related myth across multiple social media platforms and highlights the feasibility and importance of ongoing assessment of health misinformation related to addiction treatment. ",
doi="10.2196/30753",
url="https://www.jmir.org/2021/12/e30753",
url="http://www.ncbi.nlm.nih.gov/pubmed/34941555"
}


@Article{info:doi/10.2196/25414,
author="Bartlett Ellis, Rebecca
and Wright, Julie
and Miller, Soederberg Lisa
and Jake-Schoffman, Danielle
and Hekler, B. Eric
and Goldstein, M. Carly
and Arigo, Danielle
and Nebeker, Camille",
title="Lessons Learned: Beta-Testing the Digital Health Checklist for Researchers Prompts a Call to Action by Behavioral Scientists",
journal="J Med Internet Res",
year="2021",
month="Dec",
day="22",
volume="23",
number="12",
pages="e25414",
keywords="digital health",
keywords="mHealth",
keywords="research ethics",
keywords="institutional review board",
keywords="IRB",
keywords="behavioral medicine",
keywords="wearable sensors",
keywords="social media",
keywords="bioethics",
keywords="data management",
keywords="usability",
keywords="privacy",
keywords="access",
keywords="risks and benefits",
keywords="mobile phone",
doi="10.2196/25414",
url="https://www.jmir.org/2021/12/e25414",
url="http://www.ncbi.nlm.nih.gov/pubmed/34941548"
}


@Article{info:doi/10.2196/23210,
author="Taylor, A. Kimberly
and Humphrey Jr, F. William",
title="Impact of Medical Blog Reading and Information Presentation on Readers' Preventative Health Intentions: Mixed Methods, Multistudy Investigation",
journal="J Med Internet Res",
year="2021",
month="Dec",
day="22",
volume="23",
number="12",
pages="e23210",
keywords="health blogs",
keywords="patient blogs",
keywords="preventative care",
keywords="cancer",
keywords="caregivers",
keywords="perceived risk",
abstract="Background: Medical blogs have become valuable information sources for patients and caregivers. Most research has focused on patients' creation of blogs as therapy. But we know less about how these blogs affect their readers and what format of information influences readers to take preventative health actions. Objective: This study aimed to identify how reading patient medical blogs influences readers' perceived health risk and their intentions to engage in preventative health actions. Further, we aimed to examine the format of the medical blog and the reader's response. Methods: We surveyed 99 university participants and a general-population, online panel of 167 participants. Both studies randomly assigned participants to conditions and measured blog evaluation, intentions for preventative health action, and evaluation of health risk and beliefs, and allowed open-ended comments. The second study used a different sample and added a control condition. A third study used a convenience sample of blog readers to evaluate the link between reading medical blogs and taking preventative health action. Results: Across 3 studies, participants indicated a desire to take future preventative health action after reading patient blogs. Studies 1 and 2 used experimental scenario-based designs, while Study 3 employed a qualitative design with real blog readers. The 2 experimental studies showed that the type of blog impacted intentions to engage in future preventative health actions (Study 1: F2,96=6.08, P=.003; Study 2: F3,166=2.59, P=.06), with a statistical blog being most effective in both studies and a personal narrative blog showing similar effectiveness in Study 2, contrary to some prior research. The readers' perceptions of their own health risk did not impact the relationship between the blog type and health intentions. In contrast, in one study, participants' judgments about the barriers they might face to accessing care improved the fit of the model (F2,95=13.57, P<.001). In Study 3's sample of medical blog readers, 53\% (24/45) reported taking preventative health action after reading a health blog, including performing a self-check, asking a doctor about their health risk, or requesting a screening test. Additionally, these readers expressed that they read the blogs to follow the author (patient) and to learn general health information. All studies demonstrated the blogs were somewhat sad and emotional but also informative and well-written. They noted that the blogs made them appreciate life more and motivated them to consider taking some action regarding their health.? Conclusions: Reading patient blogs influences intentions to take future health actions. However, blog formats show different efficacy, and the readers' disease risk perceptions do not. Physicians, medical practitioners, and health organizations may find it useful to curate or promote selected medical blogs to influence patient behavior. ",
doi="10.2196/23210",
url="https://www.jmir.org/2021/12/e23210",
url="http://www.ncbi.nlm.nih.gov/pubmed/34941543"
}


@Article{info:doi/10.2196/31834,
author="Drescher, S. Larissa
and Roosen, Jutta
and Aue, Katja
and Dressel, Kerstin
and Sch{\"a}r, Wiebke
and G{\"o}tz, Anne",
title="The Spread of COVID-19 Crisis Communication by German Public Authorities and Experts on Twitter: Quantitative Content Analysis",
journal="JMIR Public Health Surveill",
year="2021",
month="Dec",
day="22",
volume="7",
number="12",
pages="e31834",
keywords="COVID-19",
keywords="crisis communication",
keywords="content analysis",
keywords="Twitter",
keywords="experts",
keywords="authorities",
keywords="Germany",
keywords="negative binomial regression",
keywords="social media",
keywords="communication",
keywords="crisis",
keywords="information",
keywords="development",
abstract="Background: The COVID-19 pandemic led to the necessity of immediate crisis communication by public health authorities. In Germany, as in many other countries, people choose social media, including Twitter, to obtain real-time information and understanding of the pandemic and its consequences. Next to authorities, experts such as virologists and science communicators were very prominent at the beginning of German Twitter COVID-19 crisis communication. Objective: The aim of this study was to detect similarities and differences between public authorities and individual experts in COVID-19 crisis communication on Twitter during the first year of the pandemic. Methods: Descriptive analysis and quantitative content analysis were carried out on 8251 original tweets posted from January 1, 2020, to January 15, 2021. COVID-19--related tweets of 21 authorities and 18 experts were categorized into structural, content, and style components. Negative binomial regressions were performed to evaluate tweet spread measured by the retweet and like counts of COVID-19--related tweets. Results: Descriptive statistics revealed that authorities and experts increasingly tweeted about COVID-19 over the period under study. Two experts and one authority were responsible for 70.26\% (544,418/774,865) of all retweets, thus representing COVID-19 influencers. Altogether, COVID-19 tweets by experts reached a 7-fold higher rate of retweeting (t8,249=26.94, P<.001) and 13.9 times the like rate (t8,249=31.27, P<.001) compared with those of authorities. Tweets by authorities were much more designed than those by experts, with more structural and content components; for example, 91.99\% (4997/5432) of tweets by authorities used hashtags in contrast to only 19.01\% (536/2819) of experts' COVID-19 tweets. Multivariate analysis revealed that such structural elements reduce the spread of the tweets, and the incidence rate of retweets for authorities' tweets using hashtags was approximately 0.64 that of tweets without hashtags (Z=--6.92, P<.001). For experts, the effect of hashtags on retweets was insignificant (Z=1.56, P=.12). Conclusions: Twitter data are a powerful information source and suitable for crisis communication in Germany. COVID-19 tweet activity mirrors the development of COVID-19 cases in Germany. Twitter users retweet and like communications regarding COVID-19 by experts more than those delivered by authorities. Tweets have higher coverage for both authorities and experts when they are plain and for authorities when they directly address people. For authorities, it appears that it was difficult to win recognition during COVID-19. For all stakeholders studied, the association between number of followers and number of retweets was highly significantly positive (authorities Z=28.74, P<.001; experts Z=25.99, P<.001). Updated standards might be required for successful crisis communication by authorities. ",
doi="10.2196/31834",
url="https://publichealth.jmir.org/2021/12/e31834",
url="http://www.ncbi.nlm.nih.gov/pubmed/34710054"
}


@Article{info:doi/10.2196/26644,
author="Ming, Wai-kit
and Huang, Fengqiu
and Chen, Qiuyi
and Liang, Beiting
and Jiao, Aoao
and Liu, Taoran
and Wu, Huailiang
and Akinwunmi, Babatunde
and Li, Jia
and Liu, Guan
and Zhang, P. Casper J.
and Huang, Jian
and Liu, Qian",
title="Understanding Health Communication Through Google Trends and News Coverage for COVID-19: Multinational Study in Eight Countries",
journal="JMIR Public Health Surveill",
year="2021",
month="Dec",
day="21",
volume="7",
number="12",
pages="e26644",
keywords="COVID-19",
keywords="Google Trends",
keywords="search peaks",
keywords="news coverage",
keywords="public concerns",
abstract="Background: Due to the COVID-19 pandemic, health information related to COVID-19 has spread across news media worldwide. Google is among the most used internet search engines, and the Google Trends tool can reflect how the public seeks COVID-19--related health information during the pandemic. Objective: The aim of this study was to understand health communication through Google Trends and news coverage and to explore their relationship with prevention and control of COVID-19 at the early epidemic stage. Methods: To achieve the study objectives, we analyzed the public's information-seeking behaviors on Google and news media coverage on COVID-19. We collected data on COVID-19 news coverage and Google search queries from eight countries (ie, the United States, the United Kingdom, Canada, Singapore, Ireland, Australia, South Africa, and New Zealand) between January 1 and April 29, 2020. We depicted the characteristics of the COVID-19 news coverage trends over time, as well as the search query trends for the topics of COVID-19--related ``diseases,'' ``treatments and medical resources,'' ``symptoms and signs,'' and ``public measures.'' The search query trends provided the relative search volume (RSV) as an indicator to represent the popularity of a specific search term in a specific geographic area over time. Also, time-lag correlation analysis was used to further explore the relationship between search terms trends and the number of new daily cases, as well as the relationship between search terms trends and news coverage. Results: Across all search trends in eight countries, almost all search peaks appeared between March and April 2020, and declined in April 2020. Regarding COVID-19--related ``diseases,'' in most countries, the RSV of the term ``coronavirus'' increased earlier than that of ``covid-19''; however, around April 2020, the search volume of the term ``covid-19'' surpassed that of ``coronavirus.'' Regarding the topic ``treatments and medical resources,'' the most and least searched terms were ``mask'' and ``ventilator,'' respectively. Regarding the topic ``symptoms and signs,'' ``fever'' and ``cough'' were the most searched terms. The RSV for the term ``lockdown'' was significantly higher than that for ``social distancing'' under the topic ``public health measures.'' In addition, when combining search trends with news coverage, there were three main patterns: (1) the pattern for Singapore, (2) the pattern for the United States, and (3) the pattern for the other countries. In the time-lag correlation analysis between the RSV for the topic ``treatments and medical resources'' and the number of new daily cases, the RSV for all countries except Singapore was positively correlated with new daily cases, with a maximum correlation of 0.8 for the United States. In addition, in the time-lag correlation analysis between the overall RSV for the topic ``diseases'' and the number of daily news items, the overall RSV was positively correlated with the number of daily news items, the maximum correlation coefficient was more than 0.8, and the search behavior occurred 0 to 17 days earlier than the news coverage. Conclusions: Our findings revealed public interest in masks, disease control, and public measures, and revealed the potential value of Google Trends in the face of the emergence of new infectious diseases. Also, Google Trends combined with news media can achieve more efficient health communication. Therefore, both news media and Google Trends can contribute to the early prevention and control of epidemics. ",
doi="10.2196/26644",
url="https://publichealth.jmir.org/2021/12/e26644",
url="http://www.ncbi.nlm.nih.gov/pubmed/34591781"
}


@Article{info:doi/10.2196/27183,
author="Liu, Jessica
and Wright, Caroline
and Williams, Philippa
and Elizarova, Olga
and Dahne, Jennifer
and Bian, Jiang
and Zhao, Yunpeng
and Tan, L. Andy S.",
title="Smokers' Likelihood to Engage With Information and Misinformation on Twitter About the Relative Harms of e-Cigarette Use: Results From a Randomized Controlled Trial",
journal="JMIR Public Health Surveill",
year="2021",
month="Dec",
day="21",
volume="7",
number="12",
pages="e27183",
keywords="e-cigarettes",
keywords="misinformation",
keywords="Twitter",
keywords="social media",
abstract="Background: Information and misinformation on the internet about e-cigarette harms may increase smokers' misperceptions of e-cigarettes. There is limited research on smokers' engagement with information and misinformation about e-cigarettes on social media. Objective: This study assessed smokers' likelihood to engage with---defined as replying, retweeting, liking, and sharing---tweets that contain information and misinformation and uncertainty about the harms of e-cigarettes. Methods: We conducted a web-based randomized controlled trial among 2400 UK and US adult smokers who did not vape in the past 30 days. Participants were randomly assigned to view four tweets in one of four conditions: (1) e-cigarettes are as harmful or more harmful than smoking, (2) e-cigarettes are completely harmless, (3) uncertainty about e-cigarette harms, or (4) control (physical activity). The outcome measure was participants' likelihood of engaging with tweets, which comprised the sum of whether they would reply, retweet, like, and share each tweet. We fitted Poisson regression models to predict the likelihood of engagement with tweets among 974 Twitter users and 1287 non-Twitter social media users, adjusting for covariates and stratified by UK and US participants. Results: Among Twitter users, participants were more likely to engage with tweets in condition 1 (e-cigarettes are as harmful or more harmful than smoking) than in condition 2 (e-cigarettes are completely harmless). Among other social media users, participants were more likely to likely to engage with tweets in condition 1 than in conditions 2 and 3 (e-cigarettes are completely harmless and uncertainty about e-cigarette harms). Conclusions: Tweets stating information and misinformation that e-cigarettes were as harmful or more harmful than smoking regular cigarettes may receive higher engagement than tweets indicating e-cigarettes were completely harmless. Trial Registration: International Standard Randomized Controlled Trial Number (ISRCTN) 16082420; https://doi.org/10.1186/ISRCTN16082420 ",
doi="10.2196/27183",
url="https://publichealth.jmir.org/2021/12/e27183",
url="http://www.ncbi.nlm.nih.gov/pubmed/34931999"
}


@Article{info:doi/10.2196/29187,
author="Black, Joshua
and Margolin, R. Zachary
and Bau, Gabrielle
and Olson, Richard
and Iwanicki, L. Janetta
and Dart, C. Richard",
title="Web-Based Discussion and Illicit Street Sales of Tapentadol and Oxycodone in Australia: Epidemiological Surveillance Study",
journal="JMIR Public Health Surveill",
year="2021",
month="Dec",
day="20",
volume="7",
number="12",
pages="e29187",
keywords="Australia",
keywords="opioids",
keywords="web-based discussion",
keywords="diversion",
abstract="Background: Opioid use disorder and its consequences are a persistent public health concern for Australians. Web activity has been used to understand the perception of drug safety and diversion of drugs in contexts outside of Australia. The anonymity of the internet offers several advantages for surveilling and inquiring about specific covert behaviors, such as diversion or discussion of sensitive subjects where traditional surveillance approaches might be limited. Objective: This study aims to characterize the content of web posts and compare reports of illicit sales of tapentadol and oxycodone from sources originating in Australia. First, post content is evaluated to determine whether internet discussion encourages or discourages proper therapeutic use of the drugs. Second, we hypothesize that tapentadol would have lower street price and fewer illicit sales than oxycodone. Methods: Web posts originating in Australia between 2017 and 2019 were collected using the Researched Abuse, Diversion, and Addiction-Related Surveillance System Web Monitoring Program. Using a manual coding process, unstructured post content from social media, blogs, and forums was categorized into topics of discussion related to the harms and behaviors that could lead to harm. Illicit sales data in a structured format were collected through a crowdsourcing website between 2016 and 2019 using the Researched Abuse, Diversion, and Addiction-Related Surveillance System StreetRx Program. In total, 2 multivariable regression models assessed the differences in illicit price and number of sales. Results: A total of 4.7\% (28/600) of tapentadol posts discussed an adverse event, whereas 10.27\% (95\% CI 9.32-11.21) of oxycodone posts discussed this topic. A total of 10\% (60/600) of tapentadol posts discussed unsafe use or side effects, whereas 20.17\% (95\% CI 18.92-21.41) of oxycodone posts discussed unsafe use or side effects. There were 31 illicit sales reports for tapentadol (geometric mean price per milligram: Aus \$0.12 [US \$0.09]) and 756 illicit sales reports for oxycodone (Aus \$1.28 [US \$0.91]). Models detected no differences in the street price or number of sales between the drugs when covariates were included, although the potency of the pill significantly predicted the street price (P<.001) and availability predicted the number of sales (P=.03). Conclusions: Australians searching the web for opinions could judge tapentadol as safer than oxycodone because of the web post content. The illicit sales market for tapentadol was smaller than that of oxycodone, and drug potency and licit availability are likely important factors influencing the illicit market. ",
doi="10.2196/29187",
url="https://publichealth.jmir.org/2021/12/e29187",
url="http://www.ncbi.nlm.nih.gov/pubmed/34932012"
}


@Article{info:doi/10.2196/27599,
author="van Wier, F. Marieke
and Urry, Emily
and Lissenberg-Witte, I. Birgit
and Kramer, E. Sophia",
title="A Comparison of the Use of Smart Devices, Apps, and Social Media Between Adults With and Without Hearing Impairment: Cross-sectional Web-Based Study",
journal="J Med Internet Res",
year="2021",
month="Dec",
day="20",
volume="23",
number="12",
pages="e27599",
keywords="hearing impairment",
keywords="social media use",
keywords="app use",
keywords="benefits from social media",
keywords="eHealth",
keywords="mobile phone",
abstract="Background: eHealth and social media could be of particular benefit to adults with hearing impairment, but it is unknown whether their use of smart devices, apps, and social media is similar to that of the general population. Objective: Our aim is to study whether adults with normal hearing and those with impaired hearing differ in their weekly use of smart devices, apps, and social media; reasons for using social media; and benefits from using social media. Methods: We used data from a Dutch cohort, the National Longitudinal Study on Hearing. Data were collected from September 2016 to April 2020 using a web-based questionnaire and speech-in-noise test. The results from this test were used to categorize normal hearing and hearing impairment. Outcomes were compared using (multiple) logistic regression models. Results: Adults with impaired hearing (n=384) did not differ from normal hearing adults (n=341) in their use of a smartphone or tablet. They were less likely to make use of social media apps on a smartphone, tablet, or smartwatch (age-adjusted odds ratio [OR] 0.67, 95\% CI 0.48-0.92; P=.02). Use of social media on all devices and use of other apps did not differ. Adults with hearing impairment were more likely to agree with using social media to stay in touch with family members (OR 1.54, 95\% CI 1.16-2.07; P=.003) and friends (age-adjusted OR 1.35, 95\% CI 1.01-1.81; P=.046). Furthermore, they were more likely to agree with using social media to perform their work (age-adjusted OR 1.51, 95\% CI 1.04-2.18; P=.03). There were no differences in the experienced benefits from social media. Conclusions: The potential for eHealth is confirmed because adults with hearing impairment are not less likely to use smart devices than their normal hearing peers. Adults with hearing impairment are less likely to use social media apps on a smart device but not less likely to use social media on all types of internet-connected devices. This warrants further research on the types of social media platforms that adults with hearing impairment use and on the type of device on which they prefer to use social media. Given that participants with hearing impairment are more likely than their normal hearing peers to use social media to perform their work, use of social media may be seen as an opportunity to enhance vocational rehabilitation services for persons with hearing impairment. ",
doi="10.2196/27599",
url="https://www.jmir.org/2021/12/e27599",
url="http://www.ncbi.nlm.nih.gov/pubmed/34932013"
}


@Article{info:doi/10.2196/27307,
author="Turner, Jason
and Kantardzic, Mehmed
and Vickers-Smith, Rachel",
title="Infodemiological Examination of Personal and Commercial Tweets About Cannabidiol: Term and Sentiment Analysis",
journal="J Med Internet Res",
year="2021",
month="Dec",
day="20",
volume="23",
number="12",
pages="e27307",
keywords="social media",
keywords="social networks",
keywords="text mining",
keywords="CBD",
keywords="cannabidiol",
keywords="cannabis",
keywords="public health",
keywords="drug regulation",
keywords="Twitter",
keywords="sentiment analysis",
keywords="unregulated substances",
abstract="Background: In the absence of official clinical trial information, data from social networks can be used by public health and medical researchers to assess public claims about loosely regulated substances such as cannabidiol (CBD). For example, this can be achieved by comparing the medical conditions targeted by those selling CBD against the medical conditions patients commonly treat with CBD. Objective: The objective of this study was to provide a framework for public health and medical researchers to use for identifying and analyzing the consumption and marketing of unregulated substances. Specifically, we examined CBD, which is a substance that is often presented to the public as medication despite complete evidence of efficacy and safety. Methods: We collected 567,850 tweets by searching Twitter with the Tweepy Python package using the terms ``CBD'' and ``cannabidiol.'' We trained two binary text classifiers to create two corpora of 167,755 personal use and 143,322 commercial/sales tweets. Using medical, standard, and slang dictionaries, we identified and compared the most frequently occurring medical conditions, symptoms, side effects, body parts, and other substances referenced in both corpora.  In addition, to assess popular claims about the efficacy of CBD as a medical treatment circulating on Twitter, we performed sentiment analysis via the VADER (Valence Aware Dictionary for Sentiment Reasoning) model on the personal CBD tweets. Results: We found references to medically relevant terms that were unique to either personal or commercial CBD tweet classes, as well as medically relevant terms that were common to both classes. When we calculated the average sentiment scores for both personal and commercial CBD tweets referencing at least one of 17 medical conditions/symptoms terms, an overall positive sentiment was observed in both personal and commercial CBD tweets. We observed instances of negative sentiment conveyed in personal CBD tweets referencing autism, whereas CBD was also marketed multiple times as a treatment for autism within commercial tweets. Conclusions: Our proposed framework provides a tool for public health and medical researchers to analyze the consumption and marketing of unregulated substances on social networks. Our analysis showed that most users of CBD are satisfied with it in regard to the condition that it is being advertised for, with the exception of autism. ",
doi="10.2196/27307",
url="https://www.jmir.org/2021/12/e27307",
url="http://www.ncbi.nlm.nih.gov/pubmed/34932014"
}


@Article{info:doi/10.2196/28318,
author="Song, Shijie
and Xue, Xiang
and Zhao, Chris Yuxiang
and Li, Jinhao
and Zhu, Qinghua
and Zhao, Mingming",
title="Short-Video Apps as a Health Information Source for Chronic Obstructive Pulmonary Disease: Information Quality Assessment of TikTok Videos",
journal="J Med Internet Res",
year="2021",
month="Dec",
day="20",
volume="23",
number="12",
pages="e28318",
keywords="COPD",
keywords="information quality",
keywords="social media",
keywords="short-video apps",
keywords="TikTok",
abstract="Background: Chronic obstructive pulmonary disease (COPD) has become one of the most critical public health problems worldwide. Because many COPD patients are using video-based social media to search for health information, there is an urgent need to assess the information quality of COPD videos on social media. Recently, the short-video app TikTok has demonstrated huge potential in disseminating health information and there are currently many COPD videos available on TikTok; however, the information quality of these videos remains unknown. Objective: The aim of this study was to investigate the information quality of COPD videos on TikTok. Methods: In December 2020, we retrieved and screened 300 videos from TikTok and collected a sample of 199 COPD-related videos in Chinese for data extraction. We extracted the basic video information, coded the content, and identified the video sources. Two independent raters assessed the information quality of each video using the DISCERN instrument. Results: COPD videos on TikTok came mainly from two types of sources: individual users (n=168) and organizational users (n=31). The individual users included health professionals, individual science communicators, and general TikTok users, whereas the organizational users consisted of for-profit organizations, nonprofit organizations, and news agencies. For the 199 videos, the mean scores of the DISCERN items ranged from 3.42 to 4.46, with a total mean score of 3.75. Publication reliability (P=.04) and overall quality (P=.02) showed significant differences across the six types of sources, whereas the quality of treatment choices showed only a marginally significant difference (P=.053) across the different sources. Conclusions: The overall information quality of COPD videos on TikTok is satisfactory, although the quality varies across different sources and according to specific quality dimensions. Patients should be selective and cautious when watching COPD videos on TikTok. ",
doi="10.2196/28318",
url="https://www.jmir.org/2021/12/e28318",
url="http://www.ncbi.nlm.nih.gov/pubmed/34931996"
}


@Article{info:doi/10.2196/17723,
author="Chu, Wai Joanna Ting
and Wadham, Angela
and Jiang, Yannan
and Stasiak, Karolina
and Shepherd, Matthew
and Bullen, Christopher",
title="Recruitment and Retention of Parents of Adolescents in a Text Messaging Trial (MyTeen): Secondary Analysis From a Randomized Controlled Trial",
journal="JMIR Pediatr Parent",
year="2021",
month="Dec",
day="20",
volume="4",
number="4",
pages="e17723",
keywords="parenting",
keywords="mHealth",
keywords="text messaging",
keywords="recruitment",
abstract="Background: Parenting programs are well established as an effective strategy for enhancing both parenting skills and the well-being of the child. However, recruitment for family programs in clinical and nonclinical settings remains low. Objective: This study aims to describe the recruitment and retention methods used in a text messaging program (MyTeen) trial for parents of adolescents (10-15 years) and identify key lessons learned. We aim to provide insights and direction for researchers who seek to recruit parents and build on the limited literature on recruitment and retention strategies for parenting program trials. Methods: A recruitment plan was developed, monitored, and modified as needed throughout the course of the project. Strategies to facilitate recruitment were identified (eg, program content and recruitment material, staff characteristics, and study procedures). Traditional and web-based recruitment strategies were used. Results: Over a 5-month period, 319 parents or caregivers expressed interest in our study, of which 221 agreed to participate in the study, exceeding our recruitment target of 214 participants. Attrition was low at the 1-month (4.5\% overall; intervention group: n=5, 4.6\%; control group: n=5, 4.5\%) and 3-month follow-ups (9\% overall; intervention group: n=10, 9.2\%; control group: n=10, 8.9\%). Conclusions: The use of web-based recruitment strategies appeared to be most effective for recruiting and retaining parents in a text-messaging program trial. However, we encountered recruitment challenges (ie, underrepresentation of ethnic minority groups and fathers) similar to those reported in the literature. Therefore, efforts to engage ethnic minorities and fathers are needed. Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12618000117213; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=374307 ",
doi="10.2196/17723",
url="https://pediatrics.jmir.org/2021/4/e17723",
url="http://www.ncbi.nlm.nih.gov/pubmed/34932007"
}


@Article{info:doi/10.2196/19183,
author="Lei, Yuqi
and Xu, Songhua
and Zhou, Linyun",
title="User Behaviors and User-Generated Content in Chinese Online Health Communities: Comparative Study",
journal="J Med Internet Res",
year="2021",
month="Dec",
day="15",
volume="23",
number="12",
pages="e19183",
keywords="online health community",
keywords="user behaviors",
keywords="user-generated content",
keywords="social network analysis",
keywords="weighted knowledge network",
abstract="Background: Online health communities (OHCs) have increasingly gained traction with patients, caregivers, and supporters globally. Chinese OHCs are no exception. However, user-generated content (UGC) and the associated user behaviors in Chinese OHCs are largely underexplored and rarely analyzed systematically, forfeiting valuable opportunities for optimizing treatment design and care delivery with insights gained from OHCs. Objective: This study aimed to reveal both the shared and distinct characteristics of 2 popular OHCs in China by systematically and comprehensively analyzing their UGC and the associated user behaviors. Methods: We concentrated on studying the lung cancer forum (LCF) and breast cancer forum (BCF) on Mijian, and the diabetes consultation forum (DCF) on Sweet Home, because of the importance of the 3 diseases among Chinese patients and their prevalence on Chinese OHCs in general. Our analysis explored the key user activities, small-world effect, and scale-free characteristics of each social network. We examined the UGC of these forums comprehensively and adopted the weighted knowledge network technique to discover salient topics and latent relations among these topics on each forum. Finally, we discussed the public health implications of our analysis findings. Results: Our analysis showed that the number of reads per thread on each forum followed gamma distribution (HL=0, HB=0, and HD=0); the number of replies on each forum followed exponential distribution (adjusted RL2=0.946, adjusted RB2=0.958, and adjusted RD2=0.971); and the number of threads a user is involved with (adjusted RL2=0.978, adjusted RB2=0.964, and adjusted RD2=0.970), the number of followers of a user (adjusted RL2=0.989, adjusted RB2=0.962, and adjusted RD2=0.990), and a user's degrees (adjusted RL2=0.997, adjusted RB2=0.994, and adjusted RD2=0.968) all followed power-law distribution. The study further revealed that users are generally more active during weekdays, as commonly witnessed in all 3 forums. In particular, the LCF and DCF exhibited high temporal similarity ($\rho$=0.927; P<.001) in terms of the relative thread posting frequencies during each hour of the day. Besides, the study showed that all 3 forums exhibited the small-world effect (mean $\sigma$L=517.15, mean $\sigma$B=275.23, and mean $\sigma$D=525.18) and scale-free characteristics, while the global clustering coefficients were lower than those of counterpart international OHCs. The study also discovered several hot topics commonly shared among the 3 disease forums, such as disease treatment, disease examination, and diagnosis. In particular, the study found that after the outbreak of COVID-19, users on the LCF and BCF were much more likely to bring up COVID-19--related issues while discussing their medical issues. Conclusions: UGC and related online user behaviors in Chinese OHCs can be leveraged as important sources of information to gain insights regarding individual and population health conditions. Effective and timely mining and utilization of such content can continuously provide valuable firsthand clues for enhancing the situational awareness of health providers and policymakers. ",
doi="10.2196/19183",
url="https://www.jmir.org/2021/12/e19183",
url="http://www.ncbi.nlm.nih.gov/pubmed/34914615"
}


@Article{info:doi/10.2196/34286,
author="Divi, Nomita
and Smolinski, Mark",
title="EpiHacks, a Process for Technologists and Health Experts to Cocreate Optimal Solutions for Disease Prevention and Control: User-Centered Design Approach",
journal="J Med Internet Res",
year="2021",
month="Dec",
day="15",
volume="23",
number="12",
pages="e34286",
keywords="epidemiology",
keywords="public health",
keywords="diagnostic",
keywords="tool",
keywords="disease surveillance",
keywords="technology solution",
keywords="innovative approaches to disease surveillance",
keywords="One Health",
keywords="surveillance",
keywords="hack",
keywords="innovation",
keywords="expert",
keywords="solution",
keywords="prevention",
keywords="control",
abstract="Background: Technology-based innovations that are created collaboratively by local technology specialists and health experts can optimize the addressing of priority needs for disease prevention and control. An EpiHack is a distinct, collaborative approach to developing solutions that combines the science of epidemiology with the format of a hackathon. Since 2013, a total of 12 EpiHacks have collectively brought together over 500 technology and health professionals from 29 countries. Objective: We aimed to define the EpiHack process and summarize the impacts of the technology-based innovations that have been created through this approach. Methods: The key components and timeline of an EpiHack were described in detail. The focus areas, outputs, and impacts of the twelve EpiHacks that were conducted between 2013 and 2021 were summarized. Results: EpiHack solutions have served to improve surveillance for influenza, dengue, and mass gatherings, as well as laboratory sample tracking and One Health surveillance, in rural and urban communities. Several EpiHack tools were scaled during the COVID-19 pandemic to support local governments in conducting active surveillance. All tools were designed to be open source to allow for easy replication and adaptation by other governments or parties. Conclusions: EpiHacks provide an efficient, flexible, and replicable new approach to generating relevant and timely innovations that are locally developed and owned, are scalable, and are sustainable. ",
doi="10.2196/34286",
url="https://www.jmir.org/2021/12/e34286",
url="http://www.ncbi.nlm.nih.gov/pubmed/34807832"
}


@Article{info:doi/10.2196/33617,
author="Prusaczyk, Beth
and Pietka, Kathryn
and Landman, M. Joshua
and Luke, A. Douglas",
title="Utility of Facebook's Social Connectedness Index in Modeling COVID-19 Spread: Exponential Random Graph Modeling Study",
journal="JMIR Public Health Surveill",
year="2021",
month="Dec",
day="15",
volume="7",
number="12",
pages="e33617",
keywords="COVID-19",
keywords="social media",
keywords="social networks",
keywords="network analysis",
keywords="public health",
keywords="utility",
keywords="Facebook",
keywords="connection",
keywords="modeling",
keywords="spread",
keywords="United States",
keywords="belief",
abstract="Background: The COVID-19 (the disease caused by the SARS-CoV-2 virus) pandemic has underscored the need for additional data, tools, and methods that can be used to combat emerging and existing public health concerns. Since March 2020, there has been substantial interest in using social media data to both understand and intervene in the pandemic. Researchers from many disciplines have recently found a relationship between COVID-19 and a new data set from Facebook called the Social Connectedness Index (SCI). Objective: Building off this work, we seek to use the SCI to examine how social similarity of Missouri counties could explain similarities of COVID-19 cases over time. Additionally, we aim to add to the body of literature on the utility of the SCI by using a novel modeling technique. Methods: In September 2020, we conducted this cross-sectional study using publicly available data to test the association between the SCI and COVID-19 spread in Missouri using exponential random graph models, which model relational data, and the outcome variable must be binary, representing the presence or absence of a relationship. In our model, this was the presence or absence of a highly correlated COVID-19 case count trajectory between two given counties in Missouri. Covariates included each county's total population, percent rurality, and distance between each county pair. Results: We found that all covariates were significantly associated with two counties having highly correlated COVID-19 case count trajectories. As the log of a county's total population increased, the odds of two counties having highly correlated COVID-19 case count trajectories increased by 66\% (odds ratio [OR] 1.66, 95\% CI 1.43-1.92). As the percent of a county classified as rural increased, the odds of two counties having highly correlated COVID-19 case count trajectories increased by 1\% (OR 1.01, 95\% CI 1.00-1.01). As the distance (in miles) between two counties increased, the odds of two counties having highly correlated COVID-19 case count trajectories decreased by 43\% (OR 0.57, 95\% CI 0.43-0.77). Lastly, as the log of the SCI between two Missouri counties increased, the odds of those two counties having highly correlated COVID-19 case count trajectories significantly increased by 17\% (OR 1.17, 95\% CI 1.09-1.26). Conclusions: These results could suggest that two counties with a greater likelihood of sharing Facebook friendships means residents of those counties have a higher likelihood of sharing similar belief systems, in particular as they relate to COVID-19 and public health practices. Another possibility is that the SCI is picking up travel or movement data among county residents. This suggests the SCI is capturing a unique phenomenon relevant to COVID-19 and that it may be worth adding to other COVID-19 models. Additional research is needed to better understand what the SCI is capturing practically and what it means for public health policies and prevention practices. ",
doi="10.2196/33617",
url="https://publichealth.jmir.org/2021/12/e33617",
url="http://www.ncbi.nlm.nih.gov/pubmed/34797775"
}


@Article{info:doi/10.2196/29086,
author="Parker, K. Jane
and Kelly, E. Christine
and Smith, C. Barry
and Kirkwood, F. Aidan
and Hopkins, Claire
and Gane, Simon",
title="Patients' Perspectives on Qualitative Olfactory Dysfunction: Thematic Analysis of Social Media Posts",
journal="JMIR Form Res",
year="2021",
month="Dec",
day="14",
volume="5",
number="12",
pages="e29086",
keywords="olfactory dysfunction",
keywords="parosmia",
keywords="phantosmia",
keywords="olfactory perseveration",
keywords="trigger foods",
keywords="mental health",
keywords="COVID-19",
keywords="patients' perspective",
keywords="thematic analysis",
keywords="social media",
keywords="perspective",
keywords="smell",
keywords="nose",
keywords="symptom",
keywords="concern",
keywords="support",
abstract="Background: The impact of qualitative olfactory disorders is underestimated. Parosmia, the distorted perception of familiar odors, and phantosmia, the experience of odors in the absence of a stimulus, can arise following postinfectious anosmia, and the incidences of both have increased substantially since the outbreak of COVID-19. Objective: The aims of this study are to explore the symptoms and sequalae of postinfectious olfactory dysfunction syndrome using unstructured and unsolicited threads from social media, and to articulate the perspectives and concerns of patients affected by these debilitating olfactory disorders. Methods: A thematic analysis and content analysis of posts in the AbScent Parosmia and Phantosmia Support group on Facebook was conducted between June and December 2020. Results: In this paper, we identify a novel symptom, olfactory perseveration, which is a triggered, identifiable, and usually unpleasant olfactory percept that persists in the absence of an ongoing stimulus. We also observe fluctuations in the intensity and duration of symptoms of parosmia, phantosmia, and olfactory perseveration. In addition, we identify a group of the most common items (coffee, meat, onion, and toothpaste) that trigger distortions; however, people have difficulty describing these distortions, using words associated with disgust and revulsion. The emotional aspect of living with qualitative olfactory dysfunction was evident and highlighted the detrimental impact on mental health. Conclusions: Qualitative and unsolicited data acquired from social media has provided useful insights into the patient experience of parosmia and phantosmia, which can inform rehabilitation strategies and ongoing research into understanding the molecular triggers associated with parosmic distortions and research into patient benefit. ",
doi="10.2196/29086",
url="https://formative.jmir.org/2021/12/e29086",
url="http://www.ncbi.nlm.nih.gov/pubmed/34904953"
}


@Article{info:doi/10.2196/29737,
author="Vallury, Dee Kari
and Baird, Barbara
and Miller, Emma
and Ward, Paul",
title="Going Viral: Researching Safely on Social Media",
journal="J Med Internet Res",
year="2021",
month="Dec",
day="13",
volume="23",
number="12",
pages="e29737",
keywords="cyber bullying",
keywords="online bullying",
keywords="research activities",
keywords="occupational safety",
keywords="research ethics",
keywords="students",
keywords="bullying",
keywords="social media",
doi="10.2196/29737",
url="https://www.jmir.org/2021/12/e29737",
url="http://www.ncbi.nlm.nih.gov/pubmed/34898450"
}


@Article{info:doi/10.2196/30603,
author="Alvarez-Perez, Yolanda
and Perestelo-Perez, Lilisbeth
and Rivero-Santana, Amado
and Wagner, M. Ana
and Torres-Casta{\~n}o, Alezandra
and Toledo-Ch{\'a}varri, Ana
and Duarte-D{\'i}az, Andrea
and Alvarado-Martel, D{\'a}cil
and Piccini, Barbara
and Van den Broucke, Stephan
and Vandenbosch, Jessica
and Gonz{\'a}lez-Gonz{\'a}lez, Carina
and Perello, Michelle
and Serrano-Aguilar, Pedro
and ",
title="Cocreation of Massive Open Online Courses to Improve Digital Health Literacy in Diabetes: Pilot Mixed Methods Study",
journal="JMIR Diabetes",
year="2021",
month="Dec",
day="13",
volume="6",
number="4",
pages="e30603",
keywords="diabetes",
keywords="digital health literacy",
keywords="health education",
keywords="MOOC",
abstract="Background: Self-management education is a fundamental aspect in the health care of people with diabetes to develop the necessary skills for the improvement of health outcomes. Patients are required to have the competencies to manage electronic information resources---that is, an appropriate level of digital health literacy. The European project IC-Health aimed to improve digital health literacy among people with diabetes through the cocreation of massive open online courses (MOOCs). Objective: We report the preliminary results obtained in 3 participating countries in the IC-Health project (Italy, Spain, and Sweden) regarding (1) experience of the participants during the cocreation process of MOOCs, (2) perceived changes in their digital health literacy level after using MOOCs, and (3) a preliminary assessment of the acceptability of MOOCs. Methods: The cocreation of the MOOCs included focus groups with adults and adolescents with diabetes and the creation of independent communities of practice for type 1 diabetes and type 2 diabetes participants aimed to co-design the MOOCs. Quantitative measures of the acceptability of MOOCs, experience in the cocreation process, and increase in digital health literacy (dimensions of finding, understanding, and appraisal) were assessed. Results: A total of 28 participants with diabetes participated in focus groups. Adults and adolescents agreed that the internet is a secondary source of health-related information. A total of 149 participants comprised the diabetes communities of practice. A total of 9 MOOCs were developed. Acceptability of the MOOCs and the cocreation experience were positively valued. There was a significant improvement in digital health literacy in both adults and adolescents after using MOOCs (P<.001). Conclusions: Although the results presented on self-perceived digital health literacy are preliminary and exploratory, this pilot study suggests that IC-Health MOOCs represent a promising tool for the medical care of diabetes, being able to help reduce the limitations associated with low digital health literacy and other communication barriers in the diabetes population. ",
doi="10.2196/30603",
url="https://diabetes.jmir.org/2021/4/e30603",
url="http://www.ncbi.nlm.nih.gov/pubmed/34898453"
}


@Article{info:doi/10.2196/31358,
author="Koren, Ainat
and Alam, Ul Mohammad Arif
and Koneru, Sravani
and DeVito, Alexa
and Abdallah, Lisa
and Liu, Benyuan",
title="Nursing Perspectives on the Impacts of COVID-19: Social Media Content Analysis",
journal="JMIR Form Res",
year="2021",
month="Dec",
day="10",
volume="5",
number="12",
pages="e31358",
keywords="mental health",
keywords="information retrieval",
keywords="coronavirus",
keywords="COVID-19",
keywords="nursing",
keywords="nurses",
keywords="health care workers",
keywords="pandemic",
keywords="impact",
keywords="social media analytics",
abstract="Background: Nurses are at the forefront of the COVID-19 pandemic. During the pandemic, nurses have faced an elevated risk of exposure and have experienced the hazards related to a novel virus. While being heralded as lifesaving heroes on the front lines of the pandemic, nurses have experienced more physical, mental, and psychosocial problems as a consequence of the COVID-19 outbreak. Social media discussions by nursing professionals participating in publicly formed Facebook groups constitute a valuable resource that offers longitudinal insights. Objective: This study aimed to explore how COVID-19 impacted nurses through capturing public sentiments expressed by nurses on a social media discussion platform and how these sentiments changed over time. Methods: We collected over 110,993 Facebook discussion posts and comments in an open COVID-19 group for nurses from March 2020 until the end of November 2020. Scraping of deidentified offline HTML tags on social media posts and comments was performed. Using subject-matter expert opinions and social media analytics (ie, topic modeling, information retrieval, and sentiment analysis), we performed a human-in-a-loop analysis of nursing professionals' key perspectives to identify trends of the COVID-19 impact among at-risk nursing communities. We further investigated the key insights of the trends of the nursing professionals' perspectives by detecting temporal changes of comments related to emotional effects, feelings of frustration, impacts of isolation, shortage of safety equipment, and frequency of safety equipment uses. Anonymous quotes were highlighted to add context to the data. Results: We determined that COVID-19 impacted nurses' physical, mental, and psychosocial health as expressed in the form of emotional distress, anger, anxiety, frustration, loneliness, and isolation. Major topics discussed by nurses were related to work during a pandemic, misinformation spread by the media, improper personal protective equipment (PPE), PPE side effects, the effects of testing positive for COVID-19, and lost days of work related to illness. Conclusions: Public Facebook nursing groups are venues for nurses to express their experiences, opinions, and concerns and can offer researchers an important insight into understanding the COVID-19 impact on health care workers. ",
doi="10.2196/31358",
url="https://formative.jmir.org/2021/12/e31358",
url="http://www.ncbi.nlm.nih.gov/pubmed/34623957"
}


@Article{info:doi/10.2196/30315,
author="MacKinnon, Ross Kinnon
and Kia, Hannah
and Lacombe-Duncan, Ashley",
title="Examining TikTok's Potential for Community-Engaged Digital Knowledge Mobilization With Equity-Seeking Groups",
journal="J Med Internet Res",
year="2021",
month="Dec",
day="9",
volume="23",
number="12",
pages="e30315",
keywords="trans",
keywords="nonbinary",
keywords="marginalized communities",
keywords="gender-affirming care",
keywords="digital health",
keywords="community-engaged research",
keywords="knowledge mobilization",
keywords="mobile phone",
doi="10.2196/30315",
url="https://www.jmir.org/2021/12/e30315",
url="http://www.ncbi.nlm.nih.gov/pubmed/34889739"
}


@Article{info:doi/10.2196/27613,
author="Sakib, Shahriar Ahmed
and Mukta, Hossain Md Saddam
and Huda, Rowshan Fariha
and Islam, Najmul A. K. M.
and Islam, Tohedul
and Ali, Eunus Mohammed",
title="Identifying Insomnia From Social Media Posts: Psycholinguistic Analyses of User Tweets",
journal="J Med Internet Res",
year="2021",
month="Dec",
day="9",
volume="23",
number="12",
pages="e27613",
keywords="insomnia",
keywords="Twitter",
keywords="word embedding",
keywords="Big 5 personality traits",
keywords="classification",
keywords="social media",
keywords="prediction model",
keywords="psycholinguistics",
abstract="Background: Many people suffer from insomnia, a sleep disorder characterized by difficulty falling and staying asleep during the night. As social media have become a ubiquitous platform to share users' thoughts, opinions, activities, and preferences with their friends and acquaintances, the shared content across these platforms can be used to diagnose different health problems, including insomnia. Only a few recent studies have examined the prediction of insomnia from Twitter data, and we found research gaps in predicting insomnia from word usage patterns and correlations between users' insomnia and their Big 5 personality traits as derived from social media interactions. Objective: The purpose of this study is to build an insomnia prediction model from users' psycholinguistic patterns, including the elements of word usage, semantics, and their Big 5 personality traits as derived from tweets. Methods: In this paper, we exploited both psycholinguistic and personality traits derived from tweets to identify insomnia patients. First, we built psycholinguistic profiles of the users from their word choices and the semantic relationships between the words of their tweets. We then determined the relationship between a users' personality traits and insomnia. Finally, we built a double-weighted ensemble classification model to predict insomnia from both psycholinguistic and personality traits as derived from user tweets. Results: Our classification model showed strong prediction potential (78.8\%) to predict insomnia from tweets. As insomniacs are generally ill-tempered and feel more stress and mental exhaustion, we observed significant correlations of certain word usage patterns among them. They tend to use negative words (eg, ``no,'' ``not,'' ``never''). Some people frequently use swear words (eg, ``damn,'' ``piss,'' ``fuck'') with strong temperament. They also use anxious (eg, ``worried,'' ``fearful,'' ``nervous'') and sad (eg, ``crying,'' ``grief,'' ``sad'') words in their tweets. We also found that the users with high neuroticism and conscientiousness scores for the Big 5 personality traits likely have strong correlations with insomnia. Additionally, we observed that users with high conscientiousness scores have strong correlations with insomnia patterns, while negative correlation between extraversion and insomnia was also found. Conclusions: Our model can help predict insomnia from users' social media interactions. Thus, incorporating our model into a software system can help family members detect insomnia problems in individuals before they become worse. The software system can also help doctors to diagnose possible insomnia in patients. ",
doi="10.2196/27613",
url="https://www.jmir.org/2021/12/e27613",
url="http://www.ncbi.nlm.nih.gov/pubmed/34889758"
}


@Article{info:doi/10.2196/28305,
author="Ng, Reuben",
title="Anti-Asian Sentiments During the COVID-19 Pandemic Across 20 Countries: Analysis of a 12-Billion-Word News Media Database",
journal="J Med Internet Res",
year="2021",
month="Dec",
day="8",
volume="23",
number="12",
pages="e28305",
keywords="racism",
keywords="COVID-19",
keywords="anti-Asian sentiments",
keywords="psychomics",
keywords="quantitative social science",
keywords="culture",
keywords="text as data",
keywords="xenophobia",
keywords="digital humanities",
abstract="Background: US president Joe Biden signed an executive action directing federal agencies to combat hate crimes and racism against Asians, which have percolated during the COVID-19 pandemic. This is one of the first known empirical studies to dynamically test whether global societal sentiments toward Asians have become more negative during the COVID-19 pandemic. Objective: This study aimed to investigate whether global societal sentiments toward Asians across 20 countries have become more negative, month by month, from before the pandemic (October 2019) to May 2020, along with the pandemic (incidence and mortality rates) and cultural (Hofstede's cultural dimensions) predictors of this trend. Methods: We leveraged a 12-billion-word web-based media database, with over 30 million newspaper and magazine articles taken from over 7000 sites across 20 countries, and identified 6 synonyms of ``Asian'' that are related to the coronavirus. We compiled their most frequently used descriptors (collocates) from October 2019 to May 2020 across 20 countries, culminating in 85,827 collocates that were rated by 2 independent researchers to provide a Cumulative Asian Sentiment Score (CASS) per month. This allowed us to track significant shifts in societal sentiments toward Asians from a baseline period (October to December 2019) to the onset of the pandemic (January to May 2020). We tested the competing predictors of this trend: pandemic variables of incidence and mortality rates measured monthly for all 20 countries taken from the Oxford COVID-19 Government Response Tracker, and Hofstede's Cultural Dimensions of Individualism, Power Distance, Uncertainty Avoidance, and Masculinity for the 20 countries. Results: Before the pandemic in December 2019, Jamaica and New Zealand evidenced the most negative societal sentiments toward Asians; when news about the coronavirus was released in January 2020, the United States and Nigeria evidenced the most negative sentiments toward Asians among 20 countries. Globally, sentiments of Asians became more negative---a significant linear decline during the COVID-19 pandemic. CASS trended neutral before the pandemic during the baseline period of October to November 2019 and then plummeted in February 2020. CASS were, ironically, not predicted by COVID-19's incidence and mortality rates, but rather by Hofstede's cultural dimensions: individualism, power distance, and uncertainty avoidance---as shown by mixed models (N=28,494). Specifically, higher power distance, individualism, and uncertainty avoidance were associated with negative societal sentiments toward Asians. Conclusions: Racism, in the form of Anti-Asian sentiments, are deep-seated, and predicated on structural undercurrents of culture. The COVID-19 pandemic may have indirectly and inadvertently exacerbated societal tendencies for racism. Our study lays the important groundwork to design interventions and policy communications to ameliorate Anti-Asian racism, which are culturally nuanced and contextually appropriate. ",
doi="10.2196/28305",
url="https://www.jmir.org/2021/12/e28305",
url="http://www.ncbi.nlm.nih.gov/pubmed/34678754"
}


@Article{info:doi/10.2196/26733,
author="Wang, Tingxuan
and Wong, H. Janet Y.
and Wang, Ping Man
and Li, Yin Amanda Chiu
and Kim, Suk Sang
and Lee, Jae Jung",
title="Effects of Social Networking Service (SNS) Addiction on Mental Health Status in Chinese University Students: Structural Equation Modeling Approach Using a Cross-sectional Online Survey",
journal="J Med Internet Res",
year="2021",
month="Dec",
day="8",
volume="23",
number="12",
pages="e26733",
keywords="social networking service",
keywords="SNS",
keywords="addiction",
keywords="depression",
keywords="anxiety",
keywords="psychosocial status",
keywords="youth",
keywords="mental health",
abstract="Background: Although social networking services (SNSs) have become popular among young people, problematic SNS use has also increased. However, little is known about SNS addiction and its association with SNS use patterns and mental health status. Objective: This study aims to test the mediating role of SNS addiction between SNS use patterns and mental health status among Chinese university students in Hong Kong (HK). Methods: An online cross-sectional survey was conducted using a convenience sampling method. In total, 533 university students (323 [66.9\%] female, mean age [SD]=20.87 [2.68] years) were recruited from February to March 2019. Multiple linear regression was used to assess the association between SNS use and SNS addiction. Structural equation modeling (SEM) was performed to examine the pathways and associations among SNS use, SNS addiction, psychosocial status, and mental health status (including anxiety and depressive symptoms). Results: A longer time spent on SNSs per day (>3 h), a longer time spent on each SNS access (?31 min), a higher frequency of SNS access (?every 30 min), a longer duration of SNS use before sleeping (?61 min), and a shorter duration from waking to first SNS use (?5 min) were significantly associated with a higher level of SNS addiction (adjusted beta [a$\beta$]=6.03, 95\% CI 4.66-7.40; a$\beta$=4.99, 95\% CI 3.14-6.83; a$\beta$=5.89, 95\% CI 4.14-7.64; a$\beta$=5.92, 95\% CI 4.19-7.65; and a$\beta$=3.27, 95\% CI 1.73-4.82, respectively). SEM showed a significant mediating effect of SNS addiction in the relationship between SNS use and psychosocial status, and mental health status, including an indirect effect ($\beta$=0.63, 95\% CI 0.37-0.93) and the total effect ($\beta$=0.44, 95\% CI 0.19-0.72), while the direct effect was insignificant ($\beta$=--0.19, 95\% CI --0.49 to 0.08). Conclusions: SNS use patterns were associated with SNS addiction, and SNS addiction mediated the associations between SNS use, psychosocial status, and mental health status of Chinese university students in HK. The findings suggest that screening for and addressing excessive SNS use are needed to prevent SNS addiction and mental distress among young people. ",
doi="10.2196/26733",
url="https://www.jmir.org/2021/12/e26733",
url="http://www.ncbi.nlm.nih.gov/pubmed/34889760"
}


@Article{info:doi/10.2196/25654,
author="Xie, X. Deborah
and Boss, F. Emily
and Stewart, Matthew C.",
title="Audience of Academic Otolaryngology on Twitter: Cross-sectional Study",
journal="JMIR Med Educ",
year="2021",
month="Dec",
day="8",
volume="7",
number="4",
pages="e25654",
keywords="Twitter",
keywords="otolaryngology",
keywords="residency",
keywords="medical education",
keywords="social media",
keywords="internet",
abstract="Background: Despite the ubiquity of social media, the utilization and audience reach of this communication method by otolaryngology-head and neck surgery (OHNS) residency programs has not been investigated. Objective: The purpose of this study was to evaluate the content posted to a popular social media platform (Twitter) by OHNS residency programs. Methods: In this cross-sectional study, we identified Twitter accounts for accredited academic OHNS residency programs. Tweets published over a 6-month period (March to August 2019) were extracted. Tweets were categorized and analyzed for source (original versus retweet) and target audience (medical versus layman). A random sample of 100 tweets was used to identify patterns of content, which were then used to categorize additional tweets. We quantified the total number of likes or retweets by health care professionals. Results: Of the 121 accredited programs, 35 (28.9\%) had Twitter accounts. Of the 2526 tweets in the 6-month period, 1695 (67.10\%) were original-content tweets. The majority of tweets (1283/1695, 75.69\%) were targeted toward health care workers, most of which did not directly contain medical information (954/1283, 74.36\%). These tweets contained information about the department's trainees and education (349/954, 36.6\%), participation at conferences (263/954, 27.6\%), and research publications (112/954, 11.7\%). Two-thirds of all tweets did not contain medical information. Medical professionals accounted for 1249/1362 (91.70\%) of retweets and 5616/6372 (88.14\%) of likes on original-content tweets. Conclusions: The majority of Twitter usage by OHNS residency programs is for intra and interprofessional communication, and only a minority of tweets contain information geared toward the public. Communication and information sharing with patients is not the focus of OHNS departments on Twitter. ",
doi="10.2196/25654",
url="https://mededu.jmir.org/2021/4/e25654",
url="http://www.ncbi.nlm.nih.gov/pubmed/34889748"
}


@Article{info:doi/10.2196/29167,
author="Xu, Yuepei
and Yue, Ling-Zi
and Wang, Wei
and Wu, Xiao-Ju
and Liang, Zhu-Yuan",
title="Gender-Specific Impact of Self-Monitoring and Social Norm Information on Walking Behavior Among Chinese College Students Assessed Using WeChat: Longitudinal Tracking Study",
journal="J Med Internet Res",
year="2021",
month="Dec",
day="7",
volume="23",
number="12",
pages="e29167",
keywords="self-monitoring",
keywords="social norm",
keywords="group identity",
keywords="gender differences",
keywords="mHealth",
keywords="mobile health",
abstract="Background: Walking is a simple but beneficial form of physical activity (PA). Self-monitoring and providing information about social norms are the 2 most widely used ``mobile health (mHealth)'' strategies to promote walking behavior. However, previous studies have failed to discriminate the effect of self-monitoring from the combination of the 2 strategies, and provide practical evidence within Chinese culture. Some essential moderators, such as gender and group identity, were also overlooked. Objective: We aimed to investigate the effectiveness of social norm and self-monitoring interventions for walking behavior and assess the moderating effects of gender and group identity, which could guide optimal mHealth intervention projects in China. Methods: In 2 longitudinal tracking studies (study 1, 22 days; study 2, 31 days), Chinese college students wore trackers for at least 8 hours per day (MASAI 3D Pedometer and Xiaomi Wristband 2) to record their daily step counts in baseline, intervention, and follow-up stages. In each study, participants (study 1: n=117, 54\% female, mean age 25.60 years; study 2: n=180, 51\% female, mean age 22.60 years) were randomly allocated to 1 of the following 3 groups: a self-monitoring group and 2 social norm intervention groups. In the 2 intervention groups and during the intervention stage, participants received different social norm information regarding group member step rankings corresponding to their grouping type of social norm information. In study 1, participants were grouped by within-group member PA levels (PA consistent vs PA inconsistent), and in study 2, participants were grouped by their received gender-specific social norm information (gender consistent vs gender inconsistent). Piece-wise linear mixed models were used to compare the difference in walking steps between groups. Results: In study 1, for males in the self-monitoring group, walking steps significantly decreased from the baseline stage to the intervention stage (change in slope=?1422.16; P=.02). However, additional social norm information regardless of group consistency kept their walking unchanged. For females, social norm information did not provide any extra benefit beyond self-monitoring. Females exposed to PA-inconsistent social norm information even walked less (slope during the intervention=?122.18; P=.03). In study 2, for males, a similar pattern was observed, with a decrease in walking steps in the self-monitoring group (change in slope=?151.33; P=.08), but there was no decrease in the 2 social norm intervention groups. However, for females, gender-consistent social norm information decreased walking steps (slope during the intervention=?143.68; P=.03). Conclusions: Both gender and group identity moderated the effect of social norm information on walking. Among females, social norm information showed no benefit for walking behavior and may have exerted a backfire effect. Among males, while walking behavior decreased with self-monitoring only, the inclusion of social norm information held the level of walking behavior steady. ",
doi="10.2196/29167",
url="https://www.jmir.org/2021/12/e29167",
url="http://www.ncbi.nlm.nih.gov/pubmed/34878992"
}


@Article{info:doi/10.2196/27497,
author="Kalf, J. Rachel R.
and Delnoij, J. Diana M.
and Ryll, Bettina
and Bouvy, L. Marcel
and Goettsch, G. Wim",
title="Information Patients With Melanoma Spontaneously Report About Health-Related Quality of Life on Web-Based Forums: Case Study",
journal="J Med Internet Res",
year="2021",
month="Dec",
day="7",
volume="23",
number="12",
pages="e27497",
keywords="reimbursement decision-making",
keywords="QoL",
keywords="health care",
keywords="quality of life",
abstract="Background: There is a general agreement on the importance of health-related quality of life (HRQoL). This type of information is becoming increasingly important for the value assessment of health technology assessment agencies in evaluating the benefits of new health technologies, including medicines. However, HRQoL data are often limited, and additional sources that provide this type of information may be helpful. Objective: We aim to identify the HRQoL topics important to patients with melanoma based on web-based discussions on public social media forums. Methods: We identified 3 public web-based forums from the United States and the United Kingdom, namely the Melanoma Patient Information Page, the Melanoma International Forum, and MacMillan. Their posts were randomly selected and coded using qualitative methods until saturation was reached. Results: Of the posts assessed, 36.7\% (150/409) of posts on Melanoma International Forum, 45.1\% (198/439) on MacMillan, and 35.4\% (128/362) on Melanoma Patient Information Page focused on HRQoL. The 2 themes most frequently mentioned were mental health and (un)certainty. The themes were constructed based on underlying and more detailed codes. Codes related to fear, worry and anxiety, uncertainty, and unfavorable effects were the most-often discussed ones. Conclusions: Web-based forums are a valuable source for identifying relevant HRQoL aspects in patients with a given disease. These aspects could be cross-referenced with existing tools and they might improve the content validity of patient-reported outcome measures, including HRQoL questionnaires. In addition, web-based forums may provide health technology assessment agencies with a more holistic understanding of the external aspects affecting patient HRQoL. These aspects might support the value assessment of new health technologies and could therefore help inform topic prioritization as well as the scoping phase before any value assessment. ",
doi="10.2196/27497",
url="https://www.jmir.org/2021/12/e27497",
url="http://www.ncbi.nlm.nih.gov/pubmed/34878994"
}


@Article{info:doi/10.2196/24643,
author="Dehghani, Mohammad
and Kahouei, Mehdi
and Akhondzadeh, Shahin
and Mesgarpour, Bita
and Ferdousi, Reza",
title="Expectations of Health Researchers From Academic Social Network Sites: Qualitative Study",
journal="J Med Internet Res",
year="2021",
month="Dec",
day="7",
volume="23",
number="12",
pages="e24643",
keywords="research",
keywords="social network",
keywords="academic social network",
keywords="research network",
keywords="academic",
keywords="researcher",
keywords="literature",
keywords="qualitative",
keywords="content analysis",
abstract="Background: Today, academic social network sites' role in improving the quality of education and how investigators conduct their research has become more critical. Objective: This study aimed to investigate Iranian health researchers' requirements for academic social network sites from a low-income country perspective. Methods: This qualitative study with a phenomenological approach was done in 2020. In this study, 23 researchers in the health system were selected by purposive sampling. Semistructured interviews were used to collect data. Data were analyzed by MaxQDA-10 software and the content analysis method. Results: We identified 2 categories of functional and technical characteristics in the study participants' expectations. Functional characteristics included facilitating communication and team activities, managing scientific publications, enhancing the process of conducting research, being informative, and sharing and trading laboratory materials and equipment. Technical characteristics of an academic social network include user management capabilities, high security and privacy, being user-friendly, and other technical features. Conclusions: Health researchers emphasized 2 functional and technical characteristics required to meet academic social network sites' expectations. ",
doi="10.2196/24643",
url="https://www.jmir.org/2021/12/e24643",
url="http://www.ncbi.nlm.nih.gov/pubmed/34878993"
}


@Article{info:doi/10.2196/29011,
author="Valdez, Danny
and Unger, B. Jennifer",
title="Difficulty Regulating Social Media Content of Age-Restricted Products: Comparing JUUL's Official Twitter Timeline and Social Media Content About JUUL",
journal="JMIR Infodemiology",
year="2021",
month="Dec",
day="7",
volume="1",
number="1",
pages="e29011",
keywords="social media",
keywords="JUUL",
keywords="underage marketing",
keywords="LDA",
keywords="Latent Dirichlet Allocation",
keywords="topic models",
abstract="Background: In 2018, JUUL Labs Inc, a popular e-cigarette manufacturer, announced it would substantially limit its social media presence in compliance with the Food and Drug Administration's (FDA) call to curb underage e-cigarette use. However, shortly after the announcement, a series of JUUL-related hashtags emerged on various social media platforms, calling the effectiveness of the FDA's regulations into question. Objective: The purpose of this study is to determine whether hashtags remain a common venue to market age-restricted products on social media. Methods: We used Twitter's standard application programming interface to download the 3200 most-recent tweets originating from JUUL Labs Inc's official Twitter Account (@JUULVapor), and a series of tweets (n=28,989) from other Twitter users containing either \#JUUL or mentioned JUUL in the tweet text. We ran exploratory (10{\texttimes}10) and iterative Latent Dirichlet Allocation (LDA) topic models to compare @JUULVapor's content versus our hashtag corpus. We qualitatively deliberated topic meanings and substantiated our interpretations with tweets from either corpus. Results: The topic models generated for @JUULVapor's timeline seemingly alluded to compliance with the FDA's call to prohibit marketing of age-restricted products on social media. However, the topic models generated for the hashtag corpus of tweets from other Twitter users contained several references to flavors, vaping paraphernalia, and illicit drugs, which may be appealing to younger audiences. Conclusions: Our findings underscore the complicated nature of social media regulation. Although JUUL Labs Inc seemingly complied with the FDA to limit its social media presence, JUUL and other e-cigarette manufacturers are still discussed openly in social media spaces. Much discourse about JUUL and e-cigarettes is spread via hashtags, which allow messages to reach a wide audience quickly. This suggests that social media regulations on manufacturers cannot prevent e-cigarette users, influencers, or marketers from spreading information about e-cigarette attributes that appeal to the youth, such as flavors. Stricter protocols are needed to regulate discourse about age-restricted products on social media. ",
doi="10.2196/29011",
url="https://infodemiology.jmir.org/2021/1/e29011",
url="http://www.ncbi.nlm.nih.gov/pubmed/37114198"
}


@Article{info:doi/10.2196/31791,
author="Abdel-Razig, Sawsan
and Anglade, Pascale
and Ibrahim, Halah",
title="Impact of the COVID-19 Pandemic on a Physician Group's WhatsApp Chat: Qualitative Content Analysis",
journal="JMIR Form Res",
year="2021",
month="Dec",
day="7",
volume="5",
number="12",
pages="e31791",
keywords="WhatsApp",
keywords="social media",
keywords="physician",
keywords="pandemic",
keywords="COVID-19",
keywords="qualitative",
keywords="communication",
keywords="misinformation",
keywords="information-seeking behavior",
keywords="information seeking",
keywords="information sharing",
keywords="content analysis",
keywords="community",
abstract="Background: Social media has emerged as an effective means of information sharing and community building among health professionals. The utility of these platforms is likely heightened during times of health system crises and global uncertainty. Studies have demonstrated that physicians' social media platforms serve to bridge the gap of information between on-the-ground experiences of health care workers and emerging knowledge. Objective: The primary aim of this study was to characterize the use of a physician WhatsApp (WhatsApp LLC) group chat during the early months of the COVID-19 pandemic. Methods: Through the lens of the social network theory, we performed a qualitative content analysis of the posts of a women physician WhatsApp group located in the United Arab Emirates between February 1, 2020, and May 31, 2020, that is, during the initial surge of COVID-19 cases. Results: There were 6101 posts during the study period, which reflected a 2.6-fold increase in platform use when compared with platform use in the year prior. A total of 8 themes and 9 subthemes were described. The top 3 uses of the platform were requests for information (posts: 2818/6101, 46.2\%), member support and promotion (posts: 988/6101, 16.2\%), and information sharing (posts: 896/6101, 14.7\%). A substantial proportion of posts were related to COVID-19 (2653/6101, 43.5\%), with the most popular theme being requests for logistical (nonmedical) information. Among posts containing COVID-19--related medical information, it was notable that two-thirds (571/868, 65.8\%) of these posts were from public mass media or unverified sources. Conclusions: Health crises can potentiate the use of social media platforms among physicians. This reflects physicians' tendency to turn to these platforms for information sharing and community building purposes. However, important questions remain regarding the accuracy and credibility of the information shared. Our findings suggest that the training of physicians in social media practices and information dissemination may be needed. ",
doi="10.2196/31791",
url="https://formative.jmir.org/2021/12/e31791",
url="http://www.ncbi.nlm.nih.gov/pubmed/34784291"
}


@Article{info:doi/10.2196/29127,
author="Cruickshank, Iain
and Ginossar, Tamar
and Sulskis, Jason
and Zheleva, Elena
and Berger-Wolf, Tanya",
title="Content and Dynamics of Websites Shared Over Vaccine-Related Tweets in COVID-19 Conversations: Computational Analysis",
journal="J Med Internet Res",
year="2021",
month="Dec",
day="3",
volume="23",
number="12",
pages="e29127",
keywords="COVID-19",
keywords="agenda setting",
keywords="antivaccination",
keywords="cross-platform",
keywords="data mining of social media",
keywords="misinformation",
keywords="social media",
keywords="Twitter",
keywords="vaccinations",
keywords="vaccine hesitancy",
abstract="Background: The onset of the COVID-19 pandemic and the consequent ``infodemic'' increased concerns about Twitter's role in advancing antivaccination messages, even before a vaccine became available to the public. New computational methods allow for analysis of cross-platform use by tracking links to websites shared over Twitter, which, in turn, can uncover some of the content and dynamics of information sources and agenda-setting processes. Such understanding can advance theory and efforts to reduce misinformation. Objective: Informed by agenda-setting theory, this study aimed to identify the content and temporal patterns of websites shared in vaccine-related tweets posted to COVID-19 conversations on Twitter between February and June 2020. Methods: We used triangulation of data analysis methods. Data mining consisted of the screening of around 5 million tweets posted to COVID-19 conversations to identify tweets that related to vaccination and including links to websites shared within these tweets. We further analyzed the content the 20 most-shared external websites using a mixed methods approach. Results: Of 841,896 vaccination-related tweets identified, 185,994 (22.1\%) contained links to specific websites. A wide range of websites were shared, with the 20 most-tweeted websites constituting 14.5\% (27,060/185,994) of the shared websites and typically being shared for only 2 to 3 days. Traditional media constituted the majority of these 20 websites, along with other social media and governmental sources. We identified markers of inauthentic propagation for some of these links. Conclusions: The topic of vaccination was prevalent in tweets about COVID-19 early in the pandemic. Sharing websites was a common communication strategy, and its ``bursty'' pattern and inauthentic propagation strategies pose challenges for health promotion efforts. Future studies should consider cross-platform use in dissemination of health information and in counteracting misinformation. ",
doi="10.2196/29127",
url="https://www.jmir.org/2021/12/e29127",
url="http://www.ncbi.nlm.nih.gov/pubmed/34665760"
}


@Article{info:doi/10.2196/32814,
author="Zhang, Jueman
and Wang, Yi
and Shi, Molu
and Wang, Xiuli",
title="Factors Driving the Popularity and Virality of COVID-19 Vaccine Discourse on Twitter: Text Mining and Data Visualization Study",
journal="JMIR Public Health Surveill",
year="2021",
month="Dec",
day="3",
volume="7",
number="12",
pages="e32814",
keywords="COVID-19",
keywords="vaccine",
keywords="topic modeling",
keywords="LDA",
keywords="valence",
keywords="share",
keywords="viral",
keywords="Twitter",
keywords="social media",
abstract="Background: COVID-19 vaccination is considered a critical prevention measure to help end the pandemic. Social media platforms such as Twitter have played an important role in the public discussion about COVID-19 vaccines. Objective: The aim of this study was to investigate message-level drivers of the popularity and virality of tweets about COVID-19 vaccines using machine-based text-mining techniques. We further aimed to examine the topic communities of the most liked and most retweeted tweets using network analysis and visualization. Methods: We collected US-based English-language public tweets about COVID-19 vaccines from January 1, 2020, to April 30, 2021 (N=501,531). Topic modeling and sentiment analysis were used to identify latent topics and valence, which together with autoextracted information about media presence, linguistic features, and account verification were used in regression models to predict likes and retweets. Among the 2500 most liked tweets and 2500 most retweeted tweets, network analysis and visualization were used to detect topic communities and present the relationship between the topics and the tweets. Results: Topic modeling yielded 12 topics. The regression analyses showed that 8 topics positively predicted likes and 7 topics positively predicted retweets, among which the topic of vaccine development and people's views and that of vaccine efficacy and rollout had relatively larger effects. Network analysis and visualization revealed that the 2500 most liked and most retweeted retweets clustered around the topics of vaccine access, vaccine efficacy and rollout, vaccine development and people's views, and vaccination status. The overall valence of the tweets was positive. Positive valence increased likes, but valence did not affect retweets. Media (photo, video, gif) presence and account verification increased likes and retweets. Linguistic features had mixed effects on likes and retweets. Conclusions: This study suggests the public interest in and demand for information about vaccine development and people's views, and about vaccine efficacy and rollout. These topics, along with the use of media and verified accounts, have enhanced the popularity and virality of tweets. These topics could be addressed in vaccine campaigns to help the diffusion of content on Twitter. ",
doi="10.2196/32814",
url="https://publichealth.jmir.org/2021/12/e32814",
url="http://www.ncbi.nlm.nih.gov/pubmed/34665761"
}


@Article{info:doi/10.2196/30855,
author="Xiong, Zihui
and Zhang, Liang
and Li, Zhong
and Xu, Wanchun
and Zhang, Yan
and Ye, Ting",
title="Frequency of Online Health Information Seeking and Types of Information Sought Among the General Chinese Population: Cross-sectional Study",
journal="J Med Internet Res",
year="2021",
month="Dec",
day="2",
volume="23",
number="12",
pages="e30855",
keywords="online health information seeking",
keywords="sociodemographic factors",
keywords="information types",
keywords="Chinese population",
keywords="information seeking behavior",
keywords="demography",
keywords="China",
keywords="online health information",
abstract="Background: The internet is one of the most popular health information resources, and the Chinese constitute one-fifth of the online users worldwide. As internet penetration continues to rise, more details on the Chinese population seeking online health information need to be known based on the current literature. Objective: This study aims to explore the sociodemographic differences in online health information seeking (OHIS), including the frequency of OHIS and the types of online health information sought among the general Chinese population in mainland China. Methods: A cross-sectional study for assessing the residents' health care needs with self-administered questionnaires was implemented in 4 counties and districts in China from July 2018 to August 2018. Pearson's chi-square test was used to identify the sociodemographic differences between infrequent and frequent online health information seekers. We also performed binary logistic regression for the 4 types of online health information as the dependent variables and the sociodemographic factors as the independent variables. Results: Compared with infrequent online health information seekers, frequent seekers were more likely to be female (infrequent: 1654/3318; 49.85\%; frequent: 1015/1831, 55.43\%), older (over 60 years old; infrequent: 454/3318, 13.68\%; frequent: 282/1831, 15.40\%), married (infrequent: 2649/3318, 79.84\%; frequent: 1537/1831, 83.94\%), and better educated (bachelor's or above; infrequent: 834/3318, 25.14\%; frequent: 566/1831, 30.91\%). They were also more likely to earn a higher income (over RMB {\textyen}50k [RMB {\textyen}1=US \$0.15641]; infrequent: 1139/3318, 34.33\%; frequent: 710/1831, 34.78\%), have commercial health insurance (infrequent: 628/3318, 18.93\%; frequent: 470/1831, 25.67\%), and have reported illness in the past 12 months (infrequent: 659/3318, 19.86\%; frequent: 415/1831, 22.67\%). Among the 4 health information types, health science popularization was the most searched for information by Chinese online health information seekers (3654/5149, 70.79\%), followed by healthy behaviors (3567/5149, 69.28\%), traditional Chinese medicine (1931/5149, 37.50\%), and medical concerns (1703/5149, 33.07\%). The binary logistic regression models showed that males were less likely to seek information on healthy behaviors (adjusted odds ratio [AOR] 0.69, 95\% CI 0.61-0.78) and traditional Chinese medicine (AOR 0.64, 95\% CI 0.57-0.73), and respondents who had at least 1 chronic disease were more likely to seek information on medical concerns (AOR 1.27, 95\% CI 1.07-1.51) and traditional Chinese medicine (AOR 1.26, 95\% CI 1.06-1.49). Conclusions: Sociodemographic factors were associated with the frequency of OHIS and types of information sought among the general Chinese population. The results remind providers of online health information to consider the needs of specific population groups when tailoring and presenting health information to the target population. ",
doi="10.2196/30855",
url="https://www.jmir.org/2021/12/e30855",
url="http://www.ncbi.nlm.nih.gov/pubmed/34860676"
}


@Article{info:doi/10.2196/33125,
author="Oksanen, Atte
and Oksa, Reetta
and Savela, Nina
and Celuch, Magdalena
and Savolainen, Iina",
title="Drinking and Social Media Use Among Workers During COVID-19 Pandemic Restrictions: Five-Wave Longitudinal Study",
journal="J Med Internet Res",
year="2021",
month="Dec",
day="2",
volume="23",
number="12",
pages="e33125",
keywords="excessive drinking",
keywords="alcohol",
keywords="COVID-19",
keywords="social media",
keywords="remote work",
keywords="psychological distress",
keywords="distress",
keywords="pattern",
keywords="trend",
keywords="prediction",
keywords="survey",
keywords="app",
keywords="risk",
abstract="Background: The COVID-19 pandemic restricted everyday life during 2020-2021 for many people worldwide. It also affected alcohol consumption patterns and leisure activities, including the use of social media. Objective: The aim of this study was to analyze whether social media use predicts increased risky drinking over time and during the COVID-19 pandemic restrictions in particular. Methods: This 5-wave longitudinal survey study, based on a nationwide sample of workers, was conducted in Finland in 2019-2021. A total of 840 respondents (male: 473/840, 56.31\%; age range 18-64 years; mean age 43.90, SD 11.14 years) participated in all 5 waves of the study. The outcome variable was risky drinking, measured using the 3-item Alcohol Use Disorders Identification Test (AUDIT-C). Multilevel linear hybrid modeling enabled the investigation of both within-person and between-person effects. Predictors included social media use and communication, involvement in social media identity bubbles, psychological distress, and remote working. Controls included sociodemographic factors and the Big Five personality traits. Results: Increased involvement in social media identity bubbles was associated with an increase in risky drinking behavior. Of all social media platforms examined, online dating app use was associated with riskier use of alcohol over time during the COVID-19 crisis. Daily social media communication with colleagues about nonwork topics was associated with risky drinking. Female gender, younger age, university education, nonindustrial occupational field, conscientiousness, agreeableness, and neuroticism were associated with lower levels of risky drinking. Conclusions: Social media use during a pandemic carries some risks for alcohol consumption. Involvement in social media identity bubbles and online dating are risk factors for excessive drinking during the COVID-19 pandemic. ",
doi="10.2196/33125",
url="https://www.jmir.org/2021/12/e33125",
url="http://www.ncbi.nlm.nih.gov/pubmed/34662290"
}


@Article{info:doi/10.2196/31657,
author="Parker, N. Jayelin
and Hunter, S. Alexis
and Bauermeister, A. Jose
and Bonar, E. Erin
and Carrico, Adam
and Stephenson, Rob",
title="Comparing Social Media and In-Person Recruitment: Lessons Learned From Recruiting Substance-Using, Sexual and Gender Minority Adolescents and Young Adults for a Randomized Control Trial",
journal="JMIR Public Health Surveill",
year="2021",
month="Dec",
day="1",
volume="7",
number="12",
pages="e31657",
keywords="HIV testing",
keywords="substance use",
keywords="recruitment",
keywords="sexual and gender minorities",
keywords="youth",
abstract="Background: Recruiting large samples of diverse sexual and gender minority adolescent and young adults (AYAs) into HIV intervention research is critical to the development and later dissemination of interventions that address the risk factors for HIV transmission among substance-using, sexual and gender minority AYAs. Objective: This paper aimed to describe the characteristics of the samples recruited via social media and in-person methods and makes recommendations for strategies to recruit substance-using, sexual and gender minority AYAs, a hardly reached population that is a priority for HIV prevention research. Methods: Using data from a randomized control trial of an HIV and substance use intervention with sexual and gender minority AYAs, aged 15 to 29 years in southeastern Michigan (n=414), we examined demographic and behavioral characteristics associated with successful recruitment from a range of virtual and physical venues. Results: We found that paid advertisements on Facebook, Instagram, and Grindr offered the largest quantity of eligible participants willing to enroll in the trial. Instagram offered the largest proportion of transgender masculine participants, and Grindr offered the largest proportion of Black/African American individuals. Although we attempted venue-based recruitment at clubs, bars, community centers, and AIDS service organizations, we found it to be unsuccessful for this specific hardly reached population. Social media and geobased dating applications offered the largest pool of eligible participants. Conclusions: Understanding factors associated with successful recruitment has the potential to inform effective and efficient strategies for HIV prevention research with substance-using, sexual and gender AYAs. Trial Registration: ClinicalTrials.gov NCT02945436; https://clinicaltrials.gov/ct2/show/NCT02945436 International Registered Report Identifier (IRRID): RR2-10.2196/resprot.9414 ",
doi="10.2196/31657",
url="https://publichealth.jmir.org/2021/12/e31657",
url="http://www.ncbi.nlm.nih.gov/pubmed/34855613"
}


@Article{info:doi/10.2196/29768,
author="Dey, Vishal
and Krasniak, Peter
and Nguyen, Minh
and Lee, Clara
and Ning, Xia",
title="A Pipeline to Understand Emerging Illness Via Social Media Data Analysis: Case Study on Breast Implant Illness",
journal="JMIR Med Inform",
year="2021",
month="Nov",
day="29",
volume="9",
number="11",
pages="e29768",
keywords="breast implant illness",
keywords="social media",
keywords="natural language processing",
keywords="topic modeling",
abstract="Background: A new illness can come to public attention through social media before it is medically defined, formally documented, or systematically studied. One example is a condition known as breast implant illness (BII), which has been extensively discussed on social media, although it is vaguely defined in the medical literature. Objective: The objective of this study is to construct a data analysis pipeline to understand emerging illnesses using social media data and to apply the pipeline to understand the key attributes of BII. Methods: We constructed a pipeline of social media data analysis using natural language processing and topic modeling. Mentions related to signs, symptoms, diseases, disorders, and medical procedures were extracted from social media data using the clinical Text Analysis and Knowledge Extraction System. We mapped the mentions to standard medical concepts and then summarized these mapped concepts as topics using latent Dirichlet allocation. Finally, we applied this pipeline to understand BII from several BII-dedicated social media sites. Results: Our pipeline identified topics related to toxicity, cancer, and mental health issues that were highly associated with BII. Our pipeline also showed that cancers, autoimmune disorders, and mental health problems were emerging concerns associated with breast implants, based on social media discussions. Furthermore, the pipeline identified mentions such as rupture, infection, pain, and fatigue as common self-reported issues among the public, as well as concerns about toxicity from silicone implants. Conclusions: Our study could inspire future studies on the suggested symptoms and factors of BII. Our study provides the first analysis and derived knowledge of BII from social media using natural language processing techniques and demonstrates the potential of using social media information to better understand similar emerging illnesses. ",
doi="10.2196/29768",
url="https://medinform.jmir.org/2021/11/e29768",
url="http://www.ncbi.nlm.nih.gov/pubmed/34847064"
}


@Article{info:doi/10.2196/30529,
author="Jarynowski, Andrzej
and Semenov, Alexander
and Kami?ski, Miko?aj
and Belik, Vitaly",
title="Mild Adverse Events of Sputnik V Vaccine in Russia: Social Media Content Analysis of Telegram via Deep Learning",
journal="J Med Internet Res",
year="2021",
month="Nov",
day="29",
volume="23",
number="11",
pages="e30529",
keywords="adverse events",
keywords="Sputnik V",
keywords="Gam-COVID-Vac",
keywords="social media",
keywords="Telegram",
keywords="COVID-19",
keywords="Sars-CoV-2",
keywords="deep learning",
keywords="vaccine safety",
abstract="Background: There is a limited amount of data on the safety profile of the COVID-19 vector vaccine Gam-COVID-Vac (Sputnik V). Previous infodemiology studies showed that social media discourse could be analyzed to assess the most concerning adverse events (AE) caused by drugs. Objective: We aimed to investigate mild AEs of Sputnik V based on a participatory trial conducted on Telegram in the Russian language. We compared AEs extracted from Telegram with other limited databases on Sputnik V and other COVID-19 vaccines. We explored symptom co-occurrence patterns and determined how counts of administered doses, age, gender, and sequence of shots could confound the reporting of AEs. Methods: We collected a unique dataset consisting of 11,515 self-reported Sputnik V vaccine AEs posted on the Telegram group, and we utilized natural language processing methods to extract AEs. Specifically, we performed multilabel classifications using the deep neural language model Bidirectional Encoder Representations from Transformers (BERT) ``DeepPavlov,'' which was pretrained on a Russian language corpus and applied to the Telegram messages. The resulting area under the curve score was 0.991. We chose symptom classes that represented the following AEs: fever, pain, chills, fatigue, nausea/vomiting, headache, insomnia, lymph node enlargement, erythema, pruritus, swelling, and diarrhea. Results: Telegram users complained mostly about pain (5461/11,515, 47.43\%), fever (5363/11,515, 46.57\%), fatigue (3862/11,515, 33.54\%), and headache (2855/11,515, 24.79\%). Women reported more AEs than men (1.2-fold, P<.001). In addition, there were more AEs from the first dose than from the second dose (1.1-fold, P<.001), and the number of AEs decreased with age ($\beta$=.05 per year, P<.001). The results also showed that Sputnik V AEs were more similar to other vector vaccines (132 units) than with messenger RNA vaccines (241 units) according to the average Euclidean distance between the vectors of AE frequencies. Elderly Telegram users reported significantly more (5.6-fold on average) systemic AEs than their peers, according to the results of the phase 3 clinical trials published in The Lancet. However, the AEs reported in Telegram posts were consistent (Pearson correlation r=0.94, P=.02) with those reported in the Argentinian postmarketing AE registry. Conclusions: After the Sputnik V vaccination, Russian Telegram users reported mostly pain, fever, and fatigue. The Sputnik V AE profile was comparable with other vector COVID-19 vaccines. Discussion on social media could provide meaningful information about the AE profile of novel vaccines. ",
doi="10.2196/30529",
url="https://www.jmir.org/2021/11/e30529",
url="http://www.ncbi.nlm.nih.gov/pubmed/34662291"
}


@Article{info:doi/10.2196/26123,
author="Javidan, Pedram Arshia
and Brand, Allan
and Cameron, Andrew
and D'Ovidio, Tommaso
and Persaud, Martin
and Lewis, Kirsten
and O'Connor, Chris",
title="Examination of a Canada-Wide Collaboration Platform for Order Sets: Retrospective Analysis",
journal="J Med Internet Res",
year="2021",
month="Nov",
day="29",
volume="23",
number="11",
pages="e26123",
keywords="evidence-based medicine",
keywords="health informatics",
keywords="knowledge translation",
keywords="order sets",
keywords="Web 2.0",
abstract="Background: Knowledge translation and dissemination are some of the main challenges that affect evidence-based medicine. Web 2.0 platforms promote the sharing and collaborative development of content. Executable knowledge tools, such as order sets, are a knowledge translation tool whose localization is critical to its effectiveness but a challenge for organizations to develop independently. Objective: This paper describes a Web 2.0 resource, referred to as the collaborative network (TCN), for order set development designed to share executable knowledge (order sets). This paper also analyzes the scope of its use, describes its use through network analysis, and examines the provision and use of order sets in the platform by organizational size. Methods: Data were collected from Think Research's TxConnect platform. We measured interorganization sharing across Canadian hospitals using descriptive statistics. A weighted chi-square analysis was used to evaluate institutional size to share volumes based on institution size, with post hoc Cramer V score to measure the strength of association. Results: TCN consisted of 12,495 order sets across 683 diagnoses or processes. Between January 2010 and March 2015, a total of 131 health care organizations representing 360 hospitals in Canada downloaded order sets 105,496 times. Order sets related to acute coronary syndrome, analgesia, and venous thromboembolism were most commonly shared. COVID-19 order sets were among the most actively shared, adjusting for order set lifetime. A weighted chi-square analysis showed nonrandom downloading behavior (P<.001), with medium-sized institutions downloading content from larger institutions acting as the most significant driver of this variance (chi-gram=124.70). Conclusions: In this paper, we have described and analyzed a Web 2.0 platform for the sharing of order set content with significant network activity. The robust use of TCN to access customized order sets reflects its value as a resource for health care organizations when they develop or update their own order sets. ",
doi="10.2196/26123",
url="https://www.jmir.org/2021/11/e26123",
url="http://www.ncbi.nlm.nih.gov/pubmed/34847055"
}


@Article{info:doi/10.2196/27385,
author="Card, G. Kiffer
and Lachowsky, J. Nathan
and Hogg, S. Robert",
title="Using Google Trends to Inform the Population Size Estimation and Spatial Distribution of Gay, Bisexual, and Other Men Who Have Sex With Men: Proof-of-concept Study",
journal="JMIR Public Health Surveill",
year="2021",
month="Nov",
day="29",
volume="7",
number="11",
pages="e27385",
keywords="gay, bisexual, and other men who have sex with men",
keywords="spatial distribution",
keywords="population size estimation",
keywords="pornography",
keywords="technology-aided surveillance",
abstract="Background: We must triangulate data sources to understand best the spatial distribution and population size of marginalized populations to empower public health leaders to address population-specific needs. Existing population size estimation techniques are difficult and limited. Objective: We sought to identify a passive surveillance strategy that utilizes internet and social media to enhance, validate, and triangulate population size estimates of gay, bisexual, and other men who have sex with men (gbMSM). Methods: We explored the Google Trends platform to approximate an estimate of the spatial heterogeneity of the population distribution of gbMSM. This was done by comparing the prevalence of the search term ``gay porn'' with that of the search term ``porn.'' Results: Our results suggested that most cities have a gbMSM population size between 2\% and 4\% of their total population, with large urban centers having higher estimates relative to rural or suburban areas. This represents nearly a double up of population size estimates compared to that found by other methods, which typically find that between 1\% and 2\% of the total population are gbMSM. We noted that our method was limited by unequal coverage in internet usage across Canada and differences in the frequency of porn use by gender and sexual orientation. Conclusions: We argue that Google Trends estimates may provide, for many public health planning purposes, adequate city-level estimates of gbMSM population size in regions with a high prevalence of internet access and for purposes in which a precise or narrow estimate of the population size is not required. Furthermore, the Google Trends platform does so in less than a minute at no cost, making it extremely timely and cost-effective relative to more precise (and complex) estimates. We also discuss future steps for further validation of this approach. ",
doi="10.2196/27385",
url="https://publichealth.jmir.org/2021/11/e27385",
url="http://www.ncbi.nlm.nih.gov/pubmed/34618679"
}


@Article{info:doi/10.2196/30761,
author="Gleason, Neil
and Serrano, A. Pedro
and Mu{\~n}oz, Alejandro
and French, Audrey
and Hosek, Sybil",
title="Limited Interaction Targeted Epidemiology of HIV in Sexual and Gender Minority American Adolescents and Adults: Feasibility of the Keeping it LITE Study",
journal="JMIR Form Res",
year="2021",
month="Nov",
day="26",
volume="5",
number="11",
pages="e30761",
keywords="social epidemiology",
keywords="adolescents and young adults",
keywords="sexual and gender minorities",
keywords="HIV testing",
abstract="Background: HIV infection rates among sexual minority men and transgender individuals, particularly adolescents and young adults, remain elevated in the United States despite continued improvement in the HIV public health response. However, there remains a knowledge gap in understanding the barriers faced by this community in receiving HIV care and prevention resources. To address this, the Keeping it LITE study was conducted to assess HIV risk factors and barriers to preventive treatment in a large national cohort of young sexual minority men and transgender individuals at high risk of HIV infection. Objective: This study aims to evaluate the feasibility of enrolling a large remote cohort, challenges encountered in recruitment, and adjustments made to address these challenges. Methods: A large national cohort (n=3444) of young sexual minority men and transgender individuals were recruited. Participants were recruited via advertisements on social media; social apps for lesbian, gay, bisexual, transgender, and queer individuals; print advertising; and word-of-mouth. Before enrolling, participants verified their HIV status using an at-home HIV test or by providing their own testing documentation. Descriptive statistics were generated, and a series of logistic regressions were conducted to evaluate demographic differences between recruitment methods, HIV testing methods, and enrollment status. Results: The Keeping it LITE study was particularly successful in recruiting participants via social media, with over half of the participants recruited from advertisements on social media platforms such as Facebook, Instagram, and Snapchat. Participants were also recruited via word-of-mouth; lesbian, gay, bisexual, transgender, and queer apps (ie, Grindr, Scruff); and print advertisements, and participants recruited from these sources tended to be older and have a higher risk profile. The study was also successful in recruiting a large sample of transgender youth, particularly transgender men and nonbinary individuals. At-home HIV testing was acceptable and more heavily used by younger participants, although several barriers were encountered and overcome in the implementation of this testing. The study had more limited success in recruiting participants aged 13-17 years because of lower enrollment rates and barriers to advertising on social media platforms. The implications of these findings for the future development of HIV research and intervention protocols among sexual minorities and trans youth are discussed. Conclusions: The methods used in the Keeping it LITE study, particularly recruitment via social media, were found to be feasible and acceptable to participants. ",
doi="10.2196/30761",
url="https://formative.jmir.org/2021/11/e30761",
url="http://www.ncbi.nlm.nih.gov/pubmed/34346403"
}


@Article{info:doi/10.2196/25394,
author="Santisteban-Espejo, Antonio
and Martin-Piedra, Angel Miguel
and Campos, Antonio
and Moran-Sanchez, Julia
and Cobo, J. Manuel
and Pacheco-Serrano, I. Ana
and Moral-Munoz, A. Jose",
title="Information and Scientific Impact of Advanced Therapies in the Age of Mass Media: Altmetrics-Based Analysis of Tissue Engineering",
journal="J Med Internet Res",
year="2021",
month="Nov",
day="26",
volume="23",
number="11",
pages="e25394",
keywords="advanced therapies",
keywords="tissue engineering",
keywords="scientometrics",
keywords="altmetrics",
keywords="online",
keywords="web",
keywords="communication of science",
abstract="Background: Tissue engineering (TE) constitutes a multidisciplinary field aiming to construct artificial tissues to regenerate end-stage organs. Its development has taken place since the last decade of the 20th century, entailing a clinical revolution. TE research groups have worked and shared relevant information in the mass media era. Thus, it would be interesting to study the online dimension of TE research and to compare it with traditional measures of scientific impact. Objective: The objective of this study was to evaluate the online dimension of TE documents from 2012 to 2018 using metadata obtained from the Web of Science (WoS) and Altmetric and to develop a prediction equation for the impact of TE documents from altmetric scores. Methods: We analyzed 10,112 TE documents through descriptive and statistical methods. First, the TE temporal evolution was exposed for WoS and 15 online platforms (news, blogs, policy, Twitter, patents, peer review, Weibo, Facebook, Wikipedia, Google, Reddit, F1000, Q\&A, video, and Mendeley Readers). The 10 most cited TE original articles were ranked according to the normalized WoS citations and the normalized Altmetric Attention Score. Second, to better comprehend the TE online framework, correlation and factor analyses were performed based on the suitable results previously obtained for the Bartlett sphericity and Kaiser--Meyer--Olkin tests. Finally, the linear regression model was applied to elucidate the relation between academics and online media and to construct a prediction equation for TE from altmetrics data. Results: TE dynamic shows an upward trend in WoS citations, Twitter, Mendeley Readers, and Altmetric Scores. However, WoS and Altmetric rankings for the most cited documents clearly differ. When compared, the best correlation results were obtained for Mendeley Readers and WoS ($\rho$=0.71). In addition, the factor analysis identified 6 factors that could explain the previously observed differences between academic institutions and the online platforms evaluated. At this point, the mathematical model constructed is able to predict and explain more than 40\% of TE WoS citations from Altmetric scores. Conclusions: Scientific information related to the construction of bioartificial tissues increasingly reaches society through different online media. Because the focus of TE research importantly differs when the academic institutions and online platforms are compared, basic and clinical research groups, academic institutions, and health politicians should make a coordinated effort toward the design and implementation of adequate strategies for information diffusion and population health education. ",
doi="10.2196/25394",
url="https://www.jmir.org/2021/11/e25394",
url="http://www.ncbi.nlm.nih.gov/pubmed/34842548"
}


@Article{info:doi/10.2196/29958,
author="Reuter, Katja
and Angyan, Praveen
and Le, NamQuyen
and Buchanan, A. Thomas",
title="Using Patient-Generated Health Data From Twitter to Identify, Engage, and Recruit Cancer Survivors in Clinical Trials in Los Angeles County: Evaluation of a Feasibility Study",
journal="JMIR Form Res",
year="2021",
month="Nov",
day="26",
volume="5",
number="11",
pages="e29958",
keywords="breast cancer",
keywords="cancer",
keywords="clinical research",
keywords="clinical trial",
keywords="colon cancer",
keywords="infoveillance",
keywords="kidney cancer",
keywords="lung cancer",
keywords="lymphoma",
keywords="patient engagement",
keywords="prostate cancer",
keywords="recruitment",
keywords="Twitter",
keywords="social media",
abstract="Background: Failure to find and attract clinical trial participants remains a persistent barrier to clinical research. Researchers increasingly complement recruitment methods with social media--based methods. We hypothesized that user-generated data from cancer survivors and their family members and friends on the social network Twitter could be used to identify, engage, and recruit cancer survivors for cancer trials. Objective: This pilot study aims to examine the feasibility of using user-reported health data from cancer survivors and family members and friends on Twitter in Los Angeles (LA) County to enhance clinical trial recruitment. We focus on 6 cancer conditions (breast cancer, colon cancer, kidney cancer, lymphoma, lung cancer, and prostate cancer). Methods: The social media intervention involved monitoring cancer-specific posts about the 6 cancer conditions by Twitter users in LA County to identify cancer survivors and their family members and friends and contacting eligible Twitter users with information about open cancer trials at the University of Southern California (USC) Norris Comprehensive Cancer Center. We reviewed both retrospective and prospective data published by Twitter users in LA County between July 28, 2017, and November 29, 2018. The study enrolled 124 open clinical trials at USC Norris. We used descriptive statistics to report the proportion of Twitter users who were identified, engaged, and enrolled. Results: We analyzed 107,424 Twitter posts in English by 25,032 unique Twitter users in LA County for the 6 cancer conditions. We identified and contacted 1.73\% (434/25,032) of eligible Twitter users (127/434, 29.3\% cancer survivors; 305/434, 70.3\% family members and friends; and 2/434, 0.5\% Twitter users were excluded). Of them, 51.4\% (223/434) were female and approximately one-third were male. About one-fifth were people of color, whereas most of them were White. Approximately one-fifth (85/434, 19.6\%) engaged with the outreach messages (cancer survivors: 33/85, 38\% and family members and friends: 52/85, 61\%). Of those who engaged with the messages, one-fourth were male, the majority were female, and approximately one-fifth were people of color, whereas the majority were White. Approximately 12\% (10/85) of the contacted users requested more information and 40\% (4/10) set up a prescreening. Two eligible candidates were transferred to USC Norris for further screening, but neither was enrolled. Conclusions: Our findings demonstrate the potential of identifying and engaging cancer survivors and their family members and friends on Twitter. Optimization of downstream recruitment efforts such as screening for digital populations on social media may be required. Future research could test the feasibility of the approach for other diseases, locations, languages, social media platforms, and types of research involvement (eg, survey research). Computer science methods could help to scale up the analysis of larger data sets to support more rigorous testing of the intervention. Trial Registration: ClinicalTrials.gov NCT03408561; https://clinicaltrials.gov/ct2/show/NCT03408561 ",
doi="10.2196/29958",
url="https://formative.jmir.org/2021/11/e29958",
url="http://www.ncbi.nlm.nih.gov/pubmed/34842538"
}


@Article{info:doi/10.2196/30624,
author="Loveys, Kate
and Sagar, Mark
and Zhang, Xueyuan
and Fricchione, Gregory
and Broadbent, Elizabeth",
title="Effects of Emotional Expressiveness of a Female Digital Human on Loneliness, Stress, Perceived Support, and Closeness Across Genders: Randomized Controlled Trial",
journal="J Med Internet Res",
year="2021",
month="Nov",
day="25",
volume="23",
number="11",
pages="e30624",
keywords="computer agent",
keywords="digital human",
keywords="emotional expressiveness",
keywords="loneliness",
keywords="closeness",
keywords="social support",
keywords="stress",
keywords="human-computer interaction",
keywords="voice",
keywords="face",
keywords="physiology",
abstract="Background: Loneliness is a growing public health problem that has been exacerbated in vulnerable groups during the COVID-19 pandemic. Social support interventions have been shown to reduce loneliness, including when delivered through technology. Digital humans are a new type of computer agent that show promise as supportive peers in health care. For digital humans to be effective and engaging support persons, it is important that they develop closeness with people. Closeness can be increased by emotional expressiveness, particularly in female relationships. However, it is unknown whether emotional expressiveness improves relationships with digital humans and affects physiological responses. Objective: The aim of this study is to investigate whether emotional expression by a digital human can affect psychological and physiological outcomes and whether the effects are moderated by the user's gender. Methods: A community sample of 198 adults (101 women, 95 men, and 2 gender-diverse individuals) was block-randomized by gender to complete a 15-minute self-disclosure conversation with a female digital human in 1 of 6 conditions. In these conditions, the digital human varied in modality richness and emotional expression on the face and in the voice (emotional, neutral, or no face; emotional or neutral voice). Perceived loneliness, closeness, social support, caring perceptions, and stress were measured after each interaction. Heart rate, skin temperature, and electrodermal activity were assessed during each interaction. 3-way factorial analyses of variance with post hoc tests were conducted. Results: Emotional expression in the voice was associated with greater perceptions of caring and physiological arousal during the interaction, and unexpectedly, with lower feelings of support. User gender moderated the effect of emotional expressiveness on several outcomes. For women, an emotional voice was associated with increased closeness, social support, and caring perceptions, whereas for men, a neutral voice increased these outcomes. For women, interacting with a neutral face was associated with lower loneliness and subjective stress compared with no face. Interacting with no face (ie, a voice-only black screen) resulted in lower loneliness and subjective stress for men, compared with a neutral or emotional face. No significant results were found for heart rate or skin temperature. However, average electrodermal activity was significantly higher for men while interacting with an emotional voice. Conclusions: Emotional expressiveness in a female digital human has different effects on loneliness, social, and physiological outcomes for men and women. The results inform the design of digital human support persons and have theoretical implications. Further research is needed to evaluate how more pronounced emotional facial expressions in a digital human might affect the results. Trial Registration: Australia New Zealand Clinical Trials Registry (ANZCTR) ACTRN12621000865819; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=381816\&isReview ",
doi="10.2196/30624",
url="https://www.jmir.org/2021/11/e30624",
url="http://www.ncbi.nlm.nih.gov/pubmed/34842540"
}


@Article{info:doi/10.2196/29487,
author="Boettcher, Nick",
title="Studies of Depression and Anxiety Using Reddit as a Data Source: Scoping Review",
journal="JMIR Ment Health",
year="2021",
month="Nov",
day="25",
volume="8",
number="11",
pages="e29487",
keywords="depression",
keywords="anxiety",
keywords="mental health",
keywords="Reddit",
keywords="social media",
keywords="review",
abstract="Background: The study of depression and anxiety using publicly available social media data is a research activity that has grown considerably over the past decade. The discussion platform Reddit has become a popular social media data source in this nascent area of study, in part because of the unique ways in which the platform is facilitative of research. To date, no work has been done to synthesize existing studies on depression and anxiety using Reddit. Objective: The objective of this review is to understand the scope and nature of research using Reddit as a primary data source for studying depression and anxiety. Methods: A scoping review was conducted using the Arksey and O'Malley framework. MEDLINE, Embase, CINAHL, PsycINFO, PsycARTICLES, Scopus, ScienceDirect, IEEE Xplore, and ACM academic databases were searched. Inclusion criteria were developed using the participants, concept, and context framework outlined by the Joanna Briggs Institute Scoping Review Methodology Group. Eligible studies featured an analytic focus on depression or anxiety and used naturalistic written expressions from Reddit users as a primary data source. Results: A total of 54 studies were included in the review. Tables and corresponding analyses delineate the key methodological features, including a comparatively larger focus on depression versus anxiety, an even split of original and premade data sets, a widespread analytic focus on classifying the mental health states of Reddit users, and practical implications that often recommend new methods of professionally delivered monitoring and outreach for Reddit users. Conclusions: Studies of depression and anxiety using Reddit data are currently driven by a prevailing methodology that favors a technical, solution-based orientation. Researchers interested in advancing this research area will benefit from further consideration of conceptual issues surrounding the interpretation of Reddit data with the medical model of mental health. Further efforts are also needed to locate accountability and autonomy within practice implications, suggesting new forms of engagement with Reddit users. ",
doi="10.2196/29487",
url="https://mental.jmir.org/2021/11/e29487",
url="http://www.ncbi.nlm.nih.gov/pubmed/34842560"
}


@Article{info:doi/10.2196/29600,
author="Gao, Yankun
and Xie, Zidian
and Sun, Li
and Xu, Chenliang
and Li, Dongmei",
title="Characteristics of and User Engagement With Antivaping Posts on Instagram: Observational Study",
journal="JMIR Public Health Surveill",
year="2021",
month="Nov",
day="25",
volume="7",
number="11",
pages="e29600",
keywords="anti-vaping",
keywords="Instagram",
keywords="user engagement",
keywords="e-cigarettes",
keywords="vaping",
keywords="social media",
keywords="content analysis",
keywords="public health",
keywords="lung health",
abstract="Background: Although government agencies acknowledge that messages about the adverse health effects of e-cigarette use should be promoted on social media, effectively delivering those health messages is challenging. Instagram is one of the most popular social media platforms among US youth and young adults, and it has been used to educate the public about the potential harm of vaping through antivaping posts. Objective: We aim to analyze the characteristics of and user engagement with antivaping posts on Instagram to inform future message development and information delivery. Methods: A total of 11,322 Instagram posts were collected from November 18, 2019, to January 2, 2020, by using antivaping hashtags including \#novape, \#novaping, \#stopvaping, \#dontvape, \#antivaping, \#quitvaping, \#antivape, \#stopjuuling, \#dontvapeonthepizza, and \#escapethevape. Among those posts, 1025 posts were randomly selected and 500 antivaping posts were further identified by hand coding. The image type, image content, and account type of antivaping posts were hand coded, the text information in the caption was explored by topic modeling, and the user engagement of each category was compared. Results: Analyses found that antivaping images of the educational/warning type were the most common (253/500; 50.6\%). The average likes of the educational/warning type (15 likes/post) were significantly lower than the catchphrase image type (these emphasized a slogan such as ``athletesdontvape'' in the image; 32.5 likes/post; P<.001). The majority of the antivaping posts contained the image content element text (n=332, 66.4\%), followed by the image content element people/person (n=110, 22\%). The images containing people/person elements (32.8 likes/post) had more likes than the images containing other elements (13.8-21.1 likes/post). The captions of the antivaping Instagram posts covered topics including ``lung health,'' ``teen vaping,'' ``stop vaping,'' and ``vaping death cases.'' Among the 500 antivaping Instagram posts, while most posts were from the antivaping community (n=177, 35.4\%) and personal account types (n=182, 36.4\%), the antivaping community account type had the highest average number of posts (1.69 posts/account). However, there was no difference in the number of likes among different account types. Conclusions: Multiple features of antivaping Instagram posts may be related to user engagement and perception. This study identified the critical elements associated with high user engagement, which could be used to design antivaping posts to deliver health-related information more efficiently. ",
doi="10.2196/29600",
url="https://publichealth.jmir.org/2021/11/e29600",
url="http://www.ncbi.nlm.nih.gov/pubmed/34842553"
}


@Article{info:doi/10.2196/31366,
author="Tan, Yi Ming
and Goh, Enhui Charlene
and Tan, Hon Hee",
title="Contemporary English Pain Descriptors as Detected on Social Media Using Artificial Intelligence and Emotion Analytics Algorithms: Cross-sectional Study",
journal="JMIR Form Res",
year="2021",
month="Nov",
day="25",
volume="5",
number="11",
pages="e31366",
keywords="pain descriptors",
keywords="social media",
keywords="artificial intelligence",
keywords="emotion analytics",
keywords="McGill Pain Questionnaire",
abstract="Background: Pain description is fundamental to health care. The McGill Pain Questionnaire (MPQ) has been validated as a tool for the multidimensional measurement of pain; however, its use relies heavily on language proficiency. Although the MPQ has remained unchanged since its inception, the English language has evolved significantly since then. The advent of the internet and social media has allowed for the generation of a staggering amount of publicly available data, allowing linguistic analysis at a scale never seen before. Objective: The aim of this study is to use social media data to examine the relevance of pain descriptors from the existing MPQ, identify novel contemporary English descriptors for pain among users of social media, and suggest a modification for a new MPQ for future validation and testing. Methods: All posts from social media platforms from January 1, 2019, to December 31, 2019, were extracted. Artificial intelligence and emotion analytics algorithms (Crystalace and CrystalFeel) were used to measure the emotional properties of the text, including sarcasm, anger, fear, sadness, joy, and valence. Word2Vec was used to identify new pain descriptors associated with the original descriptors from the MPQ. Analysis of count and pain intensity formed the basis for proposing new pain descriptors and determining the order of pain descriptors within each subclass. Results: A total of 118 new associated words were found via Word2Vec. Of these 118 words, 49 (41.5\%) words had a count of at least 110, which corresponded to the count of the bottom 10\% (8/78) of the original MPQ pain descriptors. The count and intensity of pain descriptors were used to formulate the inclusion criteria for a new pain questionnaire. For the suggested new pain questionnaire, 11 existing pain descriptors were removed, 13 new descriptors were added to existing subclasses, and a new Psychological subclass comprising 9 descriptors was added. Conclusions: This study presents a novel methodology using social media data to identify new pain descriptors and can be repeated at regular intervals to ensure the relevance of pain questionnaires. The original MPQ contains several potentially outdated pain descriptors and is inadequate for reporting the psychological aspects of pain. Further research is needed to examine the reliability and validity of the revised MPQ. ",
doi="10.2196/31366",
url="https://formative.jmir.org/2021/11/e31366",
url="http://www.ncbi.nlm.nih.gov/pubmed/34842554"
}


@Article{info:doi/10.2196/25618,
author="Prokhorov, V. Alexander
and Calabro, Sue Karen
and Arya, Ashish
and Russell, Sophia
and Czerniak, W. Katarzyna
and Botello, C. Gabrielle
and Chen, Minxing
and Yuan, Ying
and Perez, Adriana
and Vidrine, J. Damon
and Perry, L. Cheryl
and Khalil, Elias Georges",
title="Mobile Text Messaging for Tobacco Risk Communication Among Young Adult Community College Students: Randomized Trial of Project Debunk",
journal="JMIR Mhealth Uhealth",
year="2021",
month="Nov",
day="24",
volume="9",
number="11",
pages="e25618",
keywords="tobacco use",
keywords="risk communication",
keywords="text messaging",
keywords="message framing",
keywords="regulatory science",
keywords="young adults",
keywords="vaping",
keywords="mobile phone",
abstract="Background: The use of new and emerging tobacco products (NETPs) and conventional tobacco products (CTPs) has been linked to several alarming medical conditions among young adults (YAs). Considering that 96\% of YAs own mobile phones, SMS text messaging may be an effective strategy for tobacco risk communication. Objective: Project Debunk is a community-based randomized trial aiming to identify specific types of messages that effectively improve perceived NETP and CTP risk among YAs in community colleges. Methods: With YAs recruited offline from 3 campuses at the Houston Community College (September 2016 to July 2017), we conducted a 6-month randomized trial with 8 arms based on the combination of 3 message categories: framing (gain-framed vs loss-framed), depth (simple vs complex), and appeal (emotional vs rational). Participants received fully automated web-based SMS text messages in two 30-day campaigns (2 messages per day). We conducted repeated-measures mixed-effect models stratified by message type received, predicting perceived CTP and NETP risks. Owing to multiple testing with 7 models, an association was deemed significant for P<.007 (.05 divided by 7). Results: A total of 636 participants completed the baseline survey, were randomized to 1 of 8 conditions (between 73 and 86 participants per condition), and received messages from both campaigns. By the 2-month post campaign 2 assessment point, 70.1\% (446/636) completed all outcome measures. By the end of both campaigns, participants had a significant increase in perceived NETP risk over time (P<.001); however, participants had a marginal increase in perceived CTP risk (P=.008). Separately for each group, there was a significant increase in perceived NETP risk among participants who received rational messages (P=.005), those who received emotional messages (P=.006), those who received simple messages (P=.003), and those who received gain-framed messages (P=.003). Conclusions: In this trial, YAs had an increase in perceived NETP risk. However, with stratification, we observed a significant increase in perceived NETP risk upon exposure to rational, emotional, simple, and gain-framed messages. In addition, YAs generally had an increase in perceived CTP risk and presented nonsignificant but observable improvement upon exposure to emotional, complex, and loss-framed messages. With the results of this study, researchers and practitioners implementing mobile health programs may take advantage of our tailored messages through larger technology-based programs such as smartphone apps and social media campaigns. Trial Registration: ClinicalTrials.gov NCT03457480; https://clinicaltrials.gov/ct2/show/NCT03457480 International Registered Report Identifier (IRRID): RR2-10.2196/10977 ",
doi="10.2196/25618",
url="https://mhealth.jmir.org/2021/11/e25618",
url="http://www.ncbi.nlm.nih.gov/pubmed/34822339"
}


@Article{info:doi/10.2196/25287,
author="Assaf, Elias
and Bond, M. Robert
and Cranmer, J. Skyler
and Kaizar, E. Eloise
and Ratliff Santoro, Lauren
and Shikano, Susumu
and Sivakoff, J. David",
title="Understanding the Relationship Between Official and Social Information About Infectious Disease: Experimental Analysis",
journal="J Med Internet Res",
year="2021",
month="Nov",
day="23",
volume="23",
number="11",
pages="e25287",
keywords="disease",
keywords="social information",
keywords="official information",
keywords="network experiments",
abstract="Background: Communicating official public health information about infectious diseases is complicated by the fact that individuals receive much of their information from their social contacts, either via interpersonal interaction or social media, which can be prone to bias and misconception. Objective: This study aims to evaluate the effect of public health campaigns and the effect of socially communicated health information on learning about diseases simultaneously. Although extant literature addresses the effect of one source of information (official or social) or the other, it has not addressed the simultaneous interaction of official information (OI) and social information (SI) in an experimental setting. Methods: We used a series of experiments that exposed participants to both OI and structured SI about the symptoms and spread of hepatitis C over a series of 10 rounds of computer-based interactions. Participants were randomly assigned to receive a high, low, or control intensity of OI and to receive accurate or inaccurate SI about the disease. Results: A total of 195 participants consented to participate in the study. Of these respondents, 186 had complete responses across all ten experimental rounds, which corresponds to a 4.6\% (9/195) nonresponse rate. The OI high intensity treatment increases learning over the control condition for all symptom and contagion questions when individuals have lower levels of baseline knowledge (all P values ?.04). The accurate SI condition increased learning across experimental rounds over the inaccurate condition (all P values ?.01). We find limited evidence of an interaction between official and SI about infectious diseases. Conclusions: This project demonstrates that exposure to official public health information increases individuals' knowledge of the spread and symptoms of a disease. Socially shared information also facilitates the learning of accurate and inaccurate information, though to a lesser extent than exposure to OI. Although the effect of OI persists, preliminary results suggest that it can be degraded by persistent contradictory SI over time. ",
doi="10.2196/25287",
url="https://www.jmir.org/2021/11/e25287",
url="http://www.ncbi.nlm.nih.gov/pubmed/34817389"
}


@Article{info:doi/10.2196/30467,
author="Wang, W. Andrea
and Lan, Jo-Yu
and Wang, Ming-Hung
and Yu, Chihhao",
title="The Evolution of Rumors on a Closed Social Networking Platform During COVID-19: Algorithm Development and Content Study",
journal="JMIR Med Inform",
year="2021",
month="Nov",
day="23",
volume="9",
number="11",
pages="e30467",
keywords="COVID-19",
keywords="rumors",
keywords="rumor diffusion",
keywords="rumor propagation",
keywords="social listening",
keywords="infodemic",
keywords="social media",
keywords="closed platform",
keywords="natural language processing",
keywords="machine learning",
keywords="unsupervised learning",
keywords="computers and society",
abstract="Background: In 2020, the COVID-19 pandemic put the world in a crisis regarding both physical and psychological health. Simultaneously, a myriad of unverified information flowed on social media and online outlets. The situation was so severe that the World Health Organization identified it as an infodemic in February 2020. Objective: The aim of this study was to examine the propagation patterns and textual transformation of COVID-19--related rumors on a closed social media platform. Methods: We obtained a data set of suspicious text messages collected on Taiwan's most popular instant messaging platform, LINE, between January and July 2020. We proposed a classification-based clustering algorithm that could efficiently cluster messages into groups, with each group representing a rumor. For ease of understanding, a group is referred to as a ``rumor group.'' Messages in a rumor group could be identical or could have limited textual differences between them. Therefore, each message in a rumor group is a form of the rumor. Results: A total of 936 rumor groups with at least 10 messages each were discovered among 114,124 text messages collected from LINE. Among 936 rumors, 396 (42.3\%) were related to COVID-19. Of the 396 COVID-19--related rumors, 134 (33.8\%) had been fact-checked by the International Fact-Checking Network--certified agencies in Taiwan and determined to be false or misleading. By studying the prevalence of simplified Chinese characters or phrases in the messages that originated in China, we found that COVID-19--related messages, compared to non--COVID-19--related messages, were more likely to have been written by non-Taiwanese users. The association was statistically significant, with P<.001, as determined by the chi-square independence test. The qualitative investigations of the three most popular COVID-19 rumors revealed that key authoritative figures, mostly medical personnel, were often misquoted in the messages. In addition, these rumors resurfaced multiple times after being fact-checked, usually preceded by major societal events or textual transformations. Conclusions: To fight the infodemic, it is crucial that we first understand why and how a rumor becomes popular. While social media has given rise to an unprecedented number of unverified rumors, it also provides a unique opportunity for us to study the propagation of rumors and their interactions with society. Therefore, we must put more effort into these areas. ",
doi="10.2196/30467",
url="https://medinform.jmir.org/2021/11/e30467",
url="http://www.ncbi.nlm.nih.gov/pubmed/34623954"
}


@Article{info:doi/10.2196/27835,
author="Schenkel, K. Sandra
and Jungmann, M. Stefanie
and Gropalis, Maria
and Witth{\"o}ft, Michael",
title="Conceptualizations of Cyberchondria and Relations to the Anxiety Spectrum: Systematic Review and Meta-analysis",
journal="J Med Internet Res",
year="2021",
month="Nov",
day="18",
volume="23",
number="11",
pages="e27835",
keywords="cyberchondria",
keywords="health anxiety",
keywords="online health information seeking",
keywords="anxiety",
keywords="systematic review",
keywords="meta-analysis",
abstract="Background: Cyberchondria describes the detrimental effects of health-related internet use. Current conceptualizations agree that cyberchondria is associated with anxiety-related pathologies and may best be conceptualized as a safety behavior; however, little is known about its exact underlying mechanisms. Objective: This systematic review and meta-analysis aims to give an overview of the conceptualizations of cyberchondria and its relation to anxiety-related pathologies, quantify the strength of association to health anxiety by using meta-analyses, highlight gaps in the literature, and outline a hypothetical integrative cognitive-behavioral model of cyberchondria based on the available empirical evidence. Methods: A systematic literature search was conducted using PubMed, Web of Science, and PsycINFO electronic databases. A total of 25 studies were included for qualitative synthesis and 7 studies, comprising 3069 individuals, were included for quantitative synthesis. The meta-analysis revealed a strong association of cyberchondria (r=0.63) and its subfacets (r=0.24-0.66) with health anxiety. Results: The results indicate that cyberchondria is a distinct construct related to health anxiety, obsessive-compulsive symptoms, intolerance of uncertainty, and anxiety sensitivity. Further studies should distinguish between state and trait markers of anxiety-related pathologies and use experimental and naturalistic longitudinal designs to differentiate among risk factors, triggers, and consequences related to cyberchondria. Conclusions: Health-related internet use in the context of health anxiety is best conceptualized as health-related safety behavior maintained through intermittent reinforcement. Here, we present a corresponding integrative cognitive-behavioral model. ",
doi="10.2196/27835",
url="https://www.jmir.org/2021/11/e27835",
url="http://www.ncbi.nlm.nih.gov/pubmed/34792473"
}


@Article{info:doi/10.2196/25770,
author="Vuku{\vs}i{\'c} Rukavina, Tea
and Viski{\'c}, Jo{\vs}ko
and Machala Popla{\vs}en, Lovela
and Reli{\'c}, Danko
and Mareli{\'c}, Marko
and Jokic, Drazen
and Sedak, Kristijan",
title="Dangers and Benefits of Social Media on E-Professionalism of Health Care Professionals: Scoping Review",
journal="J Med Internet Res",
year="2021",
month="Nov",
day="17",
volume="23",
number="11",
pages="e25770",
keywords="e-professionalism",
keywords="social media",
keywords="internet",
keywords="health care professionals",
keywords="physicians",
keywords="nurses",
keywords="students",
keywords="medicine",
keywords="dental medicine",
keywords="nursing",
abstract="Background: As we are witnessing the evolution of social media (SM) use worldwide among the general population, the popularity of SM has also been embraced by health care professionals (HCPs). In the context of SM evolution and exponential growth of users, this scoping review summarizes recent findings of the e-professionalism of HCPs. Objective: The purpose of this scoping review is to characterize the recent original peer-reviewed research studies published between November 1, 2014, to December 31, 2020, on e-professionalism of HCPs; to assess the quality of the methodologies and approaches used; to explore the impact of SM on e-professionalism of HCPs; to recognize the benefits and dangers of SM; and to provide insights to guide future research in this area. Methods: A search of the literature published from November 1, 2014, to December 31, 2020, was performed in January 2021 using 3 databases (PubMed, CINAHL, and Scopus). The searches were conducted using the following defined search terms: ``professionalism'' AND ``social media'' OR ``social networks'' OR ``Internet'' OR ``Facebook'' OR ``Twitter'' OR ``Instagram'' OR ``TikTok.'' The search strategy was limited to studies published in English. This scoping review follows the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. Results: Of the 1632 retrieved papers, a total of 88 studies were finally included in this review. Overall, the quality of the studies was satisfactory. Participants in the reviewed studies were from diverse health care professions. Medical health professionals were involved in about three-quarters of the studies. Three key benefits of SM on e-professionalism of HCPs were identified: (1) professional networking and collaboration, (2) professional education and training, and (3) patient education and health promotion. For the selected studies, there were five recognized dangers of SM on e-professionalism of HCPs: (1) loosening accountability, (2) compromising confidentiality, (3) blurred professional boundaries, (4) depiction of unprofessional behavior, and (5) legal issues and disciplinary consequences. This scoping review also recognizes recommendations for changes in educational curricula regarding e-professionalism as opportunities for improvement and barriers that influence HCPs use of SM in the context of e-professionalism. Conclusions: Findings in the reviewed studies indicate the existence of both benefits and dangers of SM on e-professionalism of HCPs. Even though there are some barriers recognized, this review has highlighted existing recommendations for including e-professionalism in the educational curricula of HCPs. Based on all evidence provided, this review provided new insights and guides for future research on this area. There is a clear need for robust research to investigate new emerging SM platforms, the efficiency of guidelines and educational interventions, and the specifics of each profession regarding their SM potential and use. ",
doi="10.2196/25770",
url="https://www.jmir.org/2021/11/e25770",
url="http://www.ncbi.nlm.nih.gov/pubmed/34662284"
}


@Article{info:doi/10.2196/32167,
author="Singh, Tavleen
and Olivares, Sofia
and Cohen, Trevor
and Cobb, Nathan
and Wang, Jing
and Franklin, Amy
and Myneni, Sahiti",
title="Pragmatics to Reveal Intent in Social Media Peer Interactions: Mixed Methods Study",
journal="J Med Internet Res",
year="2021",
month="Nov",
day="17",
volume="23",
number="11",
pages="e32167",
keywords="online health communities",
keywords="diabetes self-management",
keywords="tobacco cessation",
keywords="speech acts",
keywords="behavior change",
keywords="communication themes",
abstract="Background: Online health communities (OHCs) have emerged as the leading venues for behavior change and health-related information seeking. The soul and success of these digital platforms lie in their ability to foster social togetherness and a sense of community by providing personalized support. However, we have a minimal understanding of how conversational posts in these settings lead to collaborative societies and ultimately result in positive health changes through social influence. Objective: Our objective is to develop a content-specific and intent-sensitive methodological framework for analyzing peer interactions in OHCs. Methods: We developed and applied a mixed-methods approach to understand the manifestation of expressions in peer interactions in OHCs. We applied our approach to describe online social dialogue in the context of two online communities, QuitNet (QN) and the American Diabetes Association (ADA) support community. A total of 3011 randomly selected peer interactions (n=2005 from QN, n=1006 from ADA) were analyzed. Specifically, we conducted thematic analysis to characterize communication content and linguistic expressions (speech acts) embedded within the two data sets. We also developed an empirical user persona based on their engagement levels and behavior profiles. Further, we examined the association between speech acts and communication themes across observed tiers of user engagement and self-reported behavior profiles using the chi-square test or the Fisher test. Results: Although social support, the most prevalent communication theme in both communities, was expressed in several subtle manners, the prevalence of emotions was higher in the tobacco cessation community and assertions were higher in the diabetes self-management (DSM) community. Specific communication theme-speech act relationships were revealed, such as the social support theme was significantly associated (P<.05) with 9 speech acts from a total of 10 speech acts (ie, assertion, commissive, declarative, desire, directive, expressive, question, stance, and statement) within the QN community. Only four speech acts (ie, commissive, emotion, expressive, and stance) were significantly associated (P<.05) with the social support theme in the ADA community. The speech acts were also significantly associated with the users' abstinence status within the QN community and with the users' lifestyle status within the ADA community (P<.05). Conclusions: Such an overlay of communication intent implicit in online peer interactions alongside content-specific theory-linked characterizations of social media discourse can inform the development of effective digital health technologies in the field of health promotion and behavior change. Our analysis revealed a rich gradient of expressions across a standardized thematic vocabulary, with a distinct variation in emotional and informational needs, depending on the behavioral and disease management profiles within and across the communities. This signifies the need and opportunities for coupling pragmatic messaging in digital therapeutics and care management pathways for personalized support. ",
doi="10.2196/32167",
url="https://www.jmir.org/2021/11/e32167",
url="http://www.ncbi.nlm.nih.gov/pubmed/34787578"
}


@Article{info:doi/10.2196/30642,
author="Muric, Goran
and Wu, Yusong
and Ferrara, Emilio",
title="COVID-19 Vaccine Hesitancy on Social Media: Building a Public Twitter Data Set of Antivaccine Content, Vaccine Misinformation, and Conspiracies",
journal="JMIR Public Health Surveill",
year="2021",
month="Nov",
day="17",
volume="7",
number="11",
pages="e30642",
keywords="vaccine hesitancy",
keywords="COVID-19 vaccines",
keywords="dataset",
keywords="COVID-19",
keywords="SARS-CoV-2",
keywords="social media",
keywords="network analysis",
keywords="hesitancy",
keywords="vaccine",
keywords="Twitter",
keywords="misinformation",
keywords="conspiracy",
keywords="trust",
keywords="public health",
keywords="utilization",
abstract="Background: False claims about COVID-19 vaccines can undermine public trust in ongoing vaccination campaigns, posing a threat to global public health. Misinformation originating from various sources has been spreading on the web since the beginning of the COVID-19 pandemic. Antivaccine activists have also begun to use platforms such as Twitter to promote their views. To properly understand the phenomenon of vaccine hesitancy through the lens of social media, it is of great importance to gather the relevant data. Objective: In this paper, we describe a data set of Twitter posts and Twitter accounts that publicly exhibit a strong antivaccine stance. The data set is made available to the research community via our AvaxTweets data set GitHub repository. We characterize the collected accounts in terms of prominent hashtags, shared news sources, and most likely political leaning. Methods: We started the ongoing data collection on October 18, 2020, leveraging the Twitter streaming application programming interface (API) to follow a set of specific antivaccine-related keywords. Then, we collected the historical tweets of the set of accounts that engaged in spreading antivaccination narratives between October 2020 and December 2020, leveraging the Academic Track Twitter API. The political leaning of the accounts was estimated by measuring the political bias of the media outlets they shared. Results: We gathered two curated Twitter data collections and made them publicly available: (1) a streaming keyword--centered data collection with more than 1.8 million tweets, and (2) a historical account--level data collection with more than 135 million tweets. The accounts engaged in the antivaccination narratives lean to the right (conservative) direction of the political spectrum. The vaccine hesitancy is fueled by misinformation originating from websites with already questionable credibility. Conclusions: The vaccine-related misinformation on social media may exacerbate the levels of vaccine hesitancy, hampering progress toward vaccine-induced herd immunity, and could potentially increase the number of infections related to new COVID-19 variants. For these reasons, understanding vaccine hesitancy through the lens of social media is of paramount importance. Because data access is the first obstacle to attain this goal, we published a data set that can be used in studying antivaccine misinformation on social media and enable a better understanding of vaccine hesitancy. ",
doi="10.2196/30642",
url="https://publichealth.jmir.org/2021/11/e30642",
url="http://www.ncbi.nlm.nih.gov/pubmed/34653016"
}


@Article{info:doi/10.2196/25455,
author="Yoo, Whi Dong
and Ernala, Kiranmai Sindhu
and Saket, Bahador
and Weir, Domino
and Arenare, Elizabeth
and Ali, F. Asra
and Van Meter, R. Anna
and Birnbaum, L. Michael
and Abowd, D. Gregory
and De Choudhury, Munmun",
title="Clinician Perspectives on Using Computational Mental Health Insights From Patients' Social Media Activities: Design and Qualitative Evaluation of a Prototype",
journal="JMIR Ment Health",
year="2021",
month="Nov",
day="16",
volume="8",
number="11",
pages="e25455",
keywords="mental health",
keywords="social media",
keywords="information technology",
abstract="Background: Previous studies have suggested that social media data, along with machine learning algorithms, can be used to generate computational mental health insights. These computational insights have the potential to support clinician-patient communication during psychotherapy consultations. However, how clinicians perceive and envision using computational insights during consultations has been underexplored. Objective: The aim of this study is to understand clinician perspectives regarding computational mental health insights from patients' social media activities. We focus on the opportunities and challenges of using these insights during psychotherapy consultations. Methods: We developed a prototype that can analyze consented patients' Facebook data and visually represent these computational insights. We incorporated the insights into existing clinician-facing assessment tools, the Hamilton Depression Rating Scale and Global Functioning: Social Scale. The design intent is that a clinician will verbally interview a patient (eg, How was your mood in the past week?) while they reviewed relevant insights from the patient's social media activities (eg, number of depression-indicative posts). Using the prototype, we conducted interviews (n=15) and 3 focus groups (n=13) with mental health clinicians: psychiatrists, clinical psychologists, and licensed clinical social workers. The transcribed qualitative data were analyzed using thematic analysis. Results: Clinicians reported that the prototype can support clinician-patient collaboration in agenda-setting, communicating symptoms, and navigating patients' verbal reports. They suggested potential use scenarios, such as reviewing the prototype before consultations and using the prototype when patients missed their consultations. They also speculated potential negative consequences: patients may feel like they are being monitored, which may yield negative effects, and the use of the prototype may increase the workload of clinicians, which is already difficult to manage. Finally, our participants expressed concerns regarding the prototype: they were unsure whether patients' social media accounts represented their actual behaviors; they wanted to learn how and when the machine learning algorithm can fail to meet their expectations of trust; and they were worried about situations where they could not properly respond to the insights, especially emergency situations outside of clinical settings. Conclusions: Our findings support the touted potential of computational mental health insights from patients' social media account data, especially in the context of psychotherapy consultations. However, sociotechnical issues, such as transparent algorithmic information and institutional support, should be addressed in future endeavors to design implementable and sustainable technology. ",
doi="10.2196/25455",
url="https://mental.jmir.org/2021/11/e25455",
url="http://www.ncbi.nlm.nih.gov/pubmed/34783667"
}


@Article{info:doi/10.2196/30607,
author="Koenig, Leni Julia Felicitas
and Buentzel, Judith
and Jung, Wolfram
and Truemper, Lorenz
and Wurm-Kuczera, Isabel Rebecca",
title="Using Instagram to Enhance a Hematology and Oncology Teaching Module During the COVID-19 Pandemic: Cross-sectional Study",
journal="JMIR Med Educ",
year="2021",
month="Nov",
day="15",
volume="7",
number="4",
pages="e30607",
keywords="COVID-19",
keywords="medical education",
keywords="distance learning",
keywords="undergraduate medical education",
keywords="digital medical education",
keywords="Instagram",
keywords="hematology and medical oncology",
abstract="Background: The COVID-19 pandemic necessitated the rapid expansion of novel tools for digital medical education. At our university medical center, an Instagram account was developed as a tool for medical education and used for the first time as a supplement to the hematology and medical oncology teaching module of 2020/2021. Objective: We aimed to evaluate the acceptance and role of Instagram as a novel teaching format in the education of medical students in hematology and medical oncology in the German medical curriculum. Methods: To investigate the role of Instagram in student education of hematology and medical oncology, an Instagram account was developed as a tie-in for the teaching module of 2020/21. The account was launched at the beginning of the teaching module, and 43 posts were added over the 47 days of the teaching module (at least 1 post per day). Five categories for the post content were established: (1) engagement, (2) self-awareness, (3) everyday clinical life combined with teaching aids, (4) teaching aids, and (5) scientific resources. Student interaction with the posts was measured based on overall subscription, ``likes,'' comments, and polls. Approval to conduct this retrospective study was obtained from the local ethics commission of the University Medical Center Goettingen. Results: Of 164 medical students, 119 (72.6\%) subscribed to the Instagram account, showing high acceptance and interest in the use of Instagram for medical education. The 43 posts generated 325 interactions. The highest number of interactions was observed for the category of engagement (mean 15.17 interactions, SD 5.01), followed by self-awareness (mean 14 interactions, SD 7.79). With an average of 7.3 likes per post, overall interaction was relatively low. However, although the category of scientific resources garnered the fewest likes (mean 1.86, SD 1.81), 66\% (27/41) of the student participants who answered the related Instagram poll question were interested in studies and reviews, suggesting that although likes aid the estimation of a general trend of interest, there are facets to interest that cannot be represented by likes. Interaction significantly differed between posting categories (P<.001, Welch analysis of variance). Comparing the first category (engagement) with categories 3 to 5 showed a significant difference (Student t test with the Welch correction; category 1 vs 3, P=.01; category 1 vs 4, P=.01; category 1 vs 5, P=.001). Conclusions: Instagram showed high acceptance among medical students participating in the hematology and oncology teaching curriculum. Students were most interested in posts on routine clinical life, self-care topics, and memory aids. More studies need to be conducted to comprehend the use of Instagram in medical education and to define the role Instagram will play in the future. Furthermore, evaluation guidelines and tools need to be developed. ",
doi="10.2196/30607",
url="https://mededu.jmir.org/2021/4/e30607",
url="http://www.ncbi.nlm.nih.gov/pubmed/34779777"
}


@Article{info:doi/10.2196/27297,
author="Chin, Samuel
and Carlin, Rebecca
and Mathews, Anita
and Moon, Rachel",
title="Infant Safe Sleep Practices as Portrayed on Instagram: Observational Study",
journal="JMIR Pediatr Parent",
year="2021",
month="Nov",
day="15",
volume="4",
number="4",
pages="e27297",
keywords="sleep position",
keywords="bed-sharing",
keywords="social norms",
keywords="social media",
keywords="safe sleep",
keywords="bedding",
abstract="Background: Parenting practices are highly influenced by perceived social norms. Social norms and American Academy of Pediatrics (AAP) guidelines for infant safe sleep practices are often inconsistent. Instagram has become one of the most popular social media websites among young adults (including many expectant and new parents). We hypothesized that the majority of Instagram images of infant sleep and sleep environments are inconsistent with AAP guidelines, and that the number of ``likes'' for each image would not correlate with adherence of the image to these guidelines. Objective: The objective of this study was to determine the extent of adherence of Instagram images of infant sleep and sleep environments to safe infant sleep guidelines. Methods: We searched Instagram using hashtags that were relevant to infant sleeping practices and environments. We then used an open-source web scraper to collect images and the number of ``likes'' for each image from 27 hashtags. Images were analyzed for adherence to AAP safe sleep guidelines. Results: A total of 1563 images (1134 of sleeping infant; 429 of infant sleep environment without sleeping infant) met inclusion criteria and were analyzed. Only 117 (7.49\%) of the 1563 images were consistent with AAP guidelines. The most common reasons for inconsistency with AAP guidelines were presence of bedding (1173/1563, 75.05\%) and nonrecommended sleep position (479/1134, 42.24\%). The number of ``likes'' was not correlated with adherence of the image to AAP guidelines. Conclusions: Although individuals who use Instagram and post pictures of sleeping infants or infant sleep environments may not actually use these practices regularly, the consistent portrayal of images inconsistent with AAP guidelines reinforces that these practices are normative and may influence the practice of young parents. ",
doi="10.2196/27297",
url="https://pediatrics.jmir.org/2021/4/e27297",
url="http://www.ncbi.nlm.nih.gov/pubmed/34779783"
}


@Article{info:doi/10.2196/18483,
author="Sinclair, Marlene
and McCullough, M. Julie E.
and Elliott, David
and Braz, Paula
and Cavero-Carbonell, Clara
and Dornan, Lesley
and Jamry-Dziurla, Anna
and Jo{\~a}o Santos, Ana
and Latos-Biele?ska, Anna
and Machado, Ausenda
and P{\'a}ramo-Rodr{\'i}guez, Luc{\'i}a",
title="Using Social Media as a Research Tool for a Bespoke Web-Based Platform for Stakeholders of Children With Congenital Anomalies: Development Study",
journal="JMIR Pediatr Parent",
year="2021",
month="Nov",
day="15",
volume="4",
number="4",
pages="e18483",
keywords="Facebook",
keywords="YouTube",
keywords="Twitter",
keywords="social media",
keywords="metrics",
keywords="e-forum",
keywords="congenital anomalies",
keywords="coproduction",
keywords="COVID-19",
abstract="Background: Limited research evidence exists on the development of web-based platforms for reciprocal communication, coproduction research, and dissemination of information among parents, professionals, and researchers. This paper provides learning and the outcomes of setting up a bespoke web-based platform using social media. Objective: This study aims to explore the establishment of a web-based, multicontextual research communication platform for parents and stakeholders of children with congenital anomalies using social media and to identify associated research and ethical and technical challenges. Methods: The ConnectEpeople e-forum was developed using social media platforms with a stakeholder engagement process. A multilevel approach was implemented for reciprocal engagement between parents of children with congenital anomalies, researchers, health care professionals, and other stakeholders using private and invisible and public Facebook groups, closed Twitter groups, and YouTube. Ethical approval was obtained from Ulster University. Results: Nonprofit organizations (N=128) were invited to engage with an initial response rate of 16.4\% (21/128). Of the 105 parents contacted, 32 entered the private and invisible Facebook groups to participate in the coproduction research. Public Facebook page followers rose to 215, a total of 22 posts had an engagement of >10\%, and 34 posts had a reach of over 100. Webinars included requested information on childhood milestones and behavior. YouTube coverage included 106 ConnectEpeople videos with 28,708 impressions. Project information was obtained from 35 countries. The highest Facebook activity occurred during the early morning hours. Achievement of these results required dedicated time management, social media expertise, creativity, and sharing knowledge to curate valuable content. Conclusions: Building and maintaining a multilayered online forum for coproduction and information sharing is challenging. Technical considerations include understanding the functionality and versatility of social media metrics. Social media offers valuable, easily accessible, quantitative, and qualitative data that can drive the reciprocal process of forum development. The identification and integration of the needs of the ConnectEpeople e-forum was a key driver in the dissemination of useful, meaningful, and accessible information. The necessary dedicated administration to respond to requests and posts and collate data required significant time and effort. Participant safety, the development of trust, and the maintenance of confidentiality were major ethical considerations. Discussions on social media platforms enabled parents to support each other and their children. Social media platforms are particularly useful in identifying common family needs related to early childhood development. This research approach was challenging but resulted in valuable outputs requiring further application and testing. This may be of particular importance in response to COVID-19 or future pandemics. Incorporating flexible, adaptable social media strategies into research projects is recommended to develop effective platforms for collaborative and impactful research and dissemination. ",
doi="10.2196/18483",
url="https://pediatrics.jmir.org/2021/4/e18483",
url="http://www.ncbi.nlm.nih.gov/pubmed/34779778"
}


@Article{info:doi/10.2196/32707,
author="Raffaelli, Bianca
and Kull, Pia
and Mecklenburg, Jasper
and Overeem, Hendrik Lucas
and Storch, Elisabeth
and Terhart, Maria
and Neeb, Lars
and Reuter, Uwe",
title="Patients' and Health Care Workers' Perception of Migraine Images on the Internet: Cross-sectional Survey Study",
journal="J Med Internet Res",
year="2021",
month="Nov",
day="12",
volume="23",
number="11",
pages="e32707",
keywords="migraine",
keywords="stigma",
keywords="mass media",
keywords="stock photos",
keywords="advocacy",
keywords="internet",
keywords="perception",
keywords="headache",
keywords="pain",
keywords="cross-sectional",
keywords="survey",
keywords="stereotype",
keywords="media",
keywords="awareness",
abstract="Background: The representation of migraine in the media is stereotypical. Standard images of migraine attacks display stylish young women holding their head in a pain pose. This representation may contribute to the social stigmatization of patients with migraine. Objective: We aimed to analyze how patients with migraine and health care workers perceive online images of migraine. Methods: The study consisted of an anonymous web-based survey of patients with migraine at the Headache Center of Charit{\'e} -- Universit{\"a}tsmedizin Berlin (migraine group) and employees and students at our university (health care group). A total of 10 frequently used Adobe Stock photos of migraine attacks were presented to the participants. Each photo was rated on a scale of 0\% to 100\% based on how closely it resembled a realistic migraine attack (realism score). Patients with migraine also indicated how much each photo corresponded to their own experience of migraine as a percentage (representation score). We calculated the mean realism and representation scores for all photos and conducted further analyses using the categories male or female models, younger or older models, and unilateral or bilateral pain pose. Results: A total of 367 patients with migraine and 331 health care employees and students completed the survey. In both groups, the mean realism score was <50\% (migraine group: 47.8\%, SD 18.3\%; health care group: 46.0\%, SD 16.2\%). Patients with migraine identified their own migraine experience in these photos to a lesser degree (mean representation score 44.4\%, SD 19.8\%; P<.001 when compared to the realism score). Patients and health care workers considered photos with male models to be more realistic than photos with females (P<.001) and photos with older models to be more realistic than those with younger people (P<.001). In the health care group only, a bilateral pain posture was deemed more realistic than a unilateral pose (P<.001). Conclusions: Standard images of migraine attacks are considered only slightly or moderately realistic by patients and health care workers. Some characteristics perceived as more realistic such as male sex or older age are in contrast with migraine epidemiology. A more accurate representation of migraine in the media could help to raise awareness for migraine and reduce the associated stigma. ",
doi="10.2196/32707",
url="https://www.jmir.org/2021/11/e32707",
url="http://www.ncbi.nlm.nih.gov/pubmed/34766918"
}


@Article{info:doi/10.2196/21142,
author="Wasfi, Rania
and Poirier Stephens, Zoe
and Sones, Meridith
and Laberee, Karen
and Pugh, Caitlin
and Fuller, Daniel
and Winters, Meghan
and Kestens, Yan",
title="Recruiting Participants for Population Health Intervention Research: Effectiveness and Costs of Recruitment Methods for a Cohort Study",
journal="J Med Internet Res",
year="2021",
month="Nov",
day="12",
volume="23",
number="11",
pages="e21142",
keywords="recruitment methods",
keywords="Facebook recruitment",
keywords="cost-effectiveness",
keywords="built environment",
keywords="intervention research",
keywords="natural experiment",
keywords="mobile phone",
abstract="Background: Public health research studies often rely on population-based participation and draw on various recruitment methods to establish samples. Increasingly, researchers are turning to web-based recruitment tools. However, few studies detail traditional and web-based recruitment efforts in terms of costs and potential biases. Objective: This study aims to report on and evaluate the cost-effectiveness, time effectiveness, and sociodemographic representation of diverse recruitment methods used to enroll participants in 3 cities of the Interventions, Research, and Action in Cities Team (INTERACT) study, a cohort study conducted in Canadian cities. Methods: Over 2017 and 2018 in Vancouver, Saskatoon, and Montreal, the INTERACT study used the following recruitment methods: mailed letters, social media (including sponsored Facebook advertisements), news media, partner communications, snowball recruitment, in-person recruitment, and posters. Participation in the study involved answering web-based questionnaires (at minimum), activating a smartphone app to share sensor data, and wearing a device for mobility and physical activity monitoring. We describe sociodemographic characteristics by the recruitment method and analyze performance indicators, including cost, completion rate, and time effectiveness. Effectiveness included calculating cost per completer (ie, a participant who completed at least one questionnaire), the completion rate of a health questionnaire, and the delay between completion of eligibility and health questionnaires. Cost included producing materials (ie, printing costs), transmitting recruitment messages (ie, mailing list rental, postage, and sponsored Facebook posts charges), and staff time. In Montreal, the largest INTERACT sample, we modeled the number of daily recruits through generalized linear models accounting for the distributed lagged effects of recruitment campaigns. Results: Overall, 1791 participants were recruited from 3 cities and completed at least one questionnaire: 318 in Vancouver, 315 in Saskatoon, and 1158 in Montreal. In all cities, most participants chose to participate fully (questionnaires, apps, and devices). The costs associated with a completed participant varied across recruitment methods and by city. Facebook advertisements generated the most recruits (n=687), at a cost of CAD \$15.04 (US \$11.57; including staff time) per completer. Mailed letters were the costliest, at CAD \$108.30 (US \$83.3) per completer but served to reach older participants. All methods resulted in a gender imbalance, with women participating more, specifically with social media. Partner newsletters resulted in the participation of younger adults and were cost-efficient (CAD \$5.16 [US \$3.97] per completer). A generalized linear model for daily Montreal recruitment identified 2-day lag effects on most recruitment methods, except for the snowball campaign (4 days), letters (15 days), and reminder cards (5 days). Conclusions: This study presents comprehensive data on the costs, effectiveness, and bias of population recruitment in a cohort study in 3 Canadian cities. More comprehensive documentation and reporting of recruitment efforts across studies are needed to improve our capacity to conduct inclusive intervention research. ",
doi="10.2196/21142",
url="https://www.jmir.org/2021/11/e21142",
url="http://www.ncbi.nlm.nih.gov/pubmed/34587586"
}


@Article{info:doi/10.2196/25897,
author="Boldt, Johanna
and Steinfort, Femke
and M{\"u}ller, Martin
and Exadaktylos, K. Aristomenis
and Klukowska-Roetzler, Jolanta",
title="Online Newspaper Reports on Ambulance Accidents in Austria, Germany, and Switzerland: Retrospective Cross-sectional Review",
journal="JMIR Public Health Surveill",
year="2021",
month="Nov",
day="12",
volume="7",
number="11",
pages="e25897",
keywords="ambulance accidents",
keywords="ambulance collisions",
keywords="ambulance crashes",
keywords="media-based",
keywords="media-based review",
keywords="newspaper review",
keywords="Austria",
keywords="Germany",
keywords="Switzerland",
keywords="German-speaking European countries",
keywords="retrospective",
keywords="cross-sectional",
keywords="review",
keywords="ambulance",
keywords="accident",
keywords="data",
keywords="media",
keywords="newspaper",
abstract="Background: Ambulance accidents are an unfortunate indirect result of ambulance emergency calls, which create hazardous environments for personnel, patients, and bystanders. However, in European German-speaking countries, factors contributing to ambulance accidents have not been optimally researched and analyzed. Objective: The objective of this study was to extract, analyze, and compare data from online newspaper articles on ambulance accidents for Austria, Germany, and Switzerland. We hope to highlight future strategies to offset the deficit in research data and official registers for prevention of ambulance and emergency vehicle accidents. Methods: Ambulance accident data were collected from Austrian, German, and Swiss free web-based daily newspapers, as listed in Wikipedia, for the period between January 2014 and January 2019. All included newspapers were searched for articles reporting ambulance accidents using German terms representing ``ambulance'' and ``ambulance accident.'' Characteristics of the accidents were compiled and analyzed. Only ground ambulance accidents were covered. Results: In Germany, a total of 597 ambulance accidents were recorded, corresponding to 0.719 (95\% CI 0.663-0.779) per 100,000 inhabitants; 453 of these accidents left 1170 people injured, corresponding to 1.409 (95\% CI 1.330-1.492) per 100,000 inhabitants, and 28 of these accidents caused 31 fatalities, corresponding to 0.037 (95\% CI 0.025-0.053) per 100,000 inhabitants. In Austria, a total of 62 ambulance accidents were recorded, corresponding to 0.698 (95\% CI 0.535-0.894) per 100,000 inhabitants; 47 of these accidents left 115 people injured, corresponding to 1.294 (95\% CI 1.068-1.553) per 100,000 inhabitants, and 6 of these accidents caused 7 fatalities, corresponding to 0.079 (95\% CI 0.032-0.162) per 100,000 inhabitants. In Switzerland, a total of 25 ambulance accidents were recorded, corresponding to 0.293 (95\% CI 0.189-0.432) per 100,000 inhabitants; 11 of these accidents left 18 people injured, corresponding to 0.211(95\% CI 0.113-0.308) per 100,000 inhabitants. There were no fatalities. In each of the three countries, the majority of the accidents involved another car (77\%-81\%). In Germany and Switzerland, most accidents occurred at an intersection. In Germany, Austria, and Switzerland, 38.7\%, 26\%, and 4\%, respectively, of ambulance accidents occurred at intersections for which the ambulance had a red light (P<.001). In all three countries, most of the casualties were staff and not uncommonly a third party. Most accidents took place on weekdays and during the daytime. Ambulance accidents were evenly distributed across the four seasons. The direction of travel was reported in 28\%-37\% of the accidents and the patient was in the ambulance approximately 50\% of the time in all countries. The cause of the ambulance accidents was reported to be the ambulance itself in 125 (48.1\% of accidents where the cause was reported), 22 (42\%), and 8 (40\%) accidents in Germany, Austria, and Switzerland, respectively (P=.02), and another vehicle in 118 (45.4\%), 29 (56\%), and 9 (45\%) accidents, respectively (P<.001). A total of 292 accidents occurred while blue lights and sirens were used, which caused 3 deaths and 577 injuries. Conclusions: This study draws attention to much needed auxiliary sources of data that may allow for creation of a contemporary registry of all ambulance accidents in Austria, Germany, and Switzerland. To improve risk management and set European standards, it should be mandatory to collect standardized goal-directed and representative information using various sources (including the wide range presented by the press and social media), which should then be made available for audit, analysis, and research. ",
doi="10.2196/25897",
url="https://publichealth.jmir.org/2021/11/e25897",
url="http://www.ncbi.nlm.nih.gov/pubmed/34766915"
}


@Article{info:doi/10.2196/28237,
author="Hendriks, Hanneke
and de Nooy, Wouter
and Gebhardt, A. Winifred
and van den Putte, Bas",
title="Causal Effects of Alcohol-Related Facebook Posts on Drinking Behavior: Longitudinal Experimental Study",
journal="J Med Internet Res",
year="2021",
month="Nov",
day="11",
volume="23",
number="11",
pages="e28237",
keywords="social media",
keywords="social networking site (SNS)",
keywords="alcohol-related posts",
keywords="alcoholposts",
keywords="alcohol consumption",
abstract="Background: Adolescents and young adults frequently post alcohol-related content (ie, alcoholposts) on social media. This is problematic because both social norms theory and social learning theory suggest that viewing alcoholposts of peers could increase drinking behavior. It is therefore paramount to understand the effects of exposure to alcoholposts on viewers. Objective: This study aimed to investigate the causal effects of exposure to alcoholposts on alcohol consumption by using a rigorous design. Methods: We conducted a 6-week longitudinal study during which alcoholposts were measured by a newly developed app that copied Facebook posts shared by participants (n=281) to a new social media environment. In addition, daily questionnaires assessed alcohol use. Effects of natural alcoholposts (ie, posted by the participants) were assessed in phase 1, and effects of experimental posts (ie, posted by fake participants) were explored in phase 2. Results: Results showed that natural alcoholposts increased the occurrence and quantity of drinking the following day. That is, exposure to a single additional alcoholpost increased the log odds of drinking the next day by 0.27 (b=.27, credible interval [CI] .18 to .35). Furthermore, the number of natural alcoholposts had a positive (predictive) effect on the number of glasses drunk the next day (b=.21, CI .14 to .29). In phase 2 when experimental posts were also present, these effects decreased. Experimental posts themselves had hardly any effects. Conclusions: This study illustrates clear and direct effects of exposure to alcoholposts on next-day alcohol consumption and suggests that alcoholposts represent an important societal problem that interventions need to address. ",
doi="10.2196/28237",
url="https://www.jmir.org/2021/11/e28237",
url="http://www.ncbi.nlm.nih.gov/pubmed/34762061"
}


@Article{info:doi/10.2196/26272,
author="Freeman, Benjamin Tobe Che
and Rodriguez-Esteban, Raul
and Gottowik, Juergen
and Yang, Xing
and Erpenbeck, Johannes Veit
and Leddin, Mathias",
title="A Neural Network Approach for Understanding Patient Experiences of Chronic Obstructive Pulmonary Disease (COPD): Retrospective, Cross-sectional Study of Social Media Content",
journal="JMIR Med Inform",
year="2021",
month="Nov",
day="11",
volume="9",
number="11",
pages="e26272",
keywords="outcomes research",
keywords="natural language processing",
keywords="neural networks (computer)",
keywords="social media",
keywords="exercise",
keywords="sleep deprivation",
keywords="social media listening",
keywords="drug development",
abstract="Background: The abundance of online content contributed by patients is a rich source of insight about the lived experience of disease. Patients share disease experiences with other members of the patient and caregiver community and do so using their own lexicon of words and phrases. This lexicon and the topics that are communicated using words and phrases belonging to the lexicon help us better understand disease burden. Insights from social media may ultimately guide clinical development in ways that ensure that future treatments are fit for purpose from the patient's perspective. Objective: We sought insights into the patient experience of chronic obstructive pulmonary disease (COPD) by analyzing a substantial corpus of social media content. The corpus was sufficiently large to make manual review and manual coding all but impossible to perform in a consistent and systematic fashion. Advanced analytics were applied to the corpus content in the search for associations between symptoms and impacts across the entire text corpus. Methods: We conducted a retrospective, cross-sectional study of 5663 posts sourced from open blogs and online forum posts published by COPD patients between February 2016 and August 2019. We applied a novel neural network approach to identify a lexicon of community words and phrases used by patients to describe their symptoms. We used this lexicon to explore the relationship between COPD symptoms and disease-related impacts. Results: We identified a diverse lexicon of community words and phrases for COPD symptoms, including gasping, wheezy, mucus-y, and muck. These symptoms were mentioned in association with specific words and phrases for disease impact such as frightening, breathing discomfort, and difficulty exercising. Furthermore, we found an association between mucus hypersecretion and moderate disease severity, which distinguished mucus from the other main COPD symptoms, namely breathlessness and cough. Conclusions: We demonstrated the potential of neural networks and advanced analytics to gain patient-focused insights about how each distinct COPD symptom contributes to the burden of chronic and acute respiratory illness. Using a neural network approach, we identified words and phrases for COPD symptoms that were specific to the patient community. Identifying patterns in the association between symptoms and impacts deepened our understanding of the patient experience of COPD. This approach can be readily applied to other disease areas. ",
doi="10.2196/26272",
url="https://medinform.jmir.org/2021/11/e26272",
url="http://www.ncbi.nlm.nih.gov/pubmed/34762056"
}


@Article{info:doi/10.2196/31944,
author="Choi, Bogeum
and Kim, Heejun
and Huh-Yoo, Jina",
title="Seeking Mental Health Support Among College Students in Video-Based Social Media: Content and Statistical Analysis of YouTube Videos",
journal="JMIR Form Res",
year="2021",
month="Nov",
day="11",
volume="5",
number="11",
pages="e31944",
keywords="mental health",
keywords="college student",
keywords="social media",
keywords="YouTube",
keywords="help-seeking",
keywords="experiential knowledge",
keywords="video types",
keywords="content analysis",
keywords="time distribution analysis",
keywords="depression",
keywords="anxiety",
keywords="student",
keywords="knowledge",
keywords="stigma",
keywords="strategy",
keywords="engagement",
abstract="Background: Mental health is a highly stigmatized disease, especially for young people. Due to its free, accessible format, college students increasingly use video-based social media for many aspects of information needs, including how-to tips, career, or health-related needs. The accessibility of video-based social media brings potential in supporting stigmatized contexts, such as college students' mental health. Understanding which kinds of videos about college students' mental health have increased viewer engagement will help build a foundation for exploring this potential. Little research has been done to identify video types systematically, how they have changed over time, and their associations on viewer engagement both short term and long term. Objective: This study aims to identify strategies for using video-based social media to combat stigmatized diseases, such as mental health, among college students. We identify who, with what perspective, purpose, and content, makes up the videos available on social media (ie, YouTube) about college students' mental health and how these factors associate with viewer engagement. We then identify effective strategies for designing video-based social media content for supporting college students' mental health. Methods: We performed inductive content analysis to identify different types of YouTube videos concerning college students' mental health (N=452) according to video attributes, including poster, perspective, and purpose. Time analysis showed how video types have changed over time. Fisher's exact test was used to examine the relationships between video attributes. The Mann-Whitney U test was used to test the association between video types and viewer engagement. Lastly, we investigated the difference in viewer engagement across time between two major types of videos (ie, individuals' storytelling and organization's informational videos). Results: Time trend analysis showed a notable increase in the number of (1) videos by individuals, (2) videos that represent students' perspectives, and (3) videos that share stories and experiential knowledge over the recent years. Fisher's exact test found all video attributes (ie, poster, perspective, and purpose) are significantly correlated with each other. In addition, the Mann-Whitney U test found that poster (individual vs organization) and purpose (storytelling vs sharing information) type has a significant association with viewer engagement (P<.001). Lastly, individuals' storytelling videos had a greater engagement in the short term and the long term. Conclusions: The study shows that YouTube videos on college students' mental health can be well differentiated by the types of posters and the purpose of the videos. Taken together, the videos where individuals share their personal stories, as well as experiential knowledge (ie, tips and advice), engaged more viewers in both the short term and long term. Individuals' videos on YouTube showed the potential to support college students' mental health in unique ways, such as providing social support, validating experience, and sharing the positive experience of help-seeking. ",
doi="10.2196/31944",
url="https://formative.jmir.org/2021/11/e31944",
url="http://www.ncbi.nlm.nih.gov/pubmed/34762060"
}


@Article{info:doi/10.2196/26310,
author="Chen, Liang
and Wang, Pianpian
and Ma, Xin
and Wang, Xiaohui",
title="Cancer Communication and User Engagement on Chinese Social Media: Content Analysis and Topic Modeling Study",
journal="J Med Internet Res",
year="2021",
month="Nov",
day="10",
volume="23",
number="11",
pages="e26310",
keywords="cancer-related information",
keywords="social media",
keywords="topic modeling",
keywords="user engagement",
keywords="Weibo",
keywords="cancer",
abstract="Background: Cancer ranks among the most serious public health challenges worldwide. In China---the world's most populous country---about one-quarter of the population consists of people with cancer. Social media has become an important platform that the Chinese public uses to express opinions. Objective: We investigated cancer-related discussions on the Chinese social media platform Weibo (Sina Corporation) to identify cancer topics that generate the highest levels of user engagement. Methods: We conducted topic modeling and regression analyses to analyze and visualize cancer-related messages on Weibo and to examine the relationships between different cancer topics and user engagement (ie, the number of retweets, comments, and likes). Results: Our results revealed that cancer communication on Weibo has generally focused on the following six topics: social support, cancer treatment, cancer prevention, women's cancers, smoking and skin cancer, and other topics. Discussions about social support and cancer treatment attracted the highest number of users and received the greatest numbers of retweets, comments, and likes. Conclusions: Our investigation of cancer-related communication on Weibo provides valuable insights into public concerns about cancer and can help guide the development of health campaigns in social media. ",
doi="10.2196/26310",
url="https://www.jmir.org/2021/11/e26310",
url="http://www.ncbi.nlm.nih.gov/pubmed/34757320"
}


@Article{info:doi/10.2196/32936,
author="Zhang, Zizheng
and Feng, Guanrui
and Xu, Jiahong
and Zhang, Yimin
and Li, Jinhui
and Huang, Jian
and Akinwunmi, Babatunde
and Zhang, P. Casper J.
and Ming, Wai-kit",
title="The Impact of Public Health Events on COVID-19 Vaccine Hesitancy on Chinese Social Media: National Infoveillance Study",
journal="JMIR Public Health Surveill",
year="2021",
month="Nov",
day="9",
volume="7",
number="11",
pages="e32936",
keywords="COVID-19",
keywords="vaccine",
keywords="hesitancy",
keywords="social media",
keywords="China",
keywords="sentiment analysis",
keywords="infoveillance",
keywords="public health",
keywords="surveillance",
keywords="Weibo",
keywords="data mining",
keywords="sentiment",
keywords="attitude",
abstract="Background: The ongoing COVID-19 pandemic has brought unprecedented challenges to every country worldwide. A call for global vaccination for COVID-19 plays a pivotal role in the fight against this virus. With the development of COVID-19 vaccines, public willingness to get vaccinated has become an important public health concern, considering the vaccine hesitancy observed worldwide. Social media is powerful in monitoring public attitudes and assess the dissemination, which would provide valuable information for policy makers. Objective: This study aimed to investigate the responses of vaccine positivity on social media when major public events (major outbreaks) or major adverse events related to vaccination (COVID-19 or other similar vaccines) were reported. Methods: A total of 340,783 vaccine-related posts were captured with the poster's information on Weibo, the largest social platform in China. After data cleaning, 156,223 posts were included in the subsequent analysis. Using pandas and SnowNLP Python libraries, posts were classified into 2 categories, positive and negative. After model training and sentiment analysis, the proportion of positive posts was computed to measure the public positivity toward the COVID-19 vaccine. Results: The positivity toward COVID-19 vaccines in China tends to fluctuate over time in the range of 45.7\% to 77.0\% and is intuitively correlated with public health events. In terms of gender, males were more positive (70.0\% of the time) than females. In terms of region, when regional epidemics arose, not only the region with the epidemic and surrounding regions but also the whole country showed more positive attitudes to varying degrees. When the epidemic subsided temporarily, positivity decreased with varying degrees in each region. Conclusions: In China, public positivity toward COVID-19 vaccines fluctuates over time and a regional epidemic or news on social media may cause significant variations in willingness to accept a vaccine. Furthermore, public attitudes toward COVID-19 vaccination vary from gender and region. It is crucial for policy makers to adjust their policies through the use of positive incentives with prompt responses to pandemic-related news to promote vaccination acceptance. ",
doi="10.2196/32936",
url="https://publichealth.jmir.org/2021/11/e32936",
url="http://www.ncbi.nlm.nih.gov/pubmed/34591782"
}


@Article{info:doi/10.2196/24448,
author="Panda, Ananya
and Sharma, Akash
and Dundar, Ayca
and Packard, Ann
and Aase, Lee
and Kotsenas, Amy
and Kendi, Tuba Ayse",
title="Twitter Use by Academic Nuclear Medicine Programs: Pilot Content Analysis Study",
journal="JMIR Form Res",
year="2021",
month="Nov",
day="8",
volume="5",
number="11",
pages="e24448",
keywords="social media",
keywords="Twitter",
keywords="radiology",
keywords="nuclear medicine",
keywords="nuclear radiology",
keywords="social network",
keywords="medical education",
keywords="networking",
abstract="Background: There is scant insight into the presence of nuclear medicine (NM) and nuclear radiology (NR) programs on social media. Objective: Our purpose was to assess Twitter engagement by academic NM/NR programs in the United States. Methods: We measured Twitter engagement by the academic NM/NR community, accounting for various NM/NR certification pathways. The Twitter presence of NM/NR programs at both the department and program director level was identified. Tweets by programs were cross-referenced against potential high-yield NM- or NR-related hashtags, and tabulated at a binary level. A brief survey was done to identify obstacles and benefits to Twitter use by academic NM/NR faculty. Results: For 2019-2020, 88 unique programs in the United States offered NM/NR certification pathways. Of these, 52\% (46/88) had Twitter accounts and 24\% (21/88) had at least one post related to NM/NR. Only three radiology departments had unique Twitter accounts for the NM/molecular imaging division. Of the other 103 diagnostic radiology residency programs, only 16\% (16/103) had a presence on Twitter and 5\% (5/103) had tweets about NM/NR. Only 9\% (8/88) of NM/NR program directors were on Twitter, and three program directors tweeted about NM/NR. The survey revealed a lack of clarity and resources around using Twitter, although respondents acknowledged the perceived value of Twitter engagement for attracting younger trainees. Conclusions: Currently, there is minimal Twitter engagement by the academic NM/NR community. The perceived value of Twitter engagement is counterbalanced by identifiable obstacles. Given radiologists' overall positive views of social media's usefulness, scant social media engagement by the NM community may represent a missed opportunity. More Twitter engagement and further research by trainees and colleagues should be encouraged, as well as the streamlined use of unique hashtags. ",
doi="10.2196/24448",
url="https://formative.jmir.org/2021/11/e24448",
url="http://www.ncbi.nlm.nih.gov/pubmed/34747708"
}


@Article{info:doi/10.2196/29789,
author="Liew, Ming Tau
and Lee, Sin Cia",
title="Examining the Utility of Social Media in COVID-19 Vaccination:  Unsupervised Learning of 672,133 Twitter Posts",
journal="JMIR Public Health Surveill",
year="2021",
month="Nov",
day="3",
volume="7",
number="11",
pages="e29789",
keywords="social media",
keywords="COVID-19",
keywords="vaccine hesitancy",
keywords="natural language processing",
keywords="machine learning",
keywords="infodemiology",
abstract="Background: Although COVID-19 vaccines have recently become available, efforts in global mass vaccination can be hampered by the widespread issue of vaccine hesitancy. Objective: The aim of this study was to use social media data to capture close-to-real-time public perspectives and sentiments regarding COVID-19 vaccines, with the intention to understand the key issues that have captured public attention, as well as the barriers and facilitators to successful COVID-19 vaccination. Methods: Twitter was searched for tweets related to ``COVID-19'' and ``vaccine'' over an 11-week period after November 18, 2020, following a press release regarding the first effective vaccine. An unsupervised machine learning approach (ie, structural topic modeling) was used to identify topics from tweets, with each topic further grouped into themes using manually conducted thematic analysis as well as guided by the theoretical framework of the COM-B (capability, opportunity, and motivation components of behavior) model.  Sentiment analysis of the tweets was also performed using the rule-based machine learning model VADER (Valence Aware Dictionary and Sentiment Reasoner). Results: Tweets related to COVID-19 vaccines were posted by individuals around the world (N=672,133).  Six overarching themes were identified: (1) emotional reactions related to COVID-19 vaccines (19.3\%), (2) public concerns related to COVID-19 vaccines (19.6\%), (3) discussions about news items related to COVID-19 vaccines (13.3\%), (4) public health communications about COVID-19 vaccines (10.3\%), (5) discussions about approaches to COVID-19 vaccination drives (17.1\%), and (6) discussions about the distribution of COVID-19 vaccines (20.3\%).  Tweets with negative sentiments largely fell within the themes of emotional reactions and public concerns related to COVID-19 vaccines.  Tweets related to facilitators of vaccination showed temporal variations over time, while tweets related to barriers remained largely constant throughout the study period. Conclusions: The findings from this study may facilitate the formulation of comprehensive strategies to improve COVID-19 vaccine uptake; they highlight the key processes that require attention in the planning of COVID-19 vaccination and provide feedback on evolving barriers and facilitators in ongoing vaccination drives to allow for further policy tweaks.  The findings also illustrate three key roles of social media in COVID-19 vaccination, as follows: surveillance and monitoring, a communication platform, and evaluation of government responses. ",
doi="10.2196/29789",
url="https://publichealth.jmir.org/2021/11/e29789",
url="http://www.ncbi.nlm.nih.gov/pubmed/34583316"
}


@Article{info:doi/10.2196/29390,
author="Meleo-Erwin, C. Zoe
and Basch, H. Corey
and Fera, Joseph
and Smith, Bonnie",
title="Discussion of Weight Loss Surgery in Instagram Posts: Successive Sampling Study        ",
journal="JMIR Perioper Med",
year="2021",
month="Nov",
day="1",
volume="4",
number="2",
pages="e29390",
keywords="bariatric surgery",
keywords="social media",
keywords="Instagram",
keywords="health promotion",
keywords="post-operative medicine",
keywords="online health information",
keywords="information accuracy",
keywords="surgery",
keywords="information quality",
abstract="Background: The majority of American adults search for health and illness information on the internet. However, the quality and accuracy of this information are notoriously variable. With the advent of social media, US individuals have increasingly shared their own health and illness experiences, including those related to bariatric surgery, on social media platforms. Previous research has found that peer-to-peer requesting and giving of advice related to bariatric surgery on social media is common, that such advice is often presented in stark terms, and that the advice may not reflect patient standards of care. These previous investigations have helped to map bariatric surgery content on Facebook and YouTube. Objective: This objective of this study was to document and compare weight loss surgery (WLS)--related content on Instagram in the months leading up to the COVID-19 pandemic and 1 year later. Methods: We analyzed a total of 300 Instagram posts (50 posts per week for 3 consecutive weeks in late February and early March in both 2020 and 2021) uploaded using the hashtag \#wls. Descriptive statistics were reported, and independent 1-tailed chi-square tests were used to determine if a post's publication year statistically affected its inclusion of a particular type of content. Results: Overall, advice giving and personal responsibility for outcomes were emphasized by WLS posters on Instagram. However, social support was less emphasized. The safety, challenges, and risks associated with WLS were rarely discussed. The majority of posts did not contain references to facts from reputable medical sources. Posts published in 2021 were more likely to mention stress/hardships of living with WLS (45/150, 30\%, vs 29/150, 19.3\%; P=.03); however, those published in 2020 more often identified the importance of ongoing support for WLS success (35/150, 23.3\%, vs 16/150, 10.7\%; P=.004). Conclusions: Given that bariatric patients have low rates of postoperative follow-up, yet post-operative care and yet support are associated with improved health and weight loss outcomes, and given that health content on the web is of mixed accuracy, bariatric professionals may wish to consider including an online support forum moderated by a professional as a routine part of postoperative care. Doing so may not only improve follow-up rates but may offer providers the opportunity to counter inaccuracies encountered on social media. ",
doi="10.2196/29390",
url="https://periop.jmir.org/2021/2/e29390",
url="http://www.ncbi.nlm.nih.gov/pubmed/34723828"
}


@Article{info:doi/10.2196/28069,
author="Haupt, Robert Michael
and Xu, Qing
and Yang, Joshua
and Cai, Mingxiang
and Mackey, K. Tim",
title="Characterizing Vaping Industry Political Influence and Mobilization on Facebook: Social Network Analysis",
journal="J Med Internet Res",
year="2021",
month="Oct",
day="29",
volume="23",
number="10",
pages="e28069",
keywords="vaping",
keywords="alternative tobacco industry",
keywords="e-cigarettes",
keywords="Facebook",
keywords="social network analysis",
keywords="social networks",
keywords="ehealth",
keywords="health policy",
abstract="Background: In response to recent policy efforts to regulate tobacco and vaping products, the vaping industry has been aggressive in mobilizing opposition by using a network of manufacturers, trade associations, and tobacco user communities, and by appealing to the general public. One strategy the alternative tobacco industry uses to mobilize political action is coordinating on social media platforms, such as the social networking site Facebook. However, few studies have specifically assessed how platforms such as Facebook are used to influence public sentiment and attitudes towards tobacco control policy. Objective: This study used social network analysis to examine how the alternative tobacco industry uses Facebook to mobilize online users to influence tobacco control policy outcomes with a focus on the state of California. Methods: Data were collected from local and national alternative tobacco Facebook groups that had affiliations with activities in the state of California. Network ties were constructed based on users' reactions to posts (eg, ``like'' and ``love'') and comments to characterize political mobilization networks. Results: Findings show that alternative tobacco industry employees were more likely to engage within these networks and that these employees were also more likely to be influential members (ie, be more active) in the network. Comparisons between subnetworks show that communication within the local alternative tobacco advocacy group network was less dense and more centralized in contrast to a national advocacy group that had overall higher levels of engagement among members. A timeline analysis found that a higher number of influential posts that disseminated widely across networks occurred during e-cigarette--related legislative events, suggesting strategic online engagement and increased mobilization of online activity for the purposes of influencing policy outcomes. Conclusions: Results from this study provide important insights into how tobacco industry--related advocacy groups leverage the Facebook platform to mobilize their online constituents in an effort to influence public perceptions and coordinate to defeat tobacco control efforts at the local, state, and federal level. Study results reveal one part of a vast network of socially enabled alternative tobacco industry actors and constituents that use Facebook as a mobilization point to support goals of the alternative tobacco industry. ",
doi="10.2196/28069",
url="https://www.jmir.org/2021/10/e28069",
url="http://www.ncbi.nlm.nih.gov/pubmed/34714245"
}


@Article{info:doi/10.2196/30449,
author="Baker, Venetia
and Arnold, Georgia
and Piot, Sara
and Thwala, Lesedi
and Glynn, Judith
and Hargreaves, James
and Birdthistle, Isolde",
title="Young Adults' Responses to an African and US-Based COVID-19 Edutainment Miniseries: Real-Time Qualitative Analysis of Online Social Media Engagement",
journal="JMIR Form Res",
year="2021",
month="Oct",
day="29",
volume="5",
number="10",
pages="e30449",
keywords="COVID-19",
keywords="adolescents",
keywords="young people",
keywords="social media",
keywords="edutainment",
abstract="Background: In April 2020, as cases of the novel COVID-19 spread across the globe, MTV Staying Alive Foundation created the educational entertainment miniseries MTV Shuga: Alone Together. In 70 short episodes released daily on YouTube, Alone Together aimed to disseminate timely and accurate information to increase young people's knowledge, motivation, and actions to prevent COVID-19. Objective: We sought to identify Alone Together viewer's perspectives on the global COVID-19 pandemic and national lockdowns by examining the words, conversations, experiences, and emotions expressed on social media in response to the Alone Together episodes. We also assessed how viewers used the series and its online community as a source of support during the global pandemic. Methods: A total of 3982 comments and 70 live chat conversations were extracted from YouTube between April and October 2020 and analyzed through a data-led inductive thematic approach. Aggregated demographic and geographical data were collected using YouTube Analytics. Results: The miniseries had a global reach across 5 continents, with a total of 7.7 million views across MTV Shuga platforms. The series had over 1 million views over 70 episodes on YouTube and an average of 5683 unique viewers per episode on YouTube. The dominant audience was adults under the age of 35 years and women. Across diverse countries such as Nigeria, Ghana, the United States, and the UK, viewers believed that COVID-19 was serious and expressed that it was socially responsible to follow public health measures. Storylines of the series about the impact of self-isolation on mental health, exposure to violence in lockdowns, and restricted employment opportunities due to the pandemic resonated with young viewers. Tuning in to the miniseries provided viewers with reliable information, entertainment, and an online community during an isolating, confusing, and worrying time. Conclusions: During the first wave of COVID-19, viewers from at least 53 countries connected on social media via the MTV miniseries. The analysis showed how digitally connected people under the age of 35 years, predominantly women, felt compelled to follow COVID-19 safety measures despite the pandemic's impact on their social, educational, and financial needs. Viewers used social media to reach out to fellow viewers for advice, solace, support, and resources. Organizations, governments, and individuals have been forced to innovate during the pandemic to ensure people can access services safely and remotely. This analysis showed that women under 35 years of age were especially receptive to receiving support from online communities and media services. Peer influence and support online can be a powerful public health tool as people have a great capacity to influence each other and shape norms around public health. However, online services are not accessible to everyone, and COVID-19 has increased disparities between digitally connected and unconnected younger adults. ",
doi="10.2196/30449",
url="https://formative.jmir.org/2021/10/e30449",
url="http://www.ncbi.nlm.nih.gov/pubmed/34596568"
}


@Article{info:doi/10.2196/28508,
author="Li, Shangcao
and Zhang, Jing
and Mao, Xiang
and Lu, Tianyi
and Gao, Yangyang
and Zhang, Wenran
and Wang, Hongyi
and Chu, Zhenxing
and Hu, Qinghai
and Jiang, Yongjun
and Geng, Wenqing
and Shang, Hong
and Xu, Junjie",
title="Feasibility of Indirect Secondary Distribution of HIV Self-test Kits via WeChat Among Men Who Have Sex With Men: National Cross-sectional Study in China",
journal="J Med Internet Res",
year="2021",
month="Oct",
day="26",
volume="23",
number="10",
pages="e28508",
keywords="secondary distribution",
keywords="HIV",
keywords="men who have sex with men",
keywords="WeChat",
keywords="HIV self-testing",
abstract="Background: HIV self-testing (HIVST) kits are common in key sexually active populations. Direct secondary distribution of HIVST kits (DSDHK) is effective in improving the uptake of HIVST. However, there are concerns about the various limitations of DSDHK, including limited geographic reach, payment problems, and need for face-to-face interactions. Objective: In this study, we aim to evaluate the feasibility and characteristics of indirect secondary distribution of HIVST kits (ISDHK) via WeChat (distributing HIVST application links and follow-up HIVST kits to partners) among men who have sex with men (MSM). Methods: From October 2017 to September 2019, an HIVST recruitment advertisement was disseminated on the WeChat social media platform to invite MSM to apply for the HIVST kits (referred to as index participants [IPs]). All MSM participants were encouraged to distribute the HIVST application link to their friends and sexual partners (referred to as alters) through their social networks. All the alters were further encouraged to continue distributing the HIVST application link. All participants paid a deposit (US \$7), which was refundable upon completion of the questionnaire, and uploaded the test results via a web-based survey system. Results: A total of 2263 MSM met the criteria and successfully applied for HIVST. Of these, 1816 participants returned their HIVST results, including 1422 (88.3\%) IPs and 394 (21.7\%) alters. More alters had condomless anal intercourse, a higher proportion of them had never previously tested for HIV, and they showed a greater willingness to distribute HIVST kits to their sexual partners (P=.002) than the IPs. After controlling for age, education, and income, the alters had a greater proportion of MSM who had never tested for HIV before (adjusted odds ratio [aOR] 1.29, 95\% CI 1.00-1.68), were more willing to distribute the HIVST application link (aOR 1.71, 95\% CI 1.21-2.40), had a lower number of sexual partners (aOR 0.71, 95\% CI 0.57-0.90), and were less likely to search for sexual partners on the web (aOR 0.78, 95\% CI 0.60-1.02) than IPs. In comparison, the rates of reactive HIVST results, conducting HIV confirmatory tests, HIV seropositivity, and initiation of HIV antiretroviral therapy were similar for IPs and alters. Conclusions: The ISDHK model of distributing HIVST application links among the MSM population via social media is feasible. The ISDHK model should be used to supplement the DSDHK model to enable a greater proportion of the MSM population to know their HIV infection status. ",
doi="10.2196/28508",
url="https://www.jmir.org/2021/10/e28508",
url="http://www.ncbi.nlm.nih.gov/pubmed/34698651"
}


@Article{info:doi/10.2196/30681,
author="Basch, H. Corey
and Fera, Joseph
and Pellicane, Alessia
and Basch, E. Charles",
title="Videos With the Hashtag \#vaping on TikTok and Implications for Informed Decision-making by Adolescents: Descriptive Study",
journal="JMIR Pediatr Parent",
year="2021",
month="Oct",
day="25",
volume="4",
number="4",
pages="e30681",
keywords="vaping",
keywords="TikTok",
keywords="social media",
keywords="misinformation",
keywords="decision-making",
keywords="adolescents",
keywords="young adults",
keywords="e-cigarettes",
keywords="public health",
keywords="informed decision-making",
abstract="Background: Despite the public health importance of vaping and the widespread use of TikTok by adolescents and young adults, research is lacking on the nature and scope of vaping content on this networking service. Objective: The purpose of this study is to describe the content of TikTok videos related to vaping. Methods: By searching the hashtag \#vaping in the discover feature, {\textasciitilde}478.4 million views were seen during the time of data collection. The first 100 relevant videos under that hashtag were used in this study. Relevance was determined by simply noting if the video was related in any way to vaping. Coding consisted of several categories directly related to vaping and additional categories, including the number of likes, comments, and views, and if the video involved music, humor, or dance. Results: The 100 videos included in the sample garnered 156,331,347 views; 20,335,800 likes; and 296,460 comments. The majority of the videos (n=59) used music and over one-third (n=37) used humor. The only content category observed in the majority of the videos sampled was the promotion of vaping, which was included in 57 videos that garnered over 74 million views (47.5\% of cumulative views). A total of 42\% (n=42) of the 100 videos sampled featured someone vaping or in the presence of vape pens, and these videos garnered over 22\% (>35 million) of the total views. Conclusions: It is necessary for public health agencies to improve understanding of the nature and content of videos that attract viewers' attention and harness the strength of this communication channel to promote informed decision-making about vaping. ",
doi="10.2196/30681",
url="https://pediatrics.jmir.org/2021/4/e30681",
url="http://www.ncbi.nlm.nih.gov/pubmed/34694231"
}


@Article{info:doi/10.2196/28303,
author="Struik, Laura
and Yang, Youjin",
title="e-Cigarette Cessation: Content Analysis of a Quit Vaping Community on Reddit",
journal="J Med Internet Res",
year="2021",
month="Oct",
day="25",
volume="23",
number="10",
pages="e28303",
keywords="qualitative research",
keywords="electronic nicotine delivery systems",
keywords="vaping",
keywords="cessation",
keywords="social media",
abstract="Background: e-Cigarette use, also known as vaping, has increased dramatically over the past few years, especially among younger demographics. However, researchers have found that a large number of e-cigarette users want to quit. Little is known about the unique aspects of vaping cessation, which is critical to informing the development of relevant resources and interventions for e-cigarette users who want to quit. Social media forums such as Reddit provide opportunities to understand the experiences of behavior change such as quitting vaping from the perspective of end users. Objective: This study aims to examine a quit vaping subreddit to understand how e-cigarette users are experiencing and approaching vaping cessation. Specifically, we examine methods used to approach quitting, reasons for quitting, and barriers and facilitators to quitting. Methods: A total of 1228 posts were collected. The posts were inductively coded to generate categories and subcategories using conventional content analysis. Data were analyzed using the NVivo 12 qualitative data analysis software. Results: Most users reported a preference for approaching quitting through gradual reduction, particularly through the use of their own devices by tapering the nicotine content. Their reasons for quitting were primarily related to experiencing negative physical consequences associated with vaping, especially in relation to their lungs (eg, tight chest), and tired of feeling stuck to the vape because of nicotine addiction. Top barriers to quitting were related to withdrawal symptoms and intensity of addiction. The top facilitators to quitting were related to using distraction techniques (eg, hobby, gaming, and mindfulness exercises), as well as having a positive mindset. Conclusions: The findings of this study reveal unique aspects that encompass the process of quitting vaping. These findings have significant implications for both policy and intervention development. ",
doi="10.2196/28303",
url="https://www.jmir.org/2021/10/e28303",
url="http://www.ncbi.nlm.nih.gov/pubmed/34694229"
}


@Article{info:doi/10.2196/27714,
author="Lavertu, Adam
and Hamamsy, Tymor
and Altman, B. Russ",
title="Quantifying the Severity of Adverse Drug Reactions Using Social Media: Network Analysis",
journal="J Med Internet Res",
year="2021",
month="Oct",
day="21",
volume="23",
number="10",
pages="e27714",
keywords="social media for health",
keywords="pharmacovigilance",
keywords="adverse drug reactions",
keywords="machine learning",
keywords="network analysis",
keywords="word embeddings",
keywords="drug safety",
keywords="social media",
abstract="Background: Adverse drug reactions (ADRs) affect the health of hundreds of thousands of individuals annually in the United States, with associated costs of hundreds of billions of dollars. The monitoring and analysis of the severity of ADRs is limited by the current qualitative and categorical systems of severity classification. Previous efforts have generated quantitative estimates for a subset of ADRs but were limited in scope because of the time and costs associated with the efforts. Objective: The aim of this study is to increase the number of ADRs for which there are quantitative severity estimates while improving the quality of these severity estimates. Methods: We present a semisupervised approach that estimates ADR severity by using social media word embeddings to construct a lexical network of ADRs and perform label propagation. We used this method to estimate the severity of 28,113 ADRs, representing 12,198 unique ADR concepts from the Medical Dictionary for Regulatory Activities. Results: Our Severity of Adverse Events Derived from Reddit (SAEDR) scores have good correlations with real-world outcomes. The SAEDR scores had Spearman correlations of 0.595, 0.633, and ?0.748 for death, serious outcome, and no outcome, respectively, with ADR case outcomes in the Food and Drug Administration Adverse Event Reporting System. We investigated different methods for defining initial seed term sets and evaluated their impact on the severity estimates. We analyzed severity distributions for ADRs based on their appearance in boxed warning drug label sections, as well as for ADRs with sex-specific associations. We found that ADRs discovered in the postmarketing period had significantly greater severity than those discovered during the clinical trial (P<.001). We created quantitative drug-risk profile (DRIP) scores for 968 drugs that had a Spearman correlation of 0.377 with drugs ranked by the Food and Drug Administration Adverse Event Reporting System cases resulting in death, where the given drug was the primary suspect. Conclusions: Our SAEDR and DRIP scores are well correlated with the real-world outcomes of the entities they represent and have demonstrated utility in pharmacovigilance research. We make the SAEDR scores for 12,198 ADRs and the DRIP scores for 968 drugs publicly available to enable more quantitative analysis of pharmacovigilance data. ",
doi="10.2196/27714",
url="https://www.jmir.org/2021/10/e27714",
url="http://www.ncbi.nlm.nih.gov/pubmed/34673524"
}


@Article{info:doi/10.2196/19789,
author="Taylor, Overby Casey
and Flaks-Manov, Natalie
and Ramesh, Shankar
and Choe, Kyoung Eun",
title="Willingness to Share Wearable Device Data for Research Among Mechanical Turk Workers: Web-Based Survey Study",
journal="J Med Internet Res",
year="2021",
month="Oct",
day="21",
volume="23",
number="10",
pages="e19789",
keywords="wearables",
keywords="personal data",
keywords="research participation",
keywords="crowdsourcing",
abstract="Background: Wearable devices that are used for observational research and clinical trials hold promise for collecting data from study participants in a convenient, scalable way that is more likely to reach a broad and diverse population than traditional research approaches.?Amazon Mechanical Turk (MTurk) is a potential resource that researchers can use to recruit individuals into studies that use data from wearable devices. Objective: This study aimed to explore the characteristics of wearable device users on MTurk that are associated with a willingness to share wearable device data for research. We also aimed to determine whether compensation was a factor that influenced the willingness to share such data. Methods: This was a secondary analysis of a cross-sectional survey study of MTurk workers who use wearable devices for health monitoring. A 19-question web-based survey was administered from March 1 to April 5, 2018, to participants aged ?18 years by using the MTurk platform. In order to identify characteristics that were associated with a willingness to share wearable device data, we performed logistic regression and decision tree analyses. Results: ?A total of 935 MTurk workers who use wearable devices completed the survey. The majority of respondents indicated a willingness to share their wearable device data (615/935, 65.8\%), and the majority of these respondents were willing to share their data if they received compensation (518/615, 84.2\%). The findings from our logistic regression analyses indicated that Indian nationality (odds ratio [OR] 2.74, 95\% CI 1.48-4.01, P=.007), higher annual income (OR 2.46, 95\% CI 1.26-3.67, P=.02), over 6 months of using a wearable device (OR 1.75, 95\% CI 1.21-2.29, P=.006), and the use of heartbeat and pulse tracking monitoring devices (OR 1.60, 95\% CI 0.14-2.07, P=.01) are significant parameters that influence the willingness to share data. The only factor associated with a willingness to share data if compensation is provided was Indian nationality (OR 0.47, 95\% CI 0.24-0.9, P=.02). The findings from our decision tree analyses indicated that the three leading parameters associated with a willingness to share data were the duration of wearable device use, nationality, and income. Conclusions: Most wearable device users indicated a willingness to share their data for research use (with or without compensation; 615/935, 65.8\%). The probability of having a willingness to share these data was higher among individuals who had used a wearable for more than 6 months, were of Indian nationality, or were of American (United States of America) nationality and had an annual income of more than US \$20,000. Individuals of Indian nationality who were willing to share their data expected compensation significantly less often than individuals of American nationality (P=.02). ",
doi="10.2196/19789",
url="https://www.jmir.org/2021/10/e19789",
url="http://www.ncbi.nlm.nih.gov/pubmed/34673528"
}


@Article{info:doi/10.2196/31125,
author="Huang, Xiaojie
and Yu, Maohe
and Fu, Gengfeng
and Lan, Guanghua
and Li, Linghua
and Yang, Jianzhou
and Qiao, Ying
and Zhao, Jin
and Qian, Han-Zhu
and Zhang, Xiangjun
and Liu, Xinchao
and Jin, Xia
and Chen, Guohong
and Jiang, Hui
and Tang, Weiming
and Wang, Zixin
and Xu, Junjie",
title="Willingness to Receive COVID-19 Vaccination Among People Living With HIV and AIDS in China: Nationwide Cross-sectional Online Survey",
journal="JMIR Public Health Surveill",
year="2021",
month="Oct",
day="21",
volume="7",
number="10",
pages="e31125",
keywords="people living with HIV and AIDS",
keywords="COVID-19 vaccination",
keywords="willingness",
keywords="perceptions",
keywords="internet and social media influences",
keywords="interpersonal communication",
abstract="Background: HIV infection is a significant independent risk factor for both severe COVID-19 presentation at hospital admission and in-hospital mortality. Available information has suggested that people living with HIV and AIDS (PLWHA) could benefit from COVID-19 vaccination. However, there is a dearth of evidence on willingness to receive COVID-19 vaccination among PLWHA. Objective: The aim of this study was to investigate willingness to receive COVID-19 vaccination among a national sample of PLWHA in China. Methods: This cross-sectional online survey investigated factors associated with willingness to receive COVID-19 vaccination among PLWHA aged 18 to 65 years living in eight conveniently selected Chinese metropolitan cities between January and February 2021. Eight community-based organizations (CBOs) providing services to PLWHA facilitated the recruitment. Eligible PLWHA completed an online survey developed using a widely used encrypted web-based survey platform in China. We fitted a single logistic regression model to obtain adjusted odds ratios (aORs), which involved one of the independent variables of interest and all significant background variables. Path analysis was also used in the data analysis. Results: Out of 10,845 PLWHA approached by the CBOs, 2740 completed the survey, and 170 had received at least one dose of the COVID-19 vaccine. This analysis was performed among 2570 participants who had never received COVID-19 vaccination. Over half of the participants reported willingness to receive COVID-19 vaccination (1470/2570, 57.2\%). Perceptions related to COVID-19 vaccination were significantly associated with willingness to receive COVID-19 vaccination, including positive attitudes (aOR 1.11, 95\% CI 1.09-1.12; P<.001), negative attitudes (aOR 0.96, 95\% CI 0.94-0.97; P<.001), perceived support from significant others (perceived subjective norm; aOR 1.53, 95\% CI 1.46-1.61; P<.001), and perceived behavioral control (aOR 1.13, 95\% CI 1.11-1.14; P<.001). At the interpersonal level, receiving advice supportive of COVID-19 vaccination from doctors (aOR 1.99, 95\% CI 1.65-2.40; P<.001), CBO staff (aOR 1.89, 95\% CI 1.51-2.36; P<.001), friends and/or family members (aOR 3.22, 95\% CI 1.93-5.35; P<.001), and PLWHA peers (aOR 2.38, 95\% CI 1.85-3.08; P<.001) was associated with higher willingness to receive COVID-19 vaccination. The overall opinion supporting COVID-19 vaccination for PLWHA on the internet or social media was also positively associated with willingness to receive COVID-19 vaccination (aOR 1.59, 95\% CI 1.31-1.94; P<.001). Path analysis indicated that interpersonal-level variables were indirectly associated with willingness to receive COVID-19 vaccination through perceptions ($\beta$=.43, 95\% CI .37-.51; P<.001). Conclusions: As compared to PLWHA in other countries and the general population in most parts of the world, PLWHA in China reported a relatively low willingness to receive COVID-19 vaccination. The internet and social media as well as interpersonal communications may be major sources of influence on PLWHA's perceptions and willingness to receive COVID-19 vaccination. ",
doi="10.2196/31125",
url="https://publichealth.jmir.org/2021/10/e31125",
url="http://www.ncbi.nlm.nih.gov/pubmed/34543223"
}


@Article{info:doi/10.2196/30311,
author="Lustig, Andrew
and Brookes, Gavin
and Hunt, Daniel",
title="Social Semiotics of Gangstalking Evidence Videos on YouTube: Multimodal Discourse Analysis of a Novel Persecutory Belief System",
journal="JMIR Ment Health",
year="2021",
month="Oct",
day="21",
volume="8",
number="10",
pages="e30311",
keywords="internet",
keywords="discourse analysis",
keywords="psychosis",
keywords="delusion",
keywords="semiotics",
keywords="linguistics",
keywords="computer-mediated communication",
keywords="schizophrenia",
keywords="eHealth",
keywords="video",
keywords="communication",
keywords="YouTube",
keywords="social media",
keywords="discourse",
keywords="mental health",
abstract="Background: Gangstalking refers to a novel persecutory belief system wherein sufferers believe that they are being followed, watched, and harassed by a vast network of people in their community who have been recruited as complicit perpetrators. They are frequently diagnosed as mentally ill, although they reject this formulation. Those affected by this belief system self-identify as targeted individuals (TIs). They seek to prove the veracity of their persecution and dispute the notion that they are mentally ill by posting videos online that purport to provide evidence of their claims. Objective: The objective of the study was to characterize the multimodal social semiotic practices used in gangstalking evidence videos. Methods: We assembled a group of 50 evidence videos posted on YouTube by self-identified TIs and performed a multimodal social semiotic discourse analysis using a grounded theory approach to data analysis. Results: TIs accomplished several social and interpersonal tasks in the videos. They constructed their own identity as subjects of persecution and refuted the notion that they suffered from mental illness. They also cultivated positive ambient affiliation with viewers of the videos but manifested hostility toward people who appeared in the videos. They made extensive use of multimodal deixis to generate salience and construe the gangstalking belief system. The act of filming itself was a source of conflict and served as a self-fulfilling prophecy; filming was undertaken to neutrally record hostility directed toward video bloggers (vloggers). However, the act of filming precipitated the very behaviors that they set out to document. Finally, the act of filming was also regarded as an act of resistance and empowerment by vloggers. Conclusions: These data provide insight into a novel persecutory belief system. Interpersonal concerns are important for people affected, and they construe others as either sympathetic or hostile. They create positive ambient affiliation with viewers. We found that vloggers use multimodal deixis to illustrate the salience of the belief system. The videos highlighted the Derridean concept of diff{\'e}rance, wherein the meaning of polysemous signifiers is deferred without definitive resolution. This may be important in communicating with people and patients with persecutory belief systems. Clinicians may consider stepping away from the traditional true/false dichotomy endorsed by psychiatric classification systems and focus on the ambiguity in semiotic systems generally and in persecutory belief systems specifically. ",
doi="10.2196/30311",
url="https://mental.jmir.org/2021/10/e30311",
url="http://www.ncbi.nlm.nih.gov/pubmed/34673523"
}


@Article{info:doi/10.2196/29809,
author="Clavier, Thomas
and Occhiali, Emilie
and Demailly, Zo{\'e}
and Comp{\`e}re, Vincent
and Veber, Benoit
and Selim, Jean
and Besnier, Emmanuel",
title="The Association Between Professional Accounts on Social Networks Twitter and ResearchGate and the Number of Scientific Publications and Citations Among Anesthesia Researchers: Observational Study",
journal="J Med Internet Res",
year="2021",
month="Oct",
day="15",
volume="23",
number="10",
pages="e29809",
keywords="social network",
keywords="anesthesia",
keywords="publication",
keywords="Twitter",
keywords="ResearchGate",
keywords="citation",
keywords="social media",
keywords="academic",
keywords="researcher",
keywords="bibliometrics",
keywords="research output",
abstract="Background: Social networks are now essential tools for promoting research and researchers. However, there is no study investigating the link between presence or not on professional social networks and scientific publication or citation for a given researcher. Objective: The objective of this study was to study the link between professional presence on social networks and scientific publications/citations among anesthesia researchers. Methods: We included all the French full professors and associate professors of anesthesia. We analyzed their presence on the social networks Twitter (professional account with ?1 tweet over the 6 previous months) and ResearchGate. We extracted their bibliometric parameters for the 2016-2020 period via the Web of Science Core Collection (Clarivate Analytics) database in the Science Citation Index-Expanded index. Results: A total of 162 researchers were analyzed; 42 (25.9\%) had an active Twitter account and 110 (67.9\%) a ResearchGate account. There was no difference between associate professors and full professors regarding active presence on Twitter (8/23 [35\%] vs. 34/139 [24.5\%], respectively; P=.31) or ResearchGate (15/23 [65\%] vs. 95/139 [68.3\%], respectively; P=.81). Researchers with an active Twitter account (median [IQR]) had more scientific publications (45 [28-61] vs. 26 [12-41]; P<.001), a higher h-index (12 [8-16] vs. 8 [5-11]; P<.001), a higher number of citations per publication (12.54 [9.65-21.8] vs. 10.63 [5.67-16.10]; P=.01), and a higher number of citations (563 [321-896] vs. 263 [105-484]; P<.001). Researchers with a ResearchGate account (median [IQR]) had more scientific publications (33 [17-47] vs. 26 [9-43]; P=.03) and a higher h-index (9 [6-13] vs. 8 [3-11]; P=.03). There was no difference between researchers with a ResearchGate account and those without it concerning the number of citations per publication and overall number of citations. In multivariate analysis including sex, academic status, and presence on social networks, the presence on Twitter was associated with the number of publications ($\beta$=20.2; P<.001), the number of citations ($\beta$=494.5; P<.001), and the h-index ($\beta$=4.5; P<.001). Conclusions: Among French anesthesia researchers, an active presence on Twitter is associated with higher scientific publication and citations. ",
doi="10.2196/29809",
url="https://www.jmir.org/2021/10/e29809",
url="http://www.ncbi.nlm.nih.gov/pubmed/34652279"
}


@Article{info:doi/10.2196/28923,
author="Reuter, Katja
and Liu, Chang
and Le, NamQuyen
and Angyan, Praveen
and Finley, M. James",
title="General Practice and Digital Methods to Recruit Stroke Survivors to a Clinical Mobility Study: Comparative Analysis",
journal="J Med Internet Res",
year="2021",
month="Oct",
day="13",
volume="23",
number="10",
pages="e28923",
keywords="clinical trial",
keywords="stroke",
keywords="falls",
keywords="digital media",
keywords="social media",
keywords="advertising",
keywords="participant recruitment",
keywords="Facebook",
keywords="Google",
keywords="clinical research",
keywords="research methods",
keywords="recruitment practices",
keywords="enrollment",
abstract="Background: Participant recruitment remains a barrier to conducting clinical research. The disabling nature of a stroke, which often includes functional and cognitive impairments, and the acute stage of illness at which patients are appropriate for many trials make recruiting patients particularly complex and challenging. In addition, people aged 65 years and older, which includes most stroke survivors, have been identified as a group that is difficult to reach and is commonly underrepresented in health research, particularly clinical trials. Digital media may provide effective tools to support enrollment efforts of stroke survivors in clinical trials. Objective: The objective of this study was to compare the effectiveness of general practice (traditional) and digital (online) methods of recruiting stroke survivors to a clinical mobility study. Methods: Recruitment for a clinical mobility study began in July 2018. Eligible study participants included individuals 18 years and older who had a single stroke and were currently ambulatory in the community. General recruiting practice included calling individuals listed in a stroke registry, contacting local physical therapists, and placing study flyers throughout a university campus. Between May 21, 2019, and June 26, 2019, the study was also promoted digitally using the social network Facebook and the search engine marketing tool Google AdWords. The recruitment advertisements (ads) included a link to the study page to which users who clicked were referred. Primary outcomes of interest for both general practice and digital methods included recruitment speed (enrollment rate) and sample characteristics. The data were analyzed using the Lilliefors test, the Welch two-sample t test, and the Mann-Whitney test. Significance was set at P=.05. All statistical analyses were performed in MATLAB 2019b. Results: Our results indicate that digital recruitment methods can address recruitment challenges regarding stroke survivors. Digital recruitment methods allowed us to enroll study participants at a faster rate (1.8 participants/week) compared to using general practice methods (0.57 participants/week). Our findings also demonstrate that digital and general recruitment practices can achieve an equivalent level of sample representativeness. The characteristics of the enrolled stroke survivors did not differ significantly by age (P=.95) or clinical scores (P=.22; P=.82). Comparing the cost-effectiveness of Facebook and Google, we found that the use of Facebook resulted in a lower cost per click and cost per enrollee per ad. Conclusions: Digital recruitment can be used to expedite participant recruitment of stroke survivors compared to more traditional recruitment practices, while also achieving equivalent sample representativeness. Both general practice and digital recruitment methods will be important to the successful recruitment of stroke survivors. Future studies could focus on testing the effectiveness of additional general practice and digital media approaches and include robust cost-effectiveness analyses. Examining the effectiveness of different messaging and visual approaches tailored to culturally diverse and underrepresented target subgroups could provide further data to move toward evidence-based recruitment strategies. ",
doi="10.2196/28923",
url="https://www.jmir.org/2021/10/e28923",
url="http://www.ncbi.nlm.nih.gov/pubmed/34643544"
}


@Article{info:doi/10.2196/29406,
author="Hu, Dian
and Liu, Meng-Hsin Cindy
and Hamdy, Rana
and Cziner, Michael
and Fung, Melody
and Dobbs, Samuel
and Rogers, Laura
and Turner, Mitchell Monique
and Broniatowski, Andr{\'e} David",
title="Questioning the Yelp Effect: Mixed Methods Analysis of Web-Based Reviews of Urgent Cares",
journal="J Med Internet Res",
year="2021",
month="Oct",
day="8",
volume="23",
number="10",
pages="e29406",
keywords="urgent care",
keywords="doctor-patient communication",
keywords="doctor web-based review",
keywords="review websites",
abstract="Background: Providers of on-demand care, such as those in urgent care centers, may prescribe antibiotics unnecessarily because they fear receiving negative reviews on web-based platforms from unsatisfied patients---the so-called Yelp effect. This effect is hypothesized to be a significant driver of inappropriate antibiotic prescribing, which exacerbates antibiotic resistance. Objective: In this study, we aimed to determine the frequency with which patients left negative reviews on web-based platforms after they expected to receive antibiotics in an urgent care setting but did not. Methods: We obtained a list of 8662 urgent care facilities from the Yelp application programming interface. By using this list, we automatically collected 481,825 web-based reviews from Google Maps between January 21 and February 10, 2019. We used machine learning algorithms to summarize the contents of these reviews. Additionally, 200 randomly sampled reviews were analyzed by 4 annotators to verify the types of messages present and whether they were consistent with the Yelp effect. Results: We collected 481,825 reviews, of which 1696 (95\% CI 1240-2152) exhibited the Yelp effect. Negative reviews primarily identified operations issues regarding wait times, rude staff, billing, and communication. Conclusions: Urgent care patients rarely express expectations for antibiotics in negative web-based reviews. Thus, our findings do not support an association between a lack of antibiotic prescriptions and negative web-based reviews. Rather, patients' dissatisfaction with urgent care was most strongly linked to operations issues that were not related to the clinical management plan. ",
doi="10.2196/29406",
url="https://www.jmir.org/2021/10/e29406",
url="http://www.ncbi.nlm.nih.gov/pubmed/34623316"
}


@Article{info:doi/10.2196/23312,
author="Flood-Grady, Elizabeth
and Solberg, B. Lauren
and Baralt, Claire
and Meyer, Meghan
and Stevens, Jeff
and Krieger, L. Janice",
title="Engaging Institutional Stakeholders to Develop and Implement Guidelines for Recruiting Participants in Research Studies Using Social Media: Mixed Methods, Multi-Phase Process",
journal="J Med Internet Res",
year="2021",
month="Oct",
day="8",
volume="23",
number="10",
pages="e23312",
keywords="social media",
keywords="research recruitment",
keywords="stakeholder engagement",
keywords="health communication",
abstract="Background: Limited regulatory guidance surrounding the use of social media channels for participant recruitment is an interdisciplinary challenge. Establishing stakeholder-informed procedures is essential for ethical and effective use of social media for participant recruitment. Objective: This study aims to provide replicable procedures for developing and implementing guidelines for using social media to recruit participants in research studies. Methods: Social media use cases at the university were used to identify institutional stakeholders for the initiative. After establishing workflow procedures, a scoping review of web-based materials about recruitment and research on the internet and social media from 19 peer institutions and 2 federal agencies was conducted to inform the structure of the policies and procedures. End users (investigators and study coordinators; N=14) also provided feedback on the policies and procedures and implementation. Results: Representatives (n=7) from 5 institutional offices and 15 subject-matter experts from 5 areas were identified as stakeholders in the development of policies and procedures. Peers with web-based materials (n=16) identified in the scoping review revealed 4 themes that served as a basis for developing our policies and procedures. End user feedback further informed the policies and procedures and implementation. A centrally managed social media account for communicating with participants and hosting advertising campaigns on social media was also established and, when combined with the policies and procedures, resulted in 39 advertising campaigns, and 2846 participants were enrolled in health and clinical research studies. Conclusions: Our policies and procedures allow research teams to harness the potential of social media to increase study recruitment and participation; the transparent, stakeholder-informed process can be replicated by institutional administrators to establish policies and procedures that meet the interests and needs of their research community. ",
doi="10.2196/23312",
url="https://www.jmir.org/2021/10/e23312",
url="http://www.ncbi.nlm.nih.gov/pubmed/34623319"
}


@Article{info:doi/10.2196/27153,
author="Feldhege, Johannes
and Moessner, Markus
and Bauer, Stephanie",
title="Detrimental Effects of Online Pro--Eating Disorder Communities on Weight Loss and Desired Weight: Longitudinal Observational Study",
journal="J Med Internet Res",
year="2021",
month="Oct",
day="6",
volume="23",
number="10",
pages="e27153",
keywords="pro-eating disorder communities",
keywords="weight loss",
keywords="body weight",
keywords="social media",
keywords="linear growth models",
keywords="eating disorders",
keywords="pro-ED",
keywords="Reddit",
abstract="Background: Online pro--eating disorder (pro-ED) communities are considered harmful because of their detrimental effects on their users' body dissatisfaction, dieting, and help seeking. To date, it is unknown to which extent participation in pro-ED communities affects users' body weight and desired weight loss. Objective: This study aims to investigate the changes in the current and desired body weight of users of a pro-ED community (r/proed) on the social media website Reddit over time. Methods: Data on 1170 users and the unsolicited weight information they shared with the pro-ED community were collected over a period of 15 months. Linear growth models were used to model changes in the users' current and desired BMI over time. Results: Both current and desired BMI decreased over time, with a predicted rate of 0.087 and 0.015 BMI points per week, respectively. Weight loss was moderated by the users' activity level in the community, with more active users losing more weight. Users with a higher baseline BMI experienced greater weight loss, but even users with a very low baseline weight (BMI <17 kg/m2) lost weight during their participation. In addition, users decreased their desired weight over time, with many pursuing extremely low, unrealistic weight goals. Changes in the desired weight were moderated by the baseline current BMI and baseline desired BMI. Users with higher desired weight and lower body weight at baseline decreased their desired weight more over time. Conclusions: This is the first study to demonstrate the detrimental effects of pro-ED communities in a longitudinal study based on a large data set of user-generated online data. The results extend the literature detailing the harmful effects of online pro-ED communities by showing users' weight loss, decreases in desired weight, and that higher activity levels lead to greater weight loss. Users could be driven to pursue very low, unrealistic weight loss goals by images of very thin bodies presented in these communities. ",
doi="10.2196/27153",
url="https://www.jmir.org/2021/10/e27153",
url="http://www.ncbi.nlm.nih.gov/pubmed/34612830"
}


@Article{info:doi/10.2196/27417,
author="Tan, SL Andy
and Gazarian, K. Priscilla
and Darwish, Sabreen
and Hanby, Elaine
and Farnham, C. Bethany
and Koroma-Coker, A. Faith
and Potter, Jennifer
and Ballout, Suha",
title="Smoking Protective and Risk Factors Among Transgender and Gender-Expansive Individuals (Project SPRING): Qualitative Study Using Digital Photovoice",
journal="JMIR Public Health Surveill",
year="2021",
month="Oct",
day="6",
volume="7",
number="10",
pages="e27417",
keywords="transgender and gender expansive populations",
keywords="tobacco-related health disparities",
keywords="United States",
abstract="Background: Transgender and gender-expansive (TGE) adults are twice as likely to smoke cigarettes than cisgender individuals. There is a critical gap in research on effective and culturally sensitive approaches to reduce smoking prevalence among TGE adults. Objective: This study aims to qualitatively examine the risk and protective factors of cigarette smoking among TGE adults through real-world exemplars. Methods: We conducted a digital photovoice study among a purposeful sample of 47 TGE adults aged ?18 years and currently smoking in the United States (March 2019-April 2020). Participants uploaded photos daily that depicted smoking risk and protective factors they experienced over 21 days on either private Facebook or Instagram groups. Next, we conducted separate focus group discussions to explore the experiences of these factors among a subset of participants from each group. We analyzed participants' photos, captions, and focus group transcripts and generated themes associated with smoking risk and protective factors. Results: We identified 6 major themes of risk and protective factors of smoking among TGE individuals: experience of stress, gender affirmation, health consciousness, social influences, routine behaviors, and environmental cues. We describe and illustrate each theme using exemplar photos and quotes. Conclusions: The findings of this study will inform future community-engaged research to develop culturally tailored interventions to reduce smoking prevalence among TGE individuals. ",
doi="10.2196/27417",
url="https://publichealth.jmir.org/2021/10/e27417",
url="http://www.ncbi.nlm.nih.gov/pubmed/34612842"
}


@Article{info:doi/10.2196/23465,
author="Kim, Taewan
and Hong, Hwajung",
title="Understanding University Students' Experiences, Perceptions, and Attitudes Toward Peers Displaying Mental Health--Related Problems on Social Networking Sites: Online Survey and Interview Study",
journal="JMIR Ment Health",
year="2021",
month="Oct",
day="5",
volume="8",
number="10",
pages="e23465",
keywords="mental health",
keywords="social media",
keywords="social support",
keywords="peers",
keywords="peer support",
keywords="self-disclosure",
abstract="Background: College students' mental health is at an all-time low. Students are increasingly disclosing their vulnerable, stigmatizing experiences on online social networking sites (SNSs). Peer support facilitated by SNSs can play a crucial role for the students in coping with mental health--related problems. Thus, it is imperative to understand how university students form perceptions, attitudes, and behaviors toward their peers who are dealing with mental health problems. Objective: This study aimed to provide a better understanding of how college students recognize, perceive, and react to signs of mental health problems in their peers on SNSs. Our ultimate goal in this study was to inform the design of SNSs that can facilitate online peer support. Methods: We conducted surveys with 226 students as well as semistructured interviews with 20 students at six universities in South Korea. Results: Of the 226 survey respondents, 150 (66.4\%) reported that they recognized signs of a mental health problem on their friends' SNS posts. However,  a considerable number of respondents (62/150, 41.3\%) were reluctant to offer support, even when they had identified friends who were at risk; this reluctance was due to a lack of knowledge or confidence and their desire to maintain a distance from at-risk peers to save their identity from stigmatization and to avoid emotional contagion online. Conclusions: Drawing on these results, we provide implications that could explain the construction of students' perceptions regarding their peers' mental health problems. We also provide design proposals for SNSs to serve as platforms that facilitate just-in-time and adaptive support exchanges among peers while mitigating stigma-related concerns. ",
doi="10.2196/23465",
url="https://mental.jmir.org/2021/10/e23465",
url="http://www.ncbi.nlm.nih.gov/pubmed/34609315"
}


@Article{info:doi/10.2196/17811,
author="Mayoh, Joanne
and Jones, Ian",
title="Young People's Experiences of Engaging With Fitspiration on Instagram: Gendered Perspective",
journal="J Med Internet Res",
year="2021",
month="Oct",
day="4",
volume="23",
number="10",
pages="e17811",
keywords="social media",
keywords="gender",
keywords="physical fitness",
keywords="women's health",
keywords="men's health",
keywords="body ideals",
abstract="Background: Fitness inspiration or fitspiration is a term used to describe web-based images of fit people, people in the gym, health foods, or inspirational quotes relating to diet and fitness being shared and consumed via visual social media. The popularity of this content is most notable via the Instagram platform. Currently, the majority of fitspiration research has focused on women's experiences; however, increasingly, studies have pointed to the need to explore the gendered ways by which people engage with this content. Objective: The aim of this study is to explore how young men and women engage in fitspiration content on Instagram and provide a gendered analysis of how and why they consume this content. Methods: This study used a cross-sectional web-based survey (N=1213) of UK-based fitspiration users aged 18-24 years consisting of closed-ended questions to capture quantitative data. Results: The majority actively using Instagram for fitspiration (therefore eligible participants) were women (826/1175, 70.30\%). Men were more likely to view content posted by athletes ($\chi$21, N=1153=71.8; P=.001) and bodybuilders ($\chi$21, N=1153=32.8; P<.001), whereas women were more likely to view content related to weight loss ($\chi$21, N=1153=36.8; P<.001), diet plans ($\chi$21, N=1153=11.9; P<.001), and celebrities' content ($\chi$21, N=1153=33.5; P<.001). Men were more likely to use fitspiration as a source of inspiration to exercise to gain muscle or get stronger ($\chi$21, N=1147=17.9; P<.001), whereas women were more likely to use fitspiration as inspiration for healthy eating ($\chi$21, N=1147=37.7; P<.001), or to exercise to diet or lose weight ($\chi$21, N=1147=13.5; P<.001). Women were more likely to engage in passive behaviors such as viewing content on their feed ($\chi$21, N=1139=7.9; P=.005) or scrolling through accounts ($\chi$21, N=1139=15.2; P<.001), whereas men were more likely to engage in active consumption by tagging fitspiration accounts in posts ($\chi$21, N=1139=7.2; P=.007), commenting on posts ($\chi$21, N=1139=8.1; P=.004), and posting fitspiration content ($\chi$21, N=1139=6.4; P=.01). Conclusions: Female fitspiration consumers engaged with content that reinforced the feminine thin but shapely ideal, whereas male users sought out content that reinforced the masculine muscular ideal. Male users were more likely to engage actively with content (eg, posting fitspiration content), while female users were more likely to engage passively (eg, scrolling through accounts, posts, or images). Future research should consider how fitspiration consumption reflects and reproduces oppressive gender ideology. ",
doi="10.2196/17811",
url="https://www.jmir.org/2021/10/e17811",
url="http://www.ncbi.nlm.nih.gov/pubmed/34605768"
}


@Article{info:doi/10.2196/28957,
author="Sharp, J. Kendall
and Vitagliano, A. Julia
and Weitzman, R. Elissa
and Fitzgerald, Susan
and Dahlberg, E. Suzanne
and Austin, Bryn S.",
title="Peer-to-Peer Social Media Communication About Dietary Supplements Used for Weight Loss and Sports Performance Among Military Personnel: Pilot Content Analysis of 11 Years of Posts on Reddit",
journal="JMIR Form Res",
year="2021",
month="Oct",
day="4",
volume="5",
number="10",
pages="e28957",
keywords="dietary supplements",
keywords="social media",
keywords="Reddit",
keywords="OPSS",
abstract="Background: Over 60\% of military personnel in the United States currently use dietary supplements. Two types of dietary supplements, weight loss and sports performance (WLSP) supplements, are commonly used by military personnel despite the associated serious adverse effects such as dehydration and stroke. Objective: To understand peer-to-peer communication about WLSP supplements among military personnel, we conducted a pilot study using the social media website, Reddit. Methods: A total of 64 relevant posts and 243 comments from 2009 to 2019 were collected from 6 military subreddits. The posts were coded for year of posting, subreddit, and content consistent with the following themes: resources about supplement safety and regulation, discernability of supplement use through drug testing, serious adverse effects, brand names or identifiers, and reasons for supplement use. Results: A primary concern posted by personnel who used supplements was uncertainty about the supplements that were not detectable on a drug test. Supplements to improve workout performance were the most frequently used. Conclusions: Our pilot study suggests that military personnel may seek out peer advice about WLSP supplements on Reddit and spread misinformation about the safety and effectiveness of these products through this platform. Future directions for the monitoring of WLSP supplement use in military personnel are discussed. ",
doi="10.2196/28957",
url="https://formative.jmir.org/2021/10/e28957",
url="http://www.ncbi.nlm.nih.gov/pubmed/34605769"
}


@Article{info:doi/10.2196/29025,
author="Usher, Kim
and Durkin, Joanne
and Martin, Sam
and Vanderslott, Samantha
and Vindrola-Padros, Cecilia
and Usher, Luke
and Jackson, Debra",
title="Public Sentiment and Discourse on Domestic Violence During the COVID-19 Pandemic in Australia: Analysis of Social Media Posts",
journal="J Med Internet Res",
year="2021",
month="Oct",
day="1",
volume="23",
number="10",
pages="e29025",
keywords="COVID-19",
keywords="domestic violence",
keywords="social media",
keywords="Twitter",
keywords="sentiment analysis",
keywords="discourse analysis",
keywords="keyword analysis",
keywords="pandemic",
keywords="sentiment",
keywords="public health",
keywords="public expression",
abstract="Background: Measuring public response during COVID-19 is an important way of ensuring the suitability and effectiveness of epidemic response efforts. An analysis of social media provides an approximation of public sentiment during an emergency like the current pandemic. The measures introduced across the globe to help curtail the spread of the coronavirus have led to the development of a situation labeled as a ``perfect storm,'' triggering a wave of domestic violence. As people use social media to communicate their experiences, analyzing public discourse and sentiment on social platforms offers a way to understand concerns and issues related to domestic violence during the COVID-19 pandemic. Objective: This study was based on an analysis of public discourse and sentiment related to domestic violence during the stay-at-home periods of the COVID-19 pandemic in Australia in 2020. It aimed to understand the more personal self-reported experiences, emotions, and reactions toward domestic violence that were not always classified or collected by official public bodies during the pandemic. Methods: We searched social media and news posts in Australia using key terms related to domestic violence and COVID-19 during 2020 via digital analytics tools to determine sentiments related to domestic violence during this period. Results: The study showed that the use of sentiment and discourse analysis to assess social media data is useful in measuring the public expression of feelings and sharing of resources in relation to the otherwise personal experience of domestic violence. There were a total of 63,800 posts across social media and news media. Within these posts, our analysis found that domestic violence was mentioned an average of 179 times a day. There were 30,100 tweets, 31,700 news reports, 1500 blog posts, 548 forum posts, and 7 comments (posted on news and blog websites). Negative or neutral sentiment centered on the sharp rise in domestic violence during different lockdown periods of the 2020 pandemic, and neutral and positive sentiments centered on praise for efforts that raised awareness of domestic violence as well as the positive actions of domestic violence charities and support groups in their campaigns. There were calls for a positive and proactive handling (rather than a mishandling) of the pandemic, and results indicated a high level of public discontent related to the rising rates of domestic violence and the lack of services during the pandemic. Conclusions: This study provided a timely understanding of public sentiment related to domestic violence during the COVID-19 lockdown periods in Australia using social media analysis. Social media represents an important avenue for the dissemination of information; posts can be widely dispersed and easily accessed by a range of different communities who are often difficult to reach. An improved understanding of these issues is important for future policy direction. Heightened awareness of this could help agencies tailor and target messaging to maximize impact. ",
doi="10.2196/29025",
url="https://www.jmir.org/2021/10/e29025",
url="http://www.ncbi.nlm.nih.gov/pubmed/34519659"
}


@Article{info:doi/10.2196/28765,
author="Dysthe, K. Kim
and Haavet, R. Ole
and R{\o}ssberg, I. Jan
and Brandtzaeg, B. Petter
and F{\o}lstad, Asbj{\o}rn
and Klovning, Atle",
title="Finding Relevant Psychoeducation Content for Adolescents Experiencing Symptoms of Depression: Content Analysis of User-Generated Online Texts",
journal="J Med Internet Res",
year="2021",
month="Sep",
day="30",
volume="23",
number="9",
pages="e28765",
keywords="adolescent",
keywords="depression",
keywords="internet",
keywords="education",
keywords="preventive psychiatry",
keywords="early medical intervention",
keywords="self-report",
keywords="psychoeducation",
keywords="information content",
keywords="online",
keywords="digital health",
keywords="e-health",
abstract="Background: Symptoms of depression are frequent in youth and may develop into more severe mood disorders, suggesting interventions should take place during adolescence. However, young people tend not to share mental problems with friends, family, caregivers, or professionals. Many receive misleading information when searching the internet. Among several attempts to create mental health services for adolescents, technological information platforms based on psychoeducation show promising results. Such development rests on established theories and therapeutic models. To fulfill the therapeutic potential of psychoeducation in health technologies, we lack data-driven research on young peoples' demand for information about depression. Objective: Our objective is to gain knowledge about what information is relevant to adolescents with symptoms of depression. From this knowledge, we can develop a population-specific psychoeducation for use in different technology platforms. Methods: We conducted a qualitative, constructivist-oriented content analysis of questions submitted by adolescents aged 16-20 years to an online public information service. A sample of 100 posts containing questions on depression were randomly selected from a total of 870. For analysis, we developed an a priori codebook from the main information topics of existing psychoeducational programs on youth depression. The distribution of topic prevalence in the total volume of posts containing questions on depression was calculated. Results: With a 95\% confidence level and a {\textpm}9.2\% margin of error, the distribution analysis revealed the following categories to be the most prevalent among adolescents seeking advice about depression: self-management (33\%, 61/180), etiology (20\%, 36/180), and therapy (20\%, 36/180). Self-management concerned subcategories on coping in general and how to open to friends, family, and caregivers. The therapy topic concerned therapy options, prognosis, where to seek help, and how to open up to a professional. We also found young people dichotomizing therapy and self-management as opposite entities. The etiology topic concerned stressors and risk factors. The diagnosis category was less frequently referred to (9\%, 17/180). Conclusions: Self-management, etiology, and therapy are the most prevalent categories among adolescents seeking advice about depression. Young people also dichotomize therapy and self-management as opposite entities. Future research should focus on measures to promote self-management, measures to stimulate expectations of self-efficacy, information about etiology, and information about diagnosis to improve self-monitoring skills, enhancing relapse prevention. ",
doi="10.2196/28765",
url="https://www.jmir.org/2021/9/e28765",
url="http://www.ncbi.nlm.nih.gov/pubmed/34591021"
}


@Article{info:doi/10.2196/24005,
author="Spitzer, A. Kerry
and Heineman, Brent
and Jewell, Marcella
and Moran, Michael
and Lindenauer, K. Peter",
title="Evaluation of the Acceptability of a Proposed, Instagram-Based, Randomized Controlled Trial for People With Asthma: Survey Study",
journal="JMIR Form Res",
year="2021",
month="Sep",
day="30",
volume="5",
number="9",
pages="e24005",
keywords="asthma",
keywords="social media",
keywords="Instagram",
keywords="social support",
keywords="digital storytelling",
keywords="young adult",
abstract="Background: Asthma is a chronic lung disease that affects nearly 25 million individuals in the United States. More research is needed into the potential for health care providers to leverage existing social media platforms to improve healthy behaviors and support individuals living with chronic health conditions. Objective: In this study, we assessed the willingness of Instagram users with poorly controlled asthma to participate in a pilot randomized controlled trial that will use Instagram as a means of providing social and informational support. In addition, we explored the potential for adapting the principles of photovoice and digital storytelling to Instagram. Methods: We conducted a survey study of Instagram users aged 18-40 years with poorly controlled asthma in the United States. Results: Over 3 weeks of recruitment, 457 individuals completed the presurvey screener; 347 (75.9\%) were excluded and 110 (24.1\%) were eligible and agreed to participate in the study. Of the 110 individuals, 82 (74.5\%) completed the study survey. The mean age of the respondents was 21 (SD 5.3) years. Among respondents, 56\% (46/82) were female, 65\% (53/82) were non-Hispanic White, and 72\% (59/82) had at least some college education. The majority of respondents (67/82, 82\%) indicated that they would be willing to participate in the proposed study. Conclusions: Among young adult Instagram users with asthma, there is substantial interest in participating in a pilot randomized controlled trial that will use Instagram to connect participants with peers and a health coach to share information about self-management of asthma and build social connection. ",
doi="10.2196/24005",
url="https://formative.jmir.org/2021/9/e24005",
url="http://www.ncbi.nlm.nih.gov/pubmed/34591019"
}


@Article{info:doi/10.2196/29885,
author="Li, Jinhui
and Zheng, Han
and Duan, Xu",
title="Factors Influencing the Popularity of a Health-Related Answer on a Chinese Question-and-Answer Website: Case Study",
journal="J Med Internet Res",
year="2021",
month="Sep",
day="28",
volume="23",
number="9",
pages="e29885",
keywords="answer-response behaviors",
keywords="Zhihu",
keywords="HPV vaccine information",
keywords="content features",
keywords="context features",
keywords="contributor features",
abstract="Background: Social question-and-answer (Q\&A) sites have become an important venue for individuals to obtain and share human papillomavirus (HPV) vaccine knowledge. Objective: This study aims to examine how different features of an HPV vaccine--related answer are associated with users' response behaviors on social Q\&A websites. Methods: A total of 2953 answers and 270 corresponding questions regarding the HPV vaccine were collected from a leading Chinese social Q\&A platform, Zhihu. Three types of key features, including content, context, and contributor, were extracted and coded. Negative binomial regression models were used to examine their impact on the vote and comment count of an HPV vaccine--related answer. Results: The findings showed that both content length and vividness were positively related to the response behaviors of HPV vaccine--related answers. In addition, compared with answers under the question theme benefits and risks, answers under the question theme vaccination experience received fewer votes and answers under the theme news opinions received more votes but fewer comments. The effects of characteristics of contributors were also supported, suggesting that answers from a male contributor with more followers and no professional identity would attract more votes and comments from community members. The significant interaction effect between content and context features further showed that long and vivid answers about HPV vaccination experience were more likely to receive votes and comments of users than those about benefits and risks. Conclusions: The study provides a complete picture of the underlying mechanism behind response behaviors of users toward HPV vaccine--related answers on social Q\&A websites. The results help health community organizers develop better strategies for building and maintaining a vibrant web-based community for communicating HPV vaccine knowledge. ",
doi="10.2196/29885",
url="https://www.jmir.org/2021/9/e29885",
url="http://www.ncbi.nlm.nih.gov/pubmed/34581675"
}


@Article{info:doi/10.2196/28700,
author="Matthes, J{\"o}rg
and Koban, Kevin
and Neureiter, Ariadne
and Stevic, Anja",
title="Longitudinal Relationships Among Fear of COVID-19, Smartphone Online Self-Disclosure, Happiness, and Psychological Well-being: Survey Study",
journal="J Med Internet Res",
year="2021",
month="Sep",
day="27",
volume="23",
number="9",
pages="e28700",
keywords="COVID-19 pandemic",
keywords="fear",
keywords="self-disclosure",
keywords="happiness, well-being",
keywords="panel study",
keywords="smartphones",
keywords="online platform",
keywords="social media",
abstract="Background: Given that governmental prevention measures restricted most face-to-face communications, online self-disclosure via smartphones emerged as an alternative coping strategy that aimed at reducing the impact of the COVID-19 pandemic on people's psychological health. Prepandemic research demonstrated that online self-disclosure benefits people's psychological health by establishing meaningful relationships, obtaining social support, and achieving self-acceptance, particularly in times of crisis. However, it is unclear whether these dynamics transition well to lockdown conditions where online self-disclosure must stand almost entirely on its own. Longitudinal investigations are needed to gain insights into the psychological functionalities of online self-disclosure during the COVID-19 pandemic. Objective: This study aimed to determine the temporal associations between smartphone online self-disclosure (as a communicative behavior) and critical indicators of psychological health (including psychopathological, as well as hedonic and eudaimonic states) during the first COVID-19 lockdown in Austria. Methods: We conducted a representative 2-wave panel survey between late March/April 2020 and May 2020. A total of 416 participants completed both waves (43.1\% attrition rate, given n=731 participants who completed the first wave). A partially metric measurement invariant overtime structural equation model was used to determine the temporal associations among online self-disclosure, fear of COVID-19, happiness, and psychological well-being. Results: The analysis revealed that fear of COVID-19 significantly predicted online self-disclosure over time (b=0.24, P=.003) and happiness over time (b=?0.14, P=.04), but not psychological well-being (b=0.03, P=.48), that is, stronger COVID-19 fears at T1 prompted more online self-disclosure and less happiness at T2. Online self-disclosure, on the other hand, significantly predicted happiness (b=0.09, P=.02), but neither fear of COVID-19 (b=?0.01, P=.57) nor psychological well-being (b=?0.01, P=.57) over time. Participants who engaged more strongly in online self-disclosure at T1 felt happier at T2, but they did not differ from less-disclosing participants concerning COVID-19 fears and psychological well-being at T2. Importantly, happiness and psychological well-being were significantly related over time (happiness T1 {\textrightarrow} psychological well-being T2: b=0.11, P<.001; psychological well-being T1 {\textrightarrow} happiness T2: b=0.42, P<.001). Conclusions: Our findings suggest that online self-disclosure might play a pivotal role in coping with pandemic stressors. With restrictions on their options, individuals increasingly turn to their smartphones and social media to disclose their feelings, problems, and concerns during lockdown. While online self-disclosure might not alleviate fears or improve psychological well-being, our results demonstrate that it made people experience more happiness during this crisis. This psychological resource may help them withstand the severe psychological consequences of the COVID-19 crisis over longer timeframes. ",
doi="10.2196/28700",
url="https://www.jmir.org/2021/9/e28700",
url="http://www.ncbi.nlm.nih.gov/pubmed/34519657"
}


@Article{info:doi/10.2196/22313,
author="An, Jisun
and Kwak, Haewoon
and Qureshi, M. Hanya
and Weber, Ingmar",
title="Precision Public Health Campaign: Delivering Persuasive Messages to Relevant Segments Through Targeted Advertisements on Social Media",
journal="JMIR Form Res",
year="2021",
month="Sep",
day="24",
volume="5",
number="9",
pages="e22313",
keywords="precision public health",
keywords="tailored health communication",
keywords="social media advertising",
keywords="Facebook advertising",
keywords="public health campaigns",
keywords="effectiveness of campaigns",
keywords="public health",
keywords="advertising",
doi="10.2196/22313",
url="https://formative.jmir.org/2021/9/e22313",
url="http://www.ncbi.nlm.nih.gov/pubmed/34559055"
}


@Article{info:doi/10.2196/21316,
author="Li, Ji-Bin
and Feng, Li-Fen
and Wu, S. Anise M.
and Mai, Jin-Chen
and Chen, Yu-Xia
and Mo, H. Phoenix K.
and Lau, F. Joseph T.",
title="Roles of Psychosocial Factors on the Association Between Online Social Networking Use Intensity and Depressive Symptoms Among Adolescents: Prospective Cohort Study",
journal="J Med Internet Res",
year="2021",
month="Sep",
day="21",
volume="23",
number="9",
pages="e21316",
keywords="online social networking use intensity",
keywords="depressive symptoms",
keywords="psychosocial factors",
keywords="mediation and suppression",
keywords="longitudinal study",
abstract="Background: The potential mechanisms underlying the association between online social networking use intensity and depressive symptoms are unclear and underresearched. Objective: We aimed to investigate the potential roles of interpersonal psychosocial factors on the association between online social networking use intensity and depressive symptoms among early adolescents. Methods: A total of 4237 adolescents from a 9-month longitudinal study were included. Score changes (indicated as ?) for the social function use intensity (SFUI) and entertainment function use intensity (EFUI) subscales of the Online Social Networking Activity Intensity Scale and for friendship quality, perceived family support, perceived friend support, parent--adolescent conflict, social nonconfidence, and depressive symptoms were analyzed. The potential mediation effects of unfavorable psychosocial factors and suppression effects of favorable psychosocial factors on the association of ?SFUI with ?CES-D and the association of ?EFUI with ?CES-D were tested using hierarchical regression models. Results: The association between ?SFUI and ?CES-D was partially mediated by ?mother--adolescent conflict (mediation effect size 5.11\%, P=.02) and ?social nonconfidence (mediation effect size 20.97\%, P<.001) but partially suppressed by ?friendship quality, ?perceived family support, and ?perceived friend support, with suppression effects of --0.011 (P=.003), --0.009 (P=.003), and --0.022 (P<.001), respectively. The association between ?EFUI and ?CES-D was partially mediated by ?social nonconfidence (mediation effect size 30.65\%, P<.001) but partially suppressed by ?perceived family support and ?perceived friend support, with suppression effects of --0.036 (P<.001) and --0.039 (P<.001), respectively. Conclusions: The association between online social networking use intensity and depressive symptoms was partially mediated through the indirect increase in social nonconfidence and mother--adolescent conflict; however, better perceived social support and friendship quality would partially compensate for the harmful impact of online social networking use intensity on depressive symptoms among early adolescents. ",
doi="10.2196/21316",
url="https://www.jmir.org/2021/9/e21316",
url="http://www.ncbi.nlm.nih.gov/pubmed/34546173"
}


@Article{info:doi/10.2196/27063,
author="Loeb, Stacy
and Massey, Philip
and Leader, E. Amy
and Thakker, Sameer
and Falge, Emily
and Taneja, Sabina
and Byrne, Nataliya
and Rose, Meredith
and Joy, Matthew
and Walter, Dawn
and Katz, S. Matthew
and Wong, L. Risa
and Selvan, Preethi
and Keith, W. Scott
and Giri, N. Veda",
title="Gaps in Public Awareness About BRCA and Genetic Testing in Prostate Cancer: Social Media Landscape Analysis",
journal="JMIR Cancer",
year="2021",
month="Sep",
day="20",
volume="7",
number="3",
pages="e27063",
keywords="genetic testing",
keywords="BRCA",
keywords="prostate cancer",
keywords="breast cancer",
keywords="social media",
keywords="infodemiology",
abstract="Background: Genetic testing, particularly for BRCA1/2, is increasingly important in prostate cancer (PCa) care, with impact on PCa management and hereditary cancer risk. However, the extent of public awareness and online discourse on social media is unknown, and presents opportunities to identify gaps and enhance population awareness and uptake of advances in PCa precision medicine. Objective: The objective of this study was to characterize activity and engagement across multiple social media platforms (Twitter, Facebook, and YouTube) regarding BRCA and genetic testing for PCa compared with breast cancer, which has a long history of public awareness, advocacy, and prominent social media presence. Methods: The Symplur Signals online analytics platform was used to obtain metrics for tweets about (1) \#BRCA and \#breastcancer, (2) \#BRCA and \#prostatecancer, (3) \#genetictesting and \#breastcancer, and (4) \#genetictesting and \#prostatecancer from 2016 to 2020. We examined the total number of tweets, users, and reach for each hashtag, and performed content analysis for a subset of tweets. Facebook and YouTube were queried using analogous search terms, and engagement metrics were calculated. Results: During a 5-year period, there were 10,005 tweets for \#BRCA and \#breastcancer, versus 1008 tweets about \#BRCA and \#prostatecancer. There were also more tweets about \#genetictesting and \#breastcancer (n=1748), compared with \#genetic testing and \#prostatecancer (n=328). Tweets about genetic testing (12,921,954) and BRCA (75,724,795) in breast cancer also had substantially greater reach than those about PCa (1,463,777 and 4,849,905, respectively). Facebook groups and pages regarding PCa and BRCA/genetic testing had fewer average members, new members, and new posts, as well as fewer likes and followers, compared with breast cancer. Facebook videos had more engagement than YouTube videos across both PCa and breast cancer content. Conclusions: There is substantially less social media engagement about BRCA and genetic testing in PCa compared with breast cancer. This landscape analysis provides insights into strategies for leveraging social media platforms to increase public awareness about PCa germline testing, including use of Facebook to share video content and Twitter for discussions with health professionals. ",
doi="10.2196/27063",
url="https://cancer.jmir.org/2021/3/e27063",
url="http://www.ncbi.nlm.nih.gov/pubmed/34542414"
}


@Article{info:doi/10.2196/25883,
author="Isse, Naohi
and Tachibana, Yuki
and Kinoshita, Makiko
and Fetters, D. Michael",
title="Evaluating Outcomes of a Social Media--Based Peer and Clinician-Supported Smoking Cessation Program in Preventing Smoking Relapse: Mixed Methods Case Study",
journal="JMIR Form Res",
year="2021",
month="Sep",
day="20",
volume="5",
number="9",
pages="e25883",
keywords="communication",
keywords="mixed methods case study research",
keywords="online social networking",
keywords="smoking cessation",
keywords="smoking relapse",
abstract="Background: Smoking relapse prevention after completion of a smoking cessation program is highly germane to reducing smoking rates. Objective: The purpose of this study was to evaluate the 1-year outcomes of a social media--based and peer and clinician-supported smoking cessation program on Facebook and examine communication patterns that could support smoking cessation and identify risk of relapse. Methods: We used a mixed methods case study evaluation approach featuring a single-case holistic design. We recruited volunteers who signed up after successful completion of a 12-week clinical smoking cessation program in a general medicine department in Japan. Participants contemporaneously accessed a closed Facebook page, and we analyzed their posts including text and emoticons. We used joint display analysis, which involved iterative structuring and restructuring construct-specific tables with both types of data to find the most effective approach for integrating the quantitative results with the qualitative results of content analysis. Results: One successful participant and 2 relapsed participants were analyzed to explore the specific patterns of postings prior to relapse. Decisive comments about quitting smoking were common among participants, but encouraging messages for peers were more common from the successful participant. Comments seeking social support and reassurance were warning signs of relapse. Conflicted comments also may be a warning sign of relapse risk. Conclusions: These findings based on a mixed methods case study of a social media platform supporting smoking cessation could be used to guide messaging in other online social networking service communities after a smoking cessation program to help reduce smoking relapse. Trial Registration: UMIN Clinical Trials Registry UMIN000031172; https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr\_view.cgi?recptno=R000035595 ",
doi="10.2196/25883",
url="https://formative.jmir.org/2021/9/e25883",
url="http://www.ncbi.nlm.nih.gov/pubmed/34542412"
}


@Article{info:doi/10.2196/26204,
author="Pasko, Kristen
and Arigo, Danielle",
title="The Roles of Social Comparison Orientation and Regulatory Focus in College Students' Responses to Fitspiration Posts on Social Media: Cross-sectional Study",
journal="JMIR Ment Health",
year="2021",
month="Sep",
day="15",
volume="8",
number="9",
pages="e26204",
keywords="social media",
keywords="college",
keywords="fitspiration",
keywords="subjective well-being",
keywords="social comparison",
keywords="regulatory focus",
keywords="perception",
keywords="well-being",
keywords="young adult",
keywords="college student",
keywords="cross-sectional",
keywords="motivation",
abstract="Background: Information shared via social media influences college students' self-perceptions and behavior, particularly, ``fitspiration'' posts (ie, images of healthy food, people exercising, or fitness quotations). There are mixed findings regarding the mental health implications of fitspiration and its potential to motivate healthy behavior. Individual differences such as social comparison orientation and regulatory focus could aid in determining for whom fitspiration may be helpful versus harmful, though these characteristics have received limited attention in terms of students' fitspiration perceptions. Objective: This cross-sectional study examined associations between students' fitspiration use (ie, intentional versus unintentional exposure while using social media), response tendencies (ie, feelings about the self and motivation to be physically active), social comparison orientation, and regulatory focus. Methods: College students (N=344; 239/344, 69.5\% women) completed an electronic survey in which they self-reported demographic information, the frequency of their social media use, exposure to fitspiration posts, typical feelings in response to fitspiration posts, and typical motivation for physical activity after viewing fitspiration posts. They also completed validated self-report measures of social comparison orientation and regulatory focus. Results: College students reported frequent exposure to fitspiration posts on social media and that they experienced negative feelings in response to these posts more often than positive feelings. Average motivation for physical activity was rated as feeling motivated ``some of the time.'' However, students who reported more negative feelings after viewing fitspiration also reported greater motivation to be physically active after exposure. Associations between the frequency of intentional fitspiration use and motivation for physical activity after viewing fitspiration posts were moderated by social comparison orientation (b=?0.01, P=.03) but not by regulatory focus (b=?0.002, P=.67). Conclusions: Negative feelings about the self may be motivating for students with weak social comparison orientation, as fitspiration may highlight a discrepancy between one's real and ideal self that does not prompt dejection or disengagement. However, negative feelings for prevention-focused students might not be as motivating because there are no salient negative models to avoid. Further research into these associations is warranted and could inform future efforts to promote student health and well-being during college. ",
doi="10.2196/26204",
url="https://mental.jmir.org/2021/9/e26204",
url="http://www.ncbi.nlm.nih.gov/pubmed/34524965"
}


@Article{info:doi/10.2196/29318,
author="Bushman, Maggie
and Godishala, Shreya
and Hyzer, Reese
and Jerisha, Joshua
and Jolliff, Anna
and Kaji, Ethan
and Kerr, Bradley
and Mathur, Anjali
and Tsao, Owen",
title="Adolescent Health on Social Media and the Mentorship of Youth Investigators: Five Content Analysis Studies Conducted by Youth Investigators",
journal="JMIR Ment Health",
year="2021",
month="Sep",
day="15",
volume="8",
number="9",
pages="e29318",
keywords="social media",
keywords="anxiety",
keywords="depression",
keywords="self-esteem",
keywords="Instagram",
keywords="Reddit",
keywords="Twitter",
keywords="YouTube",
keywords="content analysis",
keywords="adolescent",
doi="10.2196/29318",
url="https://mental.jmir.org/2021/9/e29318",
url="http://www.ncbi.nlm.nih.gov/pubmed/34524099"
}


@Article{info:doi/10.2196/27314,
author="Ricard, Joseph Benjamin
and Hassanpour, Saeed",
title="Deep Learning for Identification of Alcohol-Related Content on Social Media (Reddit and Twitter): Exploratory Analysis of Alcohol-Related Outcomes",
journal="J Med Internet Res",
year="2021",
month="Sep",
day="15",
volume="23",
number="9",
pages="e27314",
keywords="social media",
keywords="natural language processing",
keywords="alcohol abuse",
keywords="machine learning",
abstract="Background: Many social media studies have explored the ability of thematic structures, such as hashtags and subreddits, to identify information related to a wide variety of mental health disorders. However, studies and models trained on specific themed communities are often difficult to apply to different social media platforms and related outcomes. A deep learning framework using thematic structures from Reddit and Twitter can have distinct advantages for studying alcohol abuse, particularly among the youth in the United States. Objective: This study proposes a new deep learning pipeline that uses thematic structures to identify alcohol-related content across different platforms. We apply our method on Twitter to determine the association of the prevalence of alcohol-related tweets with alcohol-related outcomes reported from the National Institute of Alcoholism and Alcohol Abuse, Centers for Disease Control Behavioral Risk Factor Surveillance System, county health rankings, and the National Industry Classification System. Methods: The Bidirectional Encoder Representations From Transformers neural network learned to classify 1,302,524 Reddit posts as either alcohol-related or control subreddits. The trained model identified 24 alcohol-related hashtags from an unlabeled data set of 843,769 random tweets. Querying alcohol-related hashtags identified 25,558,846 alcohol-related tweets, including 790,544 location-specific (geotagged) tweets. We calculated the correlation between the prevalence of alcohol-related tweets and alcohol-related outcomes, controlling for confounding effects of age, sex, income, education, and self-reported race, as recorded by the 2013-2018 American Community Survey. Results: Significant associations were observed: between alcohol-hashtagged tweets and alcohol consumption (P=.01) and heavy drinking (P=.005) but not binge drinking (P=.37), self-reported at the metropolitan-micropolitan statistical area level; between alcohol-hashtagged tweets and self-reported excessive drinking behavior (P=.03) but not motor vehicle fatalities involving alcohol (P=.21); between alcohol-hashtagged tweets and the number of breweries (P<.001), wineries (P<.001), and beer, wine, and liquor stores (P<.001) but not drinking places (P=.23), per capita at the US county and county-equivalent level; and between alcohol-hashtagged tweets and all gallons of ethanol consumed (P<.001), as well as ethanol consumed from wine (P<.001) and liquor (P=.01) sources but not beer (P=.63), at the US state level. Conclusions: Here, we present a novel natural language processing pipeline developed using Reddit's alcohol-related subreddits that identify highly specific alcohol-related Twitter hashtags. The prevalence of identified hashtags contains interpretable information about alcohol consumption at both coarse (eg, US state) and fine-grained (eg, metropolitan-micropolitan statistical area level and county) geographical designations. This approach can expand research and deep learning interventions on alcohol abuse and other behavioral health outcomes. ",
doi="10.2196/27314",
url="https://www.jmir.org/2021/9/e27314",
url="http://www.ncbi.nlm.nih.gov/pubmed/34524095"
}


@Article{info:doi/10.2196/26207,
author="Charmaraman, Linda
and Hodes, Rachel
and Richer, M. Amanda",
title="Young Sexual Minority Adolescent Experiences of Self-expression and Isolation on Social Media: Cross-sectional Survey Study",
journal="JMIR Ment Health",
year="2021",
month="Sep",
day="15",
volume="8",
number="9",
pages="e26207",
keywords="social media",
keywords="social networking sites",
keywords="sexual minorities",
keywords="cyberbullying",
keywords="depression",
keywords="loneliness",
keywords="self-harm",
keywords="social support",
keywords="adolescents",
abstract="Background: Early adolescent years are marked by pervasive self- and peer-regulation regarding gender and sexuality norms, which can affect the mental well-being of sexual minority youth. During this developmental period, social media use is also emerging as a dominant mode of communication with peers, allowing for both risk and resilient behaviors that can impact well-being. Objective: This exploratory study aims to examine how sexual minorities in middle school use social media, who they are connected to and for what purposes, and the associations between these behaviors and mental well-being compared with their heterosexual peers. Methods: In our cross-sectional survey study of 1033 early adolescents aged between 10 and 16 years (average age 12.7, SD 1.21 years) from 4 middle school sites in the Northeastern United States, we conducted an exploratory study comparing sexual minorities (212/873, 24.3\% of sample with known sexual orientation) with their heterosexual peers (n=661), obtaining an 84.46\% (1033/1223; total possible) response rate. Results: Sexual minorities reported having smaller networks on their favorite social media website ($\beta$=?.57; P<.001), less often responded positively when friends shared good news ($\beta$=?.35; P=.002), and less often tried to make friends feel better when they shared bad news ($\beta$=?.30; P=.01). However, sexual minorities more often reported joining a group or web-based community to make themselves feel less alone ($\beta$=.28; P=.003), unlike heterosexual youth. Sexual minorities had higher averages of loneliness and social isolation ($\beta$=.19; P<.001) than heterosexual students. Sexual minorities were also twice as likely to have tried to harm themselves in the past ($\beta$=.81; odds ratio [OR] 2.24, 95\% CI 1.64-3.06; P<.001) and were more likely to have symptoms that reached the Center for Epidemiological Studies-Depression definition of depression ($\beta$=.15; OR 1.16, 95\% CI 1.08-1.25; P<.001). About 39.1\% (83/212) of sexual minorities had no one to talk to about their sexual orientation. Sexual minorities were 1.5 times more likely to have joined a social media website their parents would disapprove ($\beta$=.41; OR 1.50, 95\% CI 1.14-1.97; P=.004) and more likely to report seeing videos related to self-harm ($\beta$=.33; OR 1.39, 95\% CI 1.06-1.83; P=.02) on the web than heterosexual youth. Conclusions: Given previous reports of supportive and safe web-based spaces for sexual minority youth, our findings demonstrated that sexual minority youth prefer to maintain small, close-knit web-based communities (apart from their families) to express themselves, particularly when reaching out to web-based communities to reduce loneliness. Future longitudinal studies could determine any bidirectional influences of mental well-being and social media use in sexual minorities during this difficult developmental period. ",
doi="10.2196/26207",
url="https://mental.jmir.org/2021/9/e26207",
url="http://www.ncbi.nlm.nih.gov/pubmed/34524107"
}


@Article{info:doi/10.2196/26176,
author="Campos-Castillo, Celeste
and Thomas, Jason Brian
and Reyes, Felipe
and Laestadius, Irina Linnea",
title="Seeking Help From Trusted Adults in Response to Peers' Social Media Posts About Mental Health Struggles: Qualitative Interview Study Among Latinx Adolescents",
journal="JMIR Ment Health",
year="2021",
month="Sep",
day="15",
volume="8",
number="9",
pages="e26176",
keywords="adolescents",
keywords="confidants",
keywords="ethnicity",
keywords="gender",
keywords="network resources",
keywords="privacy",
keywords="race",
keywords="social media",
keywords="social support",
keywords="tie activation",
keywords="trust",
abstract="Background: Rather than confiding in adults about their mental health struggles, adolescents may use social media to disclose them to peers. Disclosure recipients are tasked with deciding whether to alert an adult and, if so, whom to alert. Few studies have examined how adolescents decide on a trusted adult to help a friend who posts on social media about his/her mental health struggles. Moreover, Latinx adolescents are underrepresented in research on social media use, which creates gaps in understanding how social media may influence their well-being. Objective: This qualitative study presents findings from semistructured interviews with Latinx adolescents to investigate how they seek out trusted adults when a friend posts on social media about their mental health struggles. Specifically, we sought to determine which adult ties they activated, the resources they believed the adult could provide, and the support they expected the adult to provide. Methods: We recruited participants through a nonprofit organization serving the Latinx community (primarily of Mexican origin) located in Milwaukee, Wisconsin. We conducted 43 semistructured interviews, each lasting 60-90 minutes, with Latinx adolescents (25 females, 18 males) aged 13-17 years. All interviews were conducted in English, at the adolescents' request. Using a grounded theory approach, we identified the nature of the relationship between the trusted adult and either the disclosure recipient or distressed friend, and the resources and support the trusted adult is expected to provide. Results: Participants nominated adults who were emotionally or physically proximate to either the disclosure recipient or distressed friend, particularly parents (of the recipient and friend) and school staff. However, some felt that not all parents and school staff were emotionally proximate. Adolescents sought trusted adults with access to two resources: experiential knowledge and authority. Some, particularly males, avoided adults with authority because of the risk of punishment and others thought their immigrant parents did not have relevant experiential knowledge to assist them. Interviewees felt that trusted adults with either resource could provide emotional and instrumental support either directly or indirectly, while those with experiential knowledge could provide informational support. Notably, interviews did not problematize the fact that the disclosure occurred on social media when deliberating about adults. Conclusions: To assist a distressed friend posting on social media, Latinx adolescents look not only for trusted adults who are emotionally and physically proximate but also those who have key resources that facilitate support. Efforts should focus on connecting adolescents with trusted adults and training adults who hold positions of authority or experiential knowledge to offer both direct and indirect support. Additionally, efforts should consider how immigrant experiences shape parent-child relations and address the potential long-term consequences of oversurveillance of Latinx youth, particularly males, by school staff for their access to social support. ",
doi="10.2196/26176",
url="https://mental.jmir.org/2021/9/e26176",
url="http://www.ncbi.nlm.nih.gov/pubmed/34524088"
}


@Article{info:doi/10.2196/26154,
author="Fadiran, Babayosimi
and Lee, Jessica
and Lemminger, Jared
and Jolliff, Anna",
title="How Our Technology Use Changed in 2020: Perspectives From Three Youths",
journal="JMIR Ment Health",
year="2021",
month="Sep",
day="15",
volume="8",
number="9",
pages="e26154",
keywords="mental health",
keywords="social media",
keywords="digital technology",
keywords="youth",
keywords="adolescent",
keywords="commentary",
keywords="technology",
keywords="wellness",
doi="10.2196/26154",
url="https://mental.jmir.org/2021/9/e26154",
url="http://www.ncbi.nlm.nih.gov/pubmed/34524108"
}


@Article{info:doi/10.2196/26134,
author="Rutter, A. Lauren
and Thompson, M. Holly
and Howard, Jacqueline
and Riley, N. Tennisha
and De Jes{\'u}s-Romero, Robinson
and Lorenzo-Luaces, Lorenzo",
title="Social Media Use, Physical Activity, and Internalizing Symptoms in Adolescence: Cross-sectional Analysis",
journal="JMIR Ment Health",
year="2021",
month="Sep",
day="15",
volume="8",
number="9",
pages="e26134",
keywords="social media",
keywords="depression",
keywords="anxiety",
keywords="physical activity",
keywords="adolescence",
keywords="mobile phone",
abstract="Background: Most American adolescents have access to smartphones, and recent estimates suggest that they spend considerable time on social media compared with other physical and leisure activities. A large body of literature has established that social media use is related to poor mental health, but the complicated relationship between social media and symptoms of depression and anxiety in adolescents is yet to be fully understood. Objective: We aim to investigate the relationship between social media use and depression and anxiety symptoms in adolescents by exploring physical activity as a mediator. Methods: A Qualtrics survey manager recruited adult panel participants between February and March 2019, who indicated that they had adolescent children who spoke English. A total of 4592 adolescent-parent dyads completed the survey that took approximately 39 minutes. The survey entailed completing web-based questionnaires assessing various aspects of social media use, psychological symptoms, and psychosocial factors. The average age of the adolescent participants was 14.62 (SD 1.68; range 12-17) years, and the majority of the adolescent sample was male (2392/4592, 52.09\%). Results: Total social media use was associated with more depressive symptoms (multiple R2=0.12; F3,4480=207.1; P<.001), anxiety (multiple R2=0.09; F3,4477=145.6; P<.001), and loneliness (multiple R2=0.06; F3,4512=98.06; P<.001), controlling for age and gender. Physical activity was associated with decreased depression and anxiety symptoms after controlling for other extracurricular activities and social media use (multiple R2=0.24; F5,4290=266.0; P<.001). There were significant differences in symptoms based on gender: female adolescents reported higher rates of social media use and males reported higher rates of depression. Nonbinary and transgender adolescents had higher rates of depression, anxiety, and loneliness than the female and male adolescents in the sample. Conclusions: In a nationally representative sample of adolescents, more social media use was associated with more severe symptoms of depression, anxiety, and loneliness. Increased physical activity was associated with decreased depression and anxiety symptoms. Physical activity partially mediated the relationship between social media use and depression and anxiety. As this was a cross-sectional study, we cannot conclude that social media use causes internalizing symptoms or that physical activity leads to decreased internalizing symptoms---there may be additional confounding variables producing the relationships we observed. Physical activity may protect against the potentially harmful effect of social media on some adolescents. The effect sizes were small to medium, and the results should be interpreted with caution. Other limitations of this study include our reliance on self-reporting. Future work should examine social media use beyond how much time adolescents spend using social media and instead focus on the nature of social media activity. ",
doi="10.2196/26134",
url="https://mental.jmir.org/2021/9/e26134",
url="http://www.ncbi.nlm.nih.gov/pubmed/34524096"
}


@Article{info:doi/10.2196/26029,
author="Kutok, R. Emily
and Dunsiger, Shira
and Patena, V. John
and Nugent, R. Nicole
and Riese, Alison
and Rosen, K. Rochelle
and Ranney, L. Megan",
title="A Cyberbullying Media-Based Prevention Intervention for Adolescents on Instagram: Pilot Randomized Controlled Trial",
journal="JMIR Ment Health",
year="2021",
month="Sep",
day="15",
volume="8",
number="9",
pages="e26029",
keywords="cyberbullying",
keywords="adolescents",
keywords="mobile application",
keywords="messaging",
keywords="brief interventions",
keywords="social media",
keywords="recruitment",
keywords="mobile phone",
abstract="Background: Between 15\% and 70\% of adolescents report experiencing cybervictimization. Cybervictimization is associated with multiple negative consequences, including depressed mood. Few validated, easily disseminated interventions exist to prevent cybervictimization and its consequences. With over 97\% of adolescents using social media (such as YouTube, Facebook, Instagram, or Snapchat), recruiting and delivering a prevention intervention through social media and apps may improve accessibility of prevention tools for at-risk youth. Objective: This study aims to evaluate the feasibility and acceptability of and obtain preliminary outcome data on IMPACT (Intervention Media to Prevent Adolescent Cyber-Conflict Through Technology), a brief, remote app-based intervention to prevent and reduce the effect of cyberbullying. Methods: From January 30, 2020, to May 3, 2020, a national sample of 80 adolescents with a history of past-year cybervictimization was recruited through Instagram for a randomized control trial of IMPACT, a brief, remote research assistant--led intervention and a fully automated app-based program, versus enhanced web-based resources (control). Feasibility and acceptability were measured by consent, daily use, and validated surveys. Although not powered for efficacy, outcomes (victimization, bystander self-efficacy, and well-being) were measured using validated measures at 8 and 16 weeks and evaluated using a series of longitudinal mixed models. Results: Regarding feasibility, 24.5\% (121/494) of eligible participants provided contact information; of these, 69.4\% (84/121) completed full enrollment procedures. Of the participants enrolled, 45\% (36/80) were randomized into the IMPACT intervention and 55\% (44/80) into the enhanced web-based resources groups. All participants randomized to the intervention condition completed the remote intervention session, and 89\% (77/80) of the daily prompts were answered. The retention rate was 99\% (79/80) at 8 weeks and 96\% (77/80) at 16 weeks for all participants. Regarding acceptability, 100\% (36/36) of the intervention participants were at least moderately satisfied with IMPACT overall, and 92\% (33/36) of the participants were at least moderately satisfied with the app. At both 8 and 16 weeks, well-being was significantly higher ($\beta$=1.17, SE 0.87, P=.02 at 8 weeks and $\beta$=3.24, SE 0.95, P<.001 at 16 weeks) and psychological stress was lower ($\beta$=?.66, SE 0.08, P=.04 at 8 weeks and $\beta$=?.89, SE 0.09, P<.001 at 16 weeks) among IMPACT users than among control group users. Participants in the intervention group attempted significantly more bystander interventions than those in the control group at 8 weeks ($\beta$=.82, SE 0.42; P=.02). Conclusions: This remote app-based intervention for victims of cyberbullying was feasible and acceptable, increased overall well-being and bystander interventions, and decreased psychological stress. Our findings are especially noteworthy given that the trial took place during the COVID-19 pandemic. The use of Instagram to recruit adolescents can be a successful strategy for identifying and intervening with those at the highest risk of cybervictimization. Trial Registration: ClinicalTrials.gov NCT04259216; http://clinicaltrials.gov/ct2/show/NCT04259216. ",
doi="10.2196/26029",
url="https://mental.jmir.org/2021/9/e26029",
url="http://www.ncbi.nlm.nih.gov/pubmed/34524103"
}


@Article{info:doi/10.2196/28495,
author="Raphaely, Shiri
and Goldberg, B. Simon
and Moreno, Megan
and Stowe, Zachary",
title="Rates of Assessment of Social Media Use in Psychiatric Interviews Prior to and During COVID-19: Needs Assessment Survey",
journal="JMIR Med Educ",
year="2021",
month="Sep",
day="14",
volume="7",
number="3",
pages="e28495",
keywords="social media",
keywords="screentime",
keywords="problematic Internet use",
keywords="psychiatric interview",
keywords="psychiatric training",
keywords="COVID-19",
keywords="residency",
keywords="training",
keywords="survey",
keywords="psychiatry",
keywords="evaluation",
keywords="quarantine",
abstract="Background: Current research suggests that there is a nuanced relationship between mental well-being and social media. Social media offers opportunities for empowerment, information, and connection while also showing links with depression, high-risk behavior, and harassment. As this medium rapidly integrates into interpersonal interactions, incorporation of social media assessment into the psychiatric evaluation warrants attention. Furthermore, the COVID-19 pandemic and containment measures (ie, social distancing) led to increased dependence on social media, allowing an opportunity to assess the adaptation of psychiatric interviews in response to sociocultural changes. Objective: The first aim of this study was to evaluate if general psychiatry residents and child and adolescent psychiatry fellows assessed social media use as part of the clinical interview. Second, the study examined whether changes were made to the social media assessment in response to known increase of social media use secondary to social distancing measures during the COVID-19 pandemic. Methods: As part of a quality improvement project, the authors surveyed general psychiatry residents and child psychiatry fellows in a university-based training program (n=21) about their assessment of social media use in patient evaluations. Soon after the survey closed, ``stay-at-home'' orders related to the COVID-19 pandemic began. A subsequent survey was sent out with the same questions to evaluate if residents and fellows altered their interview practices in response to the dramatic sociocultural changes (n=20). Results: Pre-COVID-19 pandemic survey results found that 10\% (2/21) of respondents incorporated social media questions in patient evaluations. In a follow-up survey after the onset of the pandemic, 20\% (4/20) of respondents included any assessment of social media use. Among the 15 participants who completed both surveys, there was a nonsignificant increase in the likelihood of asking about social media use (2/15, 13\% vs 4/15, 27\%, for pre- and during COVID-19, respectively; McNemar $\chi$21=0.25, P=.617, Cohen d=0.33). Conclusions: These small survey results raise important questions relevant to the training of residents and fellows in psychiatry. The findings suggest that the assessment of social media use is a neglected component of the psychiatric interview by trainees. The burgeoning use and diversity of social media engagement warrant scrutiny with respect to how this is addressed in interview training. Additionally, given minimal adaptation of the interview in the midst of a pandemic, these findings imply an opportunity for improving psychiatric training that incorporates adapting clinical interviews to sociocultural change. ",
doi="10.2196/28495",
url="https://mededu.jmir.org/2021/3/e28495",
url="http://www.ncbi.nlm.nih.gov/pubmed/34375297"
}


@Article{info:doi/10.2196/30854,
author="Hu, Tao
and Wang, Siqin
and Luo, Wei
and Zhang, Mengxi
and Huang, Xiao
and Yan, Yingwei
and Liu, Regina
and Ly, Kelly
and Kacker, Viraj
and She, Bing
and Li, Zhenlong",
title="Revealing Public Opinion Towards COVID-19 Vaccines With Twitter Data in the United States: Spatiotemporal Perspective",
journal="J Med Internet Res",
year="2021",
month="Sep",
day="10",
volume="23",
number="9",
pages="e30854",
keywords="Twitter",
keywords="public opinion",
keywords="COVID-19 vaccines",
keywords="sentiment analysis",
keywords="emotion analysis",
keywords="topic modeling",
keywords="COVID-19",
abstract="Background: The COVID-19 pandemic has imposed a large, initially uncontrollable, public health crisis both in the United States and across the world, with experts looking to vaccines as the ultimate mechanism of defense. The development and deployment of COVID-19 vaccines have been rapidly advancing via global efforts. Hence, it is crucial for governments, public health officials, and policy makers to understand public attitudes and opinions towards vaccines, such that effective interventions and educational campaigns can be designed to promote vaccine acceptance. Objective: The aim of this study was to investigate public opinion and perception on COVID-19 vaccines in the United States. We investigated the spatiotemporal trends of public sentiment and emotion towards COVID-19 vaccines and analyzed how such trends relate to popular topics found on Twitter. Methods: We collected over 300,000 geotagged tweets in the United States from March 1, 2020 to February 28, 2021. We examined the spatiotemporal patterns of public sentiment and emotion over time at both national and state scales and identified 3 phases along the pandemic timeline with sharp changes in public sentiment and emotion. Using sentiment analysis, emotion analysis (with cloud mapping of keywords), and topic modeling, we further identified 11 key events and major topics as the potential drivers to such changes. Results: An increasing trend in positive sentiment in conjunction with a decrease in negative sentiment were generally observed in most states, reflecting the rising confidence and anticipation of the public towards vaccines. The overall tendency of the 8 types of emotion implies that the public trusts and anticipates the vaccine. This is accompanied by a mixture of fear, sadness, and anger. Critical social or international events or announcements by political leaders and authorities may have potential impacts on public opinion towards vaccines. These factors help identify underlying themes and validate insights from the analysis. Conclusions: The analyses of near real-time social media big data benefit public health authorities by enabling them to monitor public attitudes and opinions towards vaccine-related information in a geo-aware manner, address the concerns of vaccine skeptics, and promote the confidence that individuals within a certain region or community have towards vaccines. ",
doi="10.2196/30854",
url="https://www.jmir.org/2021/9/e30854",
url="http://www.ncbi.nlm.nih.gov/pubmed/34346888"
}


@Article{info:doi/10.2196/28116,
author="Greshake Tzovaras, Bastian
and Senabre Hidalgo, Enric
and Alexiou, Karolina
and Baldy, Lukaz
and Morane, Basile
and Bussod, Ilona
and Fribourg, Melvin
and Wac, Katarzyna
and Wolf, Gary
and Ball, Mad",
title="Using an Individual-Centered Approach to Gain Insights From Wearable Data in the Quantified Flu Platform: Netnography Study",
journal="J Med Internet Res",
year="2021",
month="Sep",
day="10",
volume="23",
number="9",
pages="e28116",
keywords="symptom tracking",
keywords="COVID-19",
keywords="wearable devices",
keywords="self-tracking",
keywords="citizen science",
keywords="netnographic analysis",
keywords="cocreation",
abstract="Background: Wearables have been used widely for monitoring health in general, and recent research results show that they can be used to predict infections based on physiological symptoms. To date, evidence has been generated in large, population-based settings. In contrast, the Quantified Self and Personal Science communities are composed of people who are interested in learning about themselves individually by using their own data, which are often gathered via wearable devices. Objective: This study aims to explore how a cocreation process involving a heterogeneous community of personal science practitioners can develop a collective self-tracking system for monitoring symptoms of infection alongside wearable sensor data. Methods: We engaged in a cocreation and design process with an existing community of personal science practitioners to jointly develop a working prototype of a web-based tool for symptom tracking. In addition to the iterative creation of the prototype (started on March 16, 2020), we performed a netnographic analysis to investigate the process of how this prototype was created in a decentralized and iterative fashion.  Results: The Quantified Flu prototype allowed users to perform daily symptom reporting and was capable of presenting symptom reports on a timeline together with resting heart rates, body temperature data, and respiratory rates measured by wearable devices. We observed a high level of engagement; over half of the users (52/92, 56\%) who engaged in symptom tracking became regular users and reported over 3 months of data each. Furthermore, our netnographic analysis highlighted how the current Quantified Flu prototype was a result of an iterative and continuous cocreation process in which new prototype releases sparked further discussions of features and vice versa. Conclusions: As shown by the high level of user engagement and iterative development process, an open cocreation process can be successfully used to develop a tool that is tailored to individual needs, thereby decreasing dropout rates. ",
doi="10.2196/28116",
url="https://www.jmir.org/2021/9/e28116",
url="http://www.ncbi.nlm.nih.gov/pubmed/34505836"
}


@Article{info:doi/10.2196/25405,
author="Ramos, C. Lili M.
and Delgadillo, Joseline
and V{\'e}lez, Sarah
and Dauria, Emily
and Salas, Jamie
and Tolou-Shams, Marina",
title="Collecting Social Media Information in a Substance Use Intervention Trial With Adolescent Girls With Lifetime Substance Use History: Observational Study",
journal="JMIR Form Res",
year="2021",
month="Sep",
day="10",
volume="5",
number="9",
pages="e25405",
keywords="adolescent girls",
keywords="legal involvement",
keywords="substance use",
keywords="social media",
keywords="health intervention",
abstract="Background: Adolescents with juvenile legal system contact face numerous barriers to  participation in behavioral health intervention research, including housing disruption, legal privacy concerns, and systems mistrust. Technology, such as social media, may be a novel and developmentally appropriate adolescent research study engagement and retention tool. Objective: We examined data on social media information collected for study retention purposes from adolescents participating in a substance use intervention trial. Methods: Data were collected as part of a randomized controlled trial determining efficacy of a group-based substance use intervention for girls and young women (12-24 years) with substance use histories referred from legal and school systems in the United States. Baseline demographic and social media information was analyzed from the subset of 114 adolescent girls (mean age 15.7 years; range 13-18 years), of whom 31.6\% (36/114) were legally involved, 87.7\% (100/114) belonged to minoritized racial/ethnic groups, and 32.5\% (37/114) received public assistance. Results: Most girls (74/114, 64.9\%) provided at least one social media account (Instagram, 95\% [70/74]; Facebook, 27\% [20/74]; and Twitter, 11\% [8/74]) during study enrollment. Legally involved girls were significantly less likely to provide social media information than school-referred girls (44\% [16/36] versus 74\% [58/78]; $\chi$21 [N=114]=9.68, P=.002). Conclusions: Obtaining social media information for study retention purposes from adolescent girls with lifetime substance use appears possible; however, particular subgroups (ie, legally involved girls) may be less likely to provide accounts. Factors shaping legally involved girls' willingness to provide social media information, including mistrust and privacy concerns, and the impact of researcher's access to social media information on study retention are critical directions for future research. Trial Registration: ClinicalTrials.gov NCT02293057; https://clinicaltrials.gov/ct2/show/NCT02293057 ",
doi="10.2196/25405",
url="https://formative.jmir.org/2021/9/e25405",
url="http://www.ncbi.nlm.nih.gov/pubmed/34505833"
}


@Article{info:doi/10.2196/26513,
author="Tuck, B. Alison
and Thompson, J. Renee",
title="Social Networking Site Use During the COVID-19 Pandemic and Its Associations With Social and Emotional Well-being in College Students: Survey Study",
journal="JMIR Form Res",
year="2021",
month="Sep",
day="7",
volume="5",
number="9",
pages="e26513",
keywords="social media",
keywords="social networking sites",
keywords="COVID-19",
keywords="loneliness",
keywords="well-being",
abstract="Background: Social distancing during the COVID-19 pandemic has reduced the frequency of in-person social interactions. College students were highly impacted, since many universities transferred curriculum from in-person to entirely online formats, physically separating students with little notice. With social distancing, their use of social networking sites (SNSs) likely changed during the COVID-19 pandemic, possibly holding implications for well-being. Objective: This study aimed to determine (1) how components of SNS use (ie, weekly frequency, time per day, habitual use, engagement, enjoyment, addiction, and emotional impact) changed from before to during COVID-19, (2) how these changes in SNS use were associated with pandemic-related social and emotional well-being, and (3) how SNS use and changes in use during the pandemic were associated with loneliness. Methods: College students (N=176) were surveyed during the time when their university campus in the United States was operating online. Participants completed the same SNS use questionnaires twice, once with regard to the month preceding the onset of COVID-19 and again with regard to the month since this time. They also reported the extent to which they experienced perceived change in social support resulting from the pandemic, pandemic-related stress, and general loneliness. Results: After the onset of COVID-19, participants showed an increase in daily time spent on SNSs (t169=5.53, d=0.42, P<.001), habitual use (t173=3.60, d=0.27, P<.001), and addiction (t173=4.96, d=0.38, P<.001); further, enjoyment on SNSs decreased (t173=--2.10, d=--0.16, P=.04) and the emotional impact of SNS activities became more negative (t172=--3.76, d=--0.29, P<.001). Increased perceived social support during COVID-19 was associated with changes in frequency of SNS use, time per day, addiction, and engagement (r>0.18 for all). Pandemic-related stress was associated with changes in SNS addiction and the extent to which one's SNS content was related to the pandemic (r>0.20 for all). Loneliness was positively associated with SNS addiction (r=0.26) and negatively associated with SNS engagement (r=--0.19) during the pandemic. Loneliness was also negatively associated with changes in habit and engagement (r<--0.15 for all). Conclusions: Findings suggest that components of SNS use are associated with both positive and negative pandemic-related social outcomes, but largely negative pandemic-related emotional outcomes. Further, some components of SNS use are positively associated with loneliness (eg, addiction) while others show a negative association (eg, engagement). These findings provide a more nuanced picture of how SNS use is associated with social and emotional well-being during the time of a global health crisis when in-person interactions are scarce. ",
doi="10.2196/26513",
url="https://formative.jmir.org/2021/9/e26513",
url="http://www.ncbi.nlm.nih.gov/pubmed/34313587"
}


@Article{info:doi/10.2196/28234,
author="Lazard, J. Allison
and Collins, Reffner Meredith K.
and Hedrick, Ashley
and Varma, Tushar
and Love, Brad
and Valle, G. Carmina
and Brooks, Erik
and Benedict, Catherine",
title="Using Social Media for Peer-to-Peer Cancer Support: Interviews With Young Adults With Cancer",
journal="JMIR Cancer",
year="2021",
month="Sep",
day="2",
volume="7",
number="3",
pages="e28234",
keywords="cancer survivors",
keywords="social support",
keywords="peer groups",
keywords="social media",
keywords="young adults",
keywords="pyscho-oncology",
keywords="mobile phone",
abstract="Background: Web-based social support can address social isolation and unmet support needs among young adults with cancer (aged 18-39 years). Given that 94\% of young adults own and use smartphones, social media can offer personalized, accessible social support among peers with cancer. Objective: This study aims to examine the specific benefits, downsides, and topics of social support via social media among young adults with cancer. Methods: We conducted semistructured interviews with young adults with cancer, aged between 18 and 39 years, who were receiving treatment or had completed treatment for cancer. Results: Most participants (N=45) used general audience platforms (eg, Facebook groups), and some cancer-specific social media (eg, Caring Bridge), to discuss relevant lived experiences for medical information (managing side effects and treatment uncertainty) and navigating life with cancer (parenting and financial issues). Participants valued socializing with other young adults with cancer, making connections outside their personal networks, and being able to validate their emotional and mental health experiences without time and physical constraints. However, using social media for peer support can be an emotional burden, especially when others post disheartening or harassing content, and can heighten privacy concerns, especially when navigating cancer-related stigma. Conclusions: Social media allows young adults to connect with peers to share and feel validated about their treatment and life concerns. However, barriers exist for receiving support from social media; these could be reduced through content moderation and developing more customizable, potentially cancer-specific social media apps and platforms to enhance one's ability to find peers and manage groups. ",
doi="10.2196/28234",
url="https://cancer.jmir.org/2021/3/e28234",
url="http://www.ncbi.nlm.nih.gov/pubmed/34473063"
}


@Article{info:doi/10.2196/30409,
author="Kong, Wenwen
and Song, Shijie
and Zhao, Chris Yuxiang
and Zhu, Qinghua
and Sha, Ling",
title="TikTok as a Health Information Source: Assessment of the Quality of Information in Diabetes-Related Videos",
journal="J Med Internet Res",
year="2021",
month="Sep",
day="1",
volume="23",
number="9",
pages="e30409",
keywords="diabetes",
keywords="information quality",
keywords="infodemiology",
keywords="social media",
keywords="short video apps",
keywords="TikTok",
abstract="Background: Diabetes has become one of the most prevalent chronic diseases, and many people living with diabetes use social media to seek health information. Recently, an emerging social media app, TikTok, has received much interest owing to its popularity among general health consumers. We notice that there are many videos about diabetes on TikTok. However, it remains unclear whether the information in these videos is of satisfactory quality. Objective: This study aimed to assess the quality of the information in diabetes-related videos on TikTok. Methods: We collected a sample of 199 diabetes-related videos in Chinese. The basic information presented in the videos was coded and analyzed. First, we identified the source of each video. Next, 2 independent raters assessed each video in terms of the completeness of six types of content (the definition of the disease, symptoms, risk factors, evaluation, management, and outcomes). Then, the 2 raters independently assessed the quality of information in the videos, using the DISCERN instrument. Results: In regard to the sources of the videos, we found 6 distinct types of uploaders; these included 3 kinds of individual users (ie, health professionals, general users, and science communicators) and 3 types of organizational users (ie, news agencies, nonprofit organizations, and for-profit organizations). Regarding content, our results show that the videos were primarily about diabetes management and contained limited information on the definition of the disease, symptoms, risk factors, evaluation, and outcomes. The overall quality of the videos was acceptable, on average, although the quality of the information varied, depending on the sources. The videos created by nonprofit organizations had the highest information quality, while the videos contributed by for-profit organizations had the lowest information quality. Conclusions: Although the overall quality of the information in the diabetes videos on TikTok is acceptable, TikTok might not fully meet the health information needs of patients with diabetes, and they should exercise caution when using TikTok as a source of diabetes-related information. ",
doi="10.2196/30409",
url="https://www.jmir.org/2021/9/e30409",
url="http://www.ncbi.nlm.nih.gov/pubmed/34468327"
}


@Article{info:doi/10.2196/27715,
author="Bautista, Robert John
and Zhang, Yan
and Gwizdka, Jacek",
title="US Physicians' and Nurses' Motivations, Barriers, and Recommendations for Correcting Health Misinformation on Social Media: Qualitative Interview Study",
journal="JMIR Public Health Surveill",
year="2021",
month="Sep",
day="1",
volume="7",
number="9",
pages="e27715",
keywords="correction",
keywords="COVID-19",
keywords="physicians",
keywords="misinformation",
keywords="infodemic",
keywords="infodemiology",
keywords="nurses",
keywords="social media",
abstract="Background: Health misinformation is a public health concern. Various stakeholders have called on health care professionals, such as nurses and physicians, to be more proactive in correcting health misinformation on social media.  Objective: This study aims to identify US physicians' and nurses' motivations for correcting health misinformation on social media, the barriers they face in doing so, and their recommendations for overcoming such barriers. Methods: In-depth interviews were conducted with 30 participants, which comprised 15 (50\%) registered nurses and 15 (50\%) physicians. Qualitative data were analyzed by using thematic analysis. Results: Participants were personally (eg, personal choice) and professionally (eg, to fulfill the responsibility of a health care professional) motivated to correct health misinformation on social media. However, they also faced intrapersonal (eg, a lack of positive outcomes and time), interpersonal (eg, harassment and bullying), and institutional (eg, a lack of institutional support and social media training) barriers to correcting health misinformation on social media. To overcome these barriers, participants recommended that health care professionals should receive misinformation and social media training, including building their social media presence. Conclusions: US physicians and nurses are willing to correct health misinformation on social media despite several barriers. Nonetheless, this study provides recommendations that can be used to overcome such barriers. Overall, the findings can be used by health authorities and organizations to guide policies and activities aimed at encouraging more health care professionals to be present on social media to counteract health misinformation. ",
doi="10.2196/27715",
url="https://publichealth.jmir.org/2021/9/e27715",
url="http://www.ncbi.nlm.nih.gov/pubmed/34468331"
}


@Article{info:doi/10.2196/28169,
author="Beatty, L. Alexis
and Peyser, D. Noah
and Butcher, E. Xochitl
and Carton, W. Thomas
and Olgin, E. Jeffrey
and Pletcher, J. Mark
and Marcus, M. Gregory",
title="The COVID-19 Citizen Science Study: Protocol for a Longitudinal Digital Health Cohort Study",
journal="JMIR Res Protoc",
year="2021",
month="Aug",
day="30",
volume="10",
number="8",
pages="e28169",
keywords="COVID-19",
keywords="digital technology",
keywords="participant engagement",
keywords="electronic health records",
keywords="mobile app",
keywords="mHealth",
keywords="digital health",
abstract="Background: The COVID-19 pandemic has catalyzed a global public response and innovation in clinical study methods. Objective: The COVID-19 Citizen Science study was designed to generate knowledge about participant-reported COVID-19 symptoms, behaviors, and disease occurrence. Methods: COVID-19 Citizen Science is a longitudinal cohort study launched on March 26, 2020, on the Eureka Research Platform. This study illustrates important advances in digital clinical studies, including entirely digital study participation, targeted recruitment strategies, electronic consent, recurrent and time-updated assessments, integration with smartphone-based measurements, analytics for recruitment and engagement, connection with partner studies, novel engagement strategies such as participant-proposed questions, and feedback in the form of real-time results to participants. Results: As of February 2021, the study has enrolled over 50,000 participants. Study enrollment and participation are ongoing. Over the lifetime of the study, an average of 59\% of participants have completed at least one survey in the past 4 weeks. Conclusions: Insights about COVID-19 symptoms, behaviors, and disease occurrence can be drawn through digital clinical studies. Continued innovation in digital clinical study methods represents the future of clinical research. International Registered Report Identifier (IRRID): DERR1-10.2196/28169 ",
doi="10.2196/28169",
url="https://www.researchprotocols.org/2021/8/e28169",
url="http://www.ncbi.nlm.nih.gov/pubmed/34310336"
}


@Article{info:doi/10.2196/26395,
author="Qin, Lei
and Zhang, Xiaomei
and Wu, Anlin
and Miser, S. James
and Liu, Yen-Lin
and Hsu, C. Jason
and Shia, Ben-Chang
and Ye, Linglong",
title="Association Between Social Media Use and Cancer Screening Awareness and Behavior for People Without a Cancer Diagnosis: Matched Cohort Study",
journal="J Med Internet Res",
year="2021",
month="Aug",
day="27",
volume="23",
number="8",
pages="e26395",
keywords="social media",
keywords="cancer screening awareness",
keywords="cancer screening behavior",
keywords="gender-specific effects",
keywords="propensity-score matching",
keywords="general population",
abstract="Background: The use of social media in communications regarding cancer prevention is rapidly growing. However, less is known about the general population's social media use related to cancer screening awareness and behavior for different cancers. Objective: We aimed to examine the relationship between social media use and cancer screening awareness and behavior among people without a cancer diagnosis. Methods: Data were collected from the Health Information National Trends Survey 5 Cycle 1 to 3 in the United States (n=12,227). Our study included 10,124 participants without a cancer diagnosis and 3 measures of screening awareness (those who had heard of hepatitis C virus [HCV], human papillomavirus [HPV], and the HPV vaccine) and 4 measures of behavior (those who had prostate-specific antigen tests, Papanicolaou tests for cervical cancer, as well as breast cancer and colon cancer tests). Propensity-score matching was conducted to adjust for the sociodemographic variables between the social media user and nonuser participants. Multivariable logistic regression was used to assess the association of social media use by gender. Jackknife replicate weights were incorporated into the analyses. Results: Of the 3794 matched participants, 1861 (57.6\% weighted) were male, and the mean age was 55.5 (SD 0.42) years. Compared to social media nonusers, users were more likely to have heard of HCV (adjusted odds ratio [aOR]=2.27, 95\% CI, 1.29-3.98 and aOR=2.86, 95\% CI, 1.51-5.40, for male and female users, respectively) and HPV (aOR=1.82, 95\% CI, 1.29-2.58 and aOR=2.35, 95\% CI, 1.65-3.33, for male and female users, respectively). In addition, female users were more likely to have heard of the HPV vaccine (aOR=2.06, 95\% CI, 1.41-3.00). No significant associations were found between social media use and prostate-specific antigen tests in males, Papanicolaou tests and breast cancer tests in females, or colon cancer tests in both male and female users. Conclusions: While social media services can potentially promote cancer screening awareness in the general population, but they did not improve screening behavior after adjusting for socioeconomic status. These findings strengthened our understanding of social media use in targeting health communications for different cancers. ",
doi="10.2196/26395",
url="https://www.jmir.org/2021/8/e26395",
url="http://www.ncbi.nlm.nih.gov/pubmed/34448708"
}


@Article{info:doi/10.2196/30271,
author="Wei, Shanzun
and Ma, Ming
and Wen, Xi
and Wu, Changjing
and Zhu, Guonian
and Zhou, Xiangfu",
title="Online Public Attention Toward Premature Ejaculation in Mainland China: Infodemiology Study Using the Baidu Index",
journal="J Med Internet Res",
year="2021",
month="Aug",
day="26",
volume="23",
number="8",
pages="e30271",
keywords="premature ejaculation",
keywords="Baidu Index",
keywords="infodemiology",
keywords="public interest",
keywords="patients' concern",
keywords="sexuality",
keywords="sexual dysfunction",
abstract="Background: Premature ejaculation (PE) is one of the most described psychosocial stress and sexual complaints worldwide. Previous investigations have focused predominantly on the prospective identification of cases that meet researchers' specific criteria. The genuine demand from patients with regard to information on PE and related issues may thus be neglected. Objective: This study aims to examine the online search trend and user demand related to PE on a national and regional scale using the dominant major search engine in mainland China. Methods: The Baidu Index was queried using the PE-related terms for the period of January 2011 to December 2020. The search volume for each term was recorded to analyze the search trend and demographic distributions. For user interest, the demand and trend data were collected and analyzed. Results: Of the 36 available PE search keywords, 4 PE searching topics were identified. The Baidu Search Index for each PE topic varied from 46.30\% (86,840,487/187,558,154) to 6.40\% (12,009,307/187,558,154). The annual percent change (APC) for the complaint topic was 48.80\% (P<.001) for 2011 to 2014 and --16.82\% (P<.001) for 2014 to 2020. The APC for the inquiry topic was 16.21\% (P=.41) for 2011 to 2014 and --11.00\% (P<.001) for 2014 to 2020. For the prognosis topic, the annual APC was 11.18\% (P<.001) for 2011 to 2017 and --19.86\% (P<.001) for 2017 to 2020. For the treatment topic, the annual APC was 14.04\% (P<.001) for 2011 to 2016 and --38.83\% (P<.001) for 2016 to 2020. The age distribution of those searching for topics related to PE showed that the population aged 20 to 40 years comprised nearly 70\% of the total search inquiries (second was 17.95\% in the age group younger than 19 years). People from East China made over 50\% of the total search queries. Conclusions: The fluctuating online popularity of PE searches reflects the real-time population demands. It may help medical professionals better understand population interest, population concerns, regional variations, and gender differences on a nationwide scale and make disease-specific health care policies. The internet search data could be more reliable when the insufficient and lagging registry data are completed. ",
doi="10.2196/30271",
url="https://www.jmir.org/2021/8/e30271",
url="http://www.ncbi.nlm.nih.gov/pubmed/34435970"
}


@Article{info:doi/10.2196/26786,
author="Wu, Y. Jania J.
and Ahmad, Nurulhuda
and Samuel, Miny
and Logan, Susan
and Mattar, Z. Citra N.",
title="The Influence of Web-Based Tools on Maternal and Neonatal Outcomes in Pregnant Adolescents or Adolescent Mothers: Mixed Methods Systematic Review",
journal="J Med Internet Res",
year="2021",
month="Aug",
day="26",
volume="23",
number="8",
pages="e26786",
keywords="pregnancy in adolescence",
keywords="teenagers",
keywords="adolescents",
keywords="pregnancy",
keywords="postpartum",
keywords="internet",
keywords="digital health",
keywords="digital media",
keywords="new digital media",
keywords="eHealth",
keywords="social media",
keywords="social network",
keywords="communications media",
abstract="Background: Pregnant adolescent women increasingly seek support during pregnancy and the puerperium through digital platforms instead of the traditional support system of family, friends, and the community. However, it is uncertain whether digital, web-based tools are reliable and effective in providing information to the user on a variety of topics such as fetal development, pregnancy outcomes, delivery, and breastfeeding to improve maternal and infant outcomes. Objective: We aimed to identify web-based tools designed to promote knowledge, attitudes, and skills of pregnant adolescents or adolescent mothers and determine the efficacy of such web-based tools compared with conventional resources in promoting good pregnancy and infant outcomes. Methods: A systematic search was conducted using Medline, Scopus, CINAHL, and PsycINFO for articles published from January 2004 to November 2020 to identify randomized trials and observational studies that evaluated digital, web-based platforms to deliver resources to pregnant adolescents. All articles written in the author's languages were included. Two authors independently reviewed abstracts and full-text articles for inclusion and assessed study quality. Risk of bias in each study was assessed using appropriate tools recommended by PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) and the Joanna Briggs Institute. We adopted a qualitative synthesis and presented the results in a narrative format due to the heterogenous nature of the studies. Results: Seven articles met the inclusion criteria and were analyzed. The majority of the studies were graded to be of low to moderate risk for bias. The research methodologies represented were varied, ranging from randomized (n=1) and nonrandomized controlled trials (n=1) and prospective cohort studies (n=1) to mixed methods studies (n=1) and longitudinal surveys (n=3). Four studies included active web-based interventions, and 3 described exposure to web-based tools, including the use of social media and/or other internet content. Web-based tools positively influenced treatment-seeking intentions (intervention 17.1\%, control 11.5\%, P=.003) and actual treatment-seeking behavior for depression among postpartum adolescents (intervention 14.1\%, control 6.5\%, P<.001). In contrast, readily available information on the internet may leave adolescents with increased anxiety. The critical difference lies in information curated by health care professionals specifically to address targeted concerns versus self-acquired data sourced from various websites. Conclusions: Despite almost universal web use, few studies have used this platform for health promotion and disease prevention. Social media interventions or web-based tools have the potential to positively influence both maternal and infant outcomes in adolescent pregnancy, but there is a need for more well-conducted studies to demonstrate the effectiveness of these support programs. The vastness of the information available on the web limits the ability of health care professionals to monitor or control sources of information sought by patients. Thus, it is important to create professionally curated platforms to prevent or limit exposure to potentially misleading or harmful information on the internet while imparting useful knowledge to the user. Trial Registration: PROSPERO International Prospective Register of Systematic Reviews CRD42020195854; https://www.crd.york.ac.uk/prospero/display\_record.php?RecordID=195854 ",
doi="10.2196/26786",
url="https://www.jmir.org/2021/8/e26786",
url="http://www.ncbi.nlm.nih.gov/pubmed/34435961"
}


@Article{info:doi/10.2196/26119,
author="Fu, Guanghui
and Song, Changwei
and Li, Jianqiang
and Ma, Yue
and Chen, Pan
and Wang, Ruiqian
and Yang, Xiang Bing
and Huang, Zhisheng",
title="Distant Supervision for Mental Health Management in Social Media: Suicide Risk Classification System Development Study",
journal="J Med Internet Res",
year="2021",
month="Aug",
day="26",
volume="23",
number="8",
pages="e26119",
keywords="deep learning",
keywords="distant supervision",
keywords="mental health",
keywords="crisis prevention",
abstract="Background: Web-based social media provides common people with a platform to express their emotions conveniently and anonymously. There have been nearly 2 million messages in a particular Chinese social media data source, and several thousands more are generated each day. Therefore, it has become impossible to analyze these messages manually. However, these messages have been identified as an important data source for the prevention of suicide related to depression disorder. Objective: We proposed in this paper a distant supervision approach to developing a system that can automatically identify textual comments that are indicative of a high suicide risk. Methods: To avoid expensive manual data annotations, we used a knowledge graph method to produce approximate annotations for distant supervision, which provided a basis for a deep learning architecture that was built and refined by interactions with psychology experts. There were three annotation levels, as follows: free annotations (zero cost), easy annotations (by psychology students), and hard annotations (by psychology experts). Results: Our system was evaluated accordingly and showed that its performance at each level was promising. By combining our system with several important psychology features from user blogs, we obtained a precision of 80.75\%, a recall of 75.41\%, and an F1 score of 77.98\% for the hardest test data. Conclusions: In this paper, we proposed a distant supervision approach to develop an automatic system that can classify high and low suicide risk based on social media comments. The model can therefore provide volunteers with early warnings to prevent social media users from committing suicide. ",
doi="10.2196/26119",
url="https://www.jmir.org/2021/8/e26119",
url="http://www.ncbi.nlm.nih.gov/pubmed/34435964"
}


@Article{info:doi/10.2196/29387,
author="Sajjadi, B. Nicholas
and Feldman, Kaylea
and Shepard, Samuel
and Reddy, K. Arjun
and Torgerson, Trevor
and Hartwell, Micah
and Vassar, Matt",
title="Public Interest and Behavior Change in the United States Regarding Colorectal Cancer Following the Death of Chadwick Boseman: Infodemiology Investigation of Internet Search Trends Nationally and in At-Risk Areas",
journal="JMIR Infodemiology",
year="2021",
month="Aug",
day="26",
volume="1",
number="1",
pages="e29387",
keywords="Google Trends",
keywords="colerectal cancer",
keywords="search analytics",
keywords="public health",
keywords="data analytics",
keywords="Chadwick Boseman",
keywords="Twitter",
keywords="infodemiology",
abstract="Background: Colorectal cancer (CRC) has the third highest cancer mortality rate in the United States. Enhanced screening has reduced mortality rates; however, certain populations remain at high risk, notably African Americans. Raising awareness among at-risk populations may lead to improved CRC outcomes. The influence of celebrity death and illness is an important driver of public awareness. As such, the death of actor Chadwick Boseman from CRC may have influenced CRC awareness. Objective: We sought to assess the influence of Chadwick Boseman's death on public interest in CRC in the United States, evidenced by internet searches, website traffic, and donations to prominent cancer organizations. Methods: We used an auto-regressive integrated moving average model to forecast Google searching trends for the topic ``Colorectal cancer'' in the United States. We performed bivariate and multivariable regressions on state-wise CRC incidence rateand percent Black population. We obtained data from the American Cancer Society (ACS) and the Colon Cancer Foundation (CCF) for information regarding changes in website traffic and donations. Results: The expected national relative search volume (RSV) for colorectal cancer was 2.71 (95\% CI 1.76-3.66), reflecting a 3590\% (95\% CI 2632\%-5582\%) increase compared to the expected values. With multivariable regression, the statewise RSV increased for each percent Black population by 1.09 (SE 0.18, P<.001), with 42\% of the variance explained (P<.001). The American Cancer Society reported a 58,000\% increase in CRC-related website traffic the weekend following Chadwick Boseman's death compared to the weekend before. The Colon Cancer Foundation reported a 331\% increase in donations and a 144\% increase in revenue in the month following Boseman's death compared to the month prior. Conclusions: Our results suggest that Chadwick Boseman's death was associated with substantial increases in awareness of CRC. Increased awareness of CRC may support earlier detection and better prognoses. ",
doi="10.2196/29387",
url="https://infodemiology.jmir.org/2021/1/e29387",
url="http://www.ncbi.nlm.nih.gov/pubmed/37114199"
}


@Article{info:doi/10.2196/32105,
author="Wei, Chapman
and Bernstein, Sophie
and Adusumilli, Nagasai
and Marchitto, Mark
and Chen, Frank
and Rajpara, Anand",
title="Assessment and Evaluation of Social Engagement in Dermatology Residency Programs on Instagram: Cross-sectional Study",
journal="JMIR Dermatol",
year="2021",
month="Aug",
day="26",
volume="4",
number="2",
pages="e32105",
keywords="Instagram",
keywords="social media",
keywords="dermatology residency",
keywords="Instagram engagement score",
keywords="residency recruitment",
keywords="medical education",
doi="10.2196/32105",
url="https://derma.jmir.org/2021/2/e32105",
url="http://www.ncbi.nlm.nih.gov/pubmed/37632856"
}


@Article{info:doi/10.2196/28716,
author="Chum, Antony
and Nielsen, Andrew
and Bellows, Zachary
and Farrell, Eddie
and Durette, Pierre-Nicolas
and Banda, M. Juan
and Cupchik, Gerald",
title="Changes in Public Response Associated With Various COVID-19 Restrictions in Ontario, Canada: Observational Infoveillance Study Using Social Media Time Series Data",
journal="J Med Internet Res",
year="2021",
month="Aug",
day="25",
volume="23",
number="8",
pages="e28716",
keywords="COVID-19",
keywords="public opinion",
keywords="social media",
keywords="sentiment analysis",
keywords="public health restrictions",
keywords="infodemiology",
keywords="infoveillance",
keywords="coronavirus",
keywords="evaluation",
abstract="Background: News media coverage of antimask protests, COVID-19 conspiracies, and pandemic politicization has overemphasized extreme views but has done little to represent views of the general public. Investigating the public's response to various pandemic restrictions can provide a more balanced assessment of current views, allowing policy makers to craft better public health messages in anticipation of poor reactions to controversial restrictions. Objective: Using data from social media, this infoveillance study aims to understand the changes in public opinion associated with the implementation of COVID-19 restrictions (eg, business and school closures, regional lockdown differences, and additional public health restrictions, such as social distancing and masking). Methods: COVID-19--related tweets in Ontario (n=1,150,362) were collected based on keywords between March 12 and October 31, 2020. Sentiment scores were calculated using the VADER (Valence Aware Dictionary and Sentiment Reasoner) algorithm for each tweet to represent its negative to positive emotion. Public health restrictions were identified using government and news media websites. Dynamic regression models with autoregressive integrated moving average errors were used to examine the association between public health restrictions and changes in public opinion over time (ie, collective attention, aggregate positive sentiment, and level of disagreement), controlling for the effects of confounders (ie, daily COVID-19 case counts, holidays, and COVID-19--related official updates). Results: In addition to expected direct effects (eg, business closures led to decreased positive sentiment and increased disagreements), the impact of restrictions on public opinion was contextually driven. For example, the negative sentiment associated with business closures was reduced with higher COVID-19 case counts.  While school closures and other restrictions (eg, masking, social distancing, and travel restrictions) generated increased collective attention, they did not have an effect on aggregate sentiment or the level of disagreement (ie, sentiment polarization). Partial (ie, region-targeted) lockdowns were associated with better public response (ie, higher number of tweets with net positive sentiment and lower levels of disagreement) compared to province-wide lockdowns. Conclusions: Our study demonstrates the feasibility of a rapid and flexible method of evaluating the public response to pandemic restrictions using near real-time social media data. This information can help public health practitioners and policy makers anticipate public response to future pandemic restrictions and ensure adequate resources are dedicated to addressing increases in negative sentiment and levels of disagreement in the face of scientifically informed, but controversial, restrictions. ",
doi="10.2196/28716",
url="https://www.jmir.org/2021/8/e28716",
url="http://www.ncbi.nlm.nih.gov/pubmed/34227996"
}


@Article{info:doi/10.2196/27944,
author="Omar Bali, Ahmed
and Omer, Emad
and Abdulridha, Kawa
and Ahmad, Ramazan Araz",
title="Psychological Violence Against Arab Women in the Context of Social Media: Web-Based Questionnaire Study",
journal="J Med Internet Res",
year="2021",
month="Aug",
day="19",
volume="23",
number="8",
pages="e27944",
keywords="psychological",
keywords="violence",
keywords="Arab women",
keywords="social media",
keywords="feminism",
keywords="sociology",
keywords="abuse",
keywords="oppression",
keywords="self-esteem",
abstract="Background: Social media provides women with varying platforms to express themselves, show their talents, communicate and expand their social relationships, and break the shackles imposed by their societies. Theoretically, social media can play a significant role in developing women's freedom and decreasing social pressures; nonetheless, women continue to face violence during the social media era mainly in the form of psychological violence. Objective: This study aims to conduct an empirical in-depth analysis of how the digital space, particularly social media, provides men with new opportunities to surveil, restrict, harass, and intimidate feminists in Arab countries. Methods: This study includes an empirical survey to investigate what Arab women think are the causes and types of violence wielded against them and their perspectives on the impact of that violence. This study used a web-based questionnaire administered through Google Forms (n=1312) with responses from Arab women aged 15 years and above from all Arab countries. Results: We found that most Arab women feared posting an actual photograph of themselves on their social media accounts and only approximately one-third (490/1312, 37.3\%) did so. Most women indicated that they encountered sexual harassment regardless of their age. Furthermore, most women were not aware of the legal aspects of this crime and even those who were aware indicated that they would not press charges for several reasons, including bringing dishonor upon their families, the time-consuming nature of litigation, and fear of revenge. Conclusions: This study shows that young and less educated women are more vulnerable to abuse from either social media users or being condemned by their families. This has several effects, including lower self-esteem and hesitancy in seeking a job, feelings of mistrust and fear, cynicism, anxiety, depression, and sleep disorders. These issues hold women back from using social media in positive ways and some consider leaving social media. ",
doi="10.2196/27944",
url="https://www.jmir.org/2021/8/e27944",
url="http://www.ncbi.nlm.nih.gov/pubmed/34420919"
}


@Article{info:doi/10.2196/24523,
author="Mohd Hanim, Faiz Muhammad
and Md Sabri, Aslinie Budi
and Yusof, Norashikin",
title="Online News Coverage of the Sugar-Sweetened Beverages Tax in Malaysia: Content Analysis",
journal="JMIR Public Health Surveill",
year="2021",
month="Aug",
day="18",
volume="7",
number="8",
pages="e24523",
keywords="sugar-sweetened beverages",
keywords="obesity",
keywords="taxes",
keywords="media content analysis",
keywords="public health policy",
keywords="media content",
keywords="public health",
keywords="netnography",
keywords="malaysia",
keywords="budget",
abstract="Background: In Malaysia, the Sugar-Sweetened Beverages (SSBs) tax was announced during the parliament's 2019 Budget Speech. The tax was slated to be enforced by April 2019 but was later postponed to July 2019. The announcement has since generated significant media coverage and public feedback. Objective: This study presents a qualitative and quantitative cross-sectional study using netnography to examine how Malaysian online news articles responded to the SSBs tax after the announcement and postimplementation. Methods: Online news articles published on popular online news platforms from November 2018 to August 2019 were downloaded using NCapture and imported into NVivo for analysis using the inductive approach and thematic content analysis following the initial SSBs implementation announcement. Results: A total of 62 news articles were analyzed. Most of the articles positively portrayed the SSBs tax (46.8\%) and highlighted its health impacts (76\%). There were 7 key framing arguments identified in the articles. The positive arguments revolved around incentivizing manufacturers to introduce healthier products voluntarily, positive health consequences, the tax's impact on government revenue, and the use of the generated revenue toward beneficial social programs. The opposing arguments included increased operating costs to the manufacturer, the increased retail price of drinks, and how the SSBs tax is not a robust solution to obesity. The top priority sector considered in introducing the tax was the health perspective, followed by economic purposes and creating policies such as regulating the food and drinks industry. Conclusions: The majority of online news articles positively reported the implementation of the SSBs tax in Malaysia. This suggests media played a role in garnering support for the health policy. As such, relevant bodies can use negative findings to anticipate and reframe counteracting arguments opposing the SSBs tax. ",
doi="10.2196/24523",
url="https://publichealth.jmir.org/2021/8/e24523",
url="http://www.ncbi.nlm.nih.gov/pubmed/34406125"
}


@Article{info:doi/10.2196/32475,
author="Morant, Nicola
and Chilman, Natasha
and Lloyd-Evans, Brynmor
and Wackett, Jane
and Johnson, Sonia",
title="Acceptability of Using Social Media Content in Mental Health Research: A Reflection. Comment on ``Twitter Users' Views on Mental Health Crisis Resolution Team Care Compared With Stakeholder Interviews and Focus Groups: Qualitative Analysis''",
journal="JMIR Ment Health",
year="2021",
month="Aug",
day="17",
volume="8",
number="8",
pages="e32475",
keywords="Twitter",
keywords="social media",
keywords="qualitative",
keywords="crisis resolution team",
keywords="home treatment team",
keywords="mental health",
keywords="acute care",
keywords="severe mental illness",
doi="10.2196/32475",
url="https://mental.jmir.org/2021/8/e32475",
url="http://www.ncbi.nlm.nih.gov/pubmed/34402799"
}


@Article{info:doi/10.2196/25014,
author="Perkins, C. Ryan
and Gross, Rachel
and Regan, Kayla
and Bishay, Lara
and Sawicki, S. Gregory",
title="Perceptions of Social Media Use to Augment Health Care Among Adolescents and Young Adults With Cystic Fibrosis: Survey Study",
journal="JMIR Pediatr Parent",
year="2021",
month="Aug",
day="16",
volume="4",
number="3",
pages="e25014",
keywords="cystic fibrosis",
keywords="social media",
keywords="mobile health",
keywords="adherence",
keywords="adolescents",
keywords="young adults",
abstract="Background: For individuals with cystic fibrosis (CF), adolescence and young adulthood are times of significant vulnerability and have been associated with clinical and psychosocial challenges. Social media may offer innovative care delivery solutions to address these challenges. Objective: This study explored motivations and attitudes regarding current social media use and preferences for a social media platform in a sample of adolescents and young adults (AYA) with CF. Methods: A cross-sectional survey was administered to 50 AYA with CF followed at a large pediatric-adult CF center. The survey included questions regarding social media platform utilization, attitudes toward general and CF-specific online activities, and preferences for a CF-specific care delivery platform. Results: YouTube, Snapchat, and Instagram were the most commonly used social media platforms. AYA with CF do not report routinely using social media for health-related information acquisition, social support, or help with adherence. However, their perceptions of social media utilization and preferences for platform development suggest interest in doing so in the future. Conclusions: AYA with CF use social media and expressed interest in the development of a social media platform. Platform development will allow for gaps in health care delivery to be addressed by improving social support and adherence while augmenting current methods of health information acquisition. ",
doi="10.2196/25014",
url="https://pediatrics.jmir.org/2021/3/e25014",
url="http://www.ncbi.nlm.nih.gov/pubmed/34232121"
}


@Article{info:doi/10.2196/29150,
author="Tan, Hao
and Peng, Sheng-Lan
and Zhu, Chun-Peng
and You, Zuo
and Miao, Ming-Cheng
and Kuai, Shu-Guang",
title="Long-term Effects of the COVID-19 Pandemic on Public Sentiments in Mainland China: Sentiment Analysis of Social Media Posts",
journal="J Med Internet Res",
year="2021",
month="Aug",
day="12",
volume="23",
number="8",
pages="e29150",
keywords="COVID-19",
keywords="emotional trauma",
keywords="public sentiment on social media",
keywords="long-term effect",
abstract="Background: The COVID-19 outbreak has induced negative emotions among people. These emotions are expressed by the public on social media and are rapidly spread across the internet, which could cause high levels of panic among the public. Understanding the changes in public sentiment on social media during the pandemic can provide valuable information for developing appropriate policies to reduce the negative impact of the pandemic on the public. Previous studies have consistently shown that the COVID-19 outbreak has had a devastating negative impact on public sentiment. However, it remains unclear whether there has been a variation in the public sentiment during the recovery phase of the pandemic. Objective: In this study, we aim to determine the impact of the COVID-19 pandemic in mainland China by continuously tracking public sentiment on social media throughout 2020. Methods: We collected 64,723,242 posts from Sina Weibo, China's largest social media platform, and conducted a sentiment analysis based on natural language processing to analyze the emotions reflected in these posts. Results: We found that the COVID-19 pandemic not only affected public sentiment on social media during the initial outbreak but also induced long-term negative effects even in the recovery period. These long-term negative effects were no longer correlated with the number of new confirmed COVID-19 cases both locally and nationwide during the recovery period, and they were not attributed to the postpandemic economic recession. Conclusions: The COVID-19 pandemic induced long-term negative effects on public sentiment in mainland China even as the country recovered from the pandemic. Our study findings remind public health and government administrators of the need to pay attention to public mental health even once the pandemic has concluded. ",
doi="10.2196/29150",
url="https://www.jmir.org/2021/8/e29150",
url="http://www.ncbi.nlm.nih.gov/pubmed/34280118"
}


@Article{info:doi/10.2196/30251,
author="Liu, Siru
and Li, Jili
and Liu, Jialin",
title="Leveraging Transfer Learning to Analyze Opinions, Attitudes, and Behavioral Intentions Toward COVID-19 Vaccines: Social Media Content and Temporal Analysis",
journal="J Med Internet Res",
year="2021",
month="Aug",
day="10",
volume="23",
number="8",
pages="e30251",
keywords="vaccine",
keywords="COVID-19",
keywords="leveraging transfer learning",
keywords="pandemic",
keywords="infodemiology",
keywords="infoveillance",
keywords="public health",
keywords="social media",
keywords="content analysis",
keywords="machine learning",
keywords="online health",
abstract="Background: The COVID-19 vaccine is considered to be the most promising approach to alleviate the pandemic. However, in recent surveys, acceptance of the COVID-19 vaccine has been low. To design more effective outreach interventions, there is an urgent need to understand public perceptions of COVID-19 vaccines. Objective: Our objective was to analyze the potential of leveraging transfer learning to detect tweets containing opinions, attitudes, and behavioral intentions toward COVID-19 vaccines, and to explore temporal trends as well as automatically extract topics across a large number of tweets. Methods: We developed machine learning and transfer learning models to classify tweets, followed by temporal analysis and topic modeling on a dataset of COVID-19 vaccine--related tweets posted from November 1, 2020 to January 31, 2021. We used the F1 values as the primary outcome to compare the performance of machine learning and transfer learning models. The statistical values and P values from the Augmented Dickey-Fuller test were used to assess whether users' perceptions changed over time. The main topics in tweets were extracted by latent Dirichlet allocation analysis. Results: We collected 2,678,372 tweets related to COVID-19 vaccines from 841,978 unique users and annotated 5000 tweets. The F1 values of transfer learning models were 0.792 (95\% CI 0.789-0.795), 0.578 (95\% CI 0.572-0.584), and 0.614 (95\% CI 0.606-0.622) for these three tasks, which significantly outperformed the machine learning models (logistic regression, random forest, and support vector machine). The prevalence of tweets containing attitudes and behavioral intentions varied significantly over time. Specifically, tweets containing positive behavioral intentions increased significantly in December 2020. In addition, we selected tweets in the following categories: positive attitudes, negative attitudes, positive behavioral intentions, and negative behavioral intentions. We then identified 10 main topics and relevant terms for each category. Conclusions: Overall, we provided a method to automatically analyze the public understanding of COVID-19 vaccines from real-time data in social media, which can be used to tailor educational programs and other interventions to effectively promote the public acceptance of COVID-19 vaccines. ",
doi="10.2196/30251",
url="https://www.jmir.org/2021/8/e30251",
url="http://www.ncbi.nlm.nih.gov/pubmed/34254942"
}


@Article{info:doi/10.2196/28931,
author="Laestadius, I. Linnea
and Craig, A. Katherine
and Campos-Castillo, Celeste",
title="Perceptions of Alerts Issued by Social Media Platforms in Response to Self-injury Posts Among Latinx Adolescents: Qualitative Analysis",
journal="J Med Internet Res",
year="2021",
month="Aug",
day="10",
volume="23",
number="8",
pages="e28931",
keywords="adolescents",
keywords="social media",
keywords="mental health",
keywords="NSSI",
keywords="race and ethnicity",
keywords="mobile phone",
abstract="Background: There is growing interest in using social media data to detect and address nonsuicidal self-injury (NSSI) among adolescents. Adolescents often do not seek clinical help for NSSI and may adopt strategies to obscure detection; therefore, social media platforms may be able to facilitate early detection and treatment by using machine learning models to screen posts for harmful content and subsequently alert adults. However, such efforts have raised privacy and ethical concerns among health researchers. Little is currently known about how adolescents perceive these efforts. Objective: The aim of this study is to examine perceptions of automated alerts for NSSI posts on social media among Latinx adolescents, who are at risk for NSSI yet are underrepresented in both NSSI and health informatics research. In addition, we considered their perspectives on preferred recipients of automated alerts. Methods: We conducted semistructured, qualitative interviews with 42 Latinx adolescents between the ages of 13 and 17 years who were recruited from a nonprofit organization serving the Latinx community in Milwaukee, Wisconsin. The Latinx population in Milwaukee is largely of Mexican descent. All interviews were conducted between June and July 2019. Transcripts were analyzed using framework analysis to discern their perceptions of automated alerts sent by social media platforms and potential alert recipients. Results: Participants felt that automated alerts would make adolescents safer and expedite aid before the situation escalated. However, some worried that hyperbolic statements would generate false alerts and instigate conflicts. Interviews revealed strong opinions about ideal alert recipients. Parents were most commonly endorsed, but support was conditional on perceptions that the parent would respond appropriately. Emergency services were judged as safer but inappropriate for situations considered lower risk. Alerts sent to school staff generated the strongest privacy concerns. Altogether, the preferred alert recipients varied by individual adolescents and perceived risks in the situation. None raised ethical concerns about the collection, analysis, or storage of personal information regarding their mental health status. Conclusions: Overall, Latinx adolescents expressed broad support for automated alerts for NSSI on social media, which indicates opportunities to address NSSI. However, these efforts should be co-constructed with adolescents to ensure that preferences and needs are met, as well as embedded within broader approaches for addressing structural and cultural barriers to care. ",
doi="10.2196/28931",
url="https://www.jmir.org/2021/8/e28931",
url="http://www.ncbi.nlm.nih.gov/pubmed/34383683"
}


@Article{info:doi/10.2196/28249,
author="Tri Sakti, Muhammad Andi
and Mohamad, Emma
and Azlan, Anis Arina",
title="Mining of Opinions on COVID-19 Large-Scale Social Restrictions in Indonesia: Public Sentiment and Emotion Analysis on Online Media",
journal="J Med Internet Res",
year="2021",
month="Aug",
day="9",
volume="23",
number="8",
pages="e28249",
keywords="large-scale social restrictions",
keywords="social media",
keywords="public sentiment",
keywords="Twitter",
keywords="COVID-19",
keywords="infodemiology",
keywords="infoveillance",
abstract="Background: One of the successful measures to curb COVID-19 spread in large populations is the implementation of a movement restriction order. Globally, it was observed that countries implementing strict movement control were more successful in controlling the spread of the virus as compared with those with less stringent measures. Society's adherence to the movement control order has helped expedite the process to flatten the pandemic curve as seen in countries such as China and Malaysia. At the same time, there are countries facing challenges with society's nonconformity toward movement restriction orders due to various claims such as human rights violations as well as sociocultural and economic issues. In Indonesia, society's adherence to its large-scale social restrictions (LSSRs) order is also a challenge to achieve. Indonesia is regarded as among the worst in Southeast Asian countries in terms of managing the spread of COVID-19. It is proven by the increased number of daily confirmed cases and the total number of deaths, which was more than 6.21\% (1351/21,745) of total active cases as of May 2020. Objective: The aim of this study was to explore public sentiments and emotions toward the LSSR and identify issues, fear, and reluctance to observe this restriction among the Indonesian public. Methods: This study adopts a sentiment analysis method with a supervised machine learning approach on COVID-19-related posts on selected media platforms (Twitter, Facebook, Instagram, and YouTube). The analysis was also performed on COVID-19-related news contained in more than 500 online news platforms recognized by the Indonesian Press Council. Social media posts and news originating from Indonesian online media between March 31 and May 31, 2020, were analyzed. Emotion analysis on Twitter platform was also performed to identify collective public emotions toward the LSSR. Results: The study found that positive sentiment surpasses other sentiment categories by 51.84\% (n=1,002,947) of the total data (N=1,934,596) collected via the search engine. Negative sentiment was recorded at 35.51\% (686,892/1,934,596) and neutral sentiment at 12.65\% (244,757/1,934,596). The analysis of Twitter posts also showed that the majority of public have the emotion of ``trust'' toward the LSSR. Conclusions: Public sentiment toward the LSSR appeared to be positive despite doubts on government consistency in executing the LSSR. The emotion analysis also concluded that the majority of people believe in LSSR as the best method to break the chain of COVID-19 transmission. Overall, Indonesians showed trust and expressed hope toward the government's ability to manage this current global health crisis and win against COVID-19. ",
doi="10.2196/28249",
url="https://www.jmir.org/2021/8/e28249",
url="http://www.ncbi.nlm.nih.gov/pubmed/34280116"
}


@Article{info:doi/10.2196/26478,
author="Du, Jingcheng
and Preston, Sharice
and Sun, Hanxiao
and Shegog, Ross
and Cunningham, Rachel
and Boom, Julie
and Savas, Lara
and Amith, Muhammad
and Tao, Cui",
title="Using Machine Learning--Based Approaches for the Detection and Classification of Human Papillomavirus Vaccine Misinformation: Infodemiology Study of Reddit Discussions",
journal="J Med Internet Res",
year="2021",
month="Aug",
day="5",
volume="23",
number="8",
pages="e26478",
keywords="HPV vaccine",
keywords="social media",
keywords="misinformation",
keywords="infodemiology",
keywords="infoveillance",
keywords="deep learning",
keywords="Reddit",
keywords="machine learning",
abstract="Background: The rapid growth of social media as an information channel has made it possible to quickly spread inaccurate or false vaccine information, thus creating obstacles for vaccine promotion. Objective: The aim of this study is to develop and evaluate an intelligent automated protocol for identifying and classifying human papillomavirus (HPV) vaccine misinformation on social media using machine learning (ML)--based methods. Methods: Reddit posts (from 2007 to 2017, N=28,121) that contained keywords related to HPV vaccination were compiled. A random subset (2200/28,121, 7.82\%) was manually labeled for misinformation and served as the gold standard corpus for evaluation. A total of 5 ML-based algorithms, including a support vector machine, logistic regression, extremely randomized trees, a convolutional neural network, and a recurrent neural network designed to identify vaccine misinformation, were evaluated for identification performance. Topic modeling was applied to identify the major categories associated with HPV vaccine misinformation. Results: A convolutional neural network model achieved the highest area under the receiver operating characteristic curve of 0.7943. Of the 28,121 Reddit posts, 7207 (25.63\%) were classified as vaccine misinformation, with discussions about general safety issues identified as the leading type of misinformed posts (2666/7207, 36.99\%). Conclusions: ML-based approaches are effective in the identification and classification of HPV vaccine misinformation on Reddit and may be generalizable to other social media platforms. ML-based methods may provide the capacity and utility to meet the challenge involved in intelligent automated monitoring and classification of public health misinformation on social media platforms. The timely identification of vaccine misinformation on the internet is the first step in misinformation correction and vaccine promotion. ",
doi="10.2196/26478",
url="https://www.jmir.org/2021/8/e26478",
url="http://www.ncbi.nlm.nih.gov/pubmed/34383667"
}


@Article{info:doi/10.2196/28074,
author="Masngut, Nasaai
and Mohamad, Emma",
title="Association Between Public Opinion and Malaysian Government Communication Strategies About the COVID-19 Crisis: Content Analysis of Image Repair Strategies in Social Media",
journal="J Med Internet Res",
year="2021",
month="Aug",
day="4",
volume="23",
number="8",
pages="e28074",
keywords="COVID-19",
keywords="crisis",
keywords="health communication",
keywords="image repair",
keywords="Malaysian government",
keywords="sentiment",
keywords="communication",
keywords="content analysis",
keywords="public opinion",
keywords="social media",
keywords="strategy",
abstract="Background: The COVID-19 health crisis has posed an unprecedented challenge for governments worldwide to manage and communicate about the pandemic effectively, while maintaining public trust. Good leadership image in times of a health emergency is paramount to ensure public confidence in governments' abilities to manage the crisis. Objective: The aim of this study was to identify types of image repair strategies utilized by the Malaysian government in their communication about COVID-19 in the media and analyze public responses to these messages on social media. Methods: Content analysis was employed to analyze 120 media statements and 382 comments retrieved from Facebook pages of 2 mainstream newspapers---Berita Harian and The Star. These media statements and comments were collected within a span of 6 weeks prior to and during the first implementation of Movement Control Order by the Malaysian Government. The media statements were analyzed according to Image Repair Theory to categorize strategies employed in government communications related to COVID-19 crisis. Public opinion responses were measured using modified lexicon-based sentiment analysis to categorize positive, negative, and neutral statements. Results: The Malaysian government employed all 5 Image Repair Theory strategies in their communications in both newspapers. The strategy most utilized was reducing offensiveness (75/120, 62.5\%), followed by corrective action (30/120, 25.0\%), evading responsibilities (10/120, 8.3\%), denial (4/120, 3.3\%), and mortification (1/120, 0.8\%). This study also found multiple substrategies in government media statements including denial, shifting blame, provocation, defeasibility, accident, good intention, bolstering, minimization, differentiation, transcendence, attacking accuser, resolve problem, prevent recurrence, admit wrongdoing, and apologize. This study also found that 64.7\% of public opinion was positive in response to media statements made by the Malaysian government and also revealed a significant positive association (P=.04) between image repair strategies utilized by the Malaysian government and public opinion. Conclusions: Communication in the media may assist the government in fostering positive support from the public. Suitable image repair strategies could garner positive public responses and help build trust in times of crisis. ",
doi="10.2196/28074",
url="https://www.jmir.org/2021/8/e28074",
url="http://www.ncbi.nlm.nih.gov/pubmed/34156967"
}


@Article{info:doi/10.2196/28147,
author="Oakley-Girvan, Ingrid
and Watterson, L. Jessica
and Jones, Cheryl
and Houghton, C. Lauren
and Gibbons, P. Marley
and Gokal, Kajal
and Magsamen-Conrad, Kate",
title="Use of Social Media for Cancer Prevention Through Neighborhood Social Cohesion: Protocol for a Feasibility Study",
journal="JMIR Res Protoc",
year="2021",
month="Jul",
day="30",
volume="10",
number="7",
pages="e28147",
keywords="social cohesion",
keywords="mothers",
keywords="neighborhood",
keywords="physical activity",
keywords="social media",
keywords="social",
keywords="behavior",
keywords="health outcomes",
keywords="socioeconomic status",
keywords="community health",
keywords="chronic disease",
keywords="social network",
keywords="feasibility",
keywords="wellbeing",
keywords="cancer",
abstract="Background: Social cohesion is associated with healthier behaviors and better health outcomes, and therefore may offer a mechanism for promoting better health. Low socioeconomic status (SES) communities face higher rates of chronic disease due to both community- and individual-level factors. Objective: The aim of this study is to leverage social cohesion to promote healthier behaviors and prevent chronic disease in a low SES community. This protocol outlines the methodology for a pilot study to assess the feasibility of an intervention (Free Time For Wellness [FT4W]) using a social networking platform (Nextdoor) with mothers living in an urban, low-income community to improve social cohesion and promote healthy behaviors. Methods: The study will involve three phases: (I) co-designing the intervention with mothers in the neighborhoods of interest, (II) implementing the intervention with community leaders through the social networking platform, and (III) evaluating the intervention's feasibility. Phase I of the study will include qualitative data collection and analysis from in-depth, semistructured interviews and a co-design group session with mothers. Phases II and III of the study include a pre- and postintervention survey of participating mothers. Neighborhood-level data on social cohesion will also be collected to enable comparison of outcomes between neighborhoods with higher and lower baseline social cohesion. Results: As of March 2021, recruitment and data collection for this study are complete. This protocol outlines our original study plan, although the final enrollment numbers and intervention implementation deviated from our initial planned methodology that is outlined in this protocol. These implementation learnings will be shared in subsequent publications of our study results. Conclusions: Ultimately, this study aims to: (1) determine the barriers and facilitators to finding free time for wellness among a population of low-income mothers to inform the co-design process, and (2) implement and study the feasibility of an intervention that leverages social cohesion to promote physical activity in a community of low-income mothers. The results of this study will provide preliminary feasibility evidence to inform a larger effectiveness trial, and will further our understanding of how social cohesion might influence well-being. International Registered Report Identifier (IRRID): RR1-10.2196/28147 ",
doi="10.2196/28147",
url="https://www.researchprotocols.org/2021/7/e28147",
url="http://www.ncbi.nlm.nih.gov/pubmed/34328445"
}


@Article{info:doi/10.2196/26759,
author="Ruco, Arlinda
and Dossa, Fahima
and Tinmouth, Jill
and Llovet, Diego
and Jacobson, Jenna
and Kishibe, Teruko
and Baxter, Nancy",
title="Social Media and mHealth Technology for Cancer Screening: Systematic Review and Meta-analysis",
journal="J Med Internet Res",
year="2021",
month="Jul",
day="30",
volume="23",
number="7",
pages="e26759",
keywords="social media",
keywords="mHealth",
keywords="cancer screening",
keywords="digital health",
keywords="mass screening",
keywords="mobile phone",
abstract="Background: Cancer is a leading cause of death, and although screening can reduce cancer morbidity and mortality, participation in screening remains suboptimal. Objective: This systematic review and meta-analysis aims to evaluate the effectiveness of social media and mobile health (mHealth) interventions for cancer screening. Methods: We searched for randomized controlled trials and quasi-experimental studies of social media and mHealth interventions promoting cancer screening (breast, cervical, colorectal, lung, and prostate cancers) in adults in MEDLINE, Embase, PsycINFO, Scopus, CINAHL, Cochrane Central Register of Controlled Trials, and Communication \& Mass Media Complete from January 1, 2000, to July 17, 2020. Two independent reviewers screened the titles, abstracts, and full-text articles and completed the risk of bias assessments. We pooled odds ratios for screening participation using the Mantel-Haenszel method in a random-effects model. Results: We screened 18,008 records identifying 39 studies (35 mHealth and 4 social media). The types of interventions included peer support (n=1), education or awareness (n=6), reminders (n=13), or mixed (n=19). The overall pooled odds ratio was 1.49 (95\% CI 1.31-1.70), with similar effect sizes across cancer types. Conclusions: Screening programs should consider mHealth interventions because of their promising role in promoting cancer screening participation. Given the limited number of studies identified, further research is needed for social media interventions. Trial Registration: PROSPERO International Prospective Register of Systematic Reviews CRD42019139615; https://www.crd.york.ac.uk/prospero/display\_record.php?RecordID=139615 International Registered Report Identifier (IRRID): RR2-10.1136/bmjopen-2019-035411 ",
doi="10.2196/26759",
url="https://www.jmir.org/2021/7/e26759",
url="http://www.ncbi.nlm.nih.gov/pubmed/34328423"
}


@Article{info:doi/10.2196/24994,
author="Lee, Kyong-No
and Joo, Ji Yeon
and Choi, Yeon So
and Park, Taek Sung
and Lee, Keun-Young
and Kim, Youngmi
and Son, Ga-Hyun",
title="Content Analysis and Quality Evaluation of Cesarean Delivery--Related Videos on YouTube: Cross-sectional Study",
journal="J Med Internet Res",
year="2021",
month="Jul",
day="30",
volume="23",
number="7",
pages="e24994",
keywords="cesarean delivery",
keywords="YouTube",
keywords="internet",
keywords="quality of information",
abstract="Background: YouTube is one of the most popular open-access video-sharing websites, and it is also used to obtain health care information. Cesarean delivery is the most common major surgical intervention in many countries. Videos related to cesarean delivery have also been uploaded to YouTube. However, no study has explored the overall quality of cesarean delivery videos on the platform. Objective: The objective of this study was to analyze the content and evaluate the quality of the most frequently viewed videos related to cesarean delivery that are accessible on YouTube. Methods: We searched for a total of 18 terms by combining the 6 terms retrieved from Google AdWords and the 3 terms c section, cesarean section, and cesarean delivery, which are used interchangeably. Videos were sorted by view count, and the 100 videos with the highest view counts were chosen. The number of views, duration, likes and dislikes, content type, and source of each video were recorded. In evaluating the quality of the videos, we referred to a previous study. Additionally, we developed a detailed scoring method that comprehensively evaluates the videos related to cesarean delivery by including the necessary information for each element of the cesarean delivery and whether scientific evidence was presented. Results: Of the 100 videos analyzed, the most prevalent content (n=28) was videos that contained the actual surgical procedure of a cesarean delivery, and the most common source of cesarean delivery videos was physicians (n=30). Videos directly related to cesarean delivery, such as explanation of the surgery and the actual surgical procedure, were mainly uploaded by medical groups and scored higher than the videos indirectly related to cesarean delivery, which were mainly uploaded by nonmedical groups. In addition, videos directly related to cesarean delivery were more often uploaded earlier in time, with lower like ratios compared to indirect videos. Conclusions: YouTube is currently not an appropriate source for patients seeking information on cesarean delivery. ",
doi="10.2196/24994",
url="https://www.jmir.org/2021/7/e24994",
url="http://www.ncbi.nlm.nih.gov/pubmed/34328422"
}


@Article{info:doi/10.2196/26378,
author="Erskine, Natalie
and Hendricks, Sharief",
title="The Use of Twitter by Medical Journals: Systematic Review of the Literature",
journal="J Med Internet Res",
year="2021",
month="Jul",
day="28",
volume="23",
number="7",
pages="e26378",
keywords="Twitter",
keywords="social media",
keywords="medical journals",
keywords="impact",
abstract="Background: Medical journals use Twitter to engage and disseminate their research articles and implement a range of strategies to maximize reach and impact. Objective: This study aims to systematically review the literature to synthesize and describe the different Twitter strategies used by medical journals and their effectiveness on journal impact and readership metrics. Methods: A systematic search of the literature before February 2020 in four electronic databases (PubMed, Web of Science, Scopus, and ScienceDirect) was conducted. Articles were reviewed using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines. Results: The search identified 44 original research studies that evaluated Twitter strategies implemented by medical journals and analyzed the relationship between Twitter metrics and alternative and citation-based metrics. The key findings suggest that promoting publications on Twitter improves citation-based and alternative metrics for academic medical journals. Moreover, implementing different Twitter strategies maximizes the amount of attention that publications and journals receive. The four key Twitter strategies implemented by many medical journals are tweeting the title and link of the article, infographics, podcasts, and hosting monthly internet-based journal clubs. Each strategy was successful in promoting the publications. However, different metrics were used to measure success. Conclusions: Four key Twitter strategies are implemented by medical journals: tweeting the title and link of the article, infographics, podcasts, and hosting monthly internet-based journal clubs. In this review, each strategy was successful in promoting publications but used different metrics to measure success. Thus, it is difficult to conclude which strategy is most effective. In addition, the four strategies have different costs and effects on dissemination and readership. We recommend that journals and researchers incorporate a combination of Twitter strategies to maximize research impact and capture audiences with a variety of learning methods. ",
doi="10.2196/26378",
url="https://www.jmir.org/2021/7/e26378",
url="http://www.ncbi.nlm.nih.gov/pubmed/34319238"
}


@Article{info:doi/10.2196/29904,
author="Pakhdikian, H. Sarin
and Woo, P. Benjamin K.",
title="The Role of Providers and Influencers in the Use of Social Media as Solace for Psoriasis: Qualitative and Quantitative Study",
journal="JMIR Dermatol",
year="2021",
month="Jul",
day="28",
volume="4",
number="2",
pages="e29904",
keywords="psoriasis",
keywords="psychodermatology",
keywords="social media",
keywords="Instagram",
keywords="coping skills",
keywords="stigma",
keywords="depression",
keywords="anxiety",
keywords="psychosocial",
keywords="influencers",
keywords="internet",
abstract="Background: Psoriasis is a multisystem chronic inflammatory skin disease and is a relatively common disorder in children and adults. The burden of psoriasis impacts both the physiological and psychological areas of one's life. Given the robust use of the internet and social media, patients have turned to Instagram for educational and social support to discuss psoriasis. Objective: This study aimed to characterize how patients interact with Instagram to cope with the biopsychosocial aspects of psoriasis. We analyzed journals and organizations, and compared them with the public profiles of individuals diagnosed with psoriasis who provided information and refuge. Our goal was to identify how followers engaged and what type of content they were most receptive to in terms of psoriasis. Methods: All journals and organizations representing psoriasis were selected for review. The top 10 public profiles of individuals diagnosed with psoriasis were also selected for comparison. The numbers of followers, followings, and posts were noted to evaluate popularity. The numbers of likes and comments were also recorded to understand engagement. Results: On comparing journals and organizations to public profiles, we found that the former had a greater number of followers but engaged less with the audience on Instagram based on the number of profiles they followed. Profiles of individuals with psoriasis produced content that was more personal and relatable, including experiences with flares, motivational text, and emotional support. The content produced by journals and organizations was geared toward education and providing peer-reviewed resources and commentary from licensed health care professionals. Followers were more engaged via ``likes'' than ``comments'' on the Instagram profiles of journals and organizations, as well as the public profiles of individuals diagnosed with psoriasis. Conclusions: There was evident online presence of journals and organizations, and public profiles of individuals providing content regarding psoriasis on Instagram. However, there were distinguishing features for the type of content being produced. Journals and organizations took the traditional approach in providing evidence-based information, whereas the public profiles of individuals provided content related to the psychosocial needs of the psoriasis community. The 10 profiles of individuals provided posts involving creativity and real experiences, which were evidently well-received based on ``likes'' and ``comments.'' This research helps us appreciate what the audience on Instagram is looking for to further address how we can merge these needs to provide a holistic platform on Instagram for both providers and patients. Social media creates a space for collaboration, which can be advantageous for journals and organizations to work with patient volunteers from diverse backgrounds who can help build a therapeutic alliance and public presence on Instagram with their viewers in order to deliver medical peer-reviewed information. ",
doi="10.2196/29904",
url="https://derma.jmir.org/2021/2/e29904",
url="http://www.ncbi.nlm.nih.gov/pubmed/37632846"
}


@Article{info:doi/10.2196/29060,
author="Vandormael, Alain
and Adam, Maya
and Greuel, Merlin
and Gates, Jennifer
and Favaretti, Caterina
and Hachaturyan, Violetta
and B{\"a}rnighausen, Till",
title="The Effect of a Wordless, Animated, Social Media Video Intervention on COVID-19 Prevention: Online Randomized Controlled Trial",
journal="JMIR Public Health Surveill",
year="2021",
month="Jul",
day="27",
volume="7",
number="7",
pages="e29060",
keywords="social media",
keywords="cultural and social implications",
keywords="randomized controlled trial",
keywords="list experiment",
keywords="information literacy",
keywords="COVID-19",
keywords="pandemic",
keywords="digital health",
keywords="infodemiology",
keywords="global health",
keywords="public health",
abstract="Background: Innovative approaches to the dissemination of evidence-based COVID-19 health messages are urgently needed to counter social media misinformation about the pandemic. To this end, we designed a short, wordless, animated global health communication video (the CoVideo), which was rapidly distributed through social media channels to an international audience. Objective: The objectives of this study were to (1) establish the CoVideo's effectiveness in improving COVID-19 prevention knowledge, and (2) establish the CoVideo's effectiveness in increasing behavioral intent toward COVID-19 prevention. Methods: In May and June 2020, we enrolled 15,163 online participants from the United States, Mexico, the United Kingdom, Germany, and Spain. We randomized participants to (1) the CoVideo arm, (2) an attention placebo control (APC) arm, and (3) a do-nothing arm, and presented 18 knowledge questions about preventive COVID-19 behaviors, which was our first primary endpoint. To measure behavioral intent, our second primary endpoint, we randomized participants in each arm to five list experiments. Results: Globally, the video intervention was viewed 1.2 million times within the first 10 days of its release and more than 15 million times within the first 4 months. Knowledge in the CoVideo arm was significantly higher (mean 16.95, 95\% CI 16.91-16.99) than in the do-nothing (mean 16.86, 95\% CI 16.83-16.90; P<.001) arm. We observed high baseline levels of behavioral intent to perform many of the preventive behaviors featured in the video intervention. We were only able to detect a statistically significant impact of the CoVideo on one of the five preventive behaviors. Conclusions: Despite high baseline levels, the intervention was effective at boosting knowledge of COVID-19 prevention. We were only able to capture a measurable change in behavioral intent toward one of the five COVID-19 preventive behaviors examined in this study. The global reach of this health communication intervention and the high voluntary engagement of trial participants highlight several innovative features that could inform the design and dissemination of public health messages. Short, wordless, animated videos, distributed by health authorities via social media, may be an effective pathway for rapid global health communication during health crises. Trial Registration: German Clinical Trials Register DRKS00021582; https://tinyurl.com/6r4zkbbn International Registered Report Identifier (IRRID): RR2-10.1186/s13063-020-04942-7 ",
doi="10.2196/29060",
url="https://publichealth.jmir.org/2021/7/e29060",
url="http://www.ncbi.nlm.nih.gov/pubmed/34174778"
}


@Article{info:doi/10.2196/23876,
author="Walsh-Buhi, Eric
and Houghton, Fagen Rebecca
and Lange, Claire
and Hockensmith, Ryli
and Ferrand, John
and Martinez, Lourdes",
title="Pre-exposure Prophylaxis (PrEP) Information on Instagram: Content Analysis",
journal="JMIR Public Health Surveill",
year="2021",
month="Jul",
day="27",
volume="7",
number="7",
pages="e23876",
keywords="digital health",
keywords="social media",
keywords="HIV",
keywords="pre-exposure prophylaxis",
keywords="Instagram",
keywords="content analysis",
keywords="communication",
abstract="Background: There is still an HIV epidemic in the United States, which is a substantial issue for populations bearing a disproportionate burden of HIV infections. Daily oral pre-exposure prophylaxis (PrEP) has proven to be safe and effective in reducing HIV acquisition risk. However, studies document that PrEP awareness/usage is low. There is also limited understanding of social media platforms, such as Instagram, as PrEP information sources. Objective: Given the paucity of research on PrEP-related Instagram posts and popularity of this social media platform, the purpose of this research is to describe the source characteristics, image types, and textual contents of PrEP-related posts on Instagram. Methods: Using Crowdtangle Search, a public insights tool owned/operated by Facebook, we retrieved publicly accessible and English-language-only Instagram posts for the 12-month period preceding April 22, 2020, using the following terms: Truvada or ``pre-exposure prophylaxis'' or \#truvada or \#truvadaprep or \#truvadawhore or \#truvadaforprep. We employed a qualitative coding methodology to manually extract information from posts. Using a pretested codebook, we performed content analysis on 250 posts, examining message and source characteristics (ie, organization type [eg, government, news] and individual type [eg, physician]), including information about PrEP (eg, how it works, cost), and indicated users. Frequencies and percentages were calculated for all categorical variables. A Chi-square test was conducted to determine differences between source types on a variety of message characteristics. Results: Three-quarters of the posts (193/250, 77.2\%) were posted by organizations. Of the 250 posts reviewed, approximately two-thirds (174/250, 69.6\%) included a photograph, more than half (142/250, 56.8\%) included an infographic, and approximately one-tenth (30/250, 12\%) included a video. More than half defined PrEP (137/250, 54.8\%), but fewer posts promoted PrEP use, explained how PrEP works, and included information on the effectiveness of PrEP or who can use it. The most commonly hashtagged populations among posts were men who have sex with men (MSM), but not necessarily bisexual men. Few posts contained race-/ethnicity-related hashtags (11/250, 4.4\%). Fewer posts contained transgender-associated tags (eg, \#transgirl; 5/250, 2\%). No posts contained tags related to heterosexuals or injection drug users. We found statistical differences between source types (ie, individual versus organization). Specifically, posts from organizations more frequently contained information about who can use PrEP, whereas posts from individuals more frequently contained information describing adverse effects. Conclusions: This study is among the first to review Instagram for PrEP-related content, and it answers the National AIDS Strategy's call for a clearer articulation of the science surrounding HIV risk/prevention through better understanding of the current public information environment. This study offers a snapshot of how PrEP is being discussed (and by whom) on one of the most popular social media platforms and provides a foundation for developing and implementing PrEP promotion interventions on Instagram. ",
doi="10.2196/23876",
url="https://publichealth.jmir.org/2021/7/e23876",
url="http://www.ncbi.nlm.nih.gov/pubmed/34061759"
}


@Article{info:doi/10.2196/26183,
author="Karim, Sana
and Hsiung, Kimberly
and Symonds, Maria
and Radovic, Ana",
title="Experience of Peer Bloggers Using a Social Media Website for Adolescents With Depression or Anxiety: Proof-of-Concept Study",
journal="JMIR Form Res",
year="2021",
month="Jul",
day="22",
volume="5",
number="7",
pages="e26183",
keywords="adolescent",
keywords="social media",
keywords="blogging",
keywords="depression",
keywords="anxiety",
abstract="Background: Supporting Our Valued Adolescents (SOVA) is a moderated and anonymous social media website intervention. SOVA ambassadors are adolescents and young adults (AYA) asked to write monthly blog posts and comments on others' posts on topics surrounding mental health. Objective: This study aims to understand the feasibility and acceptability of peer blogging for a moderated mental health intervention website and explore whether bloggers---AYA who self-report symptoms of depression and anxiety---experience potential benefits. Methods: AYA aged 14 to 26 years with a self-reported history of depression or anxiety were recruited to the SOVA Peer Ambassador Program. Participants were asked to write one blog post a month and comment at least four times a month on other blog posts, for which they were compensated for up to US \$15 monthly. Outcome variables measured at baseline and 3 months after intervention included website usability and feasibility, depressive symptoms, anxiety symptoms, mental health treatment history, cybercoping, personal blogging style, self-esteem, loneliness, mental health stigma, social support, and positive youth development characteristics. Open-ended questions were asked about their blogging acceptability and usability. Results: Of 66 AYA showing interest and completing onboarding, 71\% (47/66) wrote at least one blog post, with an average of 3 posts per person. A sample of 51\% (34/66) of participants completed a 3-month survey for the full analysis. Almost all 34 participants were satisfied with the experience of blogging (32/34, 94\%) and rated the website usability as good (80.1, SD 14.9). At 3 months, self-esteem scores increased by 2.1, with a small-medium effect size (P=.01; Cohen d=0.45), and youth competence and confidence increased by 0.7 (P=.002) and 1.3 (P=.002), with medium effect sizes (Cohen d=0.62 and 0.60), respectively. Conclusions: A blogging intervention for AYA with a history of depression or anxiety was feasible with regular and active engagement and shows evidence in a one-sample design for positive changes in strength-based assets---self-esteem, competence, and confidence---which map onto resilience. ",
doi="10.2196/26183",
url="https://formative.jmir.org/2021/7/e26183",
url="http://www.ncbi.nlm.nih.gov/pubmed/34292161"
}


@Article{info:doi/10.2196/27448,
author="Grantham, L. Jordyn
and Verishagen, L. Carrie
and Whiting, J. Susan
and Henry, J. Carol
and Lieffers, L. Jessica R.",
title="Evaluation of a Social Media Campaign in Saskatchewan to Promote Healthy Eating During the COVID-19 Pandemic: Social Media Analysis and Qualitative Interview Study",
journal="J Med Internet Res",
year="2021",
month="Jul",
day="21",
volume="23",
number="7",
pages="e27448",
keywords="COVID-19",
keywords="diet, healthy",
keywords="nutrition",
keywords="health promotion",
keywords="social media",
keywords="dietitian",
keywords="Saskatchewan",
abstract="Background: The beginning of the COVID-19 pandemic presented many sudden challenges regarding food, including grocery shopping changes (eg, reduced store hours, capacity restrictions, and empty store shelves due to food hoarding), restaurant closures, the need to cook more at home, and closures of food access programs. Eat Well Saskatchewan (EWS) implemented a 16-week social media campaign, \#eatwellcovid19, led by a dietitian and nutrition student that focused on sharing stories submitted by the Saskatchewan public about how they were eating healthy during the COVID-19 pandemic. Objective: The goal of this study was to describe the implementation of the \#eatwellcovid19 social media campaign and the results from the evaluation of the campaign, which included campaign performance using social media metrics and experiences and perspectives of campaign followers. Methods: Residents of Saskatchewan, Canada, were invited to submit personal stories and experiences to EWS about how they were eating healthy during the COVID-19 pandemic from April to August 2020. Each week, one to three stories were featured on EWS social media platforms---Facebook, Instagram, and Twitter---along with evidence-based nutrition information to help residents become more resilient to challenges related to food and nutrition experienced during the COVID-19 pandemic. Individuals who submitted stories were entered into a weekly draw for a Can \$100 grocery gift card. Social media metrics and semistructured qualitative interviews of campaign followers were used to evaluate the \#eatwellcovid19 campaign. Results: In total, 75 stories were submitted by 74 individuals on a variety of topics (eg, grocery shopping, traditional skills, and gardening), and 42 stories were featured on social media. EWS shared 194 \#eatwellcovid19 posts across social media platforms (Facebook: n=100; Instagram: n=55; and Twitter: n=39). On Facebook, \#eatawellcovid19 reached 100,571 followers and left 128,818 impressions, resulting in 9575 engagements. On Instagram, the campaign reached 11,310 followers, made 14,145 impressions, and received 823 likes and 15 comments. On Twitter, \#eatwellcovid19 made 15,199 impressions and received 424 engagements. Featured story submission posts had the best engagement on Facebook and the most likes and comments on Instagram. The EWS social media pages reported increases in their following during the campaign (Instagram: +30\%; Facebook: +14\%; and Twitter: +12\%). Results from the interviews revealed that there were two types of campaign followers: those who appreciated hearing the stories submitted by followers, as it helped them to feel connected to the community during social isolation, and those who appreciated the evidence-based information. Conclusions: Numerous stories were submitted to the \#eatwellcovid19 social media campaign on various topics. On Instagram and Facebook, posts that featured these stories had the highest engagement. During this campaign, EWS's social media following increased by more than 10\% on each platform. The approach used for the \#eatwellcovid19 campaign could be considered by others looking to develop health promotion campaigns. ",
doi="10.2196/27448",
url="https://www.jmir.org/2021/7/e27448",
url="http://www.ncbi.nlm.nih.gov/pubmed/34133314"
}


@Article{info:doi/10.2196/25925,
author="Ram{\'i}rez-Cifuentes, Diana
and Freire, Ana
and Baeza-Yates, Ricardo
and Sanz Lamora, Nadia
and {\'A}lvarez, Aida
and Gonz{\'a}lez-Rodr{\'i}guez, Alexandre
and Lozano Rochel, Meritxell
and Llobet Vives, Roger
and Velazquez, Alejandro Diego
and Gonfaus, Maria Josep
and Gonz{\`a}lez, Jordi",
title="Characterization of Anorexia Nervosa on Social Media: Textual, Visual, Relational, Behavioral, and Demographical Analysis",
journal="J Med Internet Res",
year="2021",
month="Jul",
day="20",
volume="23",
number="7",
pages="e25925",
keywords="social media",
keywords="Twitter",
keywords="Spanish",
keywords="anorexia nervosa",
keywords="eating disorders",
keywords="user characterization",
abstract="Background: Eating disorders are psychological conditions characterized by unhealthy eating habits. Anorexia nervosa (AN) is defined as the belief of being overweight despite being dangerously underweight. The psychological signs involve emotional and behavioral issues. There is evidence that signs and symptoms can manifest on social media, wherein both harmful and beneficial content is shared daily. Objective: This study aims to characterize Spanish-speaking users showing anorexia signs on Twitter through the extraction and inference of behavioral, demographical, relational, and multimodal data. By using the transtheoretical model of health behavior change, we focus on characterizing and comparing users at the different stages of the model for overcoming AN, including treatment and full recovery periods. Methods: We analyzed the writings, posting patterns, social relationships, and images shared by Twitter users who underwent different stages of anorexia nervosa and compared the differences among users going through each stage of the illness and users in the control group (ie, users without AN). We also analyzed the topics of interest of their followees (ie, users followed by study participants). We used a clustering approach to distinguish users at an early phase of the illness (precontemplation) from those that recognize that their behavior is problematic (contemplation) and generated models for the detection of tweets and images related to AN. We considered two types of control users---focused control users, which are those that use terms related to anorexia, and random control users. Results: We found significant differences between users at each stage of the recovery process (P<.001) and control groups. Users with AN tweeted more frequently at night, with a median sleep time tweets ratio (STTR) of 0.05, than random control users (STTR=0.04) and focused control users (STTR=0.03). Pictures were relevant for the characterization of users. Focused and random control users were characterized by the use of text in their profile pictures. We also found a strong polarization between focused control users and users in the first stages of the disorder. There was a strong correlation among the shared interests between users with AN and their followees ($\rho$=0.96). In addition, the interests of recovered users and users in treatment were more highly correlated to those corresponding to the focused control group ($\rho$=0.87 for both) than those of AN users ($\rho$=0.67), suggesting a shift in users' interest during the recovery process. Conclusions: We mapped the signs of AN to social media context. These results support the findings of previous studies that focused on other languages and involved a deep analysis of the topics of interest of users at each phase of the disorder. The features and patterns identified provide a basis for the development of detection tools and recommender systems. ",
doi="10.2196/25925",
url="https://www.jmir.org/2021/7/e25925",
url="http://www.ncbi.nlm.nih.gov/pubmed/34283033"
}


@Article{info:doi/10.2196/26510,
author="Allem, Jon-Patrick
and Dormanesh, Allison
and Majmundar, Anuja
and Rivera, Vanessa
and Chu, Maya
and Unger, B. Jennifer
and Cruz, Boley Tess",
title="Leading Topics in Twitter Discourse on JUUL and Puff Bar Products: Content Analysis",
journal="J Med Internet Res",
year="2021",
month="Jul",
day="19",
volume="23",
number="7",
pages="e26510",
keywords="electronic cigarettes",
keywords="JUUL",
keywords="public health",
keywords="Puff Bar",
keywords="social media",
keywords="Twitter",
keywords="infodemiology",
abstract="Background: In response to the recent government restrictions, flavored JUUL products, which are rechargeable closed-system electronic cigarettes (e-cigarettes), are no longer available for sale. However, disposable closed-system products such as the flavored Puff Bar e-cigarette continues to be available. If e-cigarette consumers simply switch between products during the current government restrictions limited to 1 type of product over another, then such restrictions would be less effective. A step forward in this line of research is to understand how the public discusses these products by examining discourse referencing both Puff Bar and JUUL in the same conversation. Twitter data provide ample opportunity to capture such early trends that could be used to help public health researchers stay abreast of the rapidly changing e-cigarette marketplace. Objective: The goal of this study was to examine public discourse referencing both Puff Bar and JUUL products in the same conversation on Twitter. Methods: We collected data from Twitter's streaming application programming interface between July 16, 2019, and August 29, 2020, which included both ``Puff Bar'' and ``JUUL'' (n=2632). We then used an inductive approach to become familiar with the data and generate a codebook to identify common themes. Saturation was determined to be reached with 10 themes. Results: Posts often mentioned flavors, dual use, design features, youth use, health risks, switching 1 product for the other, price, confusion over the differences between products, longevity of the products, and nicotine concentration. Conclusions: On examining the public's conversations about Puff Bar and JUUL products on Twitter, having described themes in posts, this study aimed to help the tobacco control community stay informed about 2 popular e-cigarette products with different device features, which can be potentially substituted for one another. Future health communication campaigns may consider targeting the health consequences of using multiple e-cigarette products or dual use to reduce exposure to high levels of nicotine among younger populations. ",
doi="10.2196/26510",
url="https://www.jmir.org/2021/7/e26510",
url="http://www.ncbi.nlm.nih.gov/pubmed/34279236"
}


@Article{info:doi/10.2196/29723,
author="Fazel, S. Sajjad
and Quinn, K. Emma
and Ford-Sahibzada, A. Chelsea
and Szarka, Steven
and Peters, E. Cheryl",
title="Sunscreen Posts on Twitter in the United States and Canada, 2019: Content Analysis",
journal="JMIR Dermatol",
year="2021",
month="Jul",
day="19",
volume="4",
number="2",
pages="e29723",
keywords="sunscreen",
keywords="skin cancer",
keywords="Twitter",
keywords="misinformation",
keywords="prevention",
keywords="skin",
keywords="social media",
keywords="health promotion",
keywords="melanoma",
doi="10.2196/29723",
url="https://derma.jmir.org/2021/2/e29723",
url="http://www.ncbi.nlm.nih.gov/pubmed/37632814"
}


@Article{info:doi/10.2196/26876,
author="Stevens, R. Hannah
and Oh, Jung Yoo
and Taylor, D. Laramie",
title="Desensitization to Fear-Inducing COVID-19 Health News on Twitter: Observational Study",
journal="JMIR Infodemiology",
year="2021",
month="Jul",
day="16",
volume="1",
number="1",
pages="e26876",
keywords="desensitization",
keywords="death toll",
keywords="pandemic",
keywords="fear-inducing",
keywords="fear",
keywords="health news",
keywords="anxiety",
keywords="COVID-19",
keywords="mass media",
keywords="public health",
keywords="behavior change",
keywords="coronavirus",
abstract="Background: As of May 9, 2021, the United States had 32.7 million confirmed cases of COVID-19 (20.7\% of confirmed cases worldwide) and 580,000 deaths (17.7\% of deaths worldwide). Early on in the pandemic, widespread social, financial, and mental insecurities led to extreme and irrational coping behaviors, such as panic buying. However, despite the consistent spread of COVID-19 transmission, the public began to violate public safety measures as the pandemic got worse. Objective: In this work, we examine the effect of fear-inducing news articles on people's expression of anxiety on Twitter. Additionally, we investigate desensitization to fear-inducing health news over time, despite the steadily rising COVID-19 death toll. Methods: This study examined the anxiety levels in news articles (n=1465) and corresponding user tweets containing ``COVID,'' ``COVID-19,'' ``pandemic,'' and ``coronavirus'' over 11 months, then correlated that information with the death toll of COVID-19 in the United States. Results: Overall, tweets that shared links to anxious articles were more likely to be anxious (odds ratio [OR] 2.65, 95\% CI 1.58-4.43, P<.001). These odds decreased (OR 0.41, 95\% CI 0.2-0.83, P=.01) when the death toll reached the third quartile and fourth quartile (OR 0.42, 95\% CI 0.21-0.85, P=.01). However, user tweet anxiety rose rapidly with articles when the death toll was low and then decreased in the third quartile of deaths (OR 0.61, 95\% CI 0.37-1.01, P=.06). As predicted, in addition to the increasing death toll being matched by a lower level of article anxiety, the extent to which article anxiety elicited user tweet anxiety decreased when the death count reached the second quartile. Conclusions: The level of anxiety in users' tweets increased sharply in response to article anxiety early on in the COVID-19 pandemic, but as the casualty count climbed, news articles seemingly lost their ability to elicit anxiety among readers. Desensitization offers an explanation for why the increased threat is not eliciting widespread behavioral compliance with guidance from public health officials. This work investigated how individuals' emotional reactions to news of the COVID-19 pandemic manifest as the death toll increases. Findings suggest individuals became desensitized to the increased COVID-19 threat and their emotional responses were blunted over time. ",
doi="10.2196/26876",
url="https://infodemiology.jmir.org/2021/1/e26876",
url="http://www.ncbi.nlm.nih.gov/pubmed/34447923"
}


@Article{info:doi/10.2196/27116,
author="Tran, Thanh Huyen Thi
and Lu, Shih-Hao
and Tran, Thu Ha Thi
and Nguyen, Van Bien",
title="Social Media Insights During the COVID-19 Pandemic: Infodemiology Study Using Big Data",
journal="JMIR Med Inform",
year="2021",
month="Jul",
day="16",
volume="9",
number="7",
pages="e27116",
keywords="COVID-19",
keywords="Vietnam",
keywords="public attention",
keywords="social media",
keywords="infodemic",
keywords="issue-attention cycle",
keywords="media framing",
keywords="big data",
keywords="health crisis management",
keywords="insight",
keywords="infodemiology",
keywords="infoveillance",
keywords="social listening",
abstract="Background: The COVID-19 pandemic is still undergoing complicated developments in Vietnam and around the world. There is a lot of information about the COVID-19 pandemic, especially on the internet where people can create and share information quickly. This can lead to an infodemic, which is a challenge every government might face in the fight against pandemics. Objective: This study aims to understand public attention toward the pandemic (from December 2019 to November 2020) through 7 types of sources: Facebook, Instagram, YouTube, blogs, news sites, forums, and e-commerce sites. Methods: We collected and analyzed nearly 38 million pieces of text data from the aforementioned sources via SocialHeat, a social listening (infoveillance) platform developed by YouNet Group. We described not only public attention volume trends, discussion sentiments, top sources, top posts that gained the most public attention, and hot keyword frequency but also hot keywords' co-occurrence as visualized by the VOSviewer software tool. Results: In this study, we reached four main conclusions. First, based on changing discussion trends regarding the COVID-19 subject, 7 periods were identified based on events that can be aggregated into two pandemic waves in Vietnam. Second, community pages on Facebook were the source of the most engagement from the public. However, the sources with the highest average interaction efficiency per article were government sources. Third, people's attitudes when discussing the pandemic have changed from negative to positive emotions. Fourth, the type of content that attracts the most interactions from people varies from time to time. Besides that, the issue-attention cycle theory occurred not only once but four times during the COVID-19 pandemic in Vietnam. Conclusions: Our study shows that online resources can help the government quickly identify public attention to public health messages during times of crisis. We also determined the hot spots that most interested the public and public attention communication patterns, which can help the government get practical information to make more effective policy reactions to help prevent the spread of the pandemic. ",
doi="10.2196/27116",
url="https://medinform.jmir.org/2021/7/e27116",
url="http://www.ncbi.nlm.nih.gov/pubmed/34152994"
}


@Article{info:doi/10.2196/23242,
author="Batra, Nikita
and Colson, D. Cindy
and Alberto, C. Emily
and Burd, S. Randall",
title="Using Social Media for the Prevention of Pediatric Burn Injuries: Pilot Design and Usability Study",
journal="JMIR Form Res",
year="2021",
month="Jul",
day="15",
volume="5",
number="7",
pages="e23242",
keywords="accident prevention",
keywords="burns",
keywords="pediatric",
keywords="public health",
keywords="social media",
abstract="Background: Most pediatric burn injuries are preventable. Social media is an effective method for delivering large-scale messaging and may be useful for injury prevention in this domain. Objective: This study evaluates the feasibility of creating a social media campaign for pediatric burn injury prevention. Methods: Ad spots containing a headline, short introduction, and video were created and posted on Facebook and Instagram over 4 months. Ad spots were targeted to parents and caregivers of children in our region with the highest number of burn injuries. We assessed the impact of each ad set using ThruPlays, reach, and video plays. Results: We created 55 ad spots, with an average length of 24.1 (range 10-44) seconds. We reached 26,496 people during the campaign. The total ThruPlays of the 55 ad spots were 14,460 at US \$0.19 per ThruPlay. Ad spots related to home safety had a significantly higher daily ThruPlay rate than those related to fire safety (6.5 vs 0.5 per day; P<.001). Conclusions: Social media is a feasible modality for delivering public health messages focused on preventing pediatric burn injuries. Engagement with these ads is influenced by ad presentation and the focus of the underlying injury prevention message. ",
doi="10.2196/23242",
url="https://formative.jmir.org/2021/7/e23242",
url="http://www.ncbi.nlm.nih.gov/pubmed/34264194"
}


@Article{info:doi/10.2196/28615,
author="Margus, Colton
and Brown, Natasha
and Hertelendy, J. Attila
and Safferman, R. Michelle
and Hart, Alexander
and Ciottone, R. Gregory",
title="Emergency Physician Twitter Use in the COVID-19 Pandemic as a Potential Predictor of Impending Surge: Retrospective Observational Study",
journal="J Med Internet Res",
year="2021",
month="Jul",
day="14",
volume="23",
number="7",
pages="e28615",
keywords="COVID-19 pandemic",
keywords="emergency medicine",
keywords="disaster medicine",
keywords="crisis standards of care",
keywords="latent Dirichlet allocation",
keywords="topic modeling",
keywords="Twitter",
keywords="sentiment analysis",
keywords="surge capacity",
keywords="physician wellness",
keywords="social media",
keywords="internet",
keywords="infodemiology",
keywords="COVID-19",
abstract="Background: The early conversations on social media by emergency physicians offer a window into the ongoing response to the COVID-19 pandemic. Objective: This retrospective observational study of emergency physician Twitter use details how the health care crisis has influenced emergency physician discourse online and how this discourse may have use as a harbinger of ensuing surge. Methods: Followers of the three main emergency physician professional organizations were identified using Twitter's application programming interface. They and their followers were included in the study if they identified explicitly as US-based emergency physicians. Statuses, or tweets, were obtained between January 4, 2020, when the new disease was first reported, and December 14, 2020, when vaccination first began. Original tweets underwent sentiment analysis using the previously validated Valence Aware Dictionary and Sentiment Reasoner (VADER) tool as well as topic modeling using latent Dirichlet allocation unsupervised machine learning. Sentiment and topic trends were then correlated with daily change in new COVID-19 cases and inpatient bed utilization. Results: A total of 3463 emergency physicians produced 334,747 unique English-language tweets during the study period. Out of 3463 participants, 910 (26.3\%) stated that they were in training, and 466 of 902 (51.7\%) participants who provided their gender identified as men. Overall tweet volume went from a pre-March 2020 mean of 481.9 (SD 72.7) daily tweets to a mean of 1065.5 (SD 257.3) daily tweets thereafter. Parameter and topic number tuning led to 20 tweet topics, with a topic coherence of 0.49. Except for a week in June and 4 days in November, discourse was dominated by the health care system (45,570/334,747, 13.6\%). Discussion of pandemic response, epidemiology, and clinical care were jointly found to moderately correlate with COVID-19 hospital bed utilization (Pearson r=0.41), as was the occurrence of ``covid,'' ``coronavirus,'' or ``pandemic'' in tweet texts (r=0.47). Momentum in COVID-19 tweets, as demonstrated by a sustained crossing of 7- and 28-day moving averages, was found to have occurred on an average of 45.0 (SD 12.7) days before peak COVID-19 hospital bed utilization across the country and in the four most contributory states. Conclusions: COVID-19 Twitter discussion among emergency physicians correlates with and may precede the rising of hospital burden. This study, therefore, begins to depict the extent to which the ongoing pandemic has affected the field of emergency medicine discourse online and suggests a potential avenue for understanding predictors of surge. ",
doi="10.2196/28615",
url="https://www.jmir.org/2021/7/e28615",
url="http://www.ncbi.nlm.nih.gov/pubmed/34081612"
}


@Article{info:doi/10.2196/25049,
author="Sch{\"u}ck, St{\'e}phane
and Roustamal, Avesta
and Gedik, Ana{\"i}s
and Voillot, Pam{\'e}la
and Foulqui{\'e}, Pierre
and Penfornis, Catherine
and Job, Bernard",
title="Assessing Patient Perceptions and Experiences of Paracetamol in France: Infodemiology Study Using Social Media Data Mining",
journal="J Med Internet Res",
year="2021",
month="Jul",
day="12",
volume="23",
number="7",
pages="e25049",
keywords="analgesic use",
keywords="data mining",
keywords="infodemiology",
keywords="paracetamol",
keywords="pharmacovigilance",
keywords="social media",
keywords="patient perception",
abstract="Background: Individuals frequently turning to social media to discuss medical conditions and medication, sharing their experiences and information and asking questions among themselves. These online discussions can provide valuable insights into individual perceptions of medical treatment, and increasingly, studies are focusing on the potential use of this information to improve health care management. Objective: The objective of this infodemiology study was to identify social media posts mentioning paracetamol-containing products to develop a better understanding of patients' opinions and perceptions of the drug. Methods: Posts between January 2003 and March 2019 containing at least one mention of paracetamol were extracted from 18 French forums in May 2019 with the use of the Detec't (Kap Code) web crawler. Posts were then analyzed using the automated Detec't tool, which uses machine learning and text mining methods to inspect social media posts and extract relevant content. Posts were classified into groups: Paracetamol Only, Paracetamol and Opioids, Paracetamol and Others, and the Aggregate group. Results: Overall, 44,283 posts were analyzed from 20,883 different users. Post volume over the study period showed a peak in activity between 2009 and 2012, as well as a spike in 2017 in the Aggregate group. The number of posts tended to be higher during winter each year. Posts were made predominantly by women (14,897/20,883, 71.34\%), with 12.00\% (2507/20,883) made by men and 16.67\% (3479/20,883) by individuals of unknown gender. The mean age of web users was 39 (SD 19) years. In the Aggregate group, pain was the most common medical concept discussed (22,257/37,863, 58.78\%), and paracetamol risk was the most common discussion topic, addressed in 20.36\% (8902/43,725) of posts. Doliprane was the most common medication mentioned (14,058/44,283, 31.74\%) within the Aggregate group, and tramadol was the most commonly mentioned drug in combination with paracetamol in the Aggregate group (1038/19,587, 5.30\%). The most common unapproved indication mentioned within the Paracetamol Only group was fatigue (190/616, with 16.32\% positive for an unapproved indication), with reference to dependence made by 1.61\% (136/8470) of the web users, accounting for 1.33\% (171/12,843) of the posts in the Paracetamol Only group. Dependence mentions in the Paracetamol and Opioids group were provided by 6.94\% (248/3576) of web users, accounting for 5.44\% (342/6281) of total posts. Reference to overdose was made by 245 web users across 291 posts within the Paracetamol Only group. The most common potential adverse event detected was nausea (306/12843, 2.38\%) within the Paracetamol Only group. Conclusions: The use of social media mining with the Detec't tool provided valuable information on the perceptions and understanding of the web users, highlighting areas where providing more information for the general public on paracetamol, as well as other medications, may be of benefit. ",
doi="10.2196/25049",
url="https://www.jmir.org/2021/7/e25049",
url="http://www.ncbi.nlm.nih.gov/pubmed/34255645"
}


@Article{info:doi/10.2196/27942,
author="Alhassan, Mohammed Fatimah
and AlDossary, Abdullah Sharifah",
title="The Saudi Ministry of Health's Twitter Communication Strategies and Public Engagement During the COVID-19 Pandemic: Content Analysis Study",
journal="JMIR Public Health Surveill",
year="2021",
month="Jul",
day="12",
volume="7",
number="7",
pages="e27942",
keywords="COVID-19",
keywords="Crisis and Emergency Risk Communication",
keywords="effective communication",
keywords="health authorities",
keywords="outbreak",
keywords="pandemic",
keywords="public engagement",
keywords="public health",
keywords="social media",
keywords="Twitter",
abstract="Background: During a public health crisis such as the current COVID-19 pandemic, governments and health authorities need quick and accurate methods of communicating with the public. While social media can serve as a useful tool for effective communication during disease outbreaks, few studies have elucidated how these platforms are used by the Ministry of Health (MOH) during disease outbreaks in Saudi Arabia. Objective: Guided by the Crisis and Emergency Risk Communication model, this study aimed to explore the MOH's use of Twitter and the public's engagement during different stages of the COVID-19 pandemic in Saudi Arabia. Methods: Tweets and corresponding likes and retweets were extracted from the official Twitter account of the MOH in Saudi Arabia for the period of January 1 through August 31, 2020. Tweets related to COVID-19 were identified; subsequently, content analysis was performed, in which tweets were coded for the following message types: risk messages, warnings, preparations, uncertainty reduction, efficacy, reassurance, and digital health responses. Public engagement was measured by examining the numbers of likes and retweets. The association between outbreak stages and types of messages was assessed, as well as the effect of these messages on public engagement. Results: The MOH posted a total of 1393 original tweets during the study period. Of the total tweets, 1293 (92.82\%) were related to COVID-19, and 1217 were ultimately included in the analysis. The MOH posted the majority of its tweets (65.89\%) during the initial stage of the outbreak. Accordingly, the public showed the highest level of engagement (as indicated by numbers of likes and retweets) during the initial stage. The types of messages sent by the MOH significantly differed across outbreak stages, with messages related to uncertainty reduction, reassurance, and efficacy being prevalent among all stages. Tweet content, media type, and crisis stage influenced the level of public engagement. Engagement was negatively associated with the inclusion of hyperlinks and multimedia files, while higher level of public engagement was associated with the use of hashtags. Tweets related to warnings, uncertainty reduction, and reassurance received high levels of public engagement. Conclusions: This study provides insights into the Saudi MOH's communication strategy during the COVID-19 pandemic. Our results have implications for researchers, governments, health organizations, and practitioners with regard to their communication practices during outbreaks. To increase public engagement, governments and health authorities should consider the public's need for information. This, in turn, could raise public awareness regarding disease outbreaks. ",
doi="10.2196/27942",
url="https://publichealth.jmir.org/2021/7/e27942",
url="http://www.ncbi.nlm.nih.gov/pubmed/34117860"
}


@Article{info:doi/10.2196/24512,
author="Vornholt, Piper
and De Choudhury, Munmun",
title="Understanding the Role of Social Media--Based Mental Health Support Among College Students: Survey and Semistructured Interviews",
journal="JMIR Ment Health",
year="2021",
month="Jul",
day="12",
volume="8",
number="7",
pages="e24512",
keywords="college mental health",
keywords="social media",
keywords="social support",
keywords="mobile phone",
abstract="Background: Mental illness is a growing concern within many college campuses. Limited access to therapy resources, along with the fear of stigma, often prevents students from seeking help. Introducing supportive interventions, coping strategies, and mitigation programs might decrease the negative effects of mental illness among college students. Objective: Many college students find social support for a variety of needs through social media platforms. With the pervasive adoption of social media sites in college populations, in this study, we examine whether and how these platforms may help meet college students' mental health needs. Methods: We first conducted a survey among 101 students, followed by semistructured interviews (n=11), of a large public university in the southeast region of the United States to understand whether, to what extent, and how students appropriate social media platforms to suit their struggle with mental health concerns. The interviews were intended to provide comprehensive information on students' attitudes and their perceived benefits and limitations of social media as platforms for mental health support. Results: Our survey revealed that a large number of participating students (71/101, 70.3\%) had recently experienced some form of stress, anxiety, or other mental health challenges related to college life. Half of them (52/101, 51.5\%) also reported having appropriated some social media platforms for self-disclosure or help, indicating the pervasiveness of this practice. Through our interviews, we obtained deeper insights into these initial observations. We identified specific academic, personal, and social life stressors; motivations behind social media use for mental health needs; and specific platform affordances that helped or hindered this use. Conclusions: Students recognized the benefits of social media in helping connect with peers on campus and promoting informal and candid disclosures. However, they argued against complete anonymity in platforms for mental health help and advocated the need for privacy and boundary regulation mechanisms in social media platforms supporting this use. Our findings bear implications for informing campus counseling efforts and in designing social media--based mental health support tools for college students. ",
doi="10.2196/24512",
url="https://mental.jmir.org/2021/7/e24512",
url="http://www.ncbi.nlm.nih.gov/pubmed/34255701"
}


@Article{info:doi/10.2196/25285,
author="Valaitis, Ruta
and Cleghorn, Laura
and Vassilev, Ivaylo
and Rogers, Anne
and Ploeg, Jenny
and Kothari, Anita
and Risdon, Cathy
and Gillett, James
and Guenter, Dale
and Dolovich, Lisa",
title="A Web-Based Social Network Tool (GENIE) for Supporting Self-management Among High Users of the Health Care System: Feasibility and Usability Study",
journal="JMIR Form Res",
year="2021",
month="Jul",
day="12",
volume="5",
number="7",
pages="e25285",
keywords="web-based tool",
keywords="usability",
keywords="feasibility",
keywords="self-management",
keywords="social network",
keywords="primary care",
keywords="health and social services",
keywords="linkages",
keywords="high systems users",
keywords="volunteers",
abstract="Background: Primary care providers are well positioned to foster self-management through linking patients to community-based health and social services (HSSs). This study evaluated a web-based tool---GENIE (Generating Engagement in Network Involvement)---to support the self-management of adults. GENIE empowers patients to leverage their personal social networks and increase their access to HSSs. GENIE maps patients' personal social networks, elicits preferences, and filters local HSSs from a community service directory based on patient's interests. Trained volunteers (an extension of the primary care team) conducted home visits and conducted surveys related to life and health goals in the context of the Health TAPESTRY (Teams Advancing Patient Experience: Strengthening Quality) program, in which the GENIE tool was implemented. GENIE reports were uploaded to an electronic medical record for care planning by the team. Objective: This study aims to explore patients', volunteers', and clinicians' perceptions of the feasibility, usability, and perceived outcomes of GENIE---a tool for community-dwelling adults who are high users of the health care system. Methods: This study involved 2 primary care clinician focus groups and 1 clinician interview (n=15), 1 volunteer focus group (n=3), patient telephone interviews (n=8), field observations that captured goal-action sequences to complete GENIE, and GENIE utilization statistics. The patients were enrolled in a primary care program---Health TAPESTRY---and Ontario's Health Links Program, which coordinates care for the highest users of the health care system. NVivo 11 (QSR International) was used to support qualitative data analyses related to feasibility and perceived outcomes, and descriptive statistics were used for quantitative data. Results: Most participants reported positive overall perceptions of GENIE. However, feasibility testing showed that participants had a partial understanding of the tool; volunteer facilitation was critical to support the implementation of GENIE; clinicians perceived their navigation ability as superior to that of GENIE supported by volunteers; and tool completion took 39 minutes, which made the home visit too long for some. Usability challenges included difficulties completing some sections of the tool related to medical terminology and unclear instructions, limitations in the quality and quantity of HSSs results, and minor technological challenges. Almost all patients identified a community program or activity of interest. Half of the patients (4/8, 50\%) followed up on HSSs and added new members to their network, whereas 1 participant lost a member. Clinicians' strengthened their understanding of patients' personal social networks and needs, and patients felt less social isolation. Conclusions: This study demonstrated the potential of GENIE, when supported by volunteers, to expand patients' social networks and link them to relevant HSSs. Volunteers require training to implement GENIE for self-management support, which may help overcome the time limitations faced by primary care clinicians. Refining the filtering capability of GENIE to address adults' needs may improve primary care providers' confidence in using such tools. ",
doi="10.2196/25285",
url="https://formative.jmir.org/2021/7/e25285",
url="http://www.ncbi.nlm.nih.gov/pubmed/34255654"
}


@Article{info:doi/10.2196/28227,
author="Li, Jiacheng
and Zhang, Shaowu
and Zhang, Yijia
and Lin, Hongfei
and Wang, Jian",
title="Multifeature Fusion Attention Network for Suicide Risk Assessment Based on Social Media: Algorithm Development and Validation",
journal="JMIR Med Inform",
year="2021",
month="Jul",
day="9",
volume="9",
number="7",
pages="e28227",
keywords="suicide risk assessment",
keywords="social media",
keywords="infodemiology",
keywords="attention mechanism",
keywords="neural networks",
abstract="Background: Suicide has become the fifth leading cause of death worldwide. With development of the internet, social media has become an imperative source for studying psychological illnesses such as depression and suicide. Many methods have been proposed for suicide risk assessment. However, most of the existing methods cannot grasp the key information of the text. To solve this problem, we propose an efficient method to extract the core information from social media posts for suicide risk assessment. Objective: We developed a multifeature fusion recurrent attention model for suicide risk assessment. Methods: We used the bidirectional long short-term memory network to create the text representation with context information from social media posts. We further introduced a self-attention mechanism to extract the core information. We then fused linguistic features to improve our model. Results: We evaluated our model on the dataset delivered by the Computational Linguistics and Clinical Psychology 2019 shared task. The experimental results showed that our model improves the risk-F1, urgent-F1, and existence-F1 by 3.3\%, 0.9\%, and 3.7\%, respectively. Conclusions: We found that bidirectional long short-term memory performs well for long text representation, and the attention mechanism can identify the key information in the text. The external features can complete the semantic information lost by the neural network during feature extraction and further improve the performance of the model. The experimental results showed that our model performs better than the state-of-the-art method. Our work has theoretical and practical value for suicidal risk assessment. ",
doi="10.2196/28227",
url="https://medinform.jmir.org/2021/7/e28227",
url="http://www.ncbi.nlm.nih.gov/pubmed/34255687"
}


@Article{info:doi/10.2196/24340,
author="Sukunesan, Suku
and Huynh, Minh
and Sharp, Gemma",
title="Examining the Pro-Eating Disorders Community on Twitter Via the Hashtag \#proana: Statistical Modeling Approach",
journal="JMIR Ment Health",
year="2021",
month="Jul",
day="9",
volume="8",
number="7",
pages="e24340",
keywords="Twitter",
keywords="infodemiology",
keywords="eating disorders",
keywords="proana",
keywords="thinspo",
keywords="hashtags",
keywords="transient",
keywords="cybersectarianism",
abstract="Background: There is increasing concern around communities that promote eating disorders (Pro-ED) on social media sites through messages and images that encourage dangerous weight control behaviors. These communities share group identity formed through interactions between members and can involve the exchange of ``tips,'' restrictive dieting plans, extreme exercise plans, and motivating imagery of thin bodies. Unlike Instagram, Facebook, or Tumblr, the absence of adequate policy to moderate Pro-ED content on Twitter presents a unique space for the Pro-ED community to freely communicate. While recent research has identified terms, themes, and common lexicon used within the Pro-ED online community, very few have been longitudinal. It is important to focus upon the engagement of Pro-ED online communities over time to further understand how members interact and stay connected, which is currently lacking. Objective: The purpose of this study was to explore beyond the common messages of Pro-ED on Twitter to understand how Pro-ED communities get traction over time by using the hashtag considered to symbolize the Pro-ED movement, \#proana. Our focus was to collect longitudinal data to gain a further understanding of the engagement of Pro-ED communities on Twitter. Methods: Descriptive statistics were used to identify the preferred tweeting style of Twitter users (either as mentioning another user in a tweet or without) as well as their most frequently used hashtag, in addition to \#proana. A series of Mann Whitney U tests were then conducted to compare preferred posting style across number of followed, followers, tweets, and favorites. This was followed by linear models using a forward step-wise approach that were applied for Pro-ED Twitter users to examine the factors associated with their number of followers. Results: This study reviewed 11,620 Pro-ED Twitter accounts that posted using the hashtag \#proana between September 2015 and July 2018. These profiles then underwent a 2-step screening of inclusion and exclusion criteria to reach the final sample of 967 profiles. Over 90\% (10,484/11,620) of the profiles were found to have less than 6 tweets within the 34-month period. Most of the users were identified as preferring a mentioning style of tweeting (718/967, 74.3\%) over not mentioning (248/967, 25.7\%). Further, \#proana and \#thinspo were used interchangeably to propagate shared themes, and there was a reciprocal effect between followers and the followed. Conclusions: Our analysis showed that the number of accounts followed and number of Pro-ED tweets posted were significant predictors for the number of followers a user has, compared to likes. Our results could potentially be useful to social media platforms to understand which features could help or otherwise curtail the spread of ED messages and activity. Our findings also show that Pro-ED communities are transient in nature, engaging in superficial discussion threads but resilient, emulating cybersectarian behavior. ",
doi="10.2196/24340",
url="https://mental.jmir.org/2021/7/e24340",
url="http://www.ncbi.nlm.nih.gov/pubmed/34255707"
}


@Article{info:doi/10.2196/29942,
author="Chan, Calvin
and Sounderajah, Viknesh
and Daniels, Elisabeth
and Acharya, Amish
and Clarke, Jonathan
and Yalamanchili, Seema
and Normahani, Pasha
and Markar, Sheraz
and Ashrafian, Hutan
and Darzi, Ara",
title="The Reliability and Quality of YouTube Videos as a Source of Public Health Information Regarding COVID-19 Vaccination: Cross-sectional Study",
journal="JMIR Public Health Surveill",
year="2021",
month="Jul",
day="8",
volume="7",
number="7",
pages="e29942",
keywords="COVID-19",
keywords="infodemiology",
keywords="public health",
keywords="quality",
keywords="reliability",
keywords="social media",
keywords="vaccination",
keywords="vaccine",
keywords="video",
keywords="web-based health information",
keywords="YouTube",
abstract="Background: Recent emergency authorization and rollout of COVID-19 vaccines by regulatory bodies has generated global attention. As the most popular video-sharing platform globally, YouTube is a potent medium for the dissemination of key public health information. Understanding the nature of available content regarding COVID-19 vaccination on this widely used platform is of substantial public health interest. Objective: This study aimed to evaluate the reliability and quality of information on COVID-19 vaccination in YouTube videos. Methods: In this cross-sectional study, the phrases ``coronavirus vaccine'' and ``COVID-19 vaccine'' were searched on the UK version of YouTube on December 10, 2020. The 200 most viewed videos of each search were extracted and screened for relevance and English language. Video content and characteristics were extracted and independently rated against Health on the Net Foundation Code of Conduct and DISCERN quality criteria for consumer health information by 2 authors. Results: Forty-eight videos, with a combined total view count of 30,100,561, were included in the analysis. Topics addressed comprised the following: vaccine science (n=18, 58\%), vaccine trials (n=28, 58\%), side effects (n=23, 48\%), efficacy (n=17, 35\%), and manufacturing (n=8, 17\%). Ten (21\%) videos encouraged continued public health measures. Only 2 (4.2\%) videos made nonfactual claims. The content of 47 (98\%) videos was scored to have low (n=27, 56\%) or moderate (n=20, 42\%) adherence to Health on the Net Foundation Code of Conduct principles. Median overall DISCERN score per channel type ranged from 40.3 (IQR 34.8-47.0) to 64.3 (IQR 58.5-66.3). Educational channels produced by both medical and nonmedical professionals achieved significantly higher DISCERN scores than those of other categories. The highest median DISCERN scores were achieved by educational videos produced by medical professionals (64.3, IQR 58.5-66.3) and the lowest median scores by independent users (18, IQR 18-20). Conclusions: The overall quality and reliability of information on COVID-19 vaccines on YouTube remains poor. Videos produced by educational channels, especially by medical professionals, were higher in quality and reliability than those produced by other sources, including health-related organizations. Collaboration between health-related organizations and established medical and educational YouTube content producers provides an opportunity for the dissemination of high-quality information on COVID-19 vaccination. Such collaboration holds potential as a rapidly implementable public health intervention aiming to engage a wide audience and increase public vaccination awareness and knowledge. ",
doi="10.2196/29942",
url="https://publichealth.jmir.org/2021/7/e29942",
url="http://www.ncbi.nlm.nih.gov/pubmed/34081599"
}


@Article{info:doi/10.2196/28309,
author="Ash, I. Garrett
and Griggs, Stephanie
and Nally, M. Laura
and Stults-Kolehmainen, Matthew
and Jeon, Sangchoon
and Brandt, Cynthia
and Gulanski, I. Barbara
and Spanakis, K. Elias
and Baker, S. Julien
and Whittemore, Robin
and Weinzimer, A. Stuart
and Fucito, M. Lisa",
title="Evaluation of Web-Based and In-Person Methods to Recruit Adults With Type 1 Diabetes for a Mobile Exercise Intervention: Prospective Observational Study",
journal="JMIR Diabetes",
year="2021",
month="Jul",
day="8",
volume="6",
number="3",
pages="e28309",
keywords="type 1 diabetes mellitus",
keywords="exercise",
keywords="behavior and behavior mechanisms",
keywords="mobile phone",
abstract="Background: Our clinical trial of a mobile exercise intervention for adults 18 to 65 years old with type 1 diabetes (T1D) occurred during COVID-19 social distancing restrictions, prompting us to test web-based recruitment methods previously underexplored for this demographic. Objective: Our objectives for this study were to (1) evaluate the effectiveness and cost of using social media news feed advertisements, a clinic-based approach method, and web-based snowball sampling to reach inadequately active adults with T1D and (2) compare characteristics of enrollees against normative data. Methods: Participants were recruited between November 2019 and August 2020. In method \#1, Facebook and Instagram news feed advertisements ran for five 1-to-8-day windows targeting adults (18 to 64 years old) in the greater New Haven and Hartford, Connecticut, areas with one or more diabetes-related profile interest. If interested, participants completed a webform so that the research team could contact them for eligibility screening. In method \#2, patients 18 to 24 years old with T1D were approached in person at clinical visits in November and December 2019. Those who were interested immediately completed eligibility screening. Older patients could not be approached due to clinic restrictions. In method \#3, snowball sampling was conducted by physically active individuals with T1D contacting their peers on Facebook and via email for 48 days, with details to contact the research staff to express interest and complete eligibility screening. Other methods referred participants to the study similarly to snowball sampling. Results: In method \#1, advertisements were displayed to 11,738 unique viewers and attracted 274 clickers (2.33\%); 20 participants from this group (7.3\%) volunteered, of whom 8 (40\%) were eligible. Costs averaged US \$1.20 per click and US \$95.88 per eligible volunteer. Men had lower click rates than women (1.71\% vs 3.17\%; P<.001), but their responsiveness and eligibility rates did not differ. In method \#2, we approached 40 patients; 32 of these patients (80\%) inquired about the study, of whom 20 (63\%) volunteered, and 2 of these volunteers (10\%) were eligible. Costs including personnel for in-person approaches averaged US \$21.01 per inquirer and US \$479.79 per eligible volunteer. In method \#3, snowball sampling generated 13 inquirers; 12 of these inquirers (92\%) volunteered, of whom 8 (67\%) were eligible. Incremental costs to attract inquirers were negligible, and total costs averaged US \$20.59 per eligible volunteer.  Other methods yielded 7 inquirers; 5 of these inquirers (71\%) volunteered, of whom 2 (40\%) were eligible. Incremental costs to attract inquirers were negligible, and total costs averaged US \$34.94 per eligible volunteer. Demographic overrepresentations emerged in the overall cohort (ie, optimal glycemic control, obesity, and low exercise), among those recruited by news feed advertisements (ie, obesity and older age), and among those recruited by snowball sampling (ie, optimal glycemic control and low exercise). Conclusions: Web-based advertising and recruitment strategies are a promising means to attract adults with T1D to clinical trials and exercise interventions, with costs comparing favorably to prior trials despite targeting an uncommon condition (ie, T1D) and commitment to an intervention. These strategies should be tailored in future studies to increase access to higher-risk participants. Trial Registration: ClinicalTrials.gov NCT04204733; https://clinicaltrials.gov/ct2/show/NCT04204733 ",
doi="10.2196/28309",
url="https://diabetes.jmir.org/2021/3/e28309",
url="http://www.ncbi.nlm.nih.gov/pubmed/34047700"
}


@Article{info:doi/10.2196/27302,
author="Xie, Zidian
and Wang, Xueting
and Gu, Yu
and Li, Dongmei",
title="Exploratory Analysis of Electronic Cigarette--Related Videos on YouTube: Observational Study",
journal="Interact J Med Res",
year="2021",
month="Jul",
day="6",
volume="10",
number="3",
pages="e27302",
keywords="infodemiology",
keywords="infoveillance",
keywords="social listening",
keywords="electronic cigarettes",
keywords="e-cigarette",
keywords="YouTube",
keywords="user engagement",
keywords="provaping",
keywords="vaping-warning",
abstract="Background: Electronic cigarette (e-cigarette) use has become more popular than cigarette smoking, especially among youth. Social media platforms, including YouTube, are a popular means of sharing information about e-cigarette use (vaping). Objective: This study aimed to characterize the content and user engagement of e-cigarette--related YouTube videos. Methods: The top 400 YouTube search videos related to e-cigarettes were collected in January 2020. Among them, 340 valid videos were classified into provaping, vaping-warning, and neutral categories by hand coding. Additionally, the content of e-cigarette videos and their user engagement (including average views and likes) were analyzed and compared. Results: While provaping videos were dominant among e-cigarette--related YouTube videos from 2007 to 2017, vaping-warning videos started to emerge in 2013 and became dominant between 2018 and 2019. Compared to vaping-warning videos, provaping videos had higher average daily views (1077 vs 822) but lower average daily likes (12 vs 15). Among 161 provaping videos, videos on user demonstration (n=100, 62.11\%) were dominant, and videos on comparison with smoking had the highest user engagement (2522 average daily views and 28 average daily likes). Conversely, among 141 vaping-warning videos, videos on potential health risks were the most popular topic (n=57, 40.42\%) with the highest user engagement (1609 average daily views and 33 average daily likes). Conclusions: YouTube was dominated by provaping videos, with the majority of videos on user demonstrations before 2018. The vaping-warning videos became dominant between 2018 and 2019, with videos on potential health risks being the most popular topic. This study provides updated surveillance on e-cigarette--related YouTube videos and some important guidance on associated social media regulations. ",
doi="10.2196/27302",
url="https://www.i-jmr.org/2021/3/e27302",
url="http://www.ncbi.nlm.nih.gov/pubmed/34255663"
}


@Article{info:doi/10.2196/28656,
author="Green, Heidi
and Fernandez, Ritin
and MacPhail, Catherine",
title="Social Media as a Platform for Recruitment to a National Survey During the COVID-19 Pandemic: Feasibility and Cost Analysis",
journal="JMIR Form Res",
year="2021",
month="Jul",
day="6",
volume="5",
number="7",
pages="e28656",
keywords="social media",
keywords="survey",
keywords="online recruitment",
keywords="COVID-19",
keywords="pandemic",
keywords="methodology",
abstract="Background: With improved accessibility to social media globally, health researchers are capitalizing on social media platforms to recruit participants for research studies. This has particularly been the case during the COVID-19 pandemic, when researchers were not able to use traditional methods of recruitment. Nevertheless, there is limited evidence on the feasibility of social media for recruiting a national sample. Objective: This paper describes the use of social media as a tool for recruiting a national sample of adults to a web-based survey during the COVID-19 pandemic. Methods: Between August and October 2020, participants were recruited through Facebook via two advertisement campaigns (paid option and no-cost option) into a web-based survey exploring the relationship between social determinants of health and well-being of adults during the COVID-19 pandemic. Data were analyzed using SPSS software and Facebook metrics that were autogenerated by Facebook Ads Manager. Poststratification weights were calculated to match the Australian population on the basis of gender, age, and state or territory based on the 2016 Australian census data. Results: In total, 9594 people were reached nationally with the paid option and potentially 902,000 people were reached through the no-cost option, resulting in a total of 1211 survey responses. The total cost of the advertisement campaign was Aus \$649.66 (US \$489.23), resulting in an overall cost per click of Aus \$0.25 (US \$0.19). Conclusions: Facebook is a feasible and cost-effective method of recruiting participants for a web-based survey, enabling recruitment of population groups that are considered hard to reach or marginalized. Recruitment through Facebook facilitated diversity, with participants varying in socioeconomic status, geographical location, educational attainment, and age. ",
doi="10.2196/28656",
url="https://formative.jmir.org/2021/7/e28656",
url="http://www.ncbi.nlm.nih.gov/pubmed/34133315"
}


@Article{info:doi/10.2196/25422,
author="Wang, Peng
and Xu, Qing
and Cao, Rong-Rong
and Deng, Fei-Yan
and Lei, Shu-Feng",
title="Global Public Interests and Dynamic Trends in Osteoporosis From 2004 to 2019: Infodemiology Study",
journal="J Med Internet Res",
year="2021",
month="Jul",
day="5",
volume="23",
number="7",
pages="e25422",
keywords="global public interest",
keywords="Google trends",
keywords="osteoporosis",
keywords="seasonality",
keywords="trends",
keywords="infodemiology",
keywords="information seeking",
keywords="web-based information",
abstract="Background: With the prolonging of human life expectancy and subsequent population aging, osteoporosis (OP) has become an important public health issue. Objective: This study aimed to understand the global public search interests and dynamic trends in ``osteoporosis'' using the data derived from Google Trends. Methods: An online search was performed using the term ``osteoporosis'' in Google Trends from January 1, 2004, to December 31, 2019, under the category ``Health.'' Cosinor analysis was used to test the seasonality of relative search volume (RSV) for ``osteoporosis.'' An analysis was conducted to investigate the public search topic rising in RSV for ``osteoporosis.'' Results: There was a descending trend of global RSV for ``osteoporosis'' from January 2004 to December 2014, and a slowly increasing trend from January 2015 to December 2019. Cosinor analysis showed significant seasonal variations in global RSV for ``osteoporosis'' (P=.01), with a peak in March and a trough in September. In addition, similar decreasing trends of RSV for ``osteoporosis'' were found in Australia, New Zealand, Ireland, and Canada from January 2004 to December 2019. Cosinor test revealed significant seasonal variations in RSV for ``osteoporosis'' in Australia, New Zealand, Canada, Ireland, UK, and USA (all P<.001). Furthermore, public search rising topics related to ``osteoporosis'' included denosumab, fracture risk assessment tool, bone density, osteopenia, osteoarthritis, and risk factor. Conclusions: Our study provided evidence about the public search interest and dynamic trends in OP using web-based data, which would be helpful for public health and policy making. ",
doi="10.2196/25422",
url="https://www.jmir.org/2021/7/e25422",
url="http://www.ncbi.nlm.nih.gov/pubmed/36260400"
}


@Article{info:doi/10.2196/24433,
author="Grifell, Marc
and Mir Fuster, Guillem
and Ventura Vilamala, Mireia
and Galindo Guar{\'i}n, Liliana
and Carb{\'o}n Mallol, Xo{\'a}n
and Hart, L. Carl
and P{\'e}rez Sola, V{\'i}ctor
and Colom Victoriano, Francesc",
title="Self-reported Subjective Effects of Analytically Confirmed New Psychoactive Substances Consumed by e-Psychonauts: Protocol for a Longitudinal Study Using a New Internet-Based Methodology",
journal="JMIR Res Protoc",
year="2021",
month="Jul",
day="2",
volume="10",
number="7",
pages="e24433",
keywords="psychotropic",
keywords="psychoactive",
keywords="psychonautic",
keywords="longitudinal",
keywords="observational",
keywords="pharmacology",
keywords="psychopharmacology",
keywords="subjective effects",
keywords="sentinel",
keywords="mental health",
keywords="public health",
keywords="internet",
keywords="eHealth",
keywords="cathinones",
keywords="drugs of abuse",
keywords="psychedelics",
keywords="mobile phone",
keywords="smart phone",
keywords="online recruitment",
keywords="online forums",
abstract="Background: During the last few years, the continuous emergence of new psychoactive substances (NPS) has become an important public health challenge. The use of NPS has been rising in two different ways: buying and consuming NPS knowingly and the presence of NPS in traditional drugs as adulterants. The rise of NPS use is increasing the number of different substances in the market to an extent impossible to study with current scientific methodologies. This has caused a remarkable absence of necessary information about newer drug effects on people who use drugs, mental health professionals, and policy makers. Current scientific methodologies have failed to provide enough data in the timeframe when critical decisions must be made, being not only too slow but also too square. Last but not least, they dramatically lack the high resolution of phenomenological details. Objective: This study aims to characterize a population of e-psychonauts and the subjective effects of the NPS they used during the study period using a new, internet-based, fast, and inexpensive methodology. This will allow bridging an evidence gap between online surveys, which do not provide substance confirmation, and clinical trials, which are too slow and expensive to keep up with the new substances appearing every week. Methods: To cover this purpose, we designed a highly personalized, observational longitudinal study methodology. Participants will be recruited from online communities of people who use NPS, and they will be followed online by means of a continuous objective and qualitative evaluation lasting for at least 1 year. In addition, participants will send samples of the substances they intend to use during that period, so they can be analyzed and matched with the effects they report on the questionnaires. Results: The research protocol was approved by the Institutional Review Board of the Hospital del Mar Research Institute on December 11, 2018. Data collection started in August 2019 and was still ongoing when the protocol was submitted (September 2020). The first data collection period of the study ended in October 2020. Data analysis began in November 2020, and it is still ongoing. The authors expect to submit the first results for publication by the end of 2021. A preliminary analysis was conducted when the manuscript was submitted and was reviewed after it was accepted in February 2021. Conclusions: It is possible to conduct an institutional review board--approved study using this new methodology and collect the expected data. However, the meaning and usefulness of these data are still unknown. International Registered Report Identifier (IRRID): DERR1-10.2196/24433 ",
doi="10.2196/24433",
url="https://www.researchprotocols.org/2021/7/e24433",
url="http://www.ncbi.nlm.nih.gov/pubmed/34255715"
}


@Article{info:doi/10.2196/24435,
author="Lyu, Chen Joanne
and Han, Le Eileen
and Luli, K. Garving",
title="COVID-19 Vaccine--Related Discussion on Twitter: Topic Modeling and Sentiment Analysis",
journal="J Med Internet Res",
year="2021",
month="Jun",
day="29",
volume="23",
number="6",
pages="e24435",
keywords="COVID-19",
keywords="vaccine",
keywords="vaccination",
keywords="Twitter",
keywords="infodemiology",
keywords="infoveillance",
keywords="topic",
keywords="sentiment",
keywords="opinion",
keywords="discussion",
keywords="communication",
keywords="social media",
keywords="perception",
keywords="concern",
keywords="emotion",
abstract="Background: Vaccination is a cornerstone of the prevention of communicable infectious diseases; however, vaccines have traditionally met with public fear and hesitancy, and COVID-19 vaccines are no exception. Social media use has been demonstrated to play a role in the low acceptance of vaccines. Objective: The aim of this study is to identify the topics and sentiments in the public COVID-19 vaccine--related discussion on social media and discern the salient changes in topics and sentiments over time to better understand the public perceptions, concerns, and emotions that may influence the achievement of herd immunity goals. Methods: Tweets were downloaded from a large-scale COVID-19 Twitter chatter data set from March 11, 2020, the day the World Health Organization declared COVID-19 a pandemic, to January 31, 2021. We used R software to clean the tweets and retain tweets that contained the keywords vaccination, vaccinations, vaccine, vaccines, immunization, vaccinate, and vaccinated. The final data set included in the analysis consisted of 1,499,421 unique tweets from 583,499 different users. We used R to perform latent Dirichlet allocation for topic modeling as well as sentiment and emotion analysis using the National Research Council of Canada Emotion Lexicon. Results: Topic modeling of tweets related to COVID-19 vaccines yielded 16 topics, which were grouped into 5 overarching themes. Opinions about vaccination (227,840/1,499,421 tweets, 15.2\%) was the most tweeted topic and remained a highly discussed topic during the majority of the period of our examination. Vaccine progress around the world became the most discussed topic around August 11, 2020, when Russia approved the world's first COVID-19 vaccine. With the advancement of vaccine administration, the topic of instruction on getting vaccines gradually became more salient and became the most discussed topic after the first week of January 2021. Weekly mean sentiment scores showed that despite fluctuations, the sentiment was increasingly positive in general. Emotion analysis further showed that trust was the most predominant emotion, followed by anticipation, fear, sadness, etc. The trust emotion reached its peak on November 9, 2020, when Pfizer announced that its vaccine is 90\% effective. Conclusions: Public COVID-19 vaccine--related discussion on Twitter was largely driven by major events about COVID-19 vaccines and mirrored the active news topics in mainstream media. The discussion also demonstrated a global perspective. The increasingly positive sentiment around COVID-19 vaccines and the dominant emotion of trust shown in the social media discussion may imply higher acceptance of COVID-19 vaccines compared with previous vaccines. ",
doi="10.2196/24435",
url="https://www.jmir.org/2021/6/e24435",
url="http://www.ncbi.nlm.nih.gov/pubmed/34115608"
}


@Article{info:doi/10.2196/25742,
author="Chilman, Natasha
and Morant, Nicola
and Lloyd-Evans, Brynmor
and Wackett, Jane
and Johnson, Sonia",
title="Twitter Users' Views on Mental Health Crisis Resolution Team Care Compared With Stakeholder Interviews and Focus Groups: Qualitative Analysis",
journal="JMIR Ment Health",
year="2021",
month="Jun",
day="29",
volume="8",
number="6",
pages="e25742",
keywords="Twitter",
keywords="social media",
keywords="qualitative",
keywords="crisis resolution team",
keywords="home treatment team",
keywords="mental health",
keywords="acute care",
keywords="severe mental illness",
abstract="Background: Analyzing Twitter posts enables rapid access to how issues and experiences are socially shared and constructed among communities of health service users and providers, in ways that traditional qualitative methods may not. Objective: To enrich the understanding of mental health crisis care in the United Kingdom, this study explores views on crisis resolution teams (CRTs) expressed on Twitter. We aim to identify the similarities and differences among views expressed on Twitter compared with interviews and focus groups. Methods: We used Twitter's advanced search function to retrieve public tweets on CRTs. A thematic analysis was conducted on 500 randomly selected tweets. The principles of refutational synthesis were applied to compare themes with those identified in a multicenter qualitative interview study. Results: The most popular hashtag identified was \#CrisisTeamFail, where posts were principally related to poor quality of care and access, particularly for people given a personality disorder diagnosis. Posts about CRTs giving unhelpful self-management advice were common, as were tweets about resource strains on mental health services. This was not identified in the research interviews. Although each source yielded unique themes, there were some overlaps with themes identified via interviews and focus groups, including the importance of rapid access to care. Views expressed on Twitter were generally more critical than those obtained via face-to-face methods. Conclusions: Traditional qualitative studies may underrepresent the views of more critical stakeholders by collecting data from participants accessed via mental health services. Research on social media content can complement traditional or face-to-face methods and ensure that a broad spectrum of viewpoints can inform service development and policy. ",
doi="10.2196/25742",
url="https://mental.jmir.org/2021/6/e25742",
url="http://www.ncbi.nlm.nih.gov/pubmed/34185017"
}


@Article{info:doi/10.2196/24353,
author="Mazel, Shayna
and Zisman-Ilani, Yaara
and Hennig, Shannon
and Garnick, Deborah
and Nicholson, Joanne",
title="Virtual Engagement in a Social Media Community of Mothers With Substance Use Disorders: Content Analysis",
journal="JMIR Form Res",
year="2021",
month="Jun",
day="24",
volume="5",
number="6",
pages="e24353",
keywords="virtual engagement",
keywords="virtual community participation",
keywords="social media",
keywords="mental health",
keywords="opioids",
keywords="substance use",
abstract="Background: Co-occurring substance use disorder is common among pregnant and parenting women with mental illness, but their engagement with and utilization of relevant services and treatment is low. Social media has the potential to convey benefits and facilitate engagement among this target group. Objective: This study aimed to explore the reach and engagement of specific social media posts among pregnant women and mothers with substance use disorders. Methods: Eighteen posts providing content related to substance use (cannabis, opioids, or alcohol), varying in type of content (informational or experiential) and target (policy-, practice-, or perception-related), were posted in a closed Facebook community page comprising over 33,000 pregnant women and mothers between May 2019 and October 2019. Results: The overall level of reach of these Facebook posts ranged from 453 to 3045 community members. Engagement levels, measured via the number of likes, comments, or posts shared, varied based on the type of post content (ie, informational or experiential). Conclusions: Participation in a virtual community via social media platforms can facilitate engagement among pregnant women and mothers with mental illness by communicating relevant information about substance use, as well as potentially promoting awareness of, access to, and engagement with treatment services. ",
doi="10.2196/24353",
url="https://formative.jmir.org/2021/6/e24353/",
url="http://www.ncbi.nlm.nih.gov/pubmed/34184993"
}


@Article{info:doi/10.2196/23105,
author="Argyris, Anna Young
and Monu, Kafui
and Tan, Pang-Ning
and Aarts, Colton
and Jiang, Fan
and Wiseley, Anne Kaleigh",
title="Using Machine Learning to Compare Provaccine and Antivaccine Discourse Among the Public on Social Media: Algorithm Development Study",
journal="JMIR Public Health Surveill",
year="2021",
month="Jun",
day="24",
volume="7",
number="6",
pages="e23105",
keywords="antivaccination movement",
keywords="Twitter messaging",
keywords="public health informatics",
keywords="supervised machine learning algorithm",
keywords="unsupervised machine learning algorithm",
keywords="qualitative content analysis",
keywords="data visualization",
keywords="infodemiology",
keywords="infodemic",
keywords="health misinformation",
keywords="infoveillance",
keywords="social listening",
abstract="Background: Despite numerous counteracting efforts, antivaccine content linked to delays and refusals to vaccinate has grown persistently on social media, while only a few provaccine campaigns have succeeded in engaging with or persuading the public to accept immunization. Many prior studies have associated the diversity of topics discussed by antivaccine advocates with the public's higher engagement with such content. Nonetheless, a comprehensive comparison of discursive topics in pro- and antivaccine content in the engagement-persuasion spectrum remains unexplored. Objective: We aimed to compare discursive topics chosen by pro- and antivaccine advocates in their attempts to influence the public to accept or reject immunization in the engagement-persuasion spectrum. Our overall objective was pursued through three specific aims as follows: (1) we classified vaccine-related tweets into provaccine, antivaccine, and neutral categories; (2) we extracted and visualized discursive topics from these tweets to explain disparities in engagement between pro- and antivaccine content; and (3) we identified how those topics frame vaccines using Entman's four framing dimensions. Methods: We adopted a multimethod approach to analyze discursive topics in the vaccine debate on public social media sites. Our approach combined (1) large-scale balanced data collection from a public social media site (ie, 39,962 tweets from Twitter); (2) the development of a supervised classification algorithm for categorizing tweets into provaccine, antivaccine, and neutral groups; (3) the application of an unsupervised clustering algorithm for identifying prominent topics discussed on both sides; and (4) a multistep qualitative content analysis for identifying the prominent discursive topics and how vaccines are framed in these topics. In so doing, we alleviated methodological challenges that have hindered previous analyses of pro- and antivaccine discursive topics. Results: Our results indicated that antivaccine topics have greater intertopic distinctiveness (ie, the degree to which discursive topics are distinct from one another) than their provaccine counterparts (t122=2.30, P=.02). In addition, while antivaccine advocates use all four message frames known to make narratives persuasive and influential, provaccine advocates have neglected having a clear problem statement. Conclusions: Based on our results, we attribute higher engagement among antivaccine advocates to the distinctiveness of the topics they discuss, and we ascribe the influence of the vaccine debate on uptake rates to the comprehensiveness of the message frames. These results show the urgency of developing clear problem statements for provaccine content to counteract the negative impact of antivaccine content on uptake rates. ",
doi="10.2196/23105",
url="https://publichealth.jmir.org/2021/6/e23105/",
url="http://www.ncbi.nlm.nih.gov/pubmed/34185004"
}


@Article{info:doi/10.2196/27853,
author="P{\'o}cs, D{\'a}vid
and Adamovits, Ot{\'i}lia
and Watti, Jezdancher
and Kov{\'a}cs, R{\'o}bert
and Kelemen, Oguz",
title="Facebook Users' Interactions, Organic Reach, and Engagement in a Smoking Cessation Intervention: Content Analysis",
journal="J Med Internet Res",
year="2021",
month="Jun",
day="21",
volume="23",
number="6",
pages="e27853",
keywords="smoking",
keywords="smoking cessation",
keywords="behavior",
keywords="health behavior",
keywords="internet",
keywords="social media",
keywords="love",
keywords="comment",
keywords="motivation",
keywords="language",
keywords="public health",
abstract="Background: Facebook can be a suitable platform for public health interventions. Facebook users can express their reaction to the given social media content in many ways using interaction buttons. The analysis of these interactions can be advantageous in increasing reach and engagement of public health interventions. Objective: This research aimed at understanding how Facebook users' interactions correlate with organic reach and engagement regarding the same smoking cessation support contents. Methods: The study population consisted of Facebook users who were reached by a public smoking cessation support page without advertising. We included 1025 nonpaid Facebook posts (N=1025) which used smoking cessation strategies based on a motivational interviewing counseling style. The following data were collected from the ``Post Details'': the number of people who saw the given nonpaid content (organic reach) which consisted of fan and nonfan reach according to previous ``page like'' activity; each rate of ``engagement indicators'' (such as the symbols of ``like,'' ``love,'' ``haha,'' ``wow,'' ``sad,'' ``angry''; or other interactions: ``shares,'' ``comments,'' ``clicks''); and the rate of negative Facebook interactions (eg, ``post hides'' or ``unlike of page''). Overall, these data were analyzed with the Spearman correlation method. Results: Surprisingly, we found a significant negative correlation between organic reach and the ``like'' reaction (rs=--0.418; P<.001). The strongest significant positive correlations of organic reach were observed with the ``haha'' reaction (rs=0.396; P<.001), comments (rs=0.368; P<.001), and the ``love'' reaction (rs=0.264; P<.001). Furthermore, nonfan reach correlated positively with ``shares'' (rs=0.388; P<.001) and clicks (rs=0.135; P<.001), while fan reach correlated positively with the ``haha'' reaction (rs=0.457; P<.001), comments (rs=0.393; P<.001), and the ``love'' reaction (rs=0.310; P<.001). Contrary to expectations, the ``like'' reaction was sharply separated by significant negative correlations from ``wow'' (rs=--0.077; P=.013), ``sad'' (rs=--0.120; P<.001), ``angry'' reactions (rs=--0.136; P<.001), and comments (rs=--0.130; P<.001). Additionally, a high rate of negative Facebook interactions was significantly associated with ``wow'' (rs=0.076; P=.016) and ``sad'' reactions (rs=0.091; P=.003). Conclusions: This study has shown that it is possible to hypothesize a disadvantage of the ``like'' reaction and advantages of other interactions (eg, the ``haha'' reaction or ``comments'') in content algorithmic ranking on Facebook. In addition, the correlational analysis revealed a need of a further categorization to fan-specific interactions (eg, ``haha'' or ``love'' reactions) and nonfan-specific interactions (eg, ``shares'' and ``clicks''). Regarding the direction of the correlations, these findings suggest that some interactions (eg, negative Facebook interactions, ``wow,'' ``sad,'' and ``angry'' reactions) may decrease the engagement, while other interactions (``like,'' ``love,'' ``haha'' reactions, ``shares,'' and ``clicks'') may increase the engagement during Facebook-based smoking cessation interventions. This hypothesis-generating research offers an important insight into the relationship between organic reach, engagement, and Facebook users' interactions for public health professionals who design Facebook-based interventions. ",
doi="10.2196/27853",
url="https://www.jmir.org/2021/6/e27853",
url="http://www.ncbi.nlm.nih.gov/pubmed/34152280"
}


@Article{info:doi/10.2196/26655,
author="Massey, Daisy
and Huang, Chenxi
and Lu, Yuan
and Cohen, Alina
and Oren, Yahel
and Moed, Tali
and Matzner, Pini
and Mahajan, Shiwani
and Caraballo, C{\'e}sar
and Kumar, Navin
and Xue, Yuchen
and Ding, Qinglan
and Dreyer, Rachel
and Roy, Brita
and Krumholz, Harlan",
title="Engagement With COVID-19 Public Health Measures in the United States: A Cross-sectional Social Media Analysis from June to November 2020",
journal="J Med Internet Res",
year="2021",
month="Jun",
day="21",
volume="23",
number="6",
pages="e26655",
keywords="COVID-19",
keywords="public perception",
keywords="social media",
keywords="infodemiology",
keywords="infoveillance",
keywords="infodemic",
keywords="social media research",
keywords="social listening",
keywords="social media analysis",
keywords="natural language processing",
keywords="Reddit data",
keywords="Facebook data",
keywords="COVID-19 public health measures",
keywords="public health",
keywords="surveillance",
keywords="engagement",
keywords="United States",
keywords="cross-sectional",
keywords="Reddit",
keywords="Facebook",
keywords="behavior",
keywords="perception",
keywords="NLP",
abstract="Background: COVID-19 has continued to spread in the United States and globally. Closely monitoring public engagement and perceptions of COVID-19 and preventive measures using social media data could provide important information for understanding the progress of current interventions and planning future programs. Objective: The aim of this study is to measure the public's behaviors and perceptions regarding COVID-19 and its effects on daily life during 5 months of the pandemic. Methods: Natural language processing (NLP) algorithms were used to identify COVID-19--related and unrelated topics in over 300 million online data sources from June 15 to November 15, 2020. Posts in the sample were geotagged by NetBase, a third-party data provider, and sensitivity and positive predictive value were both calculated to validate the classification of posts. Each post may have included discussion of multiple topics. The prevalence of discussion regarding these topics was measured over this time period and compared to daily case rates in the United States. Results: The final sample size included 9,065,733 posts, 70\% of which were sourced from the United States. In October and November, discussion including mentions of COVID-19 and related health behaviors did not increase as it had from June to September, despite an increase in COVID-19 daily cases in the United States beginning in October. Additionally, discussion was more focused on daily life topics (n=6,210,255, 69\%), compared with COVID-19 in general (n=3,390,139, 37\%) and COVID-19 public health measures (n=1,836,200, 20\%). Conclusions: There was a decline in COVID-19--related social media discussion sourced mainly from the United States, even as COVID-19 cases in the United States increased to the highest rate since the beginning of the pandemic. Targeted public health messaging may be needed to ensure engagement in public health prevention measures as global vaccination efforts continue. ",
doi="10.2196/26655",
url="https://www.jmir.org/2021/6/e26655",
url="http://www.ncbi.nlm.nih.gov/pubmed/34086593"
}


@Article{info:doi/10.2196/28648,
author="Pollack, C. Catherine
and Gilbert-Diamond, Diane
and Alford-Teaster, A. Jennifer
and Onega, Tracy",
title="Language and Sentiment Regarding Telemedicine and COVID-19 on Twitter: Longitudinal Infodemiology Study",
journal="J Med Internet Res",
year="2021",
month="Jun",
day="21",
volume="23",
number="6",
pages="e28648",
keywords="telemedicine",
keywords="telehealth",
keywords="COVID-19 pandemic",
keywords="social media",
keywords="sentiment analysis",
keywords="Twitter",
keywords="COVID-19",
keywords="pandemic",
abstract="Background: The COVID-19 pandemic has necessitated a rapid shift in how individuals interact with and receive fundamental services, including health care. Although telemedicine is not a novel technology, previous studies have offered mixed opinions surrounding its utilization. However, there exists a dearth of research on how these opinions have evolved over the course of the current pandemic. Objective: This study aims to evaluate how the language and sentiment surrounding telemedicine has evolved throughout the COVID-19 pandemic. Methods: Tweets published between January 1, 2020, and April 24, 2021, containing at least one telemedicine-related and one COVID-19--related search term (``telemedicine-COVID'') were collected from the Twitter full archive search (N=351,718). A comparator sample containing only COVID-19 terms (``general-COVID'') was collected and sampled based on the daily distribution of telemedicine-COVID tweets. In addition to analyses of retweets and favorites, sentiment analysis was performed on both data sets in aggregate and within a subset of tweets receiving the top 100 most and least retweets. Results: Telemedicine gained prominence during the early stages of the pandemic (ie, March through May 2020) before leveling off and reaching a steady state from June 2020 onward. Telemedicine-COVID tweets had a 21\% lower average number of retweets than general-COVID tweets (incidence rate ratio 0.79, 95\% CI 0.63-0.99; P=.04), but there was no difference in favorites. A majority of telemedicine-COVID tweets (180,295/351,718, 51.3\%) were characterized as ``positive,'' compared to only 38.5\% (135,434/351,401) of general-COVID tweets (P<.001). This trend was also true on a monthly level from March 2020 through April 2021. The most retweeted posts in both telemedicine-COVID and general-COVID data sets were authored by journalists and politicians. Whereas the majority of the most retweeted posts within the telemedicine-COVID data set were positive (55/101, 54.5\%), a plurality of the most retweeted posts within the general-COVID data set were negative (44/89, 49.4\%; P=.01). Conclusions: During the COVID-19 pandemic, opinions surrounding telemedicine evolved to become more positive, especially when compared to the larger pool of COVID-19--related tweets. Decision makers should capitalize on these shifting public opinions to invest in telemedicine infrastructure and ensure its accessibility and success in a postpandemic world. ",
doi="10.2196/28648",
url="https://www.jmir.org/2021/6/e28648",
url="http://www.ncbi.nlm.nih.gov/pubmed/34086591"
}


@Article{info:doi/10.2196/24458,
author="Lam, Esther
and Moreno, Megan
and Bennett, Elizabeth
and Rowhani-Rahbar, Ali",
title="Receptiveness and Responsiveness Toward Using Social Media for Safe Firearm Storage Outreach: Mixed Methods Study",
journal="J Med Internet Res",
year="2021",
month="Jun",
day="18",
volume="23",
number="6",
pages="e24458",
keywords="firearm storage",
keywords="gun safety",
keywords="public health outreach",
keywords="social media",
keywords="mixed methods",
keywords="family",
abstract="Background: Childhood and adolescent firearm injury and death rates have increased over the past decade and remain major public health concerns in the United States. Safe firearm storage has proven to be an effective measure to prevent firearm injury and death among youth. Social media has been used as an avenue to promote safe firearm storage, but perceptions of this tool remain unknown. Objective: The aim of this study was to determine receptiveness and responsiveness in promoting firearm lock box and trigger lock giveaway events on social media, and to describe the characteristics of participants who learned of these events through social media. Methods: We performed a mixed methods study combining a content analysis of Facebook event post comments, quantitative analysis of positive and negative feedback on social media, and a descriptive analysis of event participant characteristics. Through a qualitative content analysis approach, we thematically coded comments from each event's social media page posting. Interrater reliability and $\kappa$ statistics were calculated. We calculated the prevalence of positive and negative feedback data. Further, we calculated descriptive statistics for demographic characteristics gathered from day-of-event intake surveys. Differences between collected measures were analyzed with $\chi$2 and t tests according to how the participant found out about the event (social media vs other means). Using concurrent analysis, we synthesized the results from both the qualitative and quantitative aims. Results: Through qualitative content analysis, 414 comments from 13 events were coded. Seven themes emerged through the comment coding process with the most common being ``positive receptiveness'' (294/414, 71.0\%). From quantitative analysis of the social media content, we found higher levels of positive feedback compared to negative feedback. The average number of event post ``likes'' was 1271.3 per event, whereas the average count in which ``hide post'' was clicked was 72.3 times per event. Overall, 35.9\% (1457/4054) of participants found out about the event through social media. The participants who learned about the event through social media were on average significantly younger than those who learned about the event through other means (--6.4 years, 95\% CI --5.5 to --7.3). Among the group that learned of the event through social media, 43.9\% (629/1433) identified as female, whereas 35.5\% (860/2420) identified as female among the group that learned of the event through other means. Conclusions: There was overall positive receptiveness and responsiveness toward firearm lock box and trigger lock giveaway events when promoted on social media. Compared with other promotional tools, social media has the ability to reach those who are younger and those who identify as female. Future studies should extend this research to determine whether there is a difference between rural and urban settings, and consider other social media platforms in the analysis. ",
doi="10.2196/24458",
url="https://www.jmir.org/2021/6/e24458",
url="http://www.ncbi.nlm.nih.gov/pubmed/34142974"
}


@Article{info:doi/10.2196/27976,
author="Miller, Michele
and Romine, William
and Oroszi, Terry",
title="Public Discussion of Anthrax on Twitter: Using Machine Learning to Identify Relevant Topics and Events",
journal="JMIR Public Health Surveill",
year="2021",
month="Jun",
day="18",
volume="7",
number="6",
pages="e27976",
keywords="anthrax",
keywords="big data",
keywords="internet",
keywords="infodemiology",
keywords="infoveillance",
keywords="social listening",
keywords="digital health",
keywords="biological weapon",
keywords="terrorism",
keywords="Federal Bureau of Investigation",
keywords="machine learning",
keywords="public health threat",
keywords="Twitter",
abstract="Background: Social media allows researchers to study opinions and reactions to events in real time. One area needing more study is anthrax-related events. A computational framework that utilizes machine learning techniques was created to collect tweets discussing anthrax, further categorize them as relevant by the month of data collection, and detect discussions on anthrax-related events. Objective: The objective of this study was to detect discussions on anthrax-related events and to determine the relevance of the tweets and topics of discussion over 12 months of data collection. Methods: This is an infoveillance study, using tweets in English containing the keyword ``Anthrax'' and ``Bacillus anthracis'', collected from September 25, 2017, through August 15, 2018. Machine learning techniques were used to determine what people were tweeting about anthrax. Data over time was plotted to determine whether an event was detected (a 3-fold spike in tweets). A machine learning classifier was created to categorize tweets by relevance to anthrax. Relevant tweets by month were examined using a topic modeling approach to determine the topics of discussion over time and how these events influence that discussion. Results: Over the 12 months of data collection, a total of 204,008 tweets were collected. Logistic regression analysis revealed the best performance for relevance (precision=0.81; recall=0.81; F1-score=0.80). In total, 26 topics were associated with anthrax-related events, tweets that were highly retweeted, natural outbreaks, and news stories. Conclusions: This study shows that tweets related to anthrax can be collected and analyzed over time to determine what people are discussing and to detect key anthrax-related events. Future studies are required to focus only on opinion tweets, use the methodology to study other terrorism events, or to monitor for terrorism threats. ",
doi="10.2196/27976",
url="https://publichealth.jmir.org/2021/6/e27976",
url="http://www.ncbi.nlm.nih.gov/pubmed/34142975"
}


@Article{info:doi/10.2196/15551,
author="Cheng, Qijin
and Lui, Carrie
and Ip, Lam Flora Wai
and Yip, Fai Paul Siu",
title="Typology and Impact of YouTube Videos Posted in Response to a Student Suicide Crisis: Social Media Metrics and Content Analyses",
journal="JMIR Ment Health",
year="2021",
month="Jun",
day="18",
volume="8",
number="6",
pages="e15551",
keywords="suicide",
keywords="suicide prevention",
keywords="social media",
keywords="infodemiology",
keywords="internet",
keywords="digital health",
keywords="YouTube",
keywords="impact evaluation",
keywords="network visualization",
abstract="Background: Videos relating to suicide are available on YouTube, but their characteristics and impacts have seldom been examined. Objective: This study aimed to examine YouTube videos posted in response to a sudden spate of student suicides in Hong Kong during the 2015-2016 school year and evaluate the impacts of those videos. Methods: Keyword search was performed on YouTube, and relevant videos were identified. Video typology was examined through content analysis, specifically grouping the videos by who uploaded the videos, what presentation formats were used in the videos, whether the videos were originally created by the uploaders, and whether the videos disclosed the uploaders' personal experiences with suicide. Impacts of the videos were assessed in terms of reach (measured by view count), engagement (measured by comment count), and insights (measured as to what extent the comments to each video could reveal personal suicide risk and attitude toward help-seeking). Statistical analysis was conducted to compare the impacts of different types of videos. The 7 most impactful videos that were originally created by the YouTubers were selected for further analysis. They were compared with 7 videos uploaded by the same YouTubers right before the student suicide videos and 7 right after the student suicide videos. The comparison focused on their impacts and the network structure of the comments to those videos. Results: A total of 162 relevant YouTube videos were identified. They were uploaded by 7 types of stakeholders, and the most common format was one person talking to the camera. A total of 87.0\% (141/162) of the videos were originally created by the uploaders and only 8.0\% (13/162) of the videos disclosed uploader personal experiences with suicide. The uploader profiles being popular or top YouTubers and the video containing disclosure of the uploader's personal experiences were found to be significantly correlated with greater impacts (P<.001). Focusing on the 7 most impactful original videos, it is found that those videos generated more engagement, especially more interactions between the viewers, and more insights than regular videos uploaded by the same YouTubers. Conclusions: When responding to a youth suicide crisis, videos made by key opinion leaders on YouTube sharing their own experiences of overcoming suicide risks could generate significant positive impacts. These types of videos offer a precious opportunity to craft online campaigns and activities to raise suicide prevention awareness and engage vulnerable youth. ",
doi="10.2196/15551",
url="https://mental.jmir.org/2021/6/e15551/"
}


@Article{info:doi/10.2196/29549,
author="Kim, Jina
and Lee, Daeun
and Park, Eunil",
title="Authors' Reply to: Bibliometric Studies and the Discipline of Social Media Mental Health Research. Comment on ``Machine Learning for Mental Health in Social Media: Bibliometric Study''",
journal="J Med Internet Res",
year="2021",
month="Jun",
day="17",
volume="23",
number="6",
pages="e29549",
keywords="bibliometric analysis",
keywords="machine learning",
keywords="mental health",
keywords="social media",
keywords="bibliometrics",
doi="10.2196/29549",
url="https://www.jmir.org/2021/6/e29549",
url="http://www.ncbi.nlm.nih.gov/pubmed/34137721"
}


@Article{info:doi/10.2196/28990,
author="Resnik, Philip
and De Choudhury, Munmun
and Musacchio Schafer, Katherine
and Coppersmith, Glen",
title="Bibliometric Studies and the Discipline of Social Media Mental Health Research. Comment on ``Machine Learning for Mental Health in Social Media: Bibliometric Study''",
journal="J Med Internet Res",
year="2021",
month="Jun",
day="17",
volume="23",
number="6",
pages="e28990",
keywords="bibliometric analysis",
keywords="machine learning",
keywords="mental health",
keywords="social media",
keywords="bibliometrics",
doi="10.2196/28990",
url="https://www.jmir.org/2021/6/e28990",
url="http://www.ncbi.nlm.nih.gov/pubmed/34137722"
}


@Article{info:doi/10.2196/29036,
author="Oksa, Reetta
and Kaakinen, Markus
and Savela, Nina
and Hakanen, J. Jari
and Oksanen, Atte",
title="Professional Social Media Usage and Work Engagement Among Professionals in Finland Before and During the COVID-19 Pandemic: Four-Wave Follow-Up Study",
journal="J Med Internet Res",
year="2021",
month="Jun",
day="15",
volume="23",
number="6",
pages="e29036",
keywords="COVID-19",
keywords="engagement",
keywords="mental health",
keywords="moderator",
keywords="predictor",
keywords="psychological distress",
keywords="social media",
keywords="social support",
keywords="support",
keywords="task resources",
keywords="usage",
keywords="work engagement",
abstract="Background: The COVID-19 pandemic has changed work life profoundly and concerns regarding the mental well-being of employees' have arisen. Organizations have made rapid digital advancements and have started to use new collaborative tools such as social media platforms overnight. Objective: Our study aimed to investigate how professional social media communication has affected work engagement before and during the COVID-19 pandemic and the role of perceived social support, task resources, and psychological distress as predictors and moderators of work engagement. Methods: Nationally representative longitudinal survey data were collected in 2019-2020, and 965 respondents participated in all 4 surveys. Measures included work engagement, perceived social support and task resources, and psychological distress. The data were analyzed using a hybrid linear regression model.? Results: Work engagement remained stable and only decreased in autumn 2020. Within-person changes in social media communication at work, social support, task resources, and psychological distress were all associated with work engagement. The negative association between psychological distress and work engagement was stronger in autumn 2020 than before the COVID-19 outbreak. Conclusions: The COVID-19 pandemic has exerted pressure on mental health at work. Fostering social support and task resources at work is important in maintaining work engagement. Social media communication could help maintain a supportive work environment. ",
doi="10.2196/29036",
url="https://www.jmir.org/2021/6/e29036",
url="http://www.ncbi.nlm.nih.gov/pubmed/34048356"
}


@Article{info:doi/10.2196/25010,
author="Tao, Chunliang
and Diaz, Destiny
and Xie, Zidian
and Chen, Long
and Li, Dongmei
and O'Connor, Richard",
title="Potential Impact of a Paper About COVID-19 and Smoking on Twitter Users' Attitudes Toward Smoking: Observational Study",
journal="JMIR Form Res",
year="2021",
month="Jun",
day="15",
volume="5",
number="6",
pages="e25010",
keywords="COVID-19",
keywords="smoking",
keywords="Twitter",
keywords="infodemiology",
keywords="infodemic",
keywords="infoveillance",
keywords="impact",
keywords="attitude",
keywords="perception",
keywords="observational",
keywords="social media",
keywords="cross-sectional",
keywords="dissemination",
keywords="research",
abstract="Background: A cross-sectional study (Miyara et al, 2020) conducted by French researchers showed that the rate of current daily smoking was significantly lower in patients with COVID-19 than in the French general population, implying a potentially protective effect of smoking. Objective: We aimed to examine the dissemination of the Miyara et al study among Twitter users and whether a shift in their attitudes toward smoking occurred after its publication as preprint on April 21, 2020. Methods: Twitter posts were crawled between April 14 and May 4, 2020, by the Tweepy stream application programming interface, using a COVID-19--related keyword query. After filtering, the final 1929 tweets were classified into three groups: (1) tweets that were not related to the Miyara et al study before it was published, (2) tweets that were not related to Miyara et al study after it was published, and (3) tweets that were related to Miyara et al study after it was published. The attitudes toward smoking, as expressed in the tweets, were compared among the above three groups using multinomial logistic regression models in the statistical analysis software R (The R Foundation). Results: Temporal analysis showed a peak in the number of tweets discussing the results from the Miyara et al study right after its publication. Multinomial logistic regression models on sentiment scores showed that the proportion of negative attitudes toward smoking in tweets related to the Miyara et al study after it was published (17.07\%) was significantly lower than the proportion in tweets that were not related to the Miyara et al study, either before (44/126, 34.9\%; P<.001) or after the Miyara et al study was published (68/198, 34.3\%; P<.001). Conclusions: The public's attitude toward smoking shifted in a positive direction after the Miyara et al study found a lower incidence of COVID-19 cases among daily smokers. ",
doi="10.2196/25010",
url="https://formative.jmir.org/2021/6/e25010",
url="http://www.ncbi.nlm.nih.gov/pubmed/33939624"
}


@Article{info:doi/10.2196/26692,
author="Rao, Ashwin
and Morstatter, Fred
and Hu, Minda
and Chen, Emily
and Burghardt, Keith
and Ferrara, Emilio
and Lerman, Kristina",
title="Political Partisanship and Antiscience Attitudes in Online Discussions About COVID-19: Twitter Content Analysis",
journal="J Med Internet Res",
year="2021",
month="Jun",
day="14",
volume="23",
number="6",
pages="e26692",
keywords="COVID-19",
keywords="Twitter",
keywords="infodemiology",
keywords="infodemic",
keywords="infoveillance",
keywords="multidimensional polarization",
keywords="social media",
keywords="social network",
abstract="Background: The novel coronavirus pandemic continues to ravage communities across the United States. Opinion surveys identified the importance of political ideology in shaping perceptions of the pandemic and compliance with preventive measures. Objective: The aim of this study was to measure political partisanship and antiscience attitudes in the discussions about the pandemic on social media, as well as their geographic and temporal distributions. Methods: We analyzed a large set of tweets from Twitter related to the pandemic, collected between January and May 2020, and developed methods to classify the ideological alignment of users along the moderacy (hardline vs moderate), political (liberal vs conservative), and science (antiscience vs proscience) dimensions. Results: We found a significant correlation in polarized views along the science and political dimensions. Moreover, politically moderate users were more aligned with proscience views, while hardline users were more aligned with antiscience views. Contrary to expectations, we did not find that polarization grew over time; instead, we saw increasing activity by moderate proscience users. We also show that antiscience conservatives in the United States tended to tweet from the southern and northwestern states, while antiscience moderates tended to tweet from the western states. The proportion of antiscience conservatives was found to correlate with COVID-19 cases. Conclusions: Our findings shed light on the multidimensional nature of polarization and the feasibility of tracking polarized opinions about the pandemic across time and space through social media data. ",
doi="10.2196/26692",
url="https://www.jmir.org/2021/6/e26692",
url="http://www.ncbi.nlm.nih.gov/pubmed/34014831"
}


@Article{info:doi/10.2196/25028,
author="Lee, Ji-Hyun
and Park, Hyeoun-Ae
and Song, Tae-Min",
title="A Determinants-of-Fertility Ontology for Detecting Future Signals of Fertility Issues From Social Media Data: Development of an Ontology",
journal="J Med Internet Res",
year="2021",
month="Jun",
day="14",
volume="23",
number="6",
pages="e25028",
keywords="ontology",
keywords="fertility",
keywords="public policy",
keywords="South Korea",
keywords="social media",
keywords="future",
keywords="infodemiology",
keywords="infoveillance",
abstract="Background: South Korea has the lowest fertility rate in the world despite considerable governmental efforts to boost it. Increasing the fertility rate and achieving the desired outcomes of any implemented policies requires reliable data on the ongoing trends in fertility and preparations for the future based on these trends. Objective: The aims of this study were to (1) develop a determinants-of-fertility ontology with terminology for collecting and analyzing social media data; (2) determine the description logics, content coverage, and structural and representational layers of the ontology; and (3) use the ontology to detect future signals of fertility issues. Methods: An ontology was developed using the Ontology Development 101 methodology. The domain and scope of the ontology were defined by compiling a list of competency questions. The terms were collected from Korean government reports, Korea's Basic Plan for Low Fertility and Aging Society, a national survey about marriage and childbirth, and social media postings on fertility issues. The classes and their hierarchy were defined using a top-down approach based on an ecological model. The internal structure of classes was defined using the entity-attribute-value model. The description logics of the ontology were evaluated using Prot{\'e}g{\'e} (version 5.5.0), and the content coverage was evaluated by comparing concepts extracted from social media posts with the list of ontology classes. The structural and representational layers of the ontology were evaluated by experts. Social media data were collected from 183 online channels between January 1, 2011, and June 30, 2015. To detect future signals of fertility issues, 2 classes of the ontology, the socioeconomic and cultural environment, and public policy, were identified as keywords. A keyword issue map was constructed, and the defined keywords were mapped to identify future signals. R software (version 3.5.2) was used to mine for future signals. Results: A determinants-of-fertility ontology comprised 236 classes and terminology comprised 1464 synonyms of the 236 classes. Concept classes in the ontology were found to be coherently and consistently defined. The ontology included more than 90\% of the concepts that appeared in social media posts on fertility policies. Average scores for all of the criteria for structural and representations layers exceeded 4 on a 5-point scale. Violence and abuse (socioeconomic and cultural factor) and flexible working arrangement (fertility policy) were weak signals, suggesting that they could increase rapidly in the future. Conclusions: The determinants-of-fertility ontology developed in this study can be used as a framework for collecting and analyzing social media data on fertility issues and detecting future signals of fertility issues. The future signals identified in this study will be useful for policy makers who are developing policy responses to low fertility. ",
doi="10.2196/25028",
url="https://www.jmir.org/2021/6/e25028",
url="http://www.ncbi.nlm.nih.gov/pubmed/34125068"
}


@Article{info:doi/10.2196/29802,
author="Neely, Stephen
and Eldredge, Christina
and Sanders, Ron",
title="Health Information Seeking Behaviors on Social Media During the COVID-19 Pandemic Among American Social Networking Site Users: Survey Study",
journal="J Med Internet Res",
year="2021",
month="Jun",
day="11",
volume="23",
number="6",
pages="e29802",
keywords="social media",
keywords="internet",
keywords="communication",
keywords="public health",
keywords="COVID-19",
keywords="usage",
keywords="United States",
keywords="information seeking",
keywords="web-based health information",
keywords="survey",
keywords="mistrust",
abstract="Background: In recent years, medical journals have emphasized the increasingly critical role that social media plays in the dissemination of public health information and disease prevention guidelines. However, platforms such as Facebook and Twitter continue to pose unique challenges for clinical health care providers and public health officials alike. In order to effectively communicate during public health emergencies, such as the COVID-19 pandemic, it is increasingly critical for health care providers and public health officials to understand how patients gather health-related information on the internet and adjudicate the merits of such information. Objective: With that goal in mind, we conducted a survey of 1003 US-based adults to better understand how health consumers have used social media to learn and stay informed about the COVID-19 pandemic, the extent to which they have relied on credible scientific information sources, and how they have gone about fact-checking pandemic-related information. Methods: A web-based survey was conducted with a sample that was purchased through an industry-leading market research provider. The results were reported with a 95\% confidence level and a margin of error of 3. Participants included 1003 US-based adults (aged ?18 years). Participants were selected via a stratified quota sampling approach to ensure that the sample was representative of the US population. Balanced quotas were determined (by region of the country) for gender, age, race, and ethnicity. Results: The results showed a heavy reliance on social media during the COVID-19 pandemic; more than three-quarters of respondents (762/1003, 76\%) reported that they have relied on social media at least ``a little,'' and 59.2\% (594/1003) of respondents indicated that they read information about COVID-19 on social media at least once per week. According to the findings, most social media users (638/1003, 63.6\%) were unlikely to fact-check what they see on the internet with a health professional, despite the high levels of mistrust in the accuracy of COVID-19--related information on social media. We also found a greater likelihood of undergoing vaccination among those following more credible scientific sources on social media during the pandemic ($\chi$216=50.790; $\phi$=0.258; P<.001). Conclusions: The findings suggest that health professionals will need to be both strategic and proactive when engaging with health consumers on social media if they hope to counteract the deleterious effects of misinformation and disinformation. Effective training, institutional support, and proactive collaboration can help health professionals adapt to the evolving patterns of health information seeking. ",
doi="10.2196/29802",
url="https://www.jmir.org/2021/6/e29802",
url="http://www.ncbi.nlm.nih.gov/pubmed/34043526"
}


@Article{info:doi/10.2196/29528,
author="Basch, H. Corey
and Mohlman, Jan
and Fera, Joseph
and Tang, Hao
and Pellicane, Alessia
and Basch, E. Charles",
title="Community Mitigation of COVID-19 and Portrayal of Testing on TikTok: Descriptive Study",
journal="JMIR Public Health Surveill",
year="2021",
month="Jun",
day="10",
volume="7",
number="6",
pages="e29528",
keywords="TikTok",
keywords="social media",
keywords="COVID-19",
keywords="testing",
keywords="disgust",
keywords="anxiety",
keywords="content analysis",
keywords="communication",
keywords="infodemiology",
keywords="infoveillance",
keywords="public health",
keywords="digital public health",
keywords="digital health",
keywords="community mitigation",
abstract="Background: COVID-19 testing remains an essential element of a comprehensive strategy for community mitigation. Social media is a popular source of information about health, including COVID-19 and testing information. One of the most popular communication channels used by adolescents and young adults who search for health information is TikTok---an emerging social media platform. Objective: The purpose of this study was to describe TikTok videos related to COVID-19 testing. Methods: The hashtag \#covidtesting was searched, and the first 100 videos were included in the study sample. At the time the sample was drawn, these 100 videos garnered more than 50\% of the views for all videos cataloged under the hashtag \#covidtesting. The content characteristics that were coded included mentions, displays, or suggestions of anxiety, COVID-19 symptoms, quarantine, types of tests, results of test, and disgust/unpleasantness. Additional data that were coded included the number and percentage of views, likes, and comments and the use of music, dance, and humor. Results: The 100 videos garnered more than 103 million views; 111,000 comments; and over 12.8 million likes. Even though only 44 videos mentioned or suggested disgust/unpleasantness and 44 mentioned or suggested anxiety, those that portrayed tests as disgusting/unpleasant garnered over 70\% of the total cumulative number of views (73,479,400/103,071,900, 71.29\%) and likes (9,354,691/12,872,505, 72.67\%), and those that mentioned or suggested anxiety attracted about 60\% of the total cumulative number of views (61,423,500/103,071,900, 59.59\%) and more than 8 million likes (8,339,598/12,872,505, 64.79\%). Independent one-tailed t tests ($\alpha$=.05) revealed that videos that mentioned or suggested that COVID-19 testing was disgusting/unpleasant were associated with receiving a higher number of views and likes. Conclusions: Our finding of an association between TikTok videos that mentioned or suggested that COVID-19 tests were disgusting/unpleasant and these videos' propensity to garner views and likes is of concern. There is a need for public health agencies to recognize and address connotations of COVID-19 testing on social media. ",
doi="10.2196/29528",
url="https://publichealth.jmir.org/2021/6/e29528",
url="http://www.ncbi.nlm.nih.gov/pubmed/34081591"
}


@Article{info:doi/10.2196/26867,
author="Zhong, Bu
and Liu, Qian",
title="Medical Insights from Posts About Irritable Bowel Syndrome by Adolescent Patients and Their Parents: Topic Modeling and Social Network Analysis",
journal="J Med Internet Res",
year="2021",
month="Jun",
day="9",
volume="23",
number="6",
pages="e26867",
keywords="irritable bowel syndrome",
keywords="health care forum",
keywords="adolescent",
keywords="parents",
keywords="topic modeling",
keywords="social network analysis",
abstract="Background: Adolescents with irritable bowel syndrome (IBS) are increasingly seeking and sharing information about their symptoms in web-based health care forums. Their posts and those from their parents contain critical insights that can be used by patients, physicians, and caregivers to manage IBS symptoms. Objective: The aim of this study is to examine the posts from adolescent patients and their parents in a health forum, IBS Group, to better understand the key challenges, concerns, and issues of interest to young patients with IBS and their caregivers. Methods: Using topic modeling and social network analysis, in this study, we analyzed all the messages (over 750 topics and 3400 replies) posted on the IBS Group forum from 2010-2019 by adolescents with IBS aged 13-17 years and parents having children with IBS. We first detected 6 major topics in the posts by adolescent patients and parents on teenagers' IBS symptoms and the interaction between the topics. Social network analysis was then performed to gain insights into the nature of web-based interaction patterns among patients and caregivers. Results: Using the Latent Dirichlet Allocation algorithm and a latent Dirichlet allocation visualization tool, this study revealed 6 leading topics of concern in adolescents with IBS: school life, treatment or diet, symptoms, boys' ties to doctors, social or friend issues, and girls' ties to doctors. The top 6 topics in the parents' discussions were school life, girls' issues, boys' issues, diet choice, symptoms, and stress. The analyses show that the adolescent patients themselves are most concerned about the effect of IBS on their everyday activities and social lives. For parents having daughters with IBS, their top concerns were related to the girls' school performance and how much help they received at school. For their sons, the parents were more concerned about the pain and suffering that their sons had to endure. Both parents and adolescents gained social support from the web-based platform. Topic modeling shows that IBS affects teenagers the most in the areas of pain and school life. Furthermore, the issues raised by parents suggest that girls are bothered more by school performance over pain, whereas boys show exactly the opposite: pain is of greater concern than school performance. Conclusions: This study represents the first attempt to leverage both machine learning approaches and social network analysis to identify top IBS concerns from the perspectives of adolescent patients and caregivers in the same health forum. Young patients with IBS must face the challenges of social influences and anxiety associated with this health disorder in addition to physical pain and other symptoms. Boys and girls are affected differently by pain and school performance and view the IBS impacts differently from the parents. ",
doi="10.2196/26867",
url="https://www.jmir.org/2021/6/e26867",
url="http://www.ncbi.nlm.nih.gov/pubmed/34106078"
}


@Article{info:doi/10.2196/27664,
author="Gambril, Alan John
and Boyd, J. Carter
and Egbaria, Jamal",
title="The Numerous Benefits of Social Media for Medicine. Comment on ``Documenting Social Media Engagement as Scholarship: A New Model for Assessing Academic Accomplishment for the Health Professions''",
journal="J Med Internet Res",
year="2021",
month="Jun",
day="9",
volume="23",
number="6",
pages="e27664",
keywords="social media",
keywords="medical education",
keywords="internet",
keywords="academic medicine",
keywords="promotion",
keywords="tenure",
keywords="health professions",
keywords="scholarship",
keywords="medicine",
keywords="research",
keywords="accomplishment",
keywords="crowd source",
keywords="contribution",
keywords="innovation",
keywords="education",
keywords="dissemination",
doi="10.2196/27664",
url="https://www.jmir.org/2021/6/e27664",
url="http://www.ncbi.nlm.nih.gov/pubmed/34106082"
}


@Article{info:doi/10.2196/25579,
author="Allem, Jon-Patrick
and Dormanesh, Allison
and Majmundar, Anuja
and Unger, B. Jennifer
and Kirkpatrick, G. Matthew
and Choube, Akshat
and Aithal, Aneesh
and Ferrara, Emilio
and Boley Cruz, Tess",
title="Topics of Nicotine-Related Discussions on Twitter: Infoveillance Study",
journal="J Med Internet Res",
year="2021",
month="Jun",
day="7",
volume="23",
number="6",
pages="e25579",
keywords="nicotine",
keywords="electronic cigarettes",
keywords="Twitter",
keywords="social media",
keywords="social bots",
keywords="cessation",
abstract="Background: Cultural trends in the United States, the nicotine consumer marketplace, and tobacco policies are changing. Objective: The goal of this study was to identify and describe nicotine-related topics of conversation authored by the public and social bots on Twitter, including any misinformation or misconceptions that health education campaigns could potentially correct. Methods: Twitter posts containing the term ``nicotine'' were obtained from September 30, 2018 to October 1, 2019. Methods were used to distinguish between posts from social bots and nonbots. Text classifiers were used to identify topics in posts (n=300,360). Results: Prevalent topics of posts included vaping, smoking, addiction, withdrawal, nicotine health risks, and quit nicotine, with mentions of going ``cold turkey'' and needing help in quitting. Cessation was a common topic, with mentions of quitting and stopping smoking. Social bots discussed unsubstantiated health claims including how hypnotherapy, acupuncture, magnets worn on the ears, and time spent in the sauna can help in smoking cessation. Conclusions: Health education efforts are needed to correct unsubstantiated health claims on Twitter and ultimately direct individuals who want to quit smoking to evidence-based cessation strategies. Future interventions could be designed to follow these topics of discussions on Twitter and engage with members of the public about evidence-based cessation methods in near real time when people are contemplating cessation. ",
doi="10.2196/25579",
url="https://www.jmir.org/2021/6/e25579",
url="http://www.ncbi.nlm.nih.gov/pubmed/34096875"
}


@Article{info:doi/10.2196/26481,
author="Cui, Limeng
and Chu, Lijuan",
title="YouTube Videos Related to the Fukushima Nuclear Disaster: Content Analysis",
journal="JMIR Public Health Surveill",
year="2021",
month="Jun",
day="7",
volume="7",
number="6",
pages="e26481",
keywords="YouTube",
keywords="Fukushima nuclear disaster",
keywords="social media",
keywords="risk communication",
keywords="disaster",
keywords="video platform",
keywords="radiation",
keywords="public safety",
keywords="nuclear disaster",
abstract="Background: YouTube (Alphabet Incorporated) has become the most popular video-sharing platform in the world. The Fukushima Daiichi Nuclear Power Plant (FDNPP) disaster resulted in public anxiety toward nuclear power and radiation worldwide. YouTube is an important source of information about the FDNPP disaster for the world. Objective: This study's objectives were to examine the characteristics of YouTube videos related to the FDNPP disaster, analyze the content and comments of videos with a quantitative method, and determine which features contribute to making a video popular with audiences. This study is the first to examine FDNPP disaster--related videos on YouTube. Methods: We searched for the term ``Fukushima nuclear disaster'' on YouTube on November 2, 2019. The first 60 eligible videos in the relevance, upload date, view count, and rating categories were recorded. ?Videos that were irrelevant, were non-English, had inappropriate words, were machine synthesized, and were <3 minutes long were excluded. In total, 111 videos met the inclusion criteria. Parameters of the videos, including the number of subscribers, length, the number of days since the video was uploaded, region, video popularity (views, views/day, likes, likes/day, dislikes, dislikes/day, comments, comments/day), the tone of the videos, the top ten comments, affiliation, whether Japanese people participated in the video, whether the video recorder visited Fukushima, whether the video contained theoretical knowledge, and whether the video contained information about the recent situation in Fukushima, were recorded. By using criteria for content and ?technical design, two evaluators scored videos and grouped them into the useful (score: 11-14), slightly useful (score: 6-10), and useless (score: 0-5) video categories. Results: Of the 111 videos, 43 (38.7\%) videos were useful, 43 (38.7\%) were slightly useful, and 25 (22.5\%) were useless. Useful videos had good visual and aural effects, provided vivid information on the Fukushima disaster, and had a mean score of 12 (SD 0.9). Useful videos had more views per day (P<.001), likes per day (P<.001), and comments per day (P=.02) than useless and slightly useful videos. The popularity of videos had a significant correlation with clear sounds (likes/day: P=.001; comments/day: P=.02), vivid information (likes/day: P<.001; comments/day: P=.007), understanding content (likes/day: P=.001; comments/day: P=.04). There was no significant difference in likes per day (P=.72) and comments per day (P=.11) between negative and neutral- and mixed-tone videos. Videos about the recent situation in Fukushima had more likes and comments per day. Video recorders who personally visited Fukushima Prefecture had more subscribers and received more views and likes. Conclusions: The possible features that made videos popular to the public included ?video quality, videos made in Fukushima, and information on the recent situation in Fukushima. During risk communication on new forms of media, health institutes should increase publicity and be more approachable to resonate with international audiences. ",
doi="10.2196/26481",
url="https://publichealth.jmir.org/2021/6/e26481",
url="http://www.ncbi.nlm.nih.gov/pubmed/34096880"
}


@Article{info:doi/10.2196/24564,
author="Wawrzuta, Dominik
and Jaworski, Mariusz
and Gotlib, Joanna
and Panczyk, Mariusz",
title="Characteristics of Antivaccine Messages on Social Media: Systematic Review",
journal="J Med Internet Res",
year="2021",
month="Jun",
day="4",
volume="23",
number="6",
pages="e24564",
keywords="vaccination",
keywords="social media",
keywords="antivaccination movement",
keywords="vaccination refusal",
keywords="health communication",
keywords="public health",
keywords="vaccines",
abstract="Background: Supporters of the antivaccination movement can easily spread information that is not scientifically proven on social media. Therefore, learning more about their posts and activities is instrumental in effectively reacting and responding to the false information they publish, which is aimed at discouraging people from taking vaccines. Objective: This study aims to gather, assess, and synthesize evidence related to the current state of knowledge about antivaccine social media users' web-based activities. Methods: We systematically reviewed English-language papers from 3 databases (Scopus, Web of Science, and PubMed). A data extraction form was established, which included authors, year of publication, specific objectives, study design, comparison, and outcomes of significance. We performed an aggregative narrative synthesis of the included studies. Results: The search strategy retrieved 731 records in total. After screening for duplicates and eligibility, 18 articles were included in the qualitative synthesis. Although most of the authors analyzed text messages, some of them studied images or videos. In addition, although most of the studies examined vaccines in general, 5 focused specifically on human papillomavirus vaccines, 2 on measles vaccines, and 1 on influenza vaccines. The synthesized studies dealt with the popularity of provaccination and antivaccination content, the style and manner in which messages about vaccines were formulated for the users, a range of topics concerning vaccines (harmful action, limited freedom of choice, and conspiracy theories), and the role and activity of bots in the dissemination of these messages in social media. Conclusions: Proponents of the antivaccine movement use a limited number of arguments in their messages; therefore, it is possible to prepare publications clarifying doubts and debunking the most common lies. Public health authorities should continuously monitor social media to quickly find new antivaccine arguments and then create information campaigns for both health professionals and other users. ",
doi="10.2196/24564",
url="https://www.jmir.org/2021/6/e24564",
url="http://www.ncbi.nlm.nih.gov/pubmed/34085943"
}


@Article{info:doi/10.2196/19697,
author="Chung, Alicia
and Vieira, Dorice
and Donley, Tiffany
and Tan, Nicholas
and Jean-Louis, Girardin
and Kiely Gouley, Kathleen
and Seixas, Azizi",
title="Adolescent Peer Influence on Eating Behaviors via Social Media: Scoping Review",
journal="J Med Internet Res",
year="2021",
month="Jun",
day="3",
volume="23",
number="6",
pages="e19697",
keywords="social media",
keywords="eating behaviors",
keywords="adolescent health",
abstract="Background: The influence of social media among adolescent peer groups can be a powerful change agent. Objective: Our scoping review aimed to elucidate the ways in which social media use among adolescent peers influences eating behaviors. Methods: A scoping review of the literature of articles published from journal inception to 2019 was performed by searching PubMed (ie, MEDLINE), Embase, CINAHL, PsycINFO, Web of Science, and other databases. The review was conducted in three steps: (1) identification of the research question and clarification of criteria using the population, intervention, comparison, and outcome (PICO) framework; (2) selection of articles from the literature using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines; and (3) charting and summarizing information from selected articles. PubMed's Medical Subject Headings (MeSH) and Embase's Emtree subject headings were reviewed along with specific keywords to construct a comprehensive search strategy. Subject headings and keywords were based on adolescent age groups, social media platforms, and eating behaviors. After screening 1387 peer-reviewed articles, 37 articles were assessed for eligibility. Participant age, gender, study location, social media channels utilized, user volume, and content themes related to findings were extracted from the articles. Results: Six articles met the final inclusion criteria. A final sample size of 1225 adolescents (aged 10 to 19 years) from the United States, the United Kingdom, Sweden, Norway, Denmark, Portugal, Brazil, and Australia were included in controlled and qualitative studies. Instagram and Facebook were among the most popular social media platforms that influenced healthful eating behaviors (ie, fruit and vegetable intake) as well as unhealthful eating behaviors related to fast food advertising. Online forums served as accessible channels for eating disorder relapse prevention among youth. Social media influence converged around four central themes: (1) visual appeal, (2) content dissemination, (3) socialized digital connections, and (4) adolescent marketer influencers. Conclusions: Adolescent peer influence in social media environments spans the spectrum of healthy eating (ie, pathological) to eating disorders (ie, nonpathological). Strategic network-driven approaches should be considered for engaging adolescents in the promotion of positive dietary behaviors. ",
doi="10.2196/19697",
url="https://www.jmir.org/2021/6/e19697",
url="http://www.ncbi.nlm.nih.gov/pubmed/34081018"
}


@Article{info:doi/10.2196/24303,
author="Yang, Nancy
and Wu, Dan
and Zhou, Yi
and Huang, Shanzi
and He, Xi
and Tucker, Joseph
and Li, Xiaofeng
and Smith, M. Kumi
and Jiang, Xiaohui
and Wang, Yehua
and Huang, Wenting
and Fu, Hongyun
and Bao, Huanyu
and Jiang, Hongbo
and Dai, Wencan
and Tang, Weiming",
title="Sexual Health Influencer Distribution of HIV/Syphilis Self-Tests Among Men Who Have Sex With Men in China: Secondary Analysis to Inform Community-Based Interventions",
journal="J Med Internet Res",
year="2021",
month="Jun",
day="1",
volume="23",
number="6",
pages="e24303",
keywords="sexual health influencer",
keywords="men who have sex with men",
keywords="HIV",
keywords="syphilis",
keywords="self-test",
keywords="sexual health",
keywords="influencer",
keywords="social network",
keywords="peers",
abstract="Background: Social network--based strategies can expand HIV/syphilis self-tests among men who have sex with men (MSM). Sexual health influencers are individuals who are particularly capable of spreading information about HIV and other sexually transmitted infections (STIs) within their social networks. However, it remains unknown whether a sexual health influencer can encourage their peers to self-test for HIV/syphilis. Objective: The aims of this study were to examine the impact of MSM sexual health influencers on improving HIV/syphilis self-test uptake within their social networks compared to that of nonsexual health influencers. Methods: In Zhuhai, China, men 16 years or older, born biologically male, who reported ever having had sex with a man, and applying for HIV/syphilis self-tests were enrolled online as indexes and encouraged to distribute self-tests to individuals (alters) in their social network. Indexes scoring >3 on a sexual health influencer scale were considered to be sexual health influencers (Cronbach $\alpha$=.87). The primary outcome was the mean number of alters encouraged to test per index for sexual health influencers compared with the number encouraged by noninfluencers. Results: Participants included 371 indexes and 278 alters. Among indexes, 77 (20.8\%) were sexual health influencers and 294 (79.2\%) were noninfluencers. On average, each sexual health influencer successfully encouraged 1.66 alters to self-test compared to 0.51 alters encouraged by each noninfluencer (adjusted rate ratio 2.07, 95\% CI 1.59-2.69). More sexual health influencers disclosed their sexual orientation (80.5\% vs 67.3\%, P=.02) and were community-based organization volunteers (18.2\% vs 2.7\%, P<.001) than noninfluencers. More alters of sexual health influencers came from a rural area (45.5\% vs 23.8\%, P<.001), had below-college education (57.7\% vs 37.1\%, P<.001), and had multiple casual male sexual partners in the past 6 months (25.2\% vs 11.9\%, P<.001). Conclusions: Being a sexual health influencer was associated with encouraging more alters with less testing access to self-test for HIV/syphilis. Sexual health influencers can be engaged as seeds to expand HIV/syphilis testing coverage. ",
doi="10.2196/24303",
url="https://www.jmir.org/2021/6/e24303",
url="http://www.ncbi.nlm.nih.gov/pubmed/34061035"
}


@Article{info:doi/10.2196/28859,
author="Oliveira J e Silva, Lucas
and Maldonado, Graciela
and Brigham, Tara
and Mullan, F. Aidan
and Utengen, Audun
and Cabrera, Daniel",
title="Evaluating Scholars' Impact and Influence: Cross-sectional Study of the Correlation Between a Novel Social Media--Based Score and an Author-Level Citation Metric",
journal="J Med Internet Res",
year="2021",
month="May",
day="31",
volume="23",
number="5",
pages="e28859",
keywords="social media",
keywords="Twitter",
keywords="journal impact factor",
keywords="h-index",
keywords="digital scholarship",
keywords="digital platform",
keywords="Scopus",
keywords="metrics",
keywords="scientometrics",
keywords="altmetrics",
keywords="stakeholders",
keywords="health care",
keywords="digital health care",
abstract="Background: The development of an author-level complementary metric could play a role in the process of academic promotion through objective evaluation of scholars' influence and impact. Objective: The objective of this study was to evaluate the correlation between the Healthcare Social Graph (HSG) score, a novel social media influence and impact metric, and the h-index, a traditional author-level metric. Methods: This was a cross-sectional study of health care stakeholders with a social media presence randomly sampled from the Symplur database in May 2020. We performed stratified random sampling to obtain a representative sample with all strata of HSG scores. We manually queried the h-index in two reference-based databases (Scopus and Google Scholar). Continuous features (HSG score and h-index) from the included profiles were summarized as the median and IQR. We calculated the Spearman correlation coefficients ($\rho$) to evaluate the correlation between the HSG scores and h-indexes obtained from Google Scholar and Scopus. Results: A total of 286 (31.2\%) of the 917 stakeholders had a Google Scholar h-index available. The median HSG score for these profiles was 61.1 (IQR 48.2), and the median h-index was 14.5 (IQR 26.0). For the 286 subjects with the HSG score and Google Scholar h-index available, the Spearman correlation coefficient $\rho$ was 0.1979 (P<.001), indicating a weak positive correlation between these two metrics. A total of 715 (78\%) of 917 stakeholders had a Scopus h-index available. The median HSG score for these profiles was 57.6 (IQR 46.4), and the median h-index was 7 (IQR 16). For the 715 subjects with the HSG score and Scopus h-index available, $\rho$ was 0.2173 (P<.001), also indicating a weak positive correlation. Conclusions: We found a weak positive correlation between a novel author-level complementary metric and the h-index. More than a chiasm between traditional citation metrics and novel social media--based metrics, our findings point toward a bridge between the two domains. ",
doi="10.2196/28859",
url="https://www.jmir.org/2021/5/e28859",
url="http://www.ncbi.nlm.nih.gov/pubmed/34057413"
}


@Article{info:doi/10.2196/24199,
author="Kochan, Andrew
and Ong, Shaun
and Guler, Sabina
and Johannson, A. Kerri
and Ryerson, J. Christopher
and Goobie, C. Gillian",
title="Social Media Content of Idiopathic Pulmonary Fibrosis Groups and Pages on Facebook: Cross-sectional Analysis",
journal="JMIR Public Health Surveill",
year="2021",
month="May",
day="31",
volume="7",
number="5",
pages="e24199",
keywords="interstitial lung disease",
keywords="idiopathic pulmonary fibrosis",
keywords="patient education",
keywords="social media",
keywords="internet",
abstract="Background: Patients use Facebook as a resource for medical information. We analyzed posts on idiopathic pulmonary fibrosis (IPF)-related Facebook groups and pages for the presence of guideline content, user engagement, and usefulness. Objective: The objective of this study was to describe and analyze posts from Facebook groups and pages that primarily focus on IPF-related content. Methods: Cross-sectional analysis was performed on a single date, identifying Facebook groups and pages resulting from separately searching ``IPF'' and ``idiopathic pulmonary fibrosis.'' For inclusion, groups and pages needed to meet either search term and be in English, publicly available, and relevant to IPF. Every 10th post was assessed for general characteristics, source, focus, and user engagement metrics. Posts were analyzed for presence of IPF guideline content, useful scientific information (eg, scientific publications), useful support information (eg, information about support groups), and potentially harmful information. Results: Eligibility criteria were met by 12 groups and 27 pages, leading to analysis of 523 posts. Of these, 42\% contained guideline content, 24\% provided useful support, 20\% provided useful scientific information, and 5\% contained potentially harmful information. The most common post source was nonmedical users (85\%). Posts most frequently focused on IPF-related news (29\%). Posts containing any guideline content had fewer likes or comments and a higher likelihood of containing potentially harmful content. Posts containing useful supportive information had more likes, shares, and comments. Conclusions: Facebook contains useful information about IPF, but posts with misinformation and less guideline content have higher user engagement, making them more visible. Identifying ways to help patients with IPF discriminate between useful and harmful information on Facebook and other social media platforms is an important task for health care professionals. ",
doi="10.2196/24199",
url="https://publichealth.jmir.org/2021/5/e24199",
url="http://www.ncbi.nlm.nih.gov/pubmed/34057425"
}


@Article{info:doi/10.2196/24108,
author="Temmesen, Gry Camilla
and Nielsen, Svarre Henriette
and Andersen, Mygleg{\aa}rd Heidi Lene
and Birch Petersen, Kathrine
and Clemensen, Jane",
title="Using Social Media for Qualitative Health Research in Danish Women of Reproductive Age: Online Focus Group Study on Facebook",
journal="JMIR Form Res",
year="2021",
month="May",
day="31",
volume="5",
number="5",
pages="e24108",
keywords="internet",
keywords="social media",
keywords="Facebook",
keywords="online focus groups",
keywords="women",
keywords="reproduction",
keywords="reproductive age",
keywords="motherhood",
keywords="participatory design",
abstract="Background: Social media platforms provide new possibilities within health research. With Facebook being the largest social network in the world, it constitutes a potential platform for recruitment and data collection from women of reproductive age. Women in Denmark and in other Western countries postpone motherhood and risk infertility due to their advanced age when they try to conceive. To date, no study has explored Danish women's reflections on the timing of motherhood within a social media setting. Objective: The aim of this study was to explore the challenges and opportunities of using Facebook as a platform for qualitative health research in Danish women of reproductive age. Methods: This study was a qualitative study based on 3 online focus groups on Facebook with 26 Danish women of reproductive age discussing the timing of motherhood in January 2020. Results: Conducting online focus groups on Facebook was successful in this study as the web-based approach was found suitable for developing qualitative data with women of reproductive age and made recruitment easy and free of charge. All participants found participating in an online focus group to be a positive experience. More than half of the women participating in the online focus groups found it advantageous to meet on Facebook instead of meeting face-to-face. Conclusions: Conducting online focus groups on Facebook is a suitable method to access qualitative data from women of reproductive age. Participants were positive toward being a part of an online focus group. Online focus groups on social media have the potential to give women of reproductive age a voice in the debate of motherhood. ",
doi="10.2196/24108",
url="https://formative.jmir.org/2021/5/e24108",
url="http://www.ncbi.nlm.nih.gov/pubmed/34057418"
}


@Article{info:doi/10.2196/20179,
author="Moreno, A. Megan
and Gaus, Quintin
and Wilt, Megan
and Arseniev-Koehler, Alina
and Ton, Adrienne
and Adrian, Molly
and VanderStoep, Ann",
title="Displayed Depression Symptoms on Facebook at Two Time Points: Content Analysis",
journal="JMIR Form Res",
year="2021",
month="May",
day="31",
volume="5",
number="5",
pages="e20179",
keywords="adolescents",
keywords="content analysis",
keywords="depression",
keywords="Facebook",
keywords="social media",
abstract="Background: Depression is a prevalent and problematic mental disorder that often has an onset in adolescence. Previous studies have illustrated that depression disclosures on social media are common and may be linked to an individual's experiences of depression. However, most studies have examined depression displays on social media at a single time point. Objective: This study aims to investigate displayed depression symptoms on Facebook at 2 developmental time points based on symptom type and gender. Methods: Participants were recruited from an ongoing longitudinal cohort study. The content analysis of text-based Facebook data over 1 year was conducted at 2 time points: time 1 (adolescence; age 17-18 years) and time 2 (young adulthood; ages 20-22 years). Diagnostic criteria for depression were applied to each post to identify the displayed depression symptoms. Data were extracted verbatim. The analysis included nonparametric tests for comparisons. Results: A total of 78 participants' Facebook profiles were examined, of which 40 (51\%) were male. At time 1, 62\% (48/78) of the adolescents had a Facebook profile, and 54\% (26/78) displayed depression symptom references with an average of 9.4 (SD 3.1) references and 3.3 (SD 2.3) symptom types. Of the 78 participants, 15 (19\%) females and 12 (15\%) males displayed depression symptom references; these prevalence estimates were not significantly different by gender (P=.59). At time 2, 35 young adults displayed symptoms of depression with an average of 4.6 (SD 2.3) references and 2.4 (SD 1.3) symptom types. There were no differences in the prevalence of symptoms of depression displayed between males (n=19) and females (n=16; P=.63). Conclusions: This content analysis study within an ongoing cohort study illustrates the differences in depression displays on Facebook by developmental stage and symptom. This study contributes to a growing body of literature by showing that using social media to observe and understand depression during the emerging adult developmental period may be a valuable approach. ",
doi="10.2196/20179",
url="https://formative.jmir.org/2021/5/e20179",
url="http://www.ncbi.nlm.nih.gov/pubmed/34057422"
}


@Article{info:doi/10.2196/23688,
author="Vogel, A. Erin
and Ramo, E. Danielle
and Prochaska, J. Judith
and Meacham, C. Meredith
and Layton, F. John
and Humfleet, L. Gary",
title="Problematic Social Media Use in Sexual and Gender Minority Young Adults: Observational Study",
journal="JMIR Ment Health",
year="2021",
month="May",
day="28",
volume="8",
number="5",
pages="e23688",
keywords="sexual and gender minorities",
keywords="social media",
keywords="Facebook",
keywords="internet",
keywords="social stigma",
keywords="mobile phone",
abstract="Background: Sexual and gender minority (SGM) individuals experience minority stress, especially when they lack social support. SGM young adults may turn to social media in search of a supportive community; however, social media use can become problematic when it interferes with functioning. Problematic social media use may be associated with experiences of minority stress among SGM young adults. Objective: The objective of this study is to examine the associations among social media use, SGM-related internalized stigma, emotional social support, and depressive symptoms in SGM young adults. Methods: Participants were SGM young adults who were regular (?4 days per week) social media users (N=302) and had enrolled in Facebook smoking cessation interventions. As part of a baseline assessment, participants self-reported problematic social media use (characterized by salience, tolerance, and withdrawal-like experiences; adapted from the Facebook Addiction Scale), hours of social media use per week, internalized SGM stigma, perceived emotional social support, and depressive symptoms. Pearson correlations tested bivariate associations among problematic social media use, hours of social media use, internalized SGM stigma, perceived emotional social support, and depressive symptoms. Multiple linear regression examined the associations between the aforementioned variables and problematic social media use and was adjusted for gender identity. Results: A total of 302 SGM young adults were included in the analyses (assigned female at birth: 218/302, 72.2\%; non-Hispanic White: 188/302, 62.3\%; age: mean 21.9 years, SD 2.2 years). The sexual identity composition of the sample was 59.3\% (179/302) bisexual and/or pansexual, 17.2\% (52/302) gay, 16.9\% (51/302) lesbian, and 6.6\% (20/302) other. The gender identity composition of the sample was 61.3\% (185/302) cisgender; 24.2\% (73/302) genderqueer, fluid, nonbinary, or other; and 14.6\% (44/302) transgender. Problematic social media use averaged 2.53 (SD 0.94) on a 5-point scale, with a median of 17 hours of social media use per week (approximately 2.5 h per day). Participants with greater problematic social media use had greater internalized SGM stigma (r=0.22; P<.001) and depressive symptoms (r=0.22; P<.001) and lower perceived emotional social support (r=?0.15; P=.007). Greater internalized SGM stigma remained was significantly associated with greater problematic social media use after accounting for the time spent on social media and other correlates (P<.001). In addition, participants with greater depressive symptoms had marginally greater problematic social media use (P=.05). In sum, signs of problematic social media use were more likely to occur among SGM young adults who had internalized SGM stigma and depressive symptoms. Conclusions: Taken together, problematic social media use among SGM young adults was associated with negative psychological experiences, including internalized stigma, low social support, and depressive symptoms. SGM young adults experiencing minority stress may be at risk for problematic social media use. ",
doi="10.2196/23688",
url="https://mental.jmir.org/2021/5/e23688",
url="http://www.ncbi.nlm.nih.gov/pubmed/34047276"
}


@Article{info:doi/10.2196/25736,
author="Bour, Charline
and Ahne, Adrian
and Schmitz, Susanne
and Perchoux, Camille
and Dessenne, Coralie
and Fagherazzi, Guy",
title="The Use of Social Media for Health Research Purposes: Scoping Review",
journal="J Med Internet Res",
year="2021",
month="May",
day="27",
volume="23",
number="5",
pages="e25736",
keywords="social media",
keywords="public health",
keywords="epidemiology",
keywords="research",
keywords="health",
keywords="medical",
keywords="social networking",
keywords="infodemiology",
keywords="eHealth",
keywords="text mining",
abstract="Background: As social media are increasingly used worldwide, more and more scientists are relying on them for their health-related projects. However, social media features, methodologies, and ethical issues are unclear so far because, to our knowledge, there has been no overview of this relatively young field of research. Objective: This scoping review aimed to provide an evidence map of the different uses of social media for health research purposes, their fields of application, and their analysis methods. Methods: We followed the scoping review methodologies developed by Arksey and O'Malley and the Joanna Briggs Institute. After developing search strategies based on keywords (eg, social media, health research), comprehensive searches were conducted in the PubMed/MEDLINE and Web of Science databases. We limited the search strategies to documents written in English and published between January 1, 2005, and April 9, 2020. After removing duplicates, articles were screened at the title and abstract level and at the full text level by two independent reviewers. One reviewer extracted data, which were descriptively analyzed to map the available evidence. Results: After screening 1237 titles and abstracts and 407 full texts, 268 unique papers were included, dating from 2009 to 2020 with an average annual growth rate of 32.71\% for the 2009-2019 period. Studies mainly came from the Americas (173/268, 64.6\%, including 151 from the United States). Articles used machine learning or data mining techniques (60/268) to analyze the data, discussed opportunities and limitations of the use of social media for research (59/268), assessed the feasibility of recruitment strategies (45/268), or discussed ethical issues (16/268). Communicable (eg, influenza, 40/268) and then chronic (eg, cancer, 24/268) diseases were the two main areas of interest. Conclusions: Since their early days, social media have been recognized as resources with high potential for health research purposes, yet the field is still suffering from strong heterogeneity in the methodologies used, which prevents the research from being compared and generalized. For the field to be fully recognized as a valid, complementary approach to more traditional health research study designs, there is now a need for more guidance by types of applications of social media for health research, both from a methodological and an ethical perspective. International Registered Report Identifier (IRRID): RR2-10.1136/bmjopen-2020-040671 ",
doi="10.2196/25736",
url="https://www.jmir.org/2021/5/e25736",
url="http://www.ncbi.nlm.nih.gov/pubmed/34042593"
}


@Article{info:doi/10.2196/22271,
author="Chiruvella, Varsha
and Guddati, Kumar Achuta",
title="Cyberspace and Libel: A Dangerous Balance for Physicians",
journal="Interact J Med Res",
year="2021",
month="May",
day="27",
volume="10",
number="2",
pages="e22271",
keywords="libel",
keywords="reputation",
keywords="physician",
keywords="law",
keywords="legal",
keywords="defamation",
doi="10.2196/22271",
url="https://www.i-jmr.org/2021/2/e22271",
url="http://www.ncbi.nlm.nih.gov/pubmed/34042594"
}


@Article{info:doi/10.2196/18771,
author="Donelle, Lorie
and Facca, Danica
and Burke, Shauna
and Hiebert, Bradley
and Bender, Emma
and Ling, Stephen",
title="Exploring Canadian Children's Social Media Use, Digital Literacy, and Quality of Life: Pilot Cross-sectional Survey Study",
journal="JMIR Form Res",
year="2021",
month="May",
day="26",
volume="5",
number="5",
pages="e18771",
keywords="child",
keywords="children",
keywords="internet",
keywords="social media",
keywords="digital literacy",
keywords="digital inclusion",
keywords="quality of life",
keywords="mobile phone",
abstract="Background: Understanding social media use and digital literacy among young Canadian children is an increasing area of concern, given the importance of digital inclusion for full and informed participation in evolving educational, civic, corporate, social, and economic spaces. Objective: The aim of this study was to explore internet and social media knowledge as well as social media use among Canadian children aged between 6 and 10 years. Methods: We conducted interview surveys with 42 children aged between 6 and 10 years who participated in an after-school health promotion program in an urban community in Southwestern Ontario to understand their digital literacy skills and social media use. The data were analyzed using both quantitative and qualitative methods. Results: Of the 42 children who participated in this study, 24 (57\%) reported that they used social media, specifically YouTube (19/24, 79\% reported use), Snapchat (16/24, 67\% reported use), and Facebook (8/24, 33\% reported use). While using social media, children reported sharing personal information, including videos or pictures of themselves (12/24, 50\%), videos or pictures of others (8/24, 33\%), and their birthday (12/24, 50\%), whereas only one-third (9/24, 38\%) of the children believed that only close family and friends had access to the content they shared. When reporting on the quality of life in the context of using social media, most (17/24, 71\%) children never felt sad, half (12/24, 50\%) never had difficulty making new friends, and nearly one-third (7/24, 30\%) indicated that they never had difficulty wanting to play outside. Conclusions: Owing to the rapidly evolving uptake and use of social media among young Canadians, the implementation of childhood digital health literacy education is vital to best support digital inclusion and well-being in Canada. The findings of our study highlight the need for future research to understand where children receive their digital literacy knowledge from and whether this knowledge is gained through self-directed social media use or observation from other actors, such as parents, siblings, or friends. ",
doi="10.2196/18771",
url="https://formative.jmir.org/2021/5/e18771",
url="http://www.ncbi.nlm.nih.gov/pubmed/34037525"
}


@Article{info:doi/10.2196/27059,
author="Daughton, R. Ashlynn
and Shelley, D. Courtney
and Barnard, Martha
and Gerts, Dax
and Watson Ross, Chrysm
and Crooker, Isabel
and Nadiga, Gopal
and Mukundan, Nilesh
and Vaquera Chavez, Yadira Nidia
and Parikh, Nidhi
and Pitts, Travis
and Fairchild, Geoffrey",
title="Mining and Validating Social Media Data for COVID-19--Related Human Behaviors Between January and July 2020: Infodemiology Study",
journal="J Med Internet Res",
year="2021",
month="May",
day="25",
volume="23",
number="5",
pages="e27059",
keywords="Twitter",
keywords="social media",
keywords="human behavior",
keywords="infectious disease",
keywords="COVID-19",
keywords="coronavirus",
keywords="infodemiology",
keywords="infoveillance",
keywords="social distancing",
keywords="shelter-in-place",
keywords="mobility",
keywords="COVID-19 intervention",
abstract="Background: Health authorities can minimize the impact of an emergent infectious disease outbreak through effective and timely risk communication, which can build trust and adherence to subsequent behavioral messaging. Monitoring the psychological impacts of an outbreak, as well as public adherence to such messaging, is also important for minimizing long-term effects of an outbreak. Objective: We used social media data from Twitter to identify human behaviors relevant to COVID-19 transmission, as well as the perceived impacts of COVID-19 on individuals, as a first step toward real-time monitoring of public perceptions to inform public health communications. Methods: We developed a coding schema for 6 categories and 11 subcategories, which included both a wide number of behaviors as well codes focused on the impacts of the pandemic (eg, economic and mental health impacts). We used this to develop training data and develop supervised learning classifiers for classes with sufficient labels. Classifiers that performed adequately were applied to our remaining corpus, and temporal and geospatial trends were assessed. We compared the classified patterns to ground truth mobility data and actual COVID-19 confirmed cases to assess the signal achieved here. Results: We applied our labeling schema to approximately 7200 tweets. The worst-performing classifiers had F1 scores of only 0.18 to 0.28 when trying to identify tweets about monitoring symptoms and testing. Classifiers about social distancing, however, were much stronger, with F1 scores of 0.64 to 0.66.  We applied the social distancing classifiers to over 228 million tweets. We showed temporal patterns consistent with real-world events, and we showed correlations of up to --0.5 between social distancing signals on Twitter and ground truth mobility throughout the United States. Conclusions: Behaviors discussed on Twitter are exceptionally varied. Twitter can provide useful information for parameterizing models that incorporate human behavior, as well as for informing public health communication strategies by describing awareness of and compliance with suggested behaviors. ",
doi="10.2196/27059",
url="https://www.jmir.org/2021/5/e27059",
url="http://www.ncbi.nlm.nih.gov/pubmed/33882015"
}


@Article{info:doi/10.2196/29145,
author="Tao, Zhuo-Ying
and Su, Yu-Xiong",
title="Authors' Reply to: Methodological Clarifications and Generalizing From Weibo Data. Comment on ``Nature and Diffusion of COVID-19--related Oral Health Information on Chinese Social Media: Analysis of Tweets on Weibo''",
journal="J Med Internet Res",
year="2021",
month="May",
day="21",
volume="23",
number="5",
pages="e29145",
keywords="COVID-19",
keywords="dentistry",
keywords="oral health",
keywords="dental health",
keywords="online health",
keywords="social media",
keywords="tweet",
keywords="Weibo",
keywords="China",
keywords="health information",
doi="10.2196/29145",
url="https://www.jmir.org/2021/5/e29145",
url="http://www.ncbi.nlm.nih.gov/pubmed/33989166"
}


@Article{info:doi/10.2196/26255,
author="Yadav, Prakash Om",
title="Methodological Clarifications and Generalizing From Weibo Data. Comment on ``Nature and Diffusion of COVID-19--related Oral Health Information on Chinese Social Media: Analysis of Tweets on Weibo''",
journal="J Med Internet Res",
year="2021",
month="May",
day="21",
volume="23",
number="5",
pages="e26255",
keywords="COVID-19",
keywords="dentistry",
keywords="oral health",
keywords="dental health",
keywords="online health",
keywords="social media",
keywords="tweet",
keywords="Weibo",
keywords="China",
keywords="health information",
doi="10.2196/26255",
url="https://www.jmir.org/2021/5/e26255",
url="http://www.ncbi.nlm.nih.gov/pubmed/33989161"
}


@Article{info:doi/10.2196/26933,
author="Himelein-Wachowiak, McKenzie
and Giorgi, Salvatore
and Devoto, Amanda
and Rahman, Muhammad
and Ungar, Lyle
and Schwartz, Andrew H.
and Epstein, H. David
and Leggio, Lorenzo
and Curtis, Brenda",
title="Bots and Misinformation Spread on Social Media: Implications for COVID-19",
journal="J Med Internet Res",
year="2021",
month="May",
day="20",
volume="23",
number="5",
pages="e26933",
keywords="COVID-19",
keywords="coronavirus",
keywords="social media",
keywords="bots",
keywords="infodemiology",
keywords="infoveillance",
keywords="social listening",
keywords="infodemic",
keywords="spambots",
keywords="misinformation",
keywords="disinformation",
keywords="fake news",
keywords="online communities",
keywords="Twitter",
keywords="public health",
doi="10.2196/26933",
url="https://www.jmir.org/2021/5/e26933",
url="http://www.ncbi.nlm.nih.gov/pubmed/33882014"
}


@Article{info:doi/10.2196/27331,
author="Stewart, H. Nancy
and Koza, Anya
and Dhaon, Serena
and Shoushtari, Christiana
and Martinez, Maylyn
and Arora, M. Vineet",
title="Sleep Disturbances in Frontline Health Care Workers During the COVID-19 Pandemic: Social Media Survey Study",
journal="J Med Internet Res",
year="2021",
month="May",
day="19",
volume="23",
number="5",
pages="e27331",
keywords="social media",
keywords="sleep disorders",
keywords="frontline health care workers",
keywords="burnout",
keywords="insomnia",
keywords="sleep",
keywords="health care worker",
keywords="stress",
keywords="survey",
keywords="demographic",
keywords="outcome",
keywords="COVID-19",
abstract="Background: During the COVID-19 pandemic, health care workers are sharing their challenges, including sleep disturbances, on social media; however, no study has evaluated sleep in predominantly US frontline health care workers during the COVID-19 pandemic. Objective: The aim of this study was to assess sleep among a sample of predominantly US frontline health care workers during the COVID-19 pandemic using validated measures through a survey distributed on social media. Methods: A self-selection survey was distributed on Facebook, Twitter, and Instagram for 16 days (August 31 to September 15, 2020), targeting health care workers who were clinically active during the COVID-19 pandemic. Study participants completed the Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI), and they reported their demographic and career information. Poor sleep quality was defined as a PSQI score ?5. Moderate-to-severe insomnia was defined as an ISI score >14. The Mini-Z Burnout Survey was used to measure burnout. Multivariate logistic regression tested associations between demographics, career characteristics, and sleep outcomes. Results: A total of 963 surveys were completed. Participants were predominantly White (894/963, 92.8\%), female (707/963, 73.4\%), aged 30-49 years (692/963, 71.9\%), and physicians (620/963, 64.4\%). Mean sleep duration was 6.1 hours (SD 1.2). Nearly 96\% (920/963, 95.5\%) of participants reported poor sleep (PSQI). One-third (288/963, 30\%) reported moderate or severe insomnia. Many participants (554/910, 60.9\%) experienced sleep disruptions due to device use or had nightmares at least once per week (420/929, 45.2\%). Over 50\% (525/932, 56.3\%) reported burnout. In multivariable logistic regressions, nonphysician (odds ratio [OR] 2.4, 95\% CI 1.7-3.4), caring for patients with COVID-19 (OR 1.8, 95\% CI 1.2-2.8), Hispanic ethnicity (OR 2.2, 95\% CI 1.4-3.5), female sex (OR 1.6, 95\% CI 1.1-2.4), and having a sleep disorder (OR 4.3, 95\% CI 2.7-6.9) were associated with increased odds of insomnia. In open-ended comments (n=310), poor sleep was mapped to four categories: children and family, work demands, personal health, and pandemic-related sleep disturbances. Conclusions: During the COVID-19 pandemic, nearly all the frontline health care workers surveyed on social media reported poor sleep, over one-third reported insomnia, and over half reported burnout. Many also reported sleep disruptions due to device use and nightmares. Sleep interventions for frontline health care workers are urgently needed. ",
doi="10.2196/27331",
url="https://www.jmir.org/2021/5/e27331",
url="http://www.ncbi.nlm.nih.gov/pubmed/33875414"
}


@Article{info:doi/10.2196/26953,
author="Kwok, Hang Stephen Wai
and Vadde, Kumar Sai
and Wang, Guanjin",
title="Tweet Topics and Sentiments Relating to COVID-19 Vaccination Among Australian Twitter Users: Machine Learning Analysis",
journal="J Med Internet Res",
year="2021",
month="May",
day="19",
volume="23",
number="5",
pages="e26953",
keywords="COVID-19",
keywords="vaccination",
keywords="public topics",
keywords="public sentiments",
keywords="Twitter",
keywords="infodemiology",
keywords="infoveillance",
keywords="social listening",
keywords="infodemic",
keywords="social media",
keywords="natural language processing",
keywords="machine learning",
keywords="latent Dirichlet allocation",
abstract="Background: COVID-19 is one of the greatest threats to human beings in terms of health care, economy, and society in recent history. Up to this moment, there have been no signs of remission, and there is no proven effective cure. Vaccination is the primary biomedical preventive measure against the novel coronavirus. However, public bias or sentiments, as reflected on social media, may have a significant impact on the progression toward achieving herd immunity. Objective: This study aimed to use machine learning methods to extract topics and sentiments relating to COVID-19 vaccination on Twitter. Methods: We collected 31,100 English tweets containing COVID-19 vaccine--related keywords between January and October 2020 from Australian Twitter users. Specifically, we analyzed tweets by visualizing high-frequency word clouds and correlations between word tokens. We built a latent Dirichlet allocation (LDA) topic model to identify commonly discussed topics in a large sample of tweets. We also performed sentiment analysis to understand the overall sentiments and emotions related to COVID-19 vaccination in Australia. Results: Our analysis identified 3 LDA topics: (1) attitudes toward COVID-19 and its vaccination, (2) advocating infection control measures against COVID-19, and (3) misconceptions and complaints about COVID-19 control. Nearly two-thirds of the sentiments of all tweets expressed a positive public opinion about the COVID-19 vaccine; around one-third were negative. Among the 8 basic emotions, trust and anticipation were the two prominent positive emotions observed in the tweets, while fear was the top negative emotion. Conclusions: Our findings indicate that some Twitter users in Australia supported infection control measures against COVID-19 and refuted misinformation. However, those who underestimated the risks and severity of COVID-19 may have rationalized their position on COVID-19 vaccination with conspiracy theories. We also noticed that the level of positive sentiment among the public may not be sufficient to increase vaccination coverage to a level high enough to achieve vaccination-induced herd immunity. Governments should explore public opinion and sentiments toward COVID-19 and COVID-19 vaccination, and implement an effective vaccination promotion scheme in addition to supporting the development and clinical administration of COVID-19 vaccines. ",
doi="10.2196/26953",
url="https://www.jmir.org/2021/5/e26953",
url="http://www.ncbi.nlm.nih.gov/pubmed/33886492"
}


@Article{info:doi/10.2196/28991,
author="Basch, H. Corey
and Meleo-Erwin, C. Zoe
and Mohlman, Jan
and Fera, Joseph
and Quinones, Nasia",
title="Use of the Instagram Hashtags \#winemom and \#momjuice Among Mothers During the COVID-19 Pandemic: Descriptive, Cross-sectional Study",
journal="JMIR Pediatr Parent",
year="2021",
month="May",
day="18",
volume="4",
number="2",
pages="e28991",
keywords="Instagram",
keywords="alcohol consumption",
keywords="COVID-19",
keywords="social media",
keywords="communication",
keywords="parenting",
abstract="Background: The tendency of parents to consume alcohol during the COVID-19 pandemic is likely to be moderated by pandemic-related stress combined with the ongoing demands of childcare and home-based education, which are reported to be more burdensome for females than males. Objective: The purpose of this study was to describe alcohol-related content posted by mothers on Instagram during the COVID-19 pandemic. Methods: Using two popular hashtags, \#momjuice and \#winemom, 50 Instagram posts on each were collected from the ``top posts'' tab. The coding categories were created inductively and were as follows: displays alcohol (drinking/holding alcohol or alcohol itself), person is making alcoholic beverages, type of alcohol featured or discussed, highlights anxiety and/or depression/mental state, highlights struggling (in general), highlights parenting challenges, encourages alcohol consumption, discourages alcohol consumption, features a person wearing clothing or shows products promoting alcohol, promotes alcohol rehabilitation, highlights caffeine to alcohol daily transition throughout the day, and highlights other drugs besides caffeine and alcohol. Results: Overall, the 100 selected posts had a total of 5108 comments and 94,671 likes. The respective averages were 51.08 (SD 77.94) and 946.71 (SD 1731.72). A majority (>50\%) of the posts reviewed encouraged alcohol consumption (n=66) and/or displayed alcohol (n=56). Of the 66 that encouraged and/or displayed alcohol, the common type of alcohol discussed or featured was wine (n=55). Only 6 posts discouraged alcohol use and only 4 provided the audience with a disclaimer. None of the videos promoted or endorsed alcohol rehabilitation in any way. Only 37 posts highlighted struggle. However, these posts garnered more than a majority of the likes (n=50,034, 52.3\%). Posts that showed struggle received an average of 1359.57 (SD 2108.02) likes. Those that did not show struggle had an average of 704.24 (SD 1447.46) likes. An independent one-tailed t test demonstrated this difference to be statistically significant (P=.0499). Conclusions: The findings of this investigation suggest that though these hashtags ostensibly exist to valorize excess alcohol consumption, they may be serving as a support system for mothers who are experiencing increased burdens and role stress during the pandemic. Given the strains placed on mothers overall and especially during the COVID-19 pandemic, efforts must be taken to increase access to and affordability of telehealth-based mental health care. ",
doi="10.2196/28991",
url="https://pediatrics.jmir.org/2021/2/e28991",
url="http://www.ncbi.nlm.nih.gov/pubmed/33848257"
}


@Article{info:doi/10.2196/26618,
author="Cresswell, Kathrin
and Tahir, Ahsen
and Sheikh, Zakariya
and Hussain, Zain
and Dom{\'i}nguez Hern{\'a}ndez, Andr{\'e}s
and Harrison, Ewen
and Williams, Robin
and Sheikh, Aziz
and Hussain, Amir",
title="Understanding Public Perceptions of COVID-19 Contact Tracing Apps: Artificial Intelligence--Enabled Social Media Analysis",
journal="J Med Internet Res",
year="2021",
month="May",
day="17",
volume="23",
number="5",
pages="e26618",
keywords="artificial intelligence",
keywords="sentiment analysis",
keywords="COVID-19",
keywords="contact tracing",
keywords="social media",
keywords="perception",
keywords="app",
keywords="exploratory",
keywords="suitability",
keywords="AI",
keywords="Facebook",
keywords="Twitter",
keywords="United Kingdom",
keywords="sentiment",
keywords="attitude",
keywords="infodemiology",
keywords="infoveillance",
abstract="Background: The emergence of SARS-CoV-2 in late 2019 and its subsequent spread worldwide continues to be a global health crisis. Many governments consider contact tracing of citizens through apps installed on mobile phones as a key mechanism to contain the spread of SARS-CoV-2. Objective: In this study, we sought to explore the suitability of artificial intelligence (AI)--enabled social media analyses using Facebook and Twitter to understand public perceptions of COVID-19 contact tracing apps in the United Kingdom. Methods: We extracted and analyzed over 10,000 relevant social media posts across an 8-month period, from March 1 to October 31, 2020. We used an initial filter with COVID-19--related keywords, which were predefined as part of an open Twitter-based COVID-19 dataset. We then applied a second filter using contract tracing app--related keywords and a geographical filter. We developed and utilized a hybrid, rule-based ensemble model, combining state-of-the-art lexicon rule-based and deep learning--based approaches. Results: Overall, we observed 76\% positive and 12\% negative sentiments, with the majority of negative sentiments reported in the North of England. These sentiments varied over time, likely influenced by ongoing public debates around implementing app-based contact tracing by using a centralized model where data would be shared with the health service, compared with decentralized contact-tracing technology. Conclusions: Variations in sentiments corroborate with ongoing debates surrounding the information governance of health-related information. AI-enabled social media analysis of public attitudes in health care can help facilitate the implementation of effective public health campaigns. ",
doi="10.2196/26618",
url="https://www.jmir.org/2021/5/e26618",
url="http://www.ncbi.nlm.nih.gov/pubmed/33939622"
}


@Article{info:doi/10.2196/25077,
author="Acquaviva, D. Kimberly",
title="Establishing and Facilitating Large-Scale Manuscript Collaborations via Social Media: Novel Method and Tools for Replication",
journal="J Med Internet Res",
year="2021",
month="May",
day="17",
volume="23",
number="5",
pages="e25077",
keywords="social media",
keywords="crowdsourcing",
keywords="collaboration",
keywords="health professions",
keywords="medicine",
keywords="scholarship",
keywords="literature",
keywords="research",
abstract="Background: Authorship teams in the health professions are typically composed of scholars who are acquainted with one another before a manuscript is written. Even if a scholar has identified a diverse group of collaborators outside their usual network, writing an article with a large number of co-authors poses significant logistical challenges. Objective: This paper describes a novel method for establishing and facilitating large-scale manuscript collaborations via social media. Methods: On September 11, 2020, I used the social media platform Twitter to invite people to collaborate on an article I had drafted. Anyone who wanted to collaborate was welcome, regardless of discipline, specialty, title, country of residence, or degree completion. During the 25 days that followed, I used Google Docs, Google Sheets, and Google Forms to manage all aspects of the collaboration. Results: The collaboration resulted in the completion of 2 manuscripts in a 25-day period. The International Council of Medical Journal Editors authorship criteria were met by 40 collaborators for the first article (``Documenting Social Media Engagement as Scholarship: A New Model for Assessing Academic Accomplishment for the Health Professions'') and 35 collaborators for the second article (``The Benefits of Using Social Media as a Health Professional in Academia''). The authorship teams for both articles were notably diverse, with 17\%-18\% (7/40 and 6/35, respectively) of authors identifying as a person of color and/or underrepresented minority, 37\%-38\% (15/40 and 13/35, respectively) identifying as LGBTQ+ (lesbian, gay, bisexual, transgender, gender non-conforming, queer and/or questioning), 73\%-74\% (29/40 and 26/35, respectively) using she/her pronouns, and 20\%-23\% (9/40 and 7/35, respectively) identifying as a person with a disability. Conclusions: Scholars in the health professions can use this paper in conjunction with the tools provided to replicate this process in carrying out their own large-scale manuscript collaborations. ",
doi="10.2196/25077",
url="https://www.jmir.org/2021/5/e25077",
url="http://www.ncbi.nlm.nih.gov/pubmed/33999002"
}


@Article{info:doi/10.2196/25252,
author="Chiang, Lee Austin
and Rabinowitz, Galler Loren
and Alakbarli, Javid
and Chan, W. Walter",
title="The Patterns and Impact of Social Media Exposure of Journal Publications in Gastroenterology: Retrospective Cohort Study",
journal="J Med Internet Res",
year="2021",
month="May",
day="14",
volume="23",
number="5",
pages="e25252",
keywords="social media",
keywords="gastroenterology journals",
keywords="gastroenterology research",
keywords="journal citations",
abstract="Background: Medical journals increasingly promote published content through social media platforms such as Twitter. However, gastroenterology journals still rank below average in social media engagement. Objective: We aimed to determine the engagement patterns of publications in gastroenterology journals on Twitter and evaluate the impact of tweets on citations. Methods: This was a retrospective cohort study comparing the 3-year citations of all full-length articles published in five major gastroenterology journals from January 1, 2012, to December 31, 2012, tweeted by official journal accounts with those that were not. Multivariate analysis using linear regression was performed to control for journal impact factor, time since publication, article type, frequency of reposting by other users (``retweets''), and media addition to tweets. Secondary analyses were performed to assess the associations between article type or subtopic and the likelihood of social media promotion/engagement. Results: A total of 1666 articles were reviewed, with 477 tweeted by the official journal account. Tweeting an article independently predicted increased citations after controlling for potential confounders ($\beta$ coefficient=13.09; P=.007). There was significant association between article type and number of retweets on analysis of variance (ANOVA) (P<.001), with guidelines/technical reviews (mean difference 1.04, 95\% CI 0.22-1.87; P<.001) and meta-analyses/systemic reviews (mean difference 1.03, 95\% CI 0.35-1.70; P<.001) being retweeted more than basic science articles. The manuscript subtopics most frequently promoted included motility/functional bowel disease (odds ratio [OR] 3.84, 95\% CI 1.93-7.64; P<.001) and education (OR 4.69, 95\% CI 1.62-13.58; P=.004), while basic science papers were less likely tweeted (OR 0.154, 95\% CI 0.07-0.34; P<.001). Conclusions: Tweeting of gastroenterology journal articles independently predicted higher 3-year citations. Wider adoption of social media to increase reach and measure uptake of published research should be considered. ",
doi="10.2196/25252",
url="https://www.jmir.org/2021/5/e25252",
url="http://www.ncbi.nlm.nih.gov/pubmed/33707166"
}


@Article{info:doi/10.2196/25229,
author="Mishra, Biswamohan
and Saini, Monica
and Doherty, M. Carolynne
and Pitceathly, S. Robert D.
and Rajan, Roopa
and Siddiqi, K. Omar
and Ramdharry, Gita
and Asranna, Ajay
and Tomaselli, Jose Pedro
and Kermode, G. Allan
and Bajwa, A. Jawad
and Garg, Divyani
and Vishnu, Y. Venugopalan",
title="Use of Twitter in Neurology: Boon or Bane?",
journal="J Med Internet Res",
year="2021",
month="May",
day="14",
volume="23",
number="5",
pages="e25229",
keywords="Twitter",
keywords="neurology",
keywords="tweet chats",
keywords="research",
keywords="tweetorials",
keywords="contemporary issues",
doi="10.2196/25229",
url="https://www.jmir.org/2021/5/e25229",
url="http://www.ncbi.nlm.nih.gov/pubmed/33988522"
}


@Article{info:doi/10.2196/28805,
author="De Gagne, C. Jennie
and Cho, Eunji
and Yamane, S. Sandra
and Jin, Haesu
and Nam, D. Jeehae
and Jung, Dukyoo",
title="Analysis of Cyberincivility in Posts by Health Professions Students: Descriptive Twitter Data Mining Study",
journal="JMIR Med Educ",
year="2021",
month="May",
day="13",
volume="7",
number="2",
pages="e28805",
keywords="cyberincivility",
keywords="digital professionalism",
keywords="health professions students",
keywords="social media",
keywords="social networking sites",
keywords="Twitter",
abstract="Background: Health professions students use social media to communicate with other students and health professionals, discuss career plans or coursework, and share the results of research projects or new information. These platforms allow students to share thoughts and perceptions that are not disclosed in formal education settings. Twitter provides an excellent window through which health professions educators can observe students' sociocultural and learning needs. However, despite its merits, cyberincivility on Twitter among health professions students has been reported. Cyber means using electronic technologies, and incivility is a general term for bad manners. As such, cyberincivility refers to any act of disrespectful, insensitive, or disruptive behavior in an electronic environment. Objective: This study aims to describe the characteristics and instances of cyberincivility posted on Twitter by self-identified health professions students. A further objective of the study is to analyze the prevalence of tweets perceived as inappropriate or potentially objectionable while describing patterns and differences in the instances of cyberincivility posted by those users. Methods: We used a cross-sectional descriptive Twitter data mining method to collect quantitative and qualitative data from August 2019 to February 2020. The sample was taken from users who self-identified as health professions students (eg, medicine, nursing, dental, pharmacy, physician assistant, and physical therapy) in their user description. Data management and analysis were performed with a combination of SAS 9.4 for descriptive and inferential statistics, including logistic regression, and NVivo 12 for descriptive patterns of textual data. Results: We analyzed 20 of the most recent tweets for each account (N=12,820). A total of 639 user accounts were analyzed for quantitative analysis, including 280 (43.8\%) medicine students and 329 (51.5\%) nursing students in 22 countries: the United States (287/639, 44.9\%), the United Kingdom (197/639, 30.8\%), unknown countries (104/639, 16.3\%), and 19 other countries (51/639, 8.0\%). Of the 639 accounts, 193 (30.2\%) were coded as having instances of cyberincivility. Of these, 61.7\% (119/193), 32.6\% (63/193), and 5.7\% (11/193) belonged to students in nursing, medicine, and other disciplines, respectively. Among 502 instances of cyberincivility identified from 641 qualitative analysis samples, the largest categories were profanity and product promotion. Several aggressive or biased comments toward other users, politicians, or certain groups of people were also found. Conclusions: Cyberincivility is a multifaceted phenomenon that must be considered in its complexity if health professions students are to embrace a culture of mutual respect and collaboration. Students' perceptions and reports of their Twitter experiences offer insights into behavior on the web and the evolving role of cyberspace, and potentially problematic posts provide opportunities for teaching digital professionalism. Our study indicates that there is a continued need to provide students with guidance and training regarding the importance of maintaining a professional persona on the web. ",
doi="10.2196/28805",
url="https://mededu.jmir.org/2021/2/e28805",
url="http://www.ncbi.nlm.nih.gov/pubmed/33983129"
}


@Article{info:doi/10.2196/26654,
author="Lai, Kaisheng
and Li, Dan
and Peng, Huijuan
and Zhao, Jingyuan
and He, Lingnan",
title="Assessing Suicide Reporting in Top Newspaper Social Media Accounts in China: Content Analysis Study",
journal="JMIR Ment Health",
year="2021",
month="May",
day="13",
volume="8",
number="5",
pages="e26654",
keywords="suicide",
keywords="suicide reporting",
keywords="mainstream publishers",
keywords="social media",
keywords="WHO guidelines",
abstract="Background: Previous studies have shown that suicide reporting in mainstream media has a significant impact on suicidal behaviors (eg, irresponsible suicide reporting can trigger imitative suicide). Traditional mainstream media are increasingly using social media platforms to disseminate information on public-related topics, including health. However, there is little empirical research on how mainstream media portrays suicide on social media platforms and the quality of their coverage. Objective: This study aims to explore the characteristics and quality of suicide reporting by mainstream publishers via social media in China. Methods: Via the application programming interface of the social media accounts of the top 10 Chinese mainstream publishers (eg, People's Daily and Beijing News), we obtained 2366 social media posts reporting suicide. This study conducted content analysis to demonstrate the characteristics and quality of the suicide reporting. According to the World Health Organization (WHO) guidelines, we assessed the quality of suicide reporting by indicators of harmful information and helpful information. Results: Chinese mainstream publishers most frequently reported on suicides stated to be associated with conflict on their social media (eg, 24.47\% [446/1823] of family conflicts and 16.18\% [295/1823] of emotional frustration). Compared with the suicides of youth (730/1446, 50.48\%) and urban populations (1454/1588, 91.56\%), social media underreported suicides in older adults (118/1446, 8.16\%) and rural residents (134/1588, 8.44\%). Harmful reporting practices were common (eg, 54.61\% [1292/2366] of the reports contained suicide-related words in the headline and 49.54\% [1172/2366] disclosed images of people who died by suicide). Helpful reporting practices were very limited (eg, 0.08\% [2/2366] of reports provided direct information about support programs). Conclusions: The suicide reporting of mainstream publishers on social media in China broadly had low adherence to the WHO guidelines. Considering the tremendous information dissemination power of social media platforms, we suggest developing national suicide reporting guidelines that apply to social media. By effectively playing their separate roles, we believe that social media practitioners, health institutions, social organizations, and the general public can endeavor to promote responsible suicide reporting in the Chinese social media environment. ",
doi="10.2196/26654",
url="https://mental.jmir.org/2021/5/e26654",
url="http://www.ncbi.nlm.nih.gov/pubmed/33983127"
}


@Article{info:doi/10.2196/17917,
author="Chen, Junhan
and Wang, Yuan",
title="Social Media Use for Health Purposes: Systematic Review",
journal="J Med Internet Res",
year="2021",
month="May",
day="12",
volume="23",
number="5",
pages="e17917",
keywords="social media",
keywords="health communication",
keywords="health researchers",
keywords="health practitioners",
keywords="health institutions",
keywords="systematic review",
abstract="Background: Social media has been widely used for health-related purposes, especially during the COVID-19 pandemic. Previous reviews have summarized social media uses for a specific health purpose such as health interventions, health campaigns, medical education, and disease outbreak surveillance. The most recent comprehensive review of social media uses for health purposes, however, was conducted in 2013. A systematic review that covers various health purposes is needed to reveal the new usages and research gaps that emerge in recent years. Objective: This study aimed to provide a systematic review of social media uses for health purposes that have been identified in previous studies. Methods: The researchers searched for peer-reviewed journal articles published between 2006 and 2020 in 12 databases covering medicine, public health, and social science. After coding the articles in terms of publication year, journal area, country, method, social media platform, and social media use for health purposes, the researchers provided a review of social media use for health purposes identified in these articles. Results: This study summarized 10 social media uses for various health purposes by health institutions, health researchers and practitioners, and the public. Conclusions: Social media can be used for various health purposes. Several new usages have emerged since 2013 including advancing health research and practice, social mobilization, and facilitating offline health-related services and events. Research gaps exist regarding advancing strategic use of social media based on audience segmentation, evaluating the impact of social media in health interventions, understanding the impact of health identity development, and addressing privacy concerns. ",
doi="10.2196/17917",
url="https://www.jmir.org/2021/5/e17917",
url="http://www.ncbi.nlm.nih.gov/pubmed/33978589"
}


@Article{info:doi/10.2196/23009,
author="Prioleau, Temiloluwa",
title="Learning From the Experiences of COVID-19 Survivors: Web-Based Survey Study",
journal="JMIR Form Res",
year="2021",
month="May",
day="11",
volume="5",
number="5",
pages="e23009",
keywords="patient-reported outcomes",
keywords="coronavirus",
keywords="COVID-19",
keywords="outcome",
keywords="crowdsourcing",
keywords="social media",
keywords="internet",
keywords="survivor",
keywords="experience",
abstract="Background: There are still many unanswered questions about the novel coronavirus; however, a largely underutilized source of knowledge is the millions of people who have recovered after contracting the virus. This includes a majority of undocumented cases of COVID-19, which were classified as mild or moderate and received little to no clinical care during the course of illness. Objective: This study aims to document and glean insights from the experiences of individuals with a first-hand experience in dealing with COVID-19, especially the so-called mild-to-moderate cases that self-resolved while in isolation. Methods: This web-based survey study called C19 Insider Scoop recruited adult participants aged 18 years or older who reside in the United States and had tested positive for COVID-19 or antibodies. Participants were recruited through various methods, including online support groups for COVID-19 survivors, advertisement in local news outlets, as well as through professional and other networks. The main outcomes measured in this study included knowledge of contraction or transmission of the virus, symptoms, and personal experiences on the road to recovery. Results: A total of 72 participants (female, n=53; male, n=19; age range: 18-73 years; mean age: 41 [SD 14] years) from 22 US states were enrolled in this study. The top known source of how people contracted SARS-CoV-2, the virus known to cause COVID-19, was through a family or household member (26/72, 35\%). This was followed by essential workers contracting the virus through the workplace (13/72, 18\%). Participants reported up to 27 less-documented symptoms that they experienced during their illness, such as brain or memory fog, palpitations, ear pain or discomfort, and neurological problems. In addition, 47 of 72 (65\%) participants reported that their symptoms lasted longer than the commonly cited 2-week period even for mild cases of COVID-19. The mean recovery time of the study participants was 4.5 weeks, and exactly one-half of participants (50\%) still experienced lingering symptoms of COVID-19 after an average of 65 days following illness onset. Additionally, 37 (51\%) participants reported that they experienced stigma associated with contracting COVID-19. Conclusions: This study presents preliminary findings suggesting that emphasis on family or household spread of COVID-19 may be lacking and that there is a general underestimation of the recovery time even for mild cases of illness with the virus. Although a larger study is needed to validate these results, it is important to note that as more people experience COVID-19, insights from COVID-19 survivors can enable a more informed public, pave the way for others who may be affected by the virus, and guide further research. ",
doi="10.2196/23009",
url="https://formative.jmir.org/2021/5/e23009",
url="http://www.ncbi.nlm.nih.gov/pubmed/33878012"
}


@Article{info:doi/10.2196/15716,
author="Bunyan, Alden
and Venuturupalli, Swamy
and Reuter, Katja",
title="Expressed Symptoms and Attitudes Toward Using Twitter for Health Care Engagement Among Patients With Lupus on Social Media: Protocol for a Mixed Methods Study",
journal="JMIR Res Protoc",
year="2021",
month="May",
day="6",
volume="10",
number="5",
pages="e15716",
keywords="health promotion",
keywords="infodemiology",
keywords="infoveillance",
keywords="Internet",
keywords="listening",
keywords="lupus",
keywords="systematic lupus erythematosus",
keywords="surveillance",
keywords="Twitter",
keywords="survey",
keywords="social media",
keywords="social network",
abstract="Background: Lupus is a complex autoimmune disease that is difficult to diagnose and treat. It is estimated that at least 5 million Americans have lupus, with more than 16,000 new cases of lupus being reported annually in the United States. Social media provides a platform for patients to find rheumatologists and peers and build awareness of the condition. Researchers have suggested that the social network Twitter may serve as a rich avenue for exploring how patients communicate about their health issues. However, there is a lack of research about the characteristics of lupus patients on Twitter and their attitudes toward using Twitter for engaging them with their health care. Objective: This study has two objectives: (1) to conduct a content analysis of Twitter data published by users (in English) in the United States between September 1, 2017 and October 31, 2018 to identify patients who publicly discuss their lupus condition and to assess their expressed health themes and (2) to conduct a cross-sectional survey among these lupus patients on Twitter to study their attitudes toward using Twitter for engaging them with their health care. Methods: This is a mixed methods study that analyzes retrospective Twitter data and conducts a cross-sectional survey among lupus patients on Twitter. We used Symplur Signals, a health care social media analytics platform, to access the Twitter data and analyze user-generated posts that include keywords related to lupus. We will use descriptive statistics to analyze the data and identify the most prevalent topics in the Twitter content among lupus patients. We will further conduct self-report surveys via Twitter by inviting all identified lupus patients who discuss their lupus condition on Twitter. The goal of the survey is to collect data about the characteristics of lupus patients (eg, gender, race/ethnicity, educational level) and their attitudes toward using Twitter for engaging them with their health care. Results: This study has been funded by the National Center for Advancing Translational Science through a Clinical and Translational Science Award. The institutional review board at the University of Southern California (HS-19-00048) approved the study. Data extraction and cleaning are complete. We obtained 47,715 Twitter posts containing terms related to ``lupus'' from users in the United States published in English between September 1, 2017 and October 31, 2018. We included 40,885 posts in the analysis. Data analysis was completed in Fall 2020. Conclusions: The data obtained in this pilot study will shed light on whether Twitter provides a promising data source for garnering health-related attitudes among lupus patients. The data will also help to determine whether Twitter might serve as a potential outreach platform for raising awareness of lupus among patients and implementing related health education interventions. International Registered Report Identifier (IRRID): DERR1-10.2196/15716 ",
doi="10.2196/15716",
url="https://www.researchprotocols.org/2021/5/e15716",
url="http://www.ncbi.nlm.nih.gov/pubmed/33955845"
}


@Article{info:doi/10.2196/28352,
author="Basch, E. Charles
and Basch, H. Corey
and Hillyer, C. Grace
and Meleo-Erwin, C. Zoe
and Zagnit, A. Emily",
title="YouTube Videos and Informed Decision-Making About COVID-19 Vaccination: Successive Sampling Study",
journal="JMIR Public Health Surveill",
year="2021",
month="May",
day="6",
volume="7",
number="5",
pages="e28352",
keywords="YouTube",
keywords="vaccination",
keywords="COVID-19",
keywords="social media",
keywords="communication",
keywords="misinformation",
keywords="disinformation",
keywords="adverse reactions",
abstract="Background: Social media platforms such as YouTube are used by many people to seek and share health-related information that may influence their decision-making about COVID-19 vaccination. Objective: The purpose of this study was to improve the understanding about the sources and content of widely viewed YouTube videos on COVID-19 vaccination. Methods: Using the keywords ``coronavirus vaccination,'' we searched for relevant YouTube videos, sorted them by view count, and selected two successive samples (with replacement) of the 100 most widely viewed videos in July and December 2020, respectively. Content related to COVID-19 vaccines were coded by two observers, and inter-rater reliability was demonstrated. Results: The videos observed in this study were viewed over 55 million times cumulatively. The number of videos that addressed fear increased from 6 in July to 20 in December 2020, and the cumulative views correspondingly increased from 2.6\% (1,449,915 views) to 16.6\% (9,553,368 views). There was also a large increase in the number of videos and cumulative views with respect to concerns about vaccine effectiveness, from 6 videos with approximately 6 million views in July to 25 videos with over 12 million views in December 2020. The number of videos and total cumulative views covering adverse reactions almost tripled, from 11 videos with approximately 6.5 million (11.7\% of cumulative views) in July to 31 videos with almost 15.7 million views (27.2\% of cumulative views) in December 2020. Conclusions: Our data show the potentially inaccurate and negative influence social media can have on population-wide vaccine uptake, which should be urgently addressed by agencies of the United States Public Health Service as well as its global counterparts. ",
doi="10.2196/28352",
url="https://publichealth.jmir.org/2021/5/e28352",
url="http://www.ncbi.nlm.nih.gov/pubmed/33886487"
}


@Article{info:doi/10.2196/23792,
author="Dailah Sr, Ghaleb Hamad
and Naeem, Muhammad",
title="A Social Media Organizational Productivity Model: Insights From Public Health Professionals",
journal="J Med Internet Res",
year="2021",
month="May",
day="5",
volume="23",
number="5",
pages="e23792",
keywords="social media",
keywords="professional socialization",
keywords="uncertainty",
keywords="institutional theory",
keywords="motivation",
keywords="public hospital",
keywords="health professionals",
abstract="Background: Many previous studies have explored socialization-oriented social media (SM), but their reach has been limited to the context of information exchange for common personal interests. This study focuses on work-oriented SM, which can enhance organizational networking and productivity levels in the context of public hospitals. Objective: This study aims to provide a theoretical framework to explain how the use of SM can enhance the skills of health professionals and levels of organizational productivity in uncertain environments. Methods: A total of 2 distinct forms of data collection techniques were combined: focus groups and semistructured interviews. Both were conducted with doctors and nurses in Saudi public sector hospitals. Results: The findings reveal that the use of SM can create professional socialization at the level of the institution, and this can enhance skills, knowledge, decision making, and the overall level of organizational productivity. The increasing use of SM creates collaboration between health experts (particularly endocrinologists and pulmonologists in this case) who arrange video calls to share best practices in terms of medication, diet, and health care plans for patients with multiple diseases. Many of these patients are particularly vulnerable, given the wider context of the current global pandemic. Conclusions: This study culminates in the Social Media Organizational Productivity model, which provides insights into how SM has increased the accessibility of health professionals through the use of technology. Access to such professionals creates a patient-centric approach and a culture of shared communication for dealing with high-risk patients during the current global pandemic. ",
doi="10.2196/23792",
url="https://www.jmir.org/2021/5/e23792",
url="http://www.ncbi.nlm.nih.gov/pubmed/33949965"
}


@Article{info:doi/10.2196/26564,
author="Mamo, Andrina
and Szeto, D. Mindy
and Mirhossaini, Roya
and Fortugno, Andrew
and Dellavalle, P. Robert",
title="Tetrahydrocannabinol and Skin Cancer: Analysis of YouTube Videos",
journal="JMIR Dermatol",
year="2021",
month="May",
day="4",
volume="4",
number="1",
pages="e26564",
keywords="THC",
keywords="tetrahydrocannabinol",
keywords="skin cancer",
keywords="YouTube",
keywords="cannabis",
keywords="social media",
keywords="internet",
abstract="Background: Cannabis oil is being used topically by patients with skin cancer as a homeopathic remedy, and has been promoted and popularized on social media, including YouTube. Although topical cannabinoids, especially tetrahydrocannabinol (THC), may have antitumor effects, results from a sparse number of clinical trials and peer-reviewed studies detailing safety and efficacy are still under investigation. Objective: We sought to assess the accuracy, quality, and reliability of THC oil and skin cancer information available on YouTube. Methods: The 10 most-viewed videos on THC oil and skin cancer were analyzed with the Global Quality Scale (GQS), DISCERN score, and useful/misleading criteria based on presentation of erroneous and scientifically unproven information. The videos were also inspected for source, length, and audience likes/dislikes. Top comments were additionally examined based on whether they were favorable, unfavorable, or neutral regarding the video content. Results: All analyzed videos (10/10, 100\%) received a GQS score of 1, corresponding to poor quality of content, and 9/10 (90\%) videos received a DISCERN score of 0, indicating poor reliability of information presented. All 10 videos were also found to be misleading and not useful according to established criteria. Top comments were largely either favorable (13/27, 48\%) or neutral (13/27, 48\%) toward the content of the videos, compared to unfavorable (1/27, 4\%). Conclusions: Dermatologists should be aware that the spread of inaccurate information on skin cancer treatment currently exists on popular social media platforms and may lead to detrimental consequences for patients interested in pursuing alternative or homeopathic approaches. ",
doi="10.2196/26564",
url="https://derma.jmir.org/2021/1/e26564",
url="http://www.ncbi.nlm.nih.gov/pubmed/37632811"
}


@Article{info:doi/10.2196/26616,
author="Yang, Yuan-Chi
and Al-Garadi, Ali Mohammed
and Bremer, Whitney
and Zhu, M. Jane
and Grande, David
and Sarker, Abeed",
title="Developing an Automatic System for Classifying Chatter About Health Services on Twitter: Case Study for Medicaid",
journal="J Med Internet Res",
year="2021",
month="May",
day="3",
volume="23",
number="5",
pages="e26616",
keywords="natural language processing",
keywords="machine learning",
keywords="Twitter",
keywords="infodemiology",
keywords="infoveillance",
keywords="social media",
keywords="Medicaid",
keywords="consumer feedback",
abstract="Background: The wide adoption of social media in daily life renders it a rich and effective resource for conducting near real-time assessments of consumers' perceptions of health services. However, its use in these assessments can be challenging because of the vast amount of data and the diversity of content in social media chatter. Objective: This study aims to develop and evaluate an automatic system involving natural language processing and machine learning to automatically characterize user-posted Twitter data about health services using Medicaid, the single largest source of health coverage in the United States, as an example. Methods: We collected data from Twitter in two ways: via the public streaming application programming interface using Medicaid-related keywords (Corpus 1) and by using the website's search option for tweets mentioning agency-specific handles (Corpus 2). We manually labeled a sample of tweets in 5 predetermined categories or other and artificially increased the number of training posts from specific low-frequency categories. Using the manually labeled data, we trained and evaluated several supervised learning algorithms, including support vector machine, random forest (RF), na{\"i}ve Bayes, shallow neural network (NN), k-nearest neighbor, bidirectional long short-term memory, and bidirectional encoder representations from transformers (BERT). We then applied the best-performing classifier to the collected tweets for postclassification analyses to assess the utility of our methods. Results: We manually annotated 11,379 tweets (Corpus 1: 9179; Corpus 2: 2200) and used 7930 (69.7\%) for training, 1449 (12.7\%) for validation, and 2000 (17.6\%) for testing. A classifier based on BERT obtained the highest accuracies (81.7\%, Corpus 1; 80.7\%, Corpus 2) and F1 scores on consumer feedback (0.58, Corpus 1; 0.90, Corpus 2), outperforming the second best classifiers in terms of accuracy (74.6\%, RF on Corpus 1; 69.4\%, RF on Corpus 2) and F1 score on consumer feedback (0.44, NN on Corpus 1; 0.82, RF on Corpus 2). Postclassification analyses revealed differing intercorpora distributions of tweet categories, with political (400778/628411, 63.78\%) and consumer feedback (15073/27337, 55.14\%) tweets being the most frequent for Corpus 1 and Corpus 2, respectively. Conclusions: The broad and variable content of Medicaid-related tweets necessitates automatic categorization to identify topic-relevant posts. Our proposed system presents a feasible solution for automatic categorization and can be deployed and generalized for health service programs other than Medicaid. Annotated data and methods are available for future studies. ",
doi="10.2196/26616",
url="https://www.jmir.org/2021/5/e26616",
url="http://www.ncbi.nlm.nih.gov/pubmed/33938807"
}


@Article{info:doi/10.2196/24407,
author="Ashraf, Sania
and Bicchieri, Cristina
and Delea, G. Maryann
and Das, Upasak
and Chauhan, Kavita
and Kuang, Jinyi
and Shpenev, Alex
and Thulin, Erik",
title="Norms and Social Network--Centric Behavior Change Intervention (Nam Nalavazhvu) for Improved Toilet Usage in Peri-Urban Communities of Tamil Nadu: Protocol for a Cluster-Randomized Controlled Trial",
journal="JMIR Res Protoc",
year="2021",
month="May",
day="3",
volume="10",
number="5",
pages="e24407",
keywords="sanitation",
keywords="behavior change",
keywords="social norms",
keywords="toilet",
abstract="Background: Inconsistent toilet usage is a continuing challenge in India. Despite the impact of social expectations on toilet usage, few programs and studies have developed theoretically grounded norm-centric behavior change interventions to increase toilet use in low-income settings. Objective: The objective of this paper is to detail the rationale and design of an ex ante, parallel cluster-randomized trial evaluating the impact of a demand-side, norm-centric behavior change intervention on exclusive toilet use and maintenance in peri-urban Tamil Nadu, India. Methods: Following formative research, we developed an evidence-based norm-centric behavior change intervention called Nam Nalavazhvu (Tamil for ``our well-being''). The multilevel intervention aims to improve toilet usage by shifting empirical expectations or beliefs about other relevant people's sanitation practices. It also provides action-oriented information to aid individuals to set goals and overcome barriers to own, consistently use, and maintain their toilets. This trial includes 76 wards in the Pudukkottai and Karur districts, where half were randomly assigned to receive the intervention and the remaining served as counterfactuals. Results: We enrolled wards and conducted a baseline survey among randomly selected individuals in all 76 wards. The 1-year behavior change intervention is currently ongoing. At the endline, we will collect relevant data and compare results between study arms to determine the impacts of the Nam Nalavazhvu intervention on sanitation-related behavioral, health, and well-being outcomes and potential moderators. This study is powered to detect differences in the prevalence of exclusive toilet use between study arms. We are also conducting a process evaluation to understand the extent to which the intervention was implemented as designed, given the special pandemic context. Conclusions: Findings from this trial will inform norm-centric behavior change strategies to improve exclusive toilet usage. Trial Registration: ClinicalTrials.gov NCT04269824; https://www.clinicaltrials.gov/ct2/show/NCT04269824 International Registered Report Identifier (IRRID): DERR1-10.2196/24407 ",
doi="10.2196/24407",
url="https://www.researchprotocols.org/2021/5/e24407",
url="http://www.ncbi.nlm.nih.gov/pubmed/33938805"
}


@Article{info:doi/10.2196/27341,
author="Adikari, Achini
and Nawaratne, Rashmika
and De Silva, Daswin
and Ranasinghe, Sajani
and Alahakoon, Oshadi
and Alahakoon, Damminda",
title="Emotions of COVID-19: Content Analysis of Self-Reported Information Using Artificial Intelligence",
journal="J Med Internet Res",
year="2021",
month="Apr",
day="30",
volume="23",
number="4",
pages="e27341",
keywords="COVID-19",
keywords="pandemic",
keywords="lockdown",
keywords="human emotions",
keywords="affective computing",
keywords="human-centric artificial intelligence",
keywords="artificial intelligence",
keywords="AI",
keywords="machine learning",
keywords="natural language processing",
keywords="language modeling",
keywords="infodemiology",
keywords="infoveillance",
abstract="Background: The COVID-19 pandemic has disrupted human societies around the world. This public health emergency was followed by a significant loss of human life; the ensuing social restrictions led to loss of employment, lack of interactions, and burgeoning psychological distress. As physical distancing regulations were introduced to manage outbreaks, individuals, groups, and communities engaged extensively on social media to express their thoughts and emotions. This internet-mediated communication of self-reported information encapsulates the emotional health and mental well-being of all individuals impacted by the pandemic. Objective: This research aims to investigate the human emotions related to the COVID-19 pandemic expressed on social media over time, using an artificial intelligence (AI) framework. Methods: Our study explores emotion classifications, intensities, transitions, and profiles, as well as alignment to key themes and topics, across the four stages of the pandemic: declaration of a global health crisis (ie, prepandemic), the first lockdown, easing of restrictions, and the second lockdown. This study employs an AI framework comprised of natural language processing, word embeddings, Markov models, and the growing self-organizing map algorithm, which are collectively used to investigate social media conversations. The investigation was carried out using 73,000 public Twitter conversations posted by users in Australia from January to September 2020. Results: The outcomes of this study enabled us to analyze and visualize different emotions and related concerns that were expressed and reflected on social media during the COVID-19 pandemic, which could be used to gain insights into citizens' mental health. First, the topic analysis showed the diverse as well as common concerns people had expressed during the four stages of the pandemic. It was noted that personal-level concerns expressed on social media had escalated to broader concerns over time. Second, the emotion intensity and emotion state transitions showed that fear and sadness emotions were more prominently expressed at first; however, emotions transitioned into anger and disgust over time. Negative emotions, except for sadness, were significantly higher (P<.05) in the second lockdown, showing increased frustration. Temporal emotion analysis was conducted by modeling the emotion state changes across the four stages of the pandemic, which demonstrated how different emotions emerged and shifted over time. Third, the concerns expressed by social media users were categorized into profiles, where differences could be seen between the first and second lockdown profiles. Conclusions: This study showed that the diverse emotions and concerns that were expressed and recorded on social media during the COVID-19 pandemic reflected the mental health of the general public. While this study established the use of social media to discover informed insights during a time when physical communication was impossible, the outcomes could also contribute toward postpandemic recovery and understanding psychological impact via emotion changes, and they could potentially inform health care decision making. This study exploited AI and social media to enhance our understanding of human behaviors in global emergencies, which could lead to improved planning and policy making for future crises. ",
doi="10.2196/27341",
url="https://www.jmir.org/2021/4/e27341",
url="http://www.ncbi.nlm.nih.gov/pubmed/33819167"
}


@Article{info:doi/10.2196/22983,
author="Xun, Helen
and He, Waverley
and Chen, Jonlin
and Sylvester, Scott
and Lerman, F. Sheera
and Caffrey, Julie",
title="Characterization and Comparison of the Utilization of Facebook Groups Between Public Medical Professionals and Technical Communities to Facilitate Idea Sharing and Crowdsourcing During the COVID-19 Pandemic: Cross-sectional Observational Study",
journal="JMIR Form Res",
year="2021",
month="Apr",
day="30",
volume="5",
number="4",
pages="e22983",
keywords="cognitive intelligence",
keywords="communication",
keywords="COVID-19",
keywords="crowdsourcing",
keywords="evidence-based",
keywords="Facebook",
keywords="Facebook groups",
keywords="internet",
keywords="social media",
keywords="virtual communities",
abstract="Background: Strict social distancing measures owing to the COVID-19 pandemic have led people to rely more heavily on social media, such as Facebook groups, as a means of communication and information sharing. Multiple Facebook groups have been formed by medical professionals, laypeople, and engineering or technical groups to discuss current issues and possible solutions to the current medical crisis. Objective: This study aimed to characterize Facebook groups formed by laypersons, medical professionals, and technical professionals, with specific focus on information dissemination and requests for crowdsourcing. Methods: Facebook was queried for user-created groups with the keywords ``COVID,'' ``Coronavirus,'' and ``SARS-CoV-2'' at a single time point on March 31, 2020. The characteristics of each group were recorded, including language, privacy settings, security requirements to attain membership, and membership type. For each membership type, the group with the greatest number of members was selected, and in each of these groups, the top 100 posts were identified using Facebook's algorithm. Each post was categorized and characterized (evidence-based, crowd-sourced, and whether the poster self-identified). STATA (version 13 SE, Stata Corp) was used for statistical analysis. Results: Our search yielded 257 COVID-19--related Facebook groups. Majority of the groups (n=229, 89\%) were for laypersons, 26 (10\%) were for medical professionals, and only 2 (1\%) were for technical professionals. The number of members was significantly greater in medical groups (21,215, SD 35,040) than in layperson groups (7623, SD 19,480) (P<.01). Medical groups were significantly more likely to require security checks to attain membership (81\% vs 43\%; P<.001) and less likely to be public (3 vs 123; P<.001) than layperson groups. Medical groups had the highest user engagement, averaging 502 (SD 633) reactions (P<.01) and 224 (SD 311) comments (P<.01) per post. Medical professionals were more likely to use the Facebook groups for education and information sharing, including academic posts (P<.001), idea sharing (P=.003), resource sharing (P=.02) and professional opinions (P<.001), and requesting for crowdsourcing (P=.003). Layperson groups were more likely to share news (P<.001), humor and motivation (P<.001), and layperson opinions (P<.001). There was no significant difference in the number of evidence-based posts among the groups (P=.10). Conclusions: Medical professionals utilize Facebook groups as a forum to facilitate collective intelligence (CI) and are more likely to use Facebook groups for education and information sharing, including academic posts, idea sharing, resource sharing, and professional opinions, which highlights the power of social media to facilitate CI across geographic distances. Layperson groups were more likely to share news, humor, and motivation, which suggests the utilization of Facebook groups to provide comedic relief as a coping mechanism. Further investigations are necessary to study Facebook groups' roles in facilitating CI, crowdsourcing, education, and community-building. ",
doi="10.2196/22983",
url="https://formative.jmir.org/2021/4/e22983",
url="http://www.ncbi.nlm.nih.gov/pubmed/33878013"
}


@Article{info:doi/10.2196/28973,
author="Eibensteiner, Fabian
and Ritschl, Valentin
and Nawaz, A. Faisal
and Fazel, S. Sajjad
and Tsagkaris, Christos
and Kulnik, Tino Stefan
and Crutzen, Rik
and Klager, Elisabeth
and V{\"o}lkl-Kernstock, Sabine
and Schaden, Eva
and Kletecka-Pulker, Maria
and Willschke, Harald
and Atanasov, G. Atanas",
title="People's Willingness to Vaccinate Against COVID-19 Despite Their Safety Concerns: Twitter Poll Analysis",
journal="J Med Internet Res",
year="2021",
month="Apr",
day="29",
volume="23",
number="4",
pages="e28973",
keywords="COVID-19",
keywords="SARS-CoV-2",
keywords="vaccine",
keywords="vaccination",
keywords="Twitter",
keywords="survey",
keywords="vaccination willingness",
keywords="vaccination hesitancy",
keywords="coronavirus",
keywords="vaccine confidence",
keywords="willingness",
keywords="hesitancy",
keywords="social media",
keywords="safety",
keywords="concern",
keywords="public health",
keywords="opinion",
keywords="perception",
abstract="Background: On January 30, 2020, the World Health Organization's Emergency Committee declared the rapid, worldwide spread of COVID-19 a global health emergency. Since then, tireless efforts have been made to mitigate the spread of the disease and its impact, and these efforts have mostly relied on nonpharmaceutical interventions. By December 2020, the safety and efficacy of the first COVID-19 vaccines were demonstrated. The large social media platform Twitter has been used by medical researchers for the analysis of important public health topics, such as the public's perception on antibiotic use and misuse and human papillomavirus vaccination. The analysis of Twitter-generated data can be further facilitated by using Twitter's built-in, anonymous polling tool to gain insight into public health issues and obtain rapid feedback on an international scale. During the fast-paced course of the COVID-19 pandemic, the Twitter polling system has provided a viable method for gaining rapid, large-scale, international public health insights on highly relevant and timely SARS-CoV-2--related topics. Objective: The purpose of this study was to understand the public's perception on the safety and acceptance of COVID-19 vaccines in real time by using Twitter polls. Methods: We developed 2 Twitter polls to explore the public's views on available COVID-19 vaccines. The surveys were pinned to the Digital Health and Patient Safety Platform Twitter timeline for 1 week in mid-February 2021, and Twitter users and influencers were asked to participate in and retweet the polls to reach the largest possible audience. Results: The adequacy of COVID-19 vaccine safety (ie, the safety of currently available vaccines; poll 1) was agreed upon by 1579 out of 3439 (45.9\%) Twitter users. In contrast, almost as many Twitter users (1434/3439, 41.7\%) were unsure about the safety of COVID-19 vaccines. Only 5.2\% (179/3439) of Twitter users rated the available COVID-19 vaccines as generally unsafe. Poll 2, which addressed the question of whether users would undergo vaccination, was answered affirmatively by 82.8\% (2862/3457) of Twitter users, and only 8\% (277/3457) categorically rejected vaccination at the time of polling. Conclusions: In contrast to the perceived high level of uncertainty about the safety of the available COVID-19 vaccines, we observed an elevated willingness to undergo vaccination among our study sample. Since people's perceptions and views are strongly influenced by social media, the snapshots provided by these media platforms represent a static image of a moving target. Thus, the results of this study need to be followed up by long-term surveys to maintain their validity. This is especially relevant due to the circumstances of the fast-paced pandemic and the need to not miss sudden rises in the incidence of vaccine hesitancy, which may have detrimental effects on the pandemic's course. ",
doi="10.2196/28973",
url="https://www.jmir.org/2021/4/e28973",
url="http://www.ncbi.nlm.nih.gov/pubmed/33872185"
}


@Article{info:doi/10.2196/25215,
author="Romer, Daniel
and Jamieson, Hall Kathleen",
title="Patterns of Media Use, Strength of Belief in COVID-19 Conspiracy Theories, and the Prevention of COVID-19 From March to July 2020 in the United States: Survey Study",
journal="J Med Internet Res",
year="2021",
month="Apr",
day="27",
volume="23",
number="4",
pages="e25215",
keywords="COVID-19",
keywords="conspiracy beliefs",
keywords="social media",
keywords="print news media",
keywords="broadcast news media",
keywords="conservative media",
keywords="vaccination",
keywords="mask wearing",
keywords="belief",
keywords="misinformation",
keywords="infodemic",
keywords="United States",
keywords="intention",
keywords="prevention",
abstract="Background: Holding conspiracy beliefs regarding the COVID-19 pandemic in the United States has been associated with reductions in both actions to prevent the spread of the infection (eg, mask wearing) and intentions to accept a vaccine when one becomes available. Patterns of media use have also been associated with acceptance of COVID-19 conspiracy beliefs. Here we ask whether the type of media on which a person relies increased, decreased, or had no additional effect on that person's COVID-19 conspiracy beliefs over a 4-month period. Objective: We used panel data to explore whether use of conservative and social media in the United States, which were previously found to be positively related to holding conspiracy beliefs about the origins and prevention of COVID-19, were associated with a net increase in the strength of those beliefs from March to July of 2020. We also asked whether mainstream news sources, which were previously found to be negatively related to belief in pandemic-related conspiracies, were associated with a net decrease in the strength of such beliefs over the study period. Additionally, we asked whether subsequent changes in pandemic conspiracy beliefs related to the use of media were also related to subsequent mask wearing and vaccination intentions. Methods: A survey that we conducted with a national US probability sample in March of 2020 and again in July with the same 840 respondents assessed belief in pandemic-related conspiracies, use of various types of media information sources, actions taken to prevent the spread of the disease and intentions to vaccinate, and various demographic characteristics. Change across the two waves was analyzed using path analytic techniques. Results: We found that conservative media use predicted an increase in conspiracy beliefs ($\beta$=.17, 99\% CI .10-.25) and that reliance on mainstream print predicted a decrease in their belief ($\beta$=--.08, 99\% CI --.14 to --.02). Although many social media platforms reported downgrading or removing false or misleading content, ongoing use of such platforms by respondents predicted growth in conspiracy beliefs as well ($\beta$=.072, 99\% CI .018-.123). Importantly, conspiracy belief changes related to media use between the two waves of the study were associated with the uptake of mask wearing and changes in vaccination intentions in July. Unlike other media, use of mainstream broadcast television predicted greater mask wearing ($\beta$=.17, 99\% CI .09-.26) and vaccination intention ($\beta$=.08, 95\% CI .02-.14), independent of conspiracy beliefs. Conclusions: The findings point to the need for greater efforts on the part of commentators, reporters, and guests on conservative media to report verifiable information about the pandemic. The results also suggest that social media platforms need to be more aggressive in downgrading, blocking, and counteracting claims about COVID-19 vaccines, claims about mask wearing, and conspiracy beliefs that have been judged problematic by public health authorities. ",
doi="10.2196/25215",
url="https://www.jmir.org/2021/4/e25215",
url="http://www.ncbi.nlm.nih.gov/pubmed/33857008"
}


@Article{info:doi/10.2196/22042,
author="Ovalle, Anaelia
and Goldstein, Orpaz
and Kachuee, Mohammad
and Wu, C. Elizabeth S.
and Hong, Chenglin
and Holloway, W. Ian
and Sarrafzadeh, Majid",
title="Leveraging Social Media Activity and Machine Learning for HIV and Substance Abuse Risk Assessment: Development and Validation Study",
journal="J Med Internet Res",
year="2021",
month="Apr",
day="26",
volume="23",
number="4",
pages="e22042",
keywords="online social networks",
keywords="machine learning",
keywords="behavioral intervention",
keywords="data mining",
keywords="msm",
keywords="public health",
abstract="Background: Social media networks provide an abundance of diverse information that can be leveraged for data-driven applications across various social and physical sciences. One opportunity to utilize such data exists in the public health domain, where data collection is often constrained by organizational funding and limited user adoption. Furthermore, the efficacy of health interventions is often based on self-reported data, which are not always reliable. Health-promotion strategies for communities facing multiple vulnerabilities, such as men who have sex with men, can benefit from an automated system that not only determines health behavior risk but also suggests appropriate intervention targets. Objective: This study aims to determine the value of leveraging social media messages to identify health risk behavior for men who have sex with men. Methods: The Gay Social Networking Analysis Program was created as a preliminary framework for intelligent web-based health-promotion intervention. The program consisted of a data collection system that automatically gathered social media data, health questionnaires, and clinical results for sexually transmitted diseases and drug tests across 51 participants over 3 months. Machine learning techniques were utilized to assess the relationship between social media messages and participants' offline sexual health and substance use biological outcomes. The F1 score, a weighted average of precision and recall, was used to evaluate each algorithm. Natural language processing techniques were employed to create health behavior risk scores from participant messages. Results: Offline HIV, amphetamine, and methamphetamine use were correctly identified using only social media data, with machine learning models obtaining F1 scores of 82.6\%, 85.9\%, and 85.3\%, respectively. Additionally, constructed risk scores were found to be reasonably comparable to risk scores adapted from the Center for Disease Control. Conclusions: To our knowledge, our study is the first empirical evaluation of a social media--based public health intervention framework for men who have sex with men. We found that social media data were correlated with offline sexual health and substance use, verified through biological testing. The proof of concept and initial results validate that public health interventions can indeed use social media--based systems to successfully determine offline health risk behaviors. The findings demonstrate the promise of deploying a social media--based just-in-time adaptive intervention to target substance use and HIV risk behavior. ",
doi="10.2196/22042",
url="https://www.jmir.org/2021/4/e22042",
url="http://www.ncbi.nlm.nih.gov/pubmed/33900200"
}


@Article{info:doi/10.2196/26720,
author="Tang, Lu
and Liu, Wenlin
and Thomas, Benjamin
and Tran, Nga Hong Thoai
and Zou, Wenxue
and Zhang, Xueying
and Zhi, Degui",
title="Texas Public Agencies' Tweets and Public Engagement During the COVID-19 Pandemic: Natural Language Processing Approach",
journal="JMIR Public Health Surveill",
year="2021",
month="Apr",
day="26",
volume="7",
number="4",
pages="e26720",
keywords="COVID-19",
keywords="public health agencies",
keywords="natural language processing",
keywords="Twitter",
keywords="health belief model",
keywords="public engagement",
keywords="social media",
keywords="belief",
keywords="public health",
keywords="engagement",
keywords="communication",
keywords="strategy",
keywords="content analysis",
keywords="dissemination",
abstract="Background: The ongoing COVID-19 pandemic is characterized by different morbidity and mortality rates across different states, cities, rural areas, and diverse neighborhoods. The absence of a national strategy for battling the pandemic also leaves state and local governments responsible for creating their own response strategies and policies. Objective: This study examines the content of COVID-19--related tweets posted by public health agencies in Texas and how content characteristics can predict the level of public engagement. Methods: All COVID-19--related tweets (N=7269) posted by Texas public agencies during the first 6 months of 2020 were classified in terms of each tweet's functions (whether the tweet provides information, promotes action, or builds community), the preventative measures mentioned, and the health beliefs discussed, by using natural language processing. Hierarchical linear regressions were conducted to explore how tweet content predicted public engagement. Results: The information function was the most prominent function, followed by the action or community functions. Beliefs regarding susceptibility, severity, and benefits were the most frequently covered health beliefs. Tweets that served the information or action functions were more likely to be retweeted, while tweets that served the action and community functions were more likely to be liked. Tweets that provided susceptibility information resulted in the most public engagement in terms of the number of retweets and likes. Conclusions: Public health agencies should continue to use Twitter to disseminate information, promote action, and build communities. They need to improve their strategies for designing social media messages about the benefits of disease prevention behaviors and audiences' self-efficacy. ",
doi="10.2196/26720",
url="https://publichealth.jmir.org/2021/4/e26720",
url="http://www.ncbi.nlm.nih.gov/pubmed/33847587"
}


@Article{info:doi/10.2196/26459,
author="Koyama, Sachiko
and Ueha, Rumi
and Kondo, Kenji",
title="Loss of Smell and Taste in Patients With Suspected COVID-19: Analyses of Patients' Reports on Social Media",
journal="J Med Internet Res",
year="2021",
month="Apr",
day="22",
volume="23",
number="4",
pages="e26459",
keywords="COVID-19",
keywords="anosmia",
keywords="ageusia",
keywords="free reports on social media",
keywords="symptomatic",
keywords="asymptomatic",
keywords="recovery of senses",
keywords="symptom",
keywords="social media",
keywords="smell",
keywords="taste",
keywords="senses",
keywords="patient-reported",
keywords="benefit",
keywords="limit",
keywords="diagnosis",
abstract="Background: The year 2020 was the year of the global COVID-19 pandemic. The severity of the situation has become so substantial that many or even most of the patients with mild to moderate symptoms had to self-isolate without specific medical treatments or even without being tested for COVID-19. Many patients joined internet membership groups to exchange information and support each other. Objective: Our goal is to determine the benefits and limits of using social media to understand the symptoms of patients with suspected COVID-19 with mild to moderate symptoms and, in particular, their symptoms of anosmia (loss of the sense of smell) and ageusia (loss of the sense of taste). The voluntary reports on an internet website of a membership group will be the platform of the analyses. Methods: Posts and comments of members of an internet group known as COVID-19 Smell and Taste Loss, founded on March 24, 2020, to support patients with suspected COVID-19 were collected and analyzed daily. Demographic data were collected using the software mechanism called Group Insights on the membership group website. Results: Membership groups on social media have become rare sources of support for patients with suspected COVID-19 with mild to moderate symptoms. These groups provided mental support to their members and became resources for information on COVID-19 tests and medicines or supplements. However, the membership was voluntary, and often the members leave without notification. It is hard to be precise from the free voluntary reports. The number of women in the group (6995/9227, 75.38\% as of October 12, 2020) was about three times more than men (2272/9227, 24.62\% as of October 12, 2020), and the peak age of members was between 20-40 years in both men and women. Patients who were asymptomatic other than the senses comprised 14.93\% (53/355) of the total patients. Recovery of the senses was higher in the patients who were asymptomatic besides having anosmia and ageusia. Most (112/123, 91.06\%) patients experienced other symptoms first and then lost their senses, on average, 4.2 days later. Patients without other symptoms tended to recover earlier (P=.02). Patients with anosmia and ageusia occasionally reported distorted smell and taste (parosmia and dysgeusia) as well as experiencing or perceiving the smell and taste without the sources of the smell or taste (phantosmia and phantogeusia). Conclusions: Our analysis of the social media database of suspected COVID-19 patients' voices demonstrated that, although accurate diagnosis of patients is not always obtained with social media--based analyses, it may be a useful tool to collect a large amount of data on symptoms and the clinical course of worldwide rapidly growing infectious diseases. ",
doi="10.2196/26459",
url="https://www.jmir.org/2021/4/e26459",
url="http://www.ncbi.nlm.nih.gov/pubmed/33788699"
}


@Article{info:doi/10.2196/22281,
author="Schneble, Olivier Christophe
and Favaretto, Maddalena
and Elger, Simonne Bernice
and Shaw, Martin David",
title="Social Media Terms and Conditions and Informed Consent From Children: Ethical Analysis",
journal="JMIR Pediatr Parent",
year="2021",
month="Apr",
day="22",
volume="4",
number="2",
pages="e22281",
keywords="social media",
keywords="big data",
keywords="ethics",
keywords="children",
keywords="health data",
keywords="terms and conditions",
keywords="trusted partnership",
keywords="medical ethics",
keywords="mobile phone",
abstract="Background: Terms and conditions define the relationship between social media companies and users. However, these legal agreements are long and written in a complex language. It remains questionable whether users understand the terms and conditions and are aware of the consequences of joining such a network. With children from a young age interacting with social media, companies are acquiring large amounts of data, resulting in longitudinal data sets that most researchers can only dream of. The use of social media by children is highly relevant to their mental and physical health for 2 reasons: their health can be adversely affected by social media and their data can be used to conduct health research. Objective: The aim of this paper is to offer an ethical analysis of how the most common social media apps and services inform users and obtain their consent regarding privacy and other issues and to discuss how lessons from research ethics can lead to trusted partnerships between users and social media companies. Our paper focuses on children, who represent a sensitive group among users of social media platforms. Methods: A thematic analysis of the terms and conditions of the 20 most popular social media platforms and the 2 predominant mobile phone ecosystems (Android and iOS) was conducted. The results of this analysis served as the basis for scoring these platforms. Results: The analysis showed that most platforms comply with the age requirements issued by legislators. However, the consent process during sign-up was not taken seriously. Terms and conditions are often too long and difficult to understand, especially for younger users. The same applies to age verification, which is not realized proactively but instead relies on other users who report underaged users. Conclusions: This study reveals that social media networks are still lacking in many respects regarding the adequate protection of children. Consent procedures are flawed because they are too complex, and in some cases, children can create social media accounts without sufficient age verification or parental oversight. Adopting measures based on key ethical principles will safeguard the health and well-being of children. This could mean standardizing the registration process in accordance with modern research ethics procedures: give users the key facts that they need in a format that can be read easily and quickly, rather than forcing them to wade through chapters of legal language that they cannot understand. Improving these processes would help safeguard the mental health of children and other social media users. ",
doi="10.2196/22281",
url="https://pediatrics.jmir.org/2021/2/e22281",
url="http://www.ncbi.nlm.nih.gov/pubmed/33885366"
}


@Article{info:doi/10.2196/23432,
author="McKeon, Grace
and Steel, Zachary
and Wells, Ruth
and Newby, Jill
and Hadzi-Pavlovic, Dusan
and Vancampfort, Davy
and Rosenbaum, Simon",
title="A Mental Health--Informed Physical Activity Intervention for First Responders and Their Partners Delivered Using Facebook: Mixed Methods Pilot Study",
journal="JMIR Form Res",
year="2021",
month="Apr",
day="22",
volume="5",
number="4",
pages="e23432",
keywords="physical activity",
keywords="PTSD",
keywords="social media",
keywords="first responders",
keywords="mental health",
keywords="families",
keywords="online",
keywords="exercise",
abstract="Background: First responders (eg, police, firefighters, and paramedics) are at high risk of experiencing poor mental health. Physical activity interventions can help reduce symptoms and improve mental health in this group. More research is needed to evaluate accessible, low-cost methods of delivering programs. Social media may be a potential platform for delivering group-based physical activity interventions. Objective: This study aims to examine the feasibility and acceptability of delivering a mental health--informed physical activity program for first responders and their self-nominated support partners. This study also aims to assess the feasibility of applying a novel multiple time series design and to explore the impact of the intervention on mental health symptoms, sleep quality, quality of life, and physical activity levels. Methods: We co-designed a 10-week web-based physical activity program delivered via a private Facebook group. We provided education and motivation around different topics weekly (eg, goal setting, overcoming barriers to exercise, and reducing sedentary behavior) and provided participants with a Fitbit. A multiple time series design was applied to assess psychological distress levels, with participants acting as their own control before the intervention. Results: In total, 24 participants (12 first responders and 12 nominated support partners) were recruited, and 21 (88\%) completed the postassessment questionnaires. High acceptability was observed in the qualitative interviews. Exploratory analyses revealed significant reductions in psychological distress during the intervention. Preintervention and postintervention analysis showed significant improvements in quality of life (P=.001; Cohen d=0.60); total depression, anxiety, and stress scores (P=.047; Cohen d=0.35); and minutes of walking (P=.04; Cohen d=0.55). Changes in perceived social support from family (P=.07; Cohen d=0.37), friends (P=.10; Cohen d=0.38), and sleep quality (P=.28; Cohen d=0.19) were not significant. Conclusions: The results provide preliminary support for the use of social media and a multiple time series design to deliver mental health--informed physical activity interventions for first responders and their support partners. Therefore, an adequately powered trial is required. Trial Registration: Australian New Zealand Clinical Trials Registry (ACTRN): 12618001267246; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12618001267246. ",
doi="10.2196/23432",
url="https://formative.jmir.org/2021/4/e23432",
url="http://www.ncbi.nlm.nih.gov/pubmed/33885376"
}


@Article{info:doi/10.2196/24586,
author="Furstrand, Dorthe
and Pihl, Andreas
and Orbe, Bayram Elif
and Kingod, Natasja
and S{\o}ndergaard, Jens",
title="``Ask a Doctor About Coronavirus'': How Physicians on Social Media Can Provide Valid Health Information During a Pandemic",
journal="J Med Internet Res",
year="2021",
month="Apr",
day="20",
volume="23",
number="4",
pages="e24586",
keywords="COVID-19",
keywords="coronavirus",
keywords="digital health literacy",
keywords="eHealth literacy",
keywords="Facebook",
keywords="framework",
keywords="health information",
keywords="health literacy",
keywords="health promotion",
keywords="infodemic",
keywords="infodemiology",
keywords="mental health",
keywords="misinformation",
keywords="pandemic",
keywords="patient-physician relationship",
keywords="public health",
keywords="social media",
keywords="trust",
keywords="web-based community",
doi="10.2196/24586",
url="https://www.jmir.org/2021/4/e24586",
url="http://www.ncbi.nlm.nih.gov/pubmed/33835935"
}


@Article{info:doi/10.2196/25757,
author="Cheng, Xiaolu
and Lin, Shuo-Yu
and Wang, Kevin
and Hong, Alicia Y.
and Zhao, Xiaoquan
and Gress, Dustin
and Wojtusiak, Janusz
and Cheskin, J. Lawrence
and Xue, Hong",
title="Healthfulness Assessment of Recipes Shared on Pinterest: Natural Language Processing and Content Analysis",
journal="J Med Internet Res",
year="2021",
month="Apr",
day="20",
volume="23",
number="4",
pages="e25757",
keywords="healthfulness assessment",
keywords="recipes on Pinterest",
keywords="social networks",
keywords="natural language processing",
abstract="Background: Although Pinterest has become a popular platform for distributing influential information that shapes users' behaviors, the role of recipes pinned on Pinterest in these behaviors is not well understood. Objective: This study aims to explore the patterns of food ingredients and the nutritional content of recipes posted on Pinterest and to examine the factors associated with recipes that engage more users. Methods: Data were collected from Pinterest between June 28 and July 12, 2020 (207 recipes and 2818 comments). All samples were collected via 2 new user accounts with no search history. A codebook was developed with a raw agreement rate of 0.97 across all variables. Content analysis and natural language processing sentiment analysis techniques were employed. Results: Recipes using seafood or vegetables as the main ingredient had, on average, fewer calories and less sodium, sugar, and cholesterol than meat- or poultry-based recipes. For recipes using meat as the main ingredient, more than half of the energy was obtained from fat (277/490, 56.6\%). Although the most followed pinners tended to post recipes containing more poultry or seafood and less meat, recipes with higher fat content or providing more calories per serving were more popular, having more shared photos or videos and comments. The natural language processing--based sentiment analysis suggested that Pinterest users weighted taste more heavily than complexity (225/2818, 8.0\%) and health (84/2828, 2.9\%). Conclusions: Although popular pinners tended to post recipes with more seafood or poultry or vegetables and less meat, recipes with higher fat and sugar content were more user-engaging, with more photo or video shares and comments. Data on Pinterest behaviors can inform the development and implementation of nutrition health interventions to promote healthy recipe sharing on social media platforms. ",
doi="10.2196/25757",
url="https://www.jmir.org/2021/4/e25757",
url="http://www.ncbi.nlm.nih.gov/pubmed/33877052"
}


@Article{info:doi/10.2196/25114,
author="Acquaviva, Kimberly",
title="Comparison of Intercom and Megaphone Hashtags Using Four Years of Tweets From the Top 44 Schools of Nursing: Thematic Analysis",
journal="JMIR Nursing",
year="2021",
month="Apr",
day="20",
volume="4",
number="2",
pages="e25114",
keywords="Twitter",
keywords="hashtag",
keywords="nurses",
keywords="media",
keywords="intercom hashtag",
keywords="megaphone hashtag",
abstract="Background: When this study began in 2018, I sought to determine the extent to which the top 50 schools of nursing were using hashtags that could attract attention from journalists on Twitter. In December 2020, the timeframe was expanded to encompass 2 more years of data, and an analysis was conducted of the types of hashtags used. Objective: The study attempted to answer the following question: to what extent are top-ranked schools of nursing using hashtags that could attract attention from journalists, policy makers, and the public on Twitter? Methods: In February 2018, 47 of the top 50 schools of nursing had public Twitter accounts. The most recent 3200 tweets were extracted from each account and analyzed. There were 31,762 tweets in the time period covered (September 29, 2016, through February 22, 2018). After 13,429 retweets were excluded, 18,333 tweets remained. In December 2020, 44 of the original 47 schools of nursing still had public Twitter accounts under the same name used in the first phase of the study. Three accounts that were no longer active were removed from the 2016-2018 data set, resulting in 16,939 tweets from 44 schools of nursing. The Twitter data for the 44 schools of nursing were obtained for the time period covered in the second phase of the study (February 23, 2018, through December 13, 2020), and the most recent 3200 tweets were extracted from each of the accounts. On excluding retweets, there were 40,368 tweets in the 2018-2020 data set. The 2016-2018 data set containing 16,939 tweets was merged with the 2018-2020 data set containing 40,368 tweets, resulting in 57,307 tweets in the 2016-2020 data set. Results: Each hashtag used 100 times or more in the 2016-2020 data set was categorized as one of the following seven types: nursing, school, conference or tweet chat, health, illness/disease/condition, population, and something else. These types were then broken down into the following two categories: intercom hashtags and megaphone hashtags. Approximately 83\% of the time, schools of nursing used intercom hashtags (inward-facing hashtags focused on in-group discussion within and about the profession). Schools of nursing rarely used outward-facing megaphone hashtags. There was no discernible shift in the way that schools of nursing used hashtags after the publication of The Woodhull Study Revisited. Conclusions: Top schools of nursing use hashtags more like intercoms to communicate with other nurses rather than megaphones to invite attention from journalists, policy makers, and the public. If schools of nursing want the media to showcase their faculty members as experts, they need to increase their use of megaphone hashtags to connect the work of their faculty with topics of interest to the public. ",
doi="10.2196/25114",
url="https://nursing.jmir.org/2021/2/e25114",
url="http://www.ncbi.nlm.nih.gov/pubmed/34345795"
}


@Article{info:doi/10.2196/20954,
author="Liu, Sam
and Perdew, Megan
and Lithopoulos, Alexander
and Rhodes, E. Ryan",
title="The Feasibility of Using Instagram Data to Predict Exercise Identity and Physical Activity Levels: Cross-sectional Observational Study",
journal="J Med Internet Res",
year="2021",
month="Apr",
day="19",
volume="23",
number="4",
pages="e20954",
keywords="social media",
keywords="exercise identity",
keywords="physical activity",
keywords="physical fitness",
abstract="Background: Exercise identity is an important predictor for regular physical activity (PA). There is a lack of research on the potential mechanisms or antecedents of identity development. Theories of exercise identity have proposed that investment, commitment and self-referential (eg, I am an exerciser) statements, and social activation (comparison, support) may be crucial to identity development. Social media may be a potential mechanism to shape identity. Objective: The objectives of this study were to (1) explore whether participants were willing to share their Instagram data with researchers to predict their lifestyle behaviors; (2) examine whether PA-related Instagram uses (ie, the percentage of PA-related Instagram posts, fitness-related followings, and the number of likes received on PA-related posts) were positively associated with exercise identity; and (3) evaluate whether exercise identity mediates the relationship between PA-related Instagram use and weekly PA minutes. Methods: Participants (18-30 years old) were asked to complete a questionnaire to evaluate their current levels of exercise identity and PA. Participants' Instagram data for the past 12 months before the completion of the questionnaire were extracted and analyzed with their permission. Instagram posts related to PA in the 12 months before their assessment, the number of likes received for each PA-related post, and verified fitness- or PA-related followings by the participants were extracted and analyzed. Pearson correlation analyses were used to evaluate the relationship among exercise identity, PA, and Instagram uses. We conducted mediation analyses using the PROCESS macro modeling tool to examine whether exercise identity mediated the relationship between Instagram use variables and PA. Descriptive statistical analyses were used to compare the number of willing participants versus those who were not willing to share their Instagram data. Results: Of the 76 participants recruited to participate, 54\% (n=41) shared their Instagram data. The percentage of PA-related Instagram posts (r=0.38; P=.01) and fitness-related Instagram followings (r=0.39; P=.01) were significantly associated with exercise identity. The average number of ``likes'' received (r=0.05, P=.75) was not significantly associated with exercise identity. Exercise identity significantly influenced the relationship between Instagram usage metrics (ie, the percentage of PA-related Instagram posts [P=.01] and verified fitness-related Instagram accounts [P=.01]) and PA level. Exercise identity did not significantly influence the relationship between the average number of ``likes'' received for the PA-related Instagram posts and PA level. Conclusions: Our results suggest that an increase in PA-related Instagram posts and fitness-related followings were associated with a greater sense of exercise identity. Higher exercise identity led to higher PA levels. Exercise identity significantly influenced the relationship between PA-related Instagram posts (P=.01) and fitness-related followings on PA levels (P=.01). These results suggest that Instagram may influence a person's exercise identity and PA levels. Future intervention studies are warranted. ",
doi="10.2196/20954",
url="https://www.jmir.org/2021/4/e20954",
url="http://www.ncbi.nlm.nih.gov/pubmed/33871380"
}


@Article{info:doi/10.2196/26874,
author="Griffith, Janessa
and Marani, Husayn
and Monkman, Helen",
title="COVID-19 Vaccine Hesitancy in Canada: Content Analysis of Tweets Using the Theoretical Domains Framework",
journal="J Med Internet Res",
year="2021",
month="Apr",
day="13",
volume="23",
number="4",
pages="e26874",
keywords="vaccine hesitancy",
keywords="vaccine",
keywords="COVID-19",
keywords="immunization",
keywords="Twitter",
keywords="infodemiology",
keywords="infoveillance",
keywords="social media",
keywords="behavioral science",
keywords="behavior",
keywords="Canada",
keywords="content analysis",
keywords="framework",
keywords="hesitancy",
abstract="Background: With the approval of two COVID-19 vaccines in Canada, many people feel a sense of relief, as hope is on the horizon. However, only about 75\% of people in Canada plan to receive one of the vaccines. Objective: The purpose of this study is to determine the reasons why people in Canada feel hesitant toward receiving a COVID-19 vaccine. Methods: We screened 3915 tweets from public Twitter profiles in Canada by using the search words ``vaccine'' and ``COVID.'' The tweets that met the inclusion criteria (ie, those about COVID-19 vaccine hesitancy) were coded via content analysis. Codes were then organized into themes and interpreted by using the Theoretical Domains Framework. Results: Overall, 605 tweets were identified as those about COVID-19 vaccine hesitancy. Vaccine hesitancy stemmed from the following themes: concerns over safety, suspicion about political or economic forces driving the COVID-19 pandemic or vaccine development, a lack of knowledge about the vaccine, antivaccine or confusing messages from authority figures, and a lack of legal liability from vaccine companies. This study also examined mistrust toward the medical industry not due to hesitancy, but due to the legacy of communities marginalized by health care institutions. These themes were categorized into the following five Theoretical Domains Framework constructs: knowledge, beliefs about consequences, environmental context and resources, social influence, and emotion. Conclusions: With the World Health Organization stating that one of the worst threats to global health is vaccine hesitancy, it is important to have a comprehensive understanding of the reasons behind this reluctance. By using a behavioral science framework, this study adds to the emerging knowledge about vaccine hesitancy in relation to COVID-19 vaccines by analyzing public discourse in tweets in real time. Health care leaders and clinicians may use this knowledge to develop public health interventions that are responsive to the concerns of people who are hesitant to receive vaccines. ",
doi="10.2196/26874",
url="https://www.jmir.org/2021/4/e26874",
url="http://www.ncbi.nlm.nih.gov/pubmed/33769946"
}


@Article{info:doi/10.2196/25892,
author="Katz, Marc
and Nandi, Neilanjan",
title="Social Media and Medical Education in the Context of the COVID-19 Pandemic: Scoping Review",
journal="JMIR Med Educ",
year="2021",
month="Apr",
day="12",
volume="7",
number="2",
pages="e25892",
keywords="social media",
keywords="medical education",
keywords="COVID-19",
keywords="medical student",
keywords="review",
keywords="doctor",
keywords="communication",
keywords="online learning",
keywords="e-learning",
keywords="online education",
keywords="delivery",
keywords="dissemination",
abstract="Background: The COVID-19 pandemic has brought virtual web-based learning to the forefront of medical education as training programs adapt to physical distancing challenges while maintaining the rigorous standards of medical training. Social media has unique and partially untapped potential to supplement formal medical education. Objective: The aim of this review is to provide a summary of the incentives, applications, challenges, and pitfalls of social media--based medical education for both trainees and educators. Methods: We performed a literature review via PubMed of medical research involving social media platforms, including Facebook, Twitter, Instagram, YouTube, WhatsApp, and podcasts. Papers were reviewed for inclusion based on the integrity and power of the study. Results: The unique characteristics of social media platforms such as Facebook, Twitter, Instagram, YouTube, WhatsApp, and podcasts endow them with unique communication capabilities that serve different educational purposes in both formal and informal education settings. However, contemporary medical education curricula lack widespread guidance on meaningful use, application, and deployment of social media in medical education. Conclusions: Clinicians and institutions must evolve to embrace the use of social media platforms for medical education. Health care professionals can approach social media engagement in the same ethical manner that they would with patients in person; however, health care institutions ultimately must enable their health care professionals to achieve this by enacting realistic social media policies. Institutions should appoint clinicians with strong social media experience to leadership roles to spearhead these generational and cultural changes. Further studies are needed to better understand how health care professionals can most effectively use social media platforms as educational tools. Ultimately, social media is here to stay, influencing lay public knowledge and trainee knowledge. Clinicians and institutions must embrace this complementary modality of trainee education and champion social media as a novel distribution platform that can also help propagate truth in a time of misinformation, such as the COVID-19 pandemic. ",
doi="10.2196/25892",
url="https://mededu.jmir.org/2021/2/e25892",
url="http://www.ncbi.nlm.nih.gov/pubmed/33755578"
}


@Article{info:doi/10.2196/24690,
author="Xu, Ran
and Cavallo, David",
title="Social Network Analysis of the Effects of a Social Media--Based Weight Loss Intervention Targeting Adults of Low Socioeconomic Status: Single-Arm Intervention Trial",
journal="J Med Internet Res",
year="2021",
month="Apr",
day="9",
volume="23",
number="4",
pages="e24690",
keywords="weight loss intervention",
keywords="social media intervention",
keywords="electronic health",
keywords="social network analysis",
abstract="Background: Obesity is a known risk factor for cardiovascular disease risk factors, including hypertension and type II diabetes. Although numerous weight loss interventions have demonstrated efficacy, there is considerably less evidence about the theoretical mechanisms through which they work. Delivering lifestyle behavior change interventions via social media provides unique opportunities for understanding mechanisms of intervention effects. Server data collected directly from web-based platforms can provide detailed, real-time behavioral information over the course of intervention programs that can be used to understand how interventions work. Objective: The objective of this study was to demonstrate how social network analysis can facilitate our understanding of the mechanisms underlying a social media--based weight loss intervention. Methods: We performed secondary analysis by using data from a pilot study that delivered a dietary and physical activity intervention to a group of participants via Facebook. We mapped out participants' interaction networks over the 12-week intervention period and linked participants' network characteristics (eg, in-degree, out-degree, network constraint) to participants' changes in theoretical mediators (ie, dietary knowledge, perceived social support, self-efficacy) and weight loss by using regression analysis. We also performed mediation analyses to explore how the effects of social network measures on weight loss could be mediated by the aforementioned theoretical mediators. Results: In this analysis, 47 participants from 2 waves completed the study and were included. We found that increases in the number of posts, comments, and reactions significantly predicted weight loss ($\beta$=--.94, P=.04); receiving comments positively predicted changes in self-efficacy ($\beta$=7.81, P=.009), and the degree to which one's network neighbors are tightly connected with each other weakly predicted changes in perceived social support ($\beta$=7.70, P=.08). In addition, change in self-efficacy mediated the relationship between receiving comments and weight loss ($\beta$=--.89, P=.02). Conclusions: Our analyses using data from this pilot study linked participants' network characteristics with changes in several important study outcomes of interest such as self-efficacy, social support, and weight. Our results point to the potential of using social network analysis to understand the social processes and mechanisms through which web-based behavioral interventions affect participants' psychological and behavioral outcomes. Future studies are warranted to validate our results and to further explore the relationship between network dynamics and study outcomes in similar and larger trials. ",
doi="10.2196/24690",
url="https://www.jmir.org/2021/4/e24690",
url="http://www.ncbi.nlm.nih.gov/pubmed/33835033"
}


@Article{info:doi/10.2196/19022,
author="Burke, R. Richard
and Weichelt, P. Bryan
and Namkoong, Kang",
title="Facebook Ads Manager as a Recruitment Tool for a Health and Safety Survey of Farm Mothers: Pilot Study",
journal="JMIR Form Res",
year="2021",
month="Apr",
day="7",
volume="5",
number="4",
pages="e19022",
keywords="Facebook",
keywords="recruitment",
keywords="advertisement",
keywords="agriculture",
keywords="health",
keywords="safety",
keywords="survey",
keywords="online",
abstract="Background: Social media platforms have experienced unprecedented levels of growth and usage over the past decade, with Facebook hosting 2.7 billion active users worldwide, including over 200 million users in the United States. Facebook users have been underutilized and understudied by the academic community as a resource for participant recruitment. Objective: We performed a pilot study to explore the efficacy and cost-effectiveness of Facebook advertisements for the recruitment of an online agricultural health and safety survey. Methods: We undertook a 1-week advertising campaign utilizing the integrated, targeted advertising platform of Facebook Ads Manager with a target-spending limit of US \$294. We created and posted three advertisements depicting varying levels of agricultural safety adoption leading to a brief survey on farm demographics and safety attitudes. We targeted our advertisements toward farm mothers aged 21-50 years in the United States and determined cost-effectiveness and potential biases. No participant incentive was offered. Results: We reached 40,024 users and gathered 318 advertisement clicks. Twenty-nine participants consented to the survey with 24 completions. Including personnel costs, the cost per completed survey was US \$17.42. Compared to the distribution of female producers in the United States, our advertisements were unexpectedly overrepresented in the eastern United States and were underrepresented in the western United States. Conclusions: Facebook Ads Manager represents a potentially cost-effective and timely method to recruit participants for online health and safety research when targeting a specific population. However, social media recruitment mirrors traditional recruitment methods in its limitations, exhibiting geographic, response, and self-selection biases that need to be addressed. ",
doi="10.2196/19022",
url="https://formative.jmir.org/2021/4/e19022",
url="http://www.ncbi.nlm.nih.gov/pubmed/33825686"
}


@Article{info:doi/10.2196/22734,
author="Oyebode, Oladapo
and Ndulue, Chinenye
and Adib, Ashfaq
and Mulchandani, Dinesh
and Suruliraj, Banuchitra
and Orji, Anulika Fidelia
and Chambers, T. Christine
and Meier, Sandra
and Orji, Rita",
title="Health, Psychosocial, and Social Issues Emanating From the COVID-19 Pandemic Based on Social Media Comments: Text Mining and Thematic Analysis Approach",
journal="JMIR Med Inform",
year="2021",
month="Apr",
day="6",
volume="9",
number="4",
pages="e22734",
keywords="social media",
keywords="COVID-19",
keywords="coronavirus",
keywords="infodemiology",
keywords="infoveillance",
keywords="natural language processing",
keywords="text mining",
keywords="thematic analysis",
keywords="interventions",
keywords="health issues",
keywords="psychosocial issues",
keywords="social issues",
abstract="Background: The COVID-19 pandemic has caused a global health crisis that affects many aspects of human lives. In the absence of vaccines and antivirals, several behavioral change and policy initiatives such as physical distancing have been implemented to control the spread of COVID-19. Social media data can reveal public perceptions toward how governments and health agencies worldwide are handling the pandemic, and the impact of the disease on people regardless of their geographic locations in line with various factors that hinder or facilitate the efforts to control the spread of the pandemic globally. Objective: This paper aims to investigate the impact of the COVID-19 pandemic on people worldwide using social media data. Methods: We applied natural language processing (NLP) and thematic analysis to understand public opinions, experiences, and issues with respect to the COVID-19 pandemic using social media data. First, we collected over 47 million COVID-19--related comments from Twitter, Facebook, YouTube, and three online discussion forums. Second, we performed data preprocessing, which involved applying NLP techniques to clean and prepare the data for automated key phrase extraction. Third, we applied the NLP approach to extract meaningful key phrases from over 1 million randomly selected comments and computed sentiment score for each key phrase and assigned sentiment polarity (ie, positive, negative, or neutral) based on the score using a lexicon-based technique. Fourth, we grouped related negative and positive key phrases into categories or broad themes. Results: A total of 34 negative themes emerged, out of which 15 were health-related issues, psychosocial issues, and social issues related to the COVID-19 pandemic from the public perspective. Some of the health-related issues were increased mortality, health concerns, struggling health systems, and fitness issues; while some of the psychosocial issues were frustrations due to life disruptions, panic shopping, and expression of fear. Social issues were harassment, domestic violence, and wrong societal attitude. In addition, 20 positive themes emerged from our results. Some of the positive themes were public awareness, encouragement, gratitude, cleaner environment, online learning, charity, spiritual support, and innovative research. Conclusions: We uncovered various negative and positive themes representing public perceptions toward the COVID-19 pandemic and recommended interventions that can help address the health, psychosocial, and social issues based on the positive themes and other research evidence. These interventions will help governments, health professionals and agencies, institutions, and individuals in their efforts to curb the spread of COVID-19 and minimize its impact, and in reacting to any future pandemics. ",
doi="10.2196/22734",
url="https://medinform.jmir.org/2021/4/e22734",
url="http://www.ncbi.nlm.nih.gov/pubmed/33684052"
}


@Article{info:doi/10.2196/26518,
author="Zhou, Xinyu
and Song, Yi
and Jiang, Hao
and Wang, Qian
and Qu, Zhiqiang
and Zhou, Xiaoyu
and Jit, Mark
and Hou, Zhiyuan
and Lin, Leesa",
title="Comparison of Public Responses to Containment Measures During the Initial Outbreak and Resurgence of COVID-19 in China: Infodemiology Study",
journal="J Med Internet Res",
year="2021",
month="Apr",
day="5",
volume="23",
number="4",
pages="e26518",
keywords="COVID-19",
keywords="engagement",
keywords="latent Dirichlet allocation",
keywords="public response",
keywords="sentiment",
keywords="social media",
keywords="topic modeling",
abstract="Background: COVID-19 cases resurged worldwide in the second half of 2020. Not much is known about the changes in public responses to containment measures from the initial outbreak to resurgence. Monitoring public responses is crucial to inform policy measures to prepare for COVID-19 resurgence. Objective: This study aimed to assess and compare public responses to containment measures during the initial outbreak and resurgence of COVID-19 in China. Methods: We curated all COVID-19--related posts from Sina Weibo (China's version of Twitter) during the initial outbreak and resurgence of COVID-19 in Beijing, China. With a Python script, we constructed subsets of Weibo posts focusing on 3 containment measures: lockdown, the test-trace-isolate strategy, and suspension of gatherings. The Baidu open-source sentiment analysis model and latent Dirichlet allocation topic modeling, a widely used machine learning algorithm, were used to assess public engagement, sentiments, and frequently discussed topics on each containment measure. Results: A total of 8,985,221 Weibo posts were curated. In China, the containment measures evolved from a complete lockdown for the general population during the initial outbreak to a more targeted response strategy for high-risk populations during COVID-19 resurgence. Between the initial outbreak and resurgence, the average daily proportion of Weibo posts with negative sentiments decreased from 57\% to 47\% for the lockdown, 56\% to 51\% for the test-trace-isolate strategy, and 55\% to 48\% for the suspension of gatherings. Among the top 3 frequently discussed topics on lockdown measures, discussions on containment measures accounted for approximately 32\% in both periods, but those on the second-most frequently discussed topic shifted from the expression of negative emotions (11\%) to its impacts on daily life or work (26\%). The public expressed a high level of panic (21\%) during the initial outbreak but almost no panic (1\%) during resurgence. The more targeted test-trace-isolate measure received the most support (60\%) among all 3 containment measures in the initial outbreak, and its support rate approached 90\% during resurgence. Conclusions: Compared to the initial outbreak, the public expressed less engagement and less negative sentiments on containment measures and were more supportive toward containment measures during resurgence. Targeted test-trace-isolate strategies were more acceptable to the public. Our results indicate that when COVID-19 resurges, more targeted test-trace-isolate strategies for high-risk populations should be promoted to balance pandemic control and its impact on daily life and the economy. ",
doi="10.2196/26518",
url="https://www.jmir.org/2021/4/e26518",
url="http://www.ncbi.nlm.nih.gov/pubmed/33750739"
}


@Article{info:doi/10.2196/23205,
author="Farsi, Deema",
title="Social Media and Health Care, Part I: Literature Review of Social Media Use by Health Care Providers",
journal="J Med Internet Res",
year="2021",
month="Apr",
day="5",
volume="23",
number="4",
pages="e23205",
keywords="social media",
keywords="social networking",
keywords="internet",
keywords="health care",
keywords="COVID-19",
keywords="research activity",
keywords="medical education",
keywords="telemedicine",
keywords="mobile phone",
abstract="Background: As the world continues to advance technologically, social media (SM) is becoming an essential part of billions of people's lives worldwide and is affecting almost every industry imaginable. As the world is becoming more digitally oriented, the health care industry is increasingly visualizing SM as an important channel for health care promotion, employment, recruiting new patients, marketing for health care providers (HCPs), building a better brand name, etc. HCPs are bound to ethical principles toward their colleagues, patients, and the public in the digital world as much as in the real world. Objective: This review aims to shed light on SM use worldwide and to discuss how it has been used as an essential tool in the health care industry from the perspective of HCPs. Methods: A literature review was conducted between March and April 2020 using MEDLINE, PubMed, Google Scholar, and Web of Science for all English-language medical studies that were published since 2007 and discussed SM use in any form for health care. Studies that were not in English, whose full text was not accessible, or that investigated patients' perspectives were excluded from this part, as were reviews pertaining to ethical and legal considerations in SM use. Results: The initial search yielded 83 studies. More studies were included from article references, and a total of 158 studies were reviewed. SM uses were best categorized as health promotion, career development or practice promotion, recruitment, professional networking or destressing, medical education, telemedicine, scientific research, influencing health behavior, and public health care issues. Conclusions: Multidimensional health care, including the pairing of health care with SM and other forms of communication, has been shown to be very successful. Striking the right balance between digital and traditional health care is important. ",
doi="10.2196/23205",
url="https://www.jmir.org/2021/4/e23205",
url="http://www.ncbi.nlm.nih.gov/pubmed/33664014"
}


@Article{info:doi/10.2196/26780,
author="Al-Ramahi, Mohammad
and Elnoshokaty, Ahmed
and El-Gayar, Omar
and Nasralah, Tareq
and Wahbeh, Abdullah",
title="Public Discourse Against Masks in the COVID-19 Era: Infodemiology Study of Twitter Data",
journal="JMIR Public Health Surveill",
year="2021",
month="Apr",
day="5",
volume="7",
number="4",
pages="e26780",
keywords="pandemic",
keywords="coronavirus",
keywords="masks",
keywords="social medial, opinion analysis",
keywords="COVID-19",
abstract="Background: Despite scientific evidence supporting the importance of wearing masks to curtail the spread of COVID-19, wearing masks has stirred up a significant debate particularly on social media. Objective: This study aimed to investigate the topics associated with the public discourse against wearing masks in the United States. We also studied the relationship between the anti-mask discourse on social media and the number of new COVID-19 cases. Methods: We collected a total of 51,170 English tweets between January 1, 2020, and October 27, 2020, by searching for hashtags against wearing masks. We used machine learning techniques to analyze the data collected. We investigated the relationship between the volume of tweets against mask-wearing and the daily volume of new COVID-19 cases using a Pearson correlation analysis between the two-time series. Results: The results and analysis showed that social media could help identify important insights related to wearing masks. The results of topic mining identified 10 categories or themes of user concerns dominated by (1) constitutional rights and freedom of choice; (2) conspiracy theory, population control, and big pharma; and (3) fake news, fake numbers, and fake pandemic. Altogether, these three categories represent almost 65\% of the volume of tweets against wearing masks. The relationship between the volume of tweets against wearing masks and newly reported COVID-19 cases depicted a strong correlation wherein the rise in the volume of negative tweets led the rise in the number of new cases by 9 days. Conclusions: These findings demonstrated the potential of mining social media for understanding the public discourse about public health issues such as wearing masks during the COVID-19 pandemic. The results emphasized the relationship between the discourse on social media and the potential impact on real events such as changing the course of the pandemic. Policy makers are advised to proactively address public perception and work on shaping this perception through raising awareness, debunking negative sentiments, and prioritizing early policy intervention toward the most prevalent topics. ",
doi="10.2196/26780",
url="https://publichealth.jmir.org/2021/4/e26780",
url="http://www.ncbi.nlm.nih.gov/pubmed/33720841"
}


@Article{info:doi/10.2196/23593,
author="Sch{\"u}ck, St{\'e}phane
and Foulqui{\'e}, Pierre
and Mebarki, Adel
and Faviez, Carole
and Khadhar, Micka{\"i}l
and Texier, Nathalie
and Katsahian, Sandrine
and Burgun, Anita
and Chen, Xiaoyi",
title="Concerns Discussed on Chinese and French Social Media During the COVID-19 Lockdown: Comparative Infodemiology Study Based on Topic Modeling",
journal="JMIR Form Res",
year="2021",
month="Apr",
day="5",
volume="5",
number="4",
pages="e23593",
keywords="comparative analysis",
keywords="content analysis",
keywords="topic model",
keywords="social media",
keywords="COVID-19",
keywords="lockdown",
keywords="China",
keywords="France",
keywords="impact",
keywords="population",
abstract="Background: During the COVID-19 pandemic, numerous countries, including China and France, have implemented lockdown measures that have been effective in controlling the epidemic. However, little is known about the impact of these measures on the population as expressed on social media from different cultural contexts. Objective: This study aims to assess and compare the evolution of the topics discussed on Chinese and French social media during the COVID-19 lockdown. Methods: We extracted posts containing COVID-19--related or lockdown-related keywords in the most commonly used microblogging social media platforms (ie, Weibo in China and Twitter in France) from 1 week before lockdown to the lifting of the lockdown. A topic model was applied independently for three periods (prelockdown, early lockdown, and mid to late lockdown) to assess the evolution of the topics discussed on Chinese and French social media. Results: A total of 6395; 23,422; and 141,643 Chinese Weibo messages, and 34,327; 119,919; and 282,965 French tweets were extracted in the prelockdown, early lockdown, and mid to late lockdown periods, respectively, in China and France. Four categories of topics were discussed in a continuously evolving way in all three periods: epidemic news and everyday life, scientific information, public measures, and solidarity and encouragement. The most represented category over all periods in both countries was epidemic news and everyday life. Scientific information was far more discussed on Weibo than in French tweets. Misinformation circulated through social media in both countries; however, it was more concerned with the virus and epidemic in China, whereas it was more concerned with the lockdown measures in France. Regarding public measures, more criticisms were identified in French tweets than on Weibo. Advantages and data privacy concerns regarding tracing apps were also addressed in French tweets. All these differences were explained by the different uses of social media, the different timelines of the epidemic, and the different cultural contexts in these two countries. Conclusions: This study is the first to compare the social media content in eastern and western countries during the unprecedented COVID-19 lockdown. Using general COVID-19--related social media data, our results describe common and different public reactions, behaviors, and concerns in China and France, even covering the topics identified in prior studies focusing on specific interests. We believe our study can help characterize country-specific public needs and appropriately address them during an outbreak. ",
doi="10.2196/23593",
url="https://formative.jmir.org/2021/4/e23593",
url="http://www.ncbi.nlm.nih.gov/pubmed/33750736"
}


@Article{info:doi/10.2196/26265,
author="Li, PengFei
and Xu, Lin
and Tang, TingTing
and Wu, Xiaoqian
and Huang, Cheng",
title="Users' Willingness to Share Health Information in a Social Question-and-Answer Community: Cross-sectional Survey in China",
journal="JMIR Med Inform",
year="2021",
month="Mar",
day="30",
volume="9",
number="3",
pages="e26265",
keywords="health information",
keywords="willingness to share information",
keywords="",
keywords="structural equation model",
keywords="Zhihu",
abstract="Background: Social question-and-answer communities play an increasingly important role in the dissemination of health information. It is important to identify influencing factors of user willingness to share health information to improve public health literacy. Objective: This study explored influencing factors of social question-and-answer community users who share health information to provide reference for the construction of a high-quality health information sharing community. Methods: A cross-sectional study was conducted through snowball sampling of 185 participants who are Zhihu users in China. A structural equation analysis was used to verify the interaction and influence of the strength between variables in the model. Hierarchical regression was also used to test the mediating effect in the model. Results: Altruism ($\beta$=.264, P<.001), intrinsic reward ($\beta$=.260, P=.03), self-efficacy ($\beta$=.468, P<.001), and community influence ($\beta$=.277, P=.003) had a positive effect on users' willingness to share health information (WSHI). By contrast, extrinsic reward ($\beta$=?0.351, P<.001) had a negative effect. Self-efficacy also had a mediating effect ($\beta$=.147, 29.15\%, 0.147/0.505) between community influence and WSHI. Conclusions: The findings suggest that users' WSHI is influenced by many factors including altruism, self-efficacy, community influence, and intrinsic reward. Improving the social atmosphere of the platform is an effective method of encouraging users to share health information. ",
doi="10.2196/26265",
url="https://medinform.jmir.org/2021/3/e26265",
url="http://www.ncbi.nlm.nih.gov/pubmed/33783364"
}


@Article{info:doi/10.2196/22695,
author="Radu, Roxana
and Hern{\'a}ndez-Ortega, Sara
and Borrega, Oriol
and Palmeri, Avril
and Athanasiou, Dimitrios
and Brooke, Nicholas
and Chap{\'i}, Inma
and Le Corvec, Ana{\"i}s
and Guglieri, Michela
and Perera-Lluna, Alexandre
and Garrido-Aguirre, Jon
and Ryll, Bettina
and Nafria Escalera, Begonya",
title="Global Collaborative Social Network (Share4Rare) to Promote Citizen Science in Rare Disease Research: Platform Development Study",
journal="JMIR Form Res",
year="2021",
month="Mar",
day="29",
volume="5",
number="3",
pages="e22695",
keywords="Share4Rare",
keywords="rare disease",
keywords="citizen science",
keywords="participatory medicine",
keywords="natural history",
keywords="genotype",
keywords="phenotype",
abstract="Background: Rare disease communities are spread around the globe and segmented by their condition. Little research has been performed on the majority of rare diseases. Most patients who are affected by a rare disease have no research on their condition because of a lack of knowledge due to absence of common groups in the research community. Objective: We aimed to develop a safe and secure community of rare disease patients, without geographic or language barriers, to promote research. Methods: Cocreation design methodology was applied to build Share4Rare, with consultation and input through workshops from a variety of stakeholders (patients, caregivers, clinicians, and researchers). Results: The workshops allowed us to develop a layered version of the platform based on educating patients and caregivers with publicly accessible information, a secure community for the patients and caregivers, and a research section with the purpose of collecting patient information for analysis, which was the core and final value of the platform. Conclusions: Rare disease research requires global collaboration in which patients and caregivers have key roles. Collective intelligence methods implemented in digital platforms reduce geographic and language boundaries and involve patients in a unique and universal project. Their contributions are essential to increase the amount of scientific knowledge that experts have on rare diseases. Share4Rare has been designed as a global platform to facilitate the donation of clinical information to foster research that matters to patients with rare conditions. The codesign methods with patients have been essential to create a patient-centric design. ",
doi="10.2196/22695",
url="https://formative.jmir.org/2021/3/e22695",
url="http://www.ncbi.nlm.nih.gov/pubmed/33779572"
}


@Article{info:doi/10.2196/18048,
author="Marchant, Amanda
and Hawton, Keith
and Burns, Lauren
and Stewart, Anne
and John, Ann",
title="Impact of Web-Based Sharing and Viewing of Self-Harm--Related Videos and Photographs on Young People: Systematic Review",
journal="J Med Internet Res",
year="2021",
month="Mar",
day="19",
volume="23",
number="3",
pages="e18048",
keywords="self-harm",
keywords="suicide",
keywords="social media",
keywords="internet",
keywords="systematic review",
abstract="Background: Given recent moves to remove or blur self-harm imagery or content on the web, it is important to understand the impact of posting, viewing, and reposting self-harm images on young people. Objective: The aim of this study is to systematically review research related to the emotional and behavioral impact on children and young people who view or share web-based self-harm--related videos or images. Methods: We searched databases (including Embase, PsychINFO, and MEDLINE) from January 1991 to February 2019. Search terms were categorized into internet use, images nonspecific and specific to the internet, and self-harm and suicide. Stepwise screening against specified criteria and data extraction were completed by two independent reviewers. Eligible articles were quality assessed, and a narrative synthesis was conducted. Results: A total of 19 independent studies (20 articles) were included. Of these, 4 studies focused on images, 10 (11 articles) on videos, and 5 on both. There were 4 quantitative, 9 qualitative, and 7 mixed methods articles. In total, 11 articles were rated as high quality. There has been an increase in graphic self-harm imagery over time. Potentially harmful content congregated on platforms with little moderation, anonymity, and easy search functions for images. A range of reactions and intentions were reported in relation to posting or viewing images of self-harm: from empathy, a sense of solidarity, and the use of images to give or receive help to potentially harmful ones suggesting new methods, normalization, and exacerbation of self-harm. Viewing images as an alternative to self-harm or a creative outlet were regarded in 2 studies as positive impacts. Reactions of anger, hostility, and ambivalence have been reported. There was some evidence of the role of imitation and reinforcement, driven partly by the number of comments and wound severity, but this was not supported by time series analyses. Conclusions: Although the results of this review support concern related to safety and exacerbation of self-harm through viewing images of self-harm, there may be potential for positive impacts in some of those exposed. Future research should evaluate the effectiveness and potential harms of current posting restrictions, incorporate user perspectives, and develop recovery-oriented content. Clinicians assessing distressed young people should ask about internet use, including access to self-harm images, as part of their assessment. ",
doi="10.2196/18048",
url="https://www.jmir.org/2021/3/e18048",
url="http://www.ncbi.nlm.nih.gov/pubmed/33739289"
}


@Article{info:doi/10.2196/22647,
author="Liu, Fan
and Guo, Peng
and Su, Xiangqian
and Cui, Ming
and Jiang, Jianlong
and Wang, Suo
and Yu, Zhouman
and Zhou, Runhe
and Ye, Yingjiang",
title="A Novel Remote Follow-Up Tool Based on an Instant Messaging/Social Media App for the Management of Patients With Low Anterior Resection Syndrome: Pilot Prospective Self-Control Study",
journal="JMIR Mhealth Uhealth",
year="2021",
month="Mar",
day="19",
volume="9",
number="3",
pages="e22647",
keywords="instant messaging social media",
keywords="rectal cancer",
keywords="low anterior resection syndrome",
keywords="follow-up",
keywords="telephone interview",
abstract="Background: Low anterior resection syndrome (LARS) is a common functional disorder that develops after patients with rectal cancer undergo anal preservation surgery. Common approaches to assess the symptoms of patients with LARS are often complex and time-consuming. Instant messaging/social media has great application potential in LARS follow-up, but has been underdeveloped. Objective: The aim of this study was to compare data between a novel instant messaging/social media follow-up system and a telephone interview in patients with LARS and to analyze the consistency of the instant messaging/social media platform. Methods: Patients with R0 resectable rectal cancer who accepted several defecation function visits via the instant messaging/social media platform and agreed to a telephone interview after the operation using the same questionnaire including subjective questions and LARS scores were included. Differences between the 2 methods were analyzed in pairs and the diagnostic consistency of instant messaging/social media was calculated based on telephone interview results. Results: In total, 21 questionnaires from 15 patients were included. The positive rates of defecation dissatisfaction, life restriction, and medication use were 10/21 (48\%), 11/21 (52\%), and 8/21 (38\%) for telephone interview and 10/21 (48\%), 13/21 (62\%), and 5/21 (24\%) for instant messaging/social media, respectively. No statistically significant difference was observed between instant messaging/social media and telephone interview in terms of total LARS score (mean 22.4 [SD 11.9] vs mean 24.7 [SD 10.7], P<.21) and LARS categories (Z=--0.264, P=.79); however, instant messaging/social media showed a more negative tendency. The kappa values of 3 subjective questions were 0.618, 0.430, and 0.674, respectively. The total LARS scores were consistent between both groups (Pearson coefficient 0.760, P<.001; category correlation coefficient 0.570, P=.005). Patients with major LARS had highly consistent results, with sensitivity, specificity, kappa value, and P value of 77.8\%, 91.7\%, 0.704, and .001, respectively. Conclusions: Instant messaging/social media can be a major LARS screening method. However, further research on information accuracy and user acceptance is needed before implementing a mature system. Trial Registration: ClinicalTrials.gov NCT03009747; https://clinicaltrials.gov/ct2/show/NCT03009747 ",
doi="10.2196/22647",
url="https://mhealth.jmir.org/2021/3/e22647",
url="http://www.ncbi.nlm.nih.gov/pubmed/33739295"
}


@Article{info:doi/10.2196/18763,
author="Zhang, Xianzuo
and Chen, Xiaoxuan
and Kourkoumelis, Nikolaos
and Gao, Ran
and Li, Guoyuan
and Zhu, Chen",
title="A Social Media--Promoted Educational Community of Joint Replacement Patients Using the WeChat App: Survey Study",
journal="JMIR Mhealth Uhealth",
year="2021",
month="Mar",
day="18",
volume="9",
number="3",
pages="e18763",
keywords="WeChat",
keywords="social media",
keywords="arthroplasty",
keywords="perioperative education",
keywords="patient satisfaction",
abstract="Background: Much effort has been made to optimize the results of total hip arthroplasty and total knee arthroplasty. With the rapid growth of social media use, mobile apps, such as WeChat, have been considered for improving outcomes and patient satisfaction after total hip arthroplasty and total knee arthroplasty. Objective: We aimed to evaluate the effectiveness of a WeChat-based community as an intervention for overall patient satisfaction. Methods: The study was conducted among discharged in-hospital patients who received hip or knee procedures in the First Affiliated Hospital of the University of Science and Technology of China from April 2019 to January 2020. An educational online social community was constructed with the WeChat app. Participants willing to join the community were enrolled in a WeChat group and received 3 months of intervention and follow-up. Those who were not willing to use the account were included in a control group and received routine publicity via telephone, mail, and brochures. The Danish Health and Medicine Authority patient satisfaction questionnaire was used to score perioperative patient education and overall satisfaction. The contents in the group chat were analyzed using natural language processing tools. Results: A total of 3428 patients were enrolled in the study, including 2292 in the WeChat group and 1236 in the control group. Participants in the WeChat group had higher overall satisfaction scores than those in the control group (mean 8.48, SD 1.12 vs mean 6.66, SD 1.80, P<.001). The difference between the two groups was significant for primary surgery based on subgroup stratification. To control confounding factors and explore the effects of WeChat participation as a mediating variable between perioperative patient education and overall satisfaction, hierarchical regression was utilized. An interpatient interaction model was found in the community group chat, and it contributed to overall satisfaction. Patients in the group with more interpatient interactions were more likely to have better overall satisfaction. Conclusions: The social media--promoted educational community using WeChat was effective among joint replacement patients. Provision of more perioperative education is associated with more active patient participation in the community and therefore more patient satisfaction in terms of the overall joint procedure. Community group chat could facilitate interactions among patients and contribute to overall satisfaction. ",
doi="10.2196/18763",
url="https://mhealth.jmir.org/2021/3/e18763",
url="http://www.ncbi.nlm.nih.gov/pubmed/33734094"
}


@Article{info:doi/10.2196/27015,
author="Shao, Ruosi
and Shi, Zhen
and Zhang, Di",
title="Social Media and Emotional Burnout Regulation During the COVID-19 Pandemic: Multilevel Approach",
journal="J Med Internet Res",
year="2021",
month="Mar",
day="16",
volume="23",
number="3",
pages="e27015",
keywords="COVID-19",
keywords="pandemic",
keywords="emotion regulation",
keywords="emotional exhaustion",
keywords="multilevel approach",
keywords="well-being",
keywords="emotion",
keywords="mental health",
keywords="social media",
keywords="perspective",
keywords="strategy",
keywords="effective",
keywords="modeling",
keywords="buffer",
abstract="Background: In February 2020, the Chinese government imposed a complete lockdown of Wuhan and other cities in Hubei Province to contain a spike of COVID-19 cases. Although such measures are effective in preventing the spread of the virus, medical professionals strongly voiced a caveat concerning the pandemic emotional burnout at the individual level. Although the lockdown limited individuals' interpersonal communication with people in their social networks, it is common that individuals turn to social media to seek and share health information, exchange social support, and express pandemic-generated feelings. Objective: Based on a holistic and multilevel perspective, this study examines how pandemic-related emotional exhaustion enacts intrapersonal, interpersonal, and hyperpersonal emotional regulation strategies, and then evaluates the effectiveness of these strategies, with a particular interest in understanding the role of hyperpersonal-level regulation or social media--based regulation. Methods: Using an online panel, this study sampled 538 Chinese internet users from Hubei Province, the epicenter of the COVID-19 outbreak in China. Survey data collection lasted for 12 days from February 7-18, 2020, two weeks after Hubei Province was placed under quarantine. The sample had an average age of 35 (SD 10.65, range 18-78) years, and a majority were married (n=369, 68.6\%). Results: Using structural equation modeling, this study found that intrapersonal-level (B=0.22; $\beta$=.24; P<.001) and interpersonal-level (B=0.35; $\beta$=.49; P<.001) emotional regulation strategies were positively associated with individuals' outcome reappraisal. In contrast with intrapersonal and interpersonal regulations, hyperpersonal (social media--based) regulation strategies, such as disclosing and retweeting negative emotions, were negatively related to the outcome reappraisal (B=--1.00; $\beta$=--.80; P<.001). Conclusions: Consistent with previous literature, intrapersonal-level regulation (eg, cognitive reappraisal, mindfulness, and self-kindness) and interpersonal-level supportive interaction may generate a buffering effect on emotional exhaustion and promote individuals' reappraisal toward the stressful situation. However, hyperpersonal-level regulation may exacerbate the experienced negative emotions and impede reappraisal of the pandemic situation. It is speculated that retweeting content that contains pandemic-related stress and anxiety may cause a digital emotion contagion. Individuals who share other people's negative emotional expressions on social media are likely to be affected by the negative affect contagion. More importantly, the possible benefits of intrapersonal and interpersonal emotion regulations may be counteracted by social media or hyperpersonal regulation. This suggests the necessity to conduct social media--based health communication interventions to mitigate the social media--wide negative affect contagion if lockdown policies related to highly infectious diseases are initiated. ",
doi="10.2196/27015",
url="https://www.jmir.org/2021/3/e27015",
url="http://www.ncbi.nlm.nih.gov/pubmed/33661753"
}


@Article{info:doi/10.2196/23272,
author="Park, Sungkyu
and Han, Sungwon
and Kim, Jeongwook
and Molaie, Majid Mir
and Vu, Dieu Hoang
and Singh, Karandeep
and Han, Jiyoung
and Lee, Wonjae
and Cha, Meeyoung",
title="COVID-19 Discourse on Twitter in Four Asian Countries: Case Study of Risk Communication",
journal="J Med Internet Res",
year="2021",
month="Mar",
day="16",
volume="23",
number="3",
pages="e23272",
keywords="COVID-19",
keywords="coronavirus",
keywords="infodemic",
keywords="infodemiology",
keywords="infoveillance",
keywords="Twitter",
keywords="topic phase detection",
keywords="topic modeling",
keywords="latent Dirichlet allocation",
keywords="risk communication",
abstract="Background: COVID-19, caused by SARS-CoV-2, has led to a global pandemic. The World Health Organization has also declared an infodemic (ie, a plethora of information regarding COVID-19 containing both false and accurate information circulated on the internet). Hence, it has become critical to test the veracity of information shared online and analyze the evolution of discussed topics among citizens related to the pandemic. Objective: This research analyzes the public discourse on COVID-19. It characterizes risk communication patterns in four Asian countries with outbreaks at varying degrees of severity: South Korea, Iran, Vietnam, and India. Methods: We collected tweets on COVID-19 from four Asian countries in the early phase of the disease outbreak from January to March 2020. The data set was collected by relevant keywords in each language, as suggested by locals. We present a method to automatically extract a time--topic cohesive relationship in an unsupervised fashion based on natural language processing. The extracted topics were evaluated qualitatively based on their semantic meanings. Results: This research found that each government's official phases of the epidemic were not well aligned with the degree of public attention represented by the daily tweet counts. Inspired by the issue-attention cycle theory, the presented natural language processing model can identify meaningful transition phases in the discussed topics among citizens. The analysis revealed an inverse relationship between the tweet count and topic diversity. Conclusions: This paper compares similarities and differences of pandemic-related social media discourse in Asian countries. We observed multiple prominent peaks in the daily tweet counts across all countries, indicating multiple issue-attention cycles. Our analysis identified which topics the public concentrated on; some of these topics were related to misinformation and hate speech. These findings and the ability to quickly identify key topics can empower global efforts to fight against an infodemic during a pandemic. ",
doi="10.2196/23272",
url="https://www.jmir.org/2021/3/e23272",
url="http://www.ncbi.nlm.nih.gov/pubmed/33684054"
}


@Article{info:doi/10.2196/25977,
author="Benis, Arriel
and Khodos, Anna
and Ran, Sivan
and Levner, Eugene
and Ashkenazi, Shai",
title="Social Media Engagement and Influenza Vaccination During the COVID-19 Pandemic: Cross-sectional Survey Study",
journal="J Med Internet Res",
year="2021",
month="Mar",
day="16",
volume="23",
number="3",
pages="e25977",
keywords="influenza",
keywords="vaccines",
keywords="vaccination",
keywords="social media",
keywords="online social networking",
keywords="health literacy",
keywords="eHealth",
keywords="information dissemination",
keywords="access to information",
keywords="COVID-19",
abstract="Background: Vaccines are one of the most important achievements of modern medicine. However, their acceptance is only partial, with vaccine hesitancy and refusal representing a major health threat. Influenza vaccines have low compliance since repeated, annual vaccination is required. Influenza vaccines stimulate discussions both in the real world and online. Social media is currently a significant source of health and medical information. Elucidating the association between social media engagement and influenza vaccination is important and may be applicable to other vaccines, including ones against COVID-19. Objective: The goal of this study is to characterize profiles of social media engagement regarding the influenza vaccine and their association with knowledge and compliance in order to support improvement of future web-associated vaccination campaigns. Methods: A weblink to an online survey in Hebrew was disseminated over social media and messaging platforms. The survey answers were collected during April 2020. Anonymous and volunteer participants aged 21 years and over answered 30 questions related to sociodemographics; social media usage; influenza- and vaccine-related knowledge and behavior; health-related information searching, its reliability, and its influence; and COVID-19-related information searching. A univariate descriptive data analysis was performed, followed by multivariate analysis via building a decision tree to define the most important attributes associated with vaccination compliance. Results: A total of 213 subjects responded to the survey, of whom 207 were included in the analysis; the majority of the respondents were female, were aged 21 to 40 years, had 1 to 2 children, lived in central Israel, were secular Israeli natives, had higher education, and had a salary close to the national average. Most respondents (128/207, 61.8\%) were not vaccinated against influenza in 2019 and used social media. Participants that used social media were younger, secular, and living in high-density agglomerations and had lower influenza vaccination rates. The perceived influence and reliability of the information on social media about COVID-19 were generally similar to those perceptions about influenza. Conclusions: Using social media is negatively linked to compliance with seasonal influenza vaccination in this study. A high proportion of noncompliant individuals can lead to increased consumption of health care services and can, therefore, overload these health services. This is particularly crucial with a concomitant outbreak, such as COVID-19. Health care professionals should use improved and targeted health communication campaigns with the aid of experts in social media. Targeted communication, based on sociodemographic factors and personalized social media usage, might increase influenza vaccination rates and compliance with other vaccines as well. ",
doi="10.2196/25977",
url="https://www.jmir.org/2021/3/e25977",
url="http://www.ncbi.nlm.nih.gov/pubmed/33651709"
}


@Article{info:doi/10.2196/25807,
author="Chew, Robert
and Kery, Caroline
and Baum, Laura
and Bukowski, Thomas
and Kim, Annice
and Navarro, Mario",
title="Predicting Age Groups of Reddit Users Based on Posting Behavior and Metadata: Classification Model Development and Validation",
journal="JMIR Public Health Surveill",
year="2021",
month="Mar",
day="16",
volume="7",
number="3",
pages="e25807",
keywords="Reddit",
keywords="social media",
keywords="age",
keywords="machine learning",
keywords="classification",
abstract="Background: Social media are important for monitoring perceptions of public health issues and for educating target audiences about health; however, limited information about the demographics of social media users makes it challenging to identify conversations among target audiences and limits how well social media can be used for public health surveillance and education outreach efforts. Certain social media platforms provide demographic information on followers of a user account, if given, but they are not always disclosed, and researchers have developed machine learning algorithms to predict social media users' demographic characteristics, mainly for Twitter. To date, there has been limited research on predicting the demographic characteristics of Reddit users. Objective: We aimed to develop a machine learning algorithm that predicts the age segment of Reddit users, as either adolescents or adults, based on publicly available data. Methods: This study was conducted between January and September 2020 using publicly available Reddit posts as input data. We manually labeled Reddit users' age by identifying and reviewing public posts in which Reddit users self-reported their age. We then collected sample posts, comments, and metadata for the labeled user accounts and created variables to capture linguistic patterns, posting behavior, and account details that would distinguish the adolescent age group (aged 13 to 20 years) from the adult age group (aged 21 to 54 years). We split the data into training (n=1660) and test sets (n=415) and performed 5-fold cross validation on the training set to select hyperparameters and perform feature selection. We ran multiple classification algorithms and tested the performance of the models (precision, recall, F1 score) in predicting the age segments of the users in the labeled data. To evaluate associations between each feature and the outcome, we calculated means and confidence intervals and compared the two age groups, with 2-sample t tests, for each transformed model feature. Results: The gradient boosted trees classifier performed the best, with an F1 score of 0.78. The test set precision and recall scores were 0.79 and 0.89, respectively, for the adolescent group (n=254) and 0.78 and 0.63, respectively, for the adult group (n=161). The most important feature in the model was the number of sentences per comment (permutation score: mean 0.100, SD 0.004). Members of the adolescent age group tended to have created accounts more recently, have higher proportions of submissions and comments in the r/teenagers subreddit, and post more in subreddits with higher subscriber counts than those in the adult group. Conclusions: We created a Reddit age prediction algorithm with competitive accuracy using publicly available data, suggesting machine learning methods can help public health agencies identify age-related target audiences on Reddit. Our results also suggest that there are characteristics of Reddit users' posting behavior, linguistic patterns, and account features that distinguish adolescents from adults. ",
doi="10.2196/25807",
url="https://publichealth.jmir.org/2021/3/e25807",
url="http://www.ncbi.nlm.nih.gov/pubmed/33724195"
}


@Article{info:doi/10.2196/24948,
author="Gesser-Edelsburg, Anat",
title="Using Narrative Evidence to Convey Health Information on Social Media: The Case of COVID-19",
journal="J Med Internet Res",
year="2021",
month="Mar",
day="15",
volume="23",
number="3",
pages="e24948",
keywords="health and risk communication",
keywords="social media",
keywords="narrative evidence",
keywords="crisis",
keywords="pandemic",
keywords="misinformation",
keywords="infodemic",
keywords="infodemiology",
keywords="COVID-19",
keywords="policy",
keywords="segmentation",
keywords="barrier reduction",
keywords="role models",
keywords="empathy and support",
keywords="strengthening self/community-efficacy",
keywords="coping tools",
keywords="preventing stigmatization",
keywords="at-risk populations",
keywords="communicating uncertainty",
keywords="positive deviance",
keywords="tailor messaging",
keywords="targeted behavioral change",
doi="10.2196/24948",
url="https://www.jmir.org/2021/3/e24948",
url="http://www.ncbi.nlm.nih.gov/pubmed/33674257"
}


@Article{info:doi/10.2196/25202,
author="Martino, Florentine
and Brooks, Ruby
and Browne, Jennifer
and Carah, Nicholas
and Zorbas, Christina
and Corben, Kirstan
and Saleeba, Emma
and Martin, Jane
and Peeters, Anna
and Backholer, Kathryn",
title="The Nature and Extent of Online Marketing by Big Food and Big Alcohol During the COVID-19 Pandemic in Australia: Content Analysis Study",
journal="JMIR Public Health Surveill",
year="2021",
month="Mar",
day="12",
volume="7",
number="3",
pages="e25202",
keywords="alcohol",
keywords="food and beverage",
keywords="COVID-19",
keywords="marketing",
keywords="social media",
abstract="Background: Emerging evidence demonstrates that obesity is associated with a higher risk of COVID-19 morbidity and mortality. Excessive alcohol consumption and ``comfort eating'' as coping mechanisms during times of high stress have been shown to further exacerbate mental and physical ill-health. Global examples suggest that unhealthy food and alcohol brands and companies are using the COVID-19 pandemic to further market their products. However, there has been no systematic, in-depth analysis of how ``Big Food'' and ``Big Alcohol'' are capitalizing on the COVID-19 pandemic to market their products and brands. Objective: We aimed to quantify the extent and nature of online marketing by alcohol and unhealthy food and beverage companies during the COVID-19 pandemic in Australia. Methods: We conducted a content analysis of all COVID-19-related social media posts made by leading alcohol and unhealthy food and beverage brands (n=42) and their parent companies (n=12) over a 4-month period (February to May 2020) during the COVID-19 pandemic in Australia. Results: Nearly 80\% of included brands and all parent companies posted content related to COVID-19 during the 4-month period. Quick service restaurants (QSRs), food and alcohol delivery companies, alcohol brands, and bottle shops were the most active in posting COVID-19-related content. The most common themes for COVID-19-related marketing were isolation activities and community support. Promotion of hygiene and home delivery was also common, particularly for QSRs and alcohol and food delivery companies. Parent companies were more likely to post about corporate social responsibility (CSR) initiatives, such as donations of money and products, and to offer health advice. Conclusions: This is the first study to show that Big Food and Big Alcohol are incessantly marketing their products and brands on social media platforms using themes related to COVID-19, such as isolation activities and community support. Parent companies are frequently posting about CSR initiatives, such as donations of money and products, thereby creating a fertile environment to loosen current regulation or resist further industry regulation. ``COVID-washing'' by large alcohol brands, food and beverage brands, and their parent companies is both common and concerning. The need for comprehensive regulations to restrict unhealthy food and alcohol marketing, as recommended by the World Health Organization, is particularly acute in the COVID-19 context and is urgently required to ``build back better'' in a post-COVID-19 world. ",
doi="10.2196/25202",
url="https://publichealth.jmir.org/2021/3/e25202",
url="http://www.ncbi.nlm.nih.gov/pubmed/33709935"
}


@Article{info:doi/10.2196/24883,
author="Slavik, E. Catherine
and Buttle, Charlotte
and Sturrock, L. Shelby
and Darlington, Connor J.
and Yiannakoulias, Niko",
title="Examining Tweet Content and Engagement of Canadian Public Health Agencies and Decision Makers During COVID-19: Mixed Methods Analysis",
journal="J Med Internet Res",
year="2021",
month="Mar",
day="11",
volume="23",
number="3",
pages="e24883",
keywords="COVID-19",
keywords="coronavirus",
keywords="pandemic",
keywords="public health",
keywords="Twitter",
keywords="social media",
keywords="engagement",
keywords="risk communication",
keywords="infodemiology",
keywords="content analysis",
abstract="Background: Effective communication during a health crisis can ease public concerns and promote the adoption of important risk-mitigating behaviors. Public health agencies and leaders have served as the primary communicators of information related to COVID-19, and a key part of their public outreach has taken place on social media platforms. Objective: This study examined the content and engagement of COVID-19 tweets authored by Canadian public health agencies and decision makers. We propose ways for public health accounts to adjust their tweeting practices during public health crises to improve risk communication and maximize engagement. Methods: We retrieved data from tweets by Canadian public health agencies and decision makers from January 1, 2020, to June 30, 2020. The Twitter accounts were categorized as belonging to either a public health agency, regional or local health department, provincial health authority, medical health officer, or minister of health. We analyzed trends in COVID-19 tweet engagement and conducted a content analysis on a stratified random sample of 485 tweets to examine the message functions and risk communication strategies used by each account type. Results: We analyzed 32,737 tweets authored by 118 Canadian public health Twitter accounts, of which 6982 tweets were related to COVID-19. Medical health officers authored the largest percentage of COVID-19--related tweets (n=1337, 35\%) relative to their total number of tweets and averaged the highest number of retweets per COVID-19 tweet (112 retweets per tweet). Public health agencies had the highest frequency of daily tweets about COVID-19 throughout the study period. Compared to tweets containing media and user mentions, hashtags and URLs were used in tweets more frequently by all account types, appearing in 69\% (n=4798 tweets) and 68\% (n=4781 tweets) of COVID-19--related tweets, respectively. Tweets containing hashtags also received the highest average retweets (47 retweets per tweet). Our content analysis revealed that of the three tweet message functions analyzed (information, action, community), tweets providing information were the most commonly used across most account types, constituting 39\% (n=181) of all tweets; however, tweets promoting actions from users received higher than average retweets (55 retweets per tweet). When examining tweets that received one or more retweet (n=359), the difference between mean retweets across the message functions was statistically significant (P<.001). The risk communication strategies that we examined were not widely used by any account type, appearing in only 262 out of 485 tweets. However, when these strategies were used, these tweets received more retweets compared to tweets that did not use any risk communication strategies (P<.001) (61 retweets versus 13 retweets on average). Conclusions: Public health agencies and decision makers should examine what messaging best meets the needs of their Twitter audiences to maximize sharing of their communications. Public health accounts that do not currently employ risk communication strategies in their tweets may be missing an important opportunity to engage with users about the mitigation of health risks related to COVID-19. ",
doi="10.2196/24883",
url="https://www.jmir.org/2021/3/e24883",
url="http://www.ncbi.nlm.nih.gov/pubmed/33651705"
}


@Article{info:doi/10.2196/24966,
author="Thayer, K. Erin
and Pam, Molly
and Al Achkar, Morhaf
and Mentch, Laura
and Brown, Georgia
and Kazmerski, M. Traci
and Godfrey, Emily",
title="Best Practices for Virtual Engagement of Patient-Centered Outcomes Research Teams During and After the COVID-19 Pandemic: Qualitative Study",
journal="J Particip Med",
year="2021",
month="Mar",
day="11",
volume="13",
number="1",
pages="e24966",
keywords="attributes",
keywords="best practices",
keywords="COVID-19",
keywords="cystic fibrosis",
keywords="engagement",
keywords="outcome",
keywords="patient",
keywords="patient-centered outcomes research",
keywords="qualitative",
keywords="research",
keywords="stakeholder engagement",
keywords="user guide",
keywords="virtual care",
keywords="virtual teams",
keywords="web-based collaboration",
abstract="Background: Patient-centered outcomes research (PCOR) engages patients as partners in research and focuses on questions and outcomes that are important to patients. The COVID-19 pandemic has forced PCOR teams to engage through web-based platforms rather than in person. Similarly, virtual engagement is the only safe alternative for members of the cystic fibrosis (CF) community, who spend their lives following strict infection control guidelines and are already restricted from in-person interactions. In the absence of universal best practices, the CF community has developed its own guidelines to help PCOR teams engage through web-based platforms. Objective: This study aimed to identify the important attributes, facilitators, and barriers to teams when selecting web-based platforms. Methods: We conducted semistructured interviews with CF community members, nonprofit stakeholders, and researchers to obtain information regarding their experience with using web-based platforms, including the effectiveness and efficiency of these platforms and their satisfaction with and confidence while using each platform. Interviews conducted via Zoom were audio recorded and transcribed. We identified key themes through content analysis with an iterative, inductive, and deductive coding process. Results: In total, 15 participants reported using web-based platforms for meetings, project management, document sharing, scheduling, and communication. When selecting web-based platforms, participants valued their accessibility, ease of use, and integration with other platforms. Participants speculated that successful web-based collaboration involved platforms that emulate in-person interactions, recognized the digital literacy levels of the team members, intentionally aligned platforms with collaboration goals, and achieved team member buy-in to adopt new platforms. Conclusions: Successful web-based engagement in PCOR requires the use of multiple platforms in order to fully meet the asynchronous or synchronous goals of the project. This study identified the key attributes for the successful practice of PCOR on web-based platforms and the common challenges and solutions associated with their use. Our findings provide the best practices for selecting platforms and the lessons learned through web-based PCOR collaborations. ",
doi="10.2196/24966",
url="https://jopm.jmir.org/2021/1/e24966",
url="http://www.ncbi.nlm.nih.gov/pubmed/33646964"
}


@Article{info:doi/10.2196/24870,
author="Kim, Jina
and Lee, Daeun
and Park, Eunil",
title="Machine Learning for Mental Health in Social Media: Bibliometric Study",
journal="J Med Internet Res",
year="2021",
month="Mar",
day="8",
volume="23",
number="3",
pages="e24870",
keywords="bibliometric analysis",
keywords="machine learning",
keywords="mental health",
keywords="social media",
abstract="Background: Social media platforms provide an easily accessible and time-saving communication approach for individuals with mental disorders compared to face-to-face meetings with medical providers. Recently, machine learning (ML)-based mental health exploration using large-scale social media data has attracted significant attention. Objective: We aimed to provide a bibliometric analysis and discussion on research trends of ML for mental health in social media. Methods: Publications addressing social media and ML in the field of mental health were retrieved from the Scopus and Web of Science databases. We analyzed the publication distribution to measure productivity on sources, countries, institutions, authors, and research subjects, and visualized the trends in this field using a keyword co-occurrence network. The research methodologies of previous studies with high citations are also thoroughly described. Results: We obtained a total of 565 relevant papers published from 2015 to 2020. In the last 5 years, the number of publications has demonstrated continuous growth with Lecture Notes in Computer Science and Journal of Medical Internet Research as the two most productive sources based on Scopus and Web of Science records. In addition, notable methodological approaches with data resources presented in high-ranking publications were investigated. Conclusions: The results of this study highlight continuous growth in this research area. Moreover, we retrieved three main discussion points from a comprehensive overview of highly cited publications that provide new in-depth directions for both researchers and practitioners. ",
doi="10.2196/24870",
url="https://www.jmir.org/2021/3/e24870",
url="http://www.ncbi.nlm.nih.gov/pubmed/33683209"
}


@Article{info:doi/10.2196/23892,
author="Carrotte, Rose Elise
and Webb, Marianne
and Flego, Anna
and Vincent, Bonnie
and Heath, Jack
and Blanchard, Michelle",
title="Acceptability, Safety, and Resonance of the Pilot Digital Suicide Prevention Campaign ``Better Off With You'': Qualitative Study",
journal="JMIR Form Res",
year="2021",
month="Mar",
day="3",
volume="5",
number="3",
pages="e23892",
keywords="suicide",
keywords="interpersonal theory of suicide",
keywords="social media",
keywords="co-design",
keywords="lived experience",
abstract="Background: The Interpersonal Theory of Suicide posits that there are three key elements of suicidal behavior: perceived burdensomeness, thwarted belongingness, and the acquired capability for suicide. The digital campaign Better Off With You was developed to directly challenge the idea of perceived burdensomeness among people who are contemplating suicide in 2 communities within Australia. Objective: The aim of this study is to explore the needs and preferences of people with lived experience of suicidal thoughts and actions to inform the development of Better Off With You. Methods: This study involved a series of focus groups that aimed to discuss campaign messaging, scope, and approach. People with lived experience of suicidal thoughts and actions attended the focus groups. After the completion of initial focus groups, the results informed the creation of campaign collateral by creative agencies. Early versions of the campaign collateral were then presented in the user testing sessions. Transcriptions were analyzed via thematic analysis. Results: In total, 13 participants attended the focus groups and 14 attended the user testing sessions. The following three overarching themes were presented: acceptability, safety, and resonance. Participants believed that suicide is a serious and ongoing issue in their communities and welcomed a localized suicide prevention focus via peer-to-peer storytelling. The idea of perceived burdensomeness required clarification but was perceived as acceptable and relevant. Participants seemed drawn toward peer narratives that they perceived to be authentic, genuine, and believable as given by real people with lived experience. Campaign messaging needs to be clear and empathetic while directly talking about suicide. Participants did not anticipate any significant negative or harmful impact from any campaign videos and highlighted the importance of providing appropriate help-seeking information. Conclusions: This iterative study provided important insights and knowledge about peer-to-peer storytelling in suicide prevention campaigns. Future campaigns should involve simple messaging, be validating and empathetic, and consider including a lived experience perspective. ",
doi="10.2196/23892",
url="https://formative.jmir.org/2021/3/e23892",
url="http://www.ncbi.nlm.nih.gov/pubmed/33656441"
}


@Article{info:doi/10.2196/23588,
author="Casanova, Georgia
and Zaccaria, Daniele
and Rolandi, Elena
and Guaita, Antonio",
title="The Effect of Information and Communication Technology and Social Networking Site Use on Older People's Well-Being in Relation to Loneliness: Review of Experimental Studies",
journal="J Med Internet Res",
year="2021",
month="Mar",
day="1",
volume="23",
number="3",
pages="e23588",
keywords="review",
keywords="aging",
keywords="loneliness",
keywords="older people's well-being",
keywords="ICTs",
keywords="social network sites",
abstract="Background: In the last decades, the relationship between social networking sites (SNSs) and older people's loneliness is gaining specific relevance. Studies in this field are often based on qualitative methods to study in-depth self-perceived issues, including loneliness and well-being, or quantitative surveys to report the links between information and communication technologies (ICTs) and older people's well-being or loneliness. However, these nonexperimental methods are unable to deeply analyze the causal relationship. Moreover, the research on older people's SNS use is still scant, especially regarding its impact on health and well-being. In recent years, the existing review studies have separately focused their attention on loneliness and social isolation of older people or on the use of ICTs and SNSs in elderly populations without addressing the relationship between the former and the latter. This thorough qualitative review provides an analysis of research performed using an experimental or quasi-experimental design that investigates the causal effect of ICT and SNS use on elderly people's well-being related to loneliness. Objective: The aims of this review are to contrast and compare research designs (sampling and recruitment, evaluation tools, interventions) and the findings of these studies and highlight their limitations. Methods: Using an approach that integrates the methodological framework for scoping studies and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for systematic reviews, we identified 11 articles that met our inclusion criteria. A thematic and content analysis was performed based on the ex post categorization of the data on the selected studies, and the data were summarized in tables. Results: The analysis of the selected articles showed that: (1) ICT use is positively but weakly related to the different measures of older people's well-being and loneliness, (2) overall, the studies under review lack a sound experimental design, (3) the main limitations of these studies lie in the lack of rigor in the sampling method and in the recruitment strategy. Conclusions: The analysis of the reviewed studies confirms the existence of a beneficial effect of ICT use on the well-being of older people in terms of reduced loneliness. However, the causal relationship is often found to be weak. This review highlights the need to study these issues further with adequate methodological rigor. ",
doi="10.2196/23588",
url="https://www.jmir.org/2021/3/e23588",
url="http://www.ncbi.nlm.nih.gov/pubmed/33439127"
}


@Article{info:doi/10.2196/21266,
author="Ramirez, G. Amelie
and Aguilar, P. Rosalie
and Merck, Amanda
and Despres, Cliff
and Sukumaran, Pramod
and Cantu-Pawlik, Stacy
and Chalela, Patricia",
title="Use of \#SaludTues Tweetchats for the Dissemination of Culturally Relevant Information on Latino Health Equity: Exploratory Case Study",
journal="JMIR Public Health Surveill",
year="2021",
month="Mar",
day="1",
volume="7",
number="3",
pages="e21266",
keywords="Latino",
keywords="social media",
keywords="social cognitive theory",
keywords="health communication",
keywords="health equity",
keywords="policy",
keywords="community health",
keywords="mobile phone",
abstract="Background: Latinx people comprise 18\% of the US adult population and a large share of youth and continue to experience inequities that perpetuate health disparities. To engage Latinx people in advocacy for health equity based on this population's heavy share of smartphone, social media, and Twitter users, Salud America! launched the \#SaludTues Tweetchat series. In this paper, we explore the use of \#SaludTues to promote advocacy for Latinx health equity. Objective: This study aims to understand how \#SaludTues Tweetchats are used to promote dissemination of culturally relevant information on social determinants of health, to determine whether tweetchats serve to drive web traffic to the Salud America! website, and to understand who participates in \#SaludTues Tweetchats and what we can learn about the participants. We also aim to share our own experiences and present a step-by-step guide of how tweetchats are planned, developed, promoted, and executed. Methods: We explored tweetchat data collected between 2014 and 2018 using Symplur and Google Analytics to identify groups of stakeholders and web traffic. Network analysis and mapping tools were also used to derive insights from this series of chats. Results: We conducted 187 chats with 24,609 reported users, 177,466 tweets, and more than 1.87 billion impressions using the hashtag \#SaludTues during this span, demonstrating effective dissemination of and exposure to culturally relevant information. Traffic to the Salud America! website was higher on Tuesdays than any other day of the week, suggesting that \#SaludTues Tweetchats acted effectively as a website traffic--driving tool. Most participants came from advocacy organizations (165/1000, 16.5\%) and other health care--related organizations (162/1000, 16.2\%), whereas others were unknown users (147/1000, 14.7\%) and individual users outside of the health care sector (117/1000, 11.7\%). The majority of participants were located in Texas, California, New York, and Florida, all states with high Latinx populations. Conclusions: Carefully planned, culturally relevant tweetchats such as \#SaludTues can be a powerful tool for public health practitioners and advocates to engage audiences on Twitter around health issues, advocacy, and policy solutions for Latino health equity. Further information is needed to determine the effect that \#SaludTues Tweetchats have on self- and collective efficacy for advocacy in the area of Latino health equity. ",
doi="10.2196/21266",
url="https://publichealth.jmir.org/2021/3/e21266",
url="http://www.ncbi.nlm.nih.gov/pubmed/33646131"
}


@Article{info:doi/10.2196/19239,
author="Chang, Leanne
and Chattopadhyay, Kaushik
and Li, Jialin
and Xu, Miao
and Li, Li",
title="Interplay of Support, Comparison, and Surveillance in Social Media Weight Management Interventions: Qualitative Study",
journal="JMIR Mhealth Uhealth",
year="2021",
month="Mar",
day="1",
volume="9",
number="3",
pages="e19239",
keywords="obesity",
keywords="social comparison",
keywords="social media",
keywords="social support",
keywords="surveillance",
keywords="weight control",
abstract="Background: There has been a significant increase in the trend of using social media as a platform to deliver weight management interventions. This illustrates a need to develop a holistic understanding of doctor-patient communication and peer-to-peer communication in social media interventions and to determine their influences on weight management for people with overweight or obesity. Such studies will highlight how social media can be more effectively integrated into weight management programs to enhance individuals' short-term and long-term weight management behaviors. Objective: The aim of this study was to examine patients' experiences with doctor-patient communication and peer interactions in a social media--based (WeChat) weight management program, and to describe the interplay of three social influence factors---social support, social comparison, and surveillance---in their weight control practices. The program, designed and implemented by the research team located in a tertiary referral hospital in a southeastern province in China, included both diet and physical activity components that targeted people with overweight or obesity. Methods: We conducted in-depth interviews with 32 program participants of different ages (mean  35.6, SD 7.7 years), gender (18 women), duration of program membership (mean 1.4 years), and weight loss outcomes (54\% weight loss to 9\% weight gain). All interview data were audio-recorded, transcribed, and translated using the translation-backtranslation technique. Nvivo software was used to facilitate the coding process. Results: Results of thematic analysis indicated the distinct functions of professionally led support and peer support. Professional support was presented in the form of knowledge infusion, efficacy enhancement, and provision of timely feedback. Peer support fostered empathy and sense of belonging, and had a mutually reinforcing relationship with peer comparison and peer-based surveillance. Peer comparison enhanced motivation and positive competition. However, it also reinforced negative group norms, and resulted in downturns in reference standards and collective inactivity. Social media surveillance prompted participants' reactions to the gaze from medical professionals and peers that could be encouraging or inhibiting. Surveillance enhanced vigilance with weight control norms; however, its influence weakened when participants chose to fake weight data and turn off notifications. Findings from this study illustrated the interrelated and fluctuating influences of support, comparison, and surveillance. Conclusions: The interactive traits of social media eased the practices of social support and social comparison, and created new forms of surveillance. This study contributes to an in-depth understanding of social media influences on individuals' weight control behaviors. Practical implications of the study concern improved strategies for maintaining the positive dynamics of social media interactions and preventing negative resistance to surveillance technology. Trial Registration: Chinese Clinical Trial Registry ChiCTR1900025861; http://www.chictr.org.cn/showprojen.aspx?proj=42497 ",
doi="10.2196/19239",
url="https://mhealth.jmir.org/2021/3/e19239",
url="http://www.ncbi.nlm.nih.gov/pubmed/33646130"
}


@Article{info:doi/10.2196/23720,
author="Hsing, C. Julianna
and Ma, Jasmin
and Barrero-Castillero, Alejandra
and Jani, G. Shilpa
and Pulendran, Palam Uma
and Lin, Bea-Jane
and Thomas-Uribe, Monika
and Wang, Jason C.",
title="Influence of Health Beliefs on Adherence to COVID-19 Preventative Practices: International, Social Media--Based Survey Study",
journal="J Med Internet Res",
year="2021",
month="Feb",
day="26",
volume="23",
number="2",
pages="e23720",
keywords="COVID-19 pandemic",
keywords="health belief model",
keywords="behavior change",
keywords="preventative health behaviors",
keywords="handwashing",
keywords="social distancing",
keywords="international",
keywords="online survey",
keywords="social media",
keywords="cross-sectional study",
abstract="Background: Health behavior is influenced by culture and social context. However, there are limited data evaluating the scope of these influences on COVID-19 response. Objective: This study aimed to compare handwashing and social distancing practices in different countries and evaluate practice predictors using the health belief model (HBM). Methods: From April 11 to May 1, 2020, we conducted an online, cross-sectional survey disseminated internationally via social media. Participants were adults aged 18 years or older from four different countries: the United States, Mexico, Hong Kong (China), and Taiwan. Primary outcomes were self-reported handwashing and social distancing practices during COVID-19. Predictors included constructs of the HBM: perceived susceptibility, perceived severity, perceived benefits, perceived barriers, self-efficacy, and cues to action. Associations of these constructs with behavioral outcomes were assessed by multivariable logistic regression. Results: We analyzed a total of 71,851 participants, with 3070 from the United States, 3946 from Mexico, 1201 from Hong Kong (China), and 63,634 from Taiwan. Of these countries, respondents from the United States adhered to the most social distancing practices ($\chi$23=2169.7, P<.001), while respondents from Taiwan performed the most handwashing ($\chi$23=309.8, P<.001). Multivariable logistic regression analyses indicated that self-efficacy was a positive predictor for handwashing (odds ratio [OR]United States 1.58, 95\% CI 1.21-2.07; ORMexico 1.5, 95\% CI 1.21-1.96; ORHong Kong 2.48, 95\% CI 1.80-3.44; ORTaiwan 2.30, 95\% CI 2.21-2.39) and social distancing practices (ORUnited States 1.77, 95\% CI 1.24-2.49; ORMexico 1.77, 95\% CI 1.40-2.25; ORHong Kong 3.25, 95\% CI 2.32-4.62; ORTaiwan 2.58, 95\% CI 2.47-2.68) in all countries. Handwashing was positively associated with perceived susceptibility in Mexico, Hong Kong, and Taiwan, while social distancing was positively associated with perceived severity in the United States, Mexico, and Taiwan. Conclusions: Social media recruitment strategies can be used to reach a large audience during a pandemic. Self-efficacy was the strongest predictor for handwashing and social distancing. Policies that address relevant health beliefs can facilitate adoption of necessary actions for preventing COVID-19. Our findings may be explained by the timing of government policies, the number of cases reported in each country, individual beliefs, and cultural context. ",
doi="10.2196/23720",
url="https://www.jmir.org/2021/2/e23720",
url="http://www.ncbi.nlm.nih.gov/pubmed/33571103"
}


@Article{info:doi/10.2196/19134,
author="Niu, Zhaomeng
and Willoughby, Jessica
and Zhou, Rongting",
title="Associations of Health Literacy, Social Media Use, and Self-Efficacy With Health Information--Seeking Intentions Among Social Media Users in China: Cross-sectional Survey",
journal="J Med Internet Res",
year="2021",
month="Feb",
day="25",
volume="23",
number="2",
pages="e19134",
keywords="behavioral intention",
keywords="health literacy",
keywords="self-efficacy",
keywords="social media",
abstract="Background: Empirical research has demonstrated that people frequently use social media for gathering and sharing online health information. Health literacy, social media use, and self-efficacy are important factors that may influence people's health behaviors online. Objective: We aimed to examine the associations between health literacy, health-related social media use, self-efficacy, and health behavioral intentions online. Methods: We conducted a cross-sectional survey of adults 18 years and older (n=449) to examine predictors of health-related behavioral intentions online including health literacy, social media use, and self-efficacy in China using 2 moderated mediation models. Mediation and moderation analyses were conducted. Results: Self-efficacy mediated the effects of health literacy (Bindirect=0.213, 95\% CI 0.101 to 0.339) and social media use (Bindirect=0.023, 95\% CI 0.008 to 0.045) on health behavioral intentions on social media. Age moderated the effects of health literacy on self-efficacy (P=.03), while previous experience moderated the effects of social media use on self-efficacy (P<.001). Conclusions: Health literacy and health-related social media use influenced health behavioral intentions on social media via their prior effects on self-efficacy. The association between health literacy and self-efficacy was stronger among younger respondents, whereas the association between health-related social media use and self-efficacy was stronger among those who previously had positive experiences with health information on social media. Health practitioners should target self-efficacy among older populations and increase positive media experience related to health. ",
doi="10.2196/19134",
url="https://www.jmir.org/2021/2/e19134",
url="http://www.ncbi.nlm.nih.gov/pubmed/33629955"
}


@Article{info:doi/10.2196/22975,
author="Yan, Qi
and Jensen, J. Katherine
and Thomas, Rose
and Field, R. Alyssa
and Jiang, Zheng
and Goei, Christian
and Davies, G. Mark",
title="Digital Footprint of Academic Vascular Surgeons in the Southern United States on Physician Rating Websites: Cross-sectional Evaluation Study",
journal="JMIR Cardio",
year="2021",
month="Feb",
day="24",
volume="5",
number="1",
pages="e22975",
keywords="internet",
keywords="patient satisfaction",
keywords="quality of care",
keywords="physician rating sites",
keywords="patient experience",
keywords="professional reviews",
keywords="social media",
abstract="Background: The internet has become a popular platform for patients to obtain information and to review the health care providers they interact with. However, little is known about the digital footprint of vascular surgeons and their interactions with patients on social media. Objective: This study aims to understand the activity of academic vascular surgeons on physician rating websites. Methods: Information on attending vascular surgeons affiliated with vascular residency or with fellowships in the Southern Association for Vascular Surgery (SAVS) was collected from public sources. A listing of websites containing physician ratings was obtained via literature reviews and Google search. Open access websites with either qualitative or quantitative evaluations of vascular surgeons were included. Closed access websites were excluded. Ranking scores from each website were converted to a standard 5-point scale for comparison. Results: A total of 6238 quantitative and 967 qualitative reviews were written for 287 physicians (236 males, 82.2\%) across 16 websites that met the inclusion criteria out of the 62 websites screened. The surgeons affiliated with the integrated vascular residency and vascular fellowship programs in SAVS had a median of 8 (IQR 7-10) profiles across 16 websites, with only 1 surgeon having no web presence in any of the websites. The median number of quantitative ratings for each physician was 17 (IQR 6-34, range 1-137) and the median number of narrative reviews was 3 (IQR 2-6, range 1-28). Vitals, WebMD, and Healthgrades were the only 3 websites where over a quarter of the physicians were rated, and those rated had more than 5 ratings on average. The median score for the quantitative reviews was 4.4 (IQR 4.0-4.9). Most narrative reviews (758/967, 78.4\%) were positive, but 20.2\% (195/967) were considered negative; only 1.4\% (14/967) were considered equivocal. No statistical difference was found in the number of quantitative reviews or in the overall average score in the physician ratings between physicians with social media profiles and those without social media profiles (departmental social media profile: median 23 vs 15, respectively, P=.22; personal social media profile: median 19 vs 14, respectively, P=.08). Conclusions: The representation of vascular surgeons on physician rating websites is varied, with the majority of the vascular surgeons represented only in half of the physician rating websites The number of quantitative and qualitative reviews for academic vascular surgeons is low. No vascular surgeon responded to any of the reviews. The activity of vascular surgeons in this area of social media is low and reflects only a small digital footprint that patients can reach and review. ",
doi="10.2196/22975",
url="https://cardio.jmir.org/2021/1/e22975",
url="http://www.ncbi.nlm.nih.gov/pubmed/33625359"
}


@Article{info:doi/10.2196/22854,
author="Moseson, Heidi
and Wollum, Alexandra
and Seymour, W. Jane
and Zuniga, Carmela
and Thompson, Terri-Ann
and Gerdts, Caitlin",
title="Comparison of Facebook, Google Ads, and Reddit for the Recruitment of People Who Considered but Did Not Obtain Abortion Care in the United States: Cross-sectional Survey",
journal="JMIR Form Res",
year="2021",
month="Feb",
day="24",
volume="5",
number="2",
pages="e22854",
keywords="abortion, induced",
keywords="abortion seekers",
keywords="abortion surveys",
keywords="bias, selection",
keywords="pregnancy, unplanned",
keywords="research subject recruitment",
keywords="reproductive health",
keywords="social media",
keywords="social stigma",
abstract="Background: In the United States, abortion access is restricted by numerous logistical, financial, social, and policy barriers. Most studies on abortion-seeking experiences in the United States have recruited participants from abortion clinics. However, clinic-based recruitment strategies fail to capture the experiences of people who consider an abortion but do not make it to an abortion clinic. Research indicates that many people search for abortion information on the web; however, web-based recruitment remains underutilized in abortion research. Objective: This study aims to establish the feasibility of using Facebook, Google Ads, and Reddit as recruitment platforms for a study on abortion-seeking experiences in the United States. Methods: From August to September 2018, we posted recruitment advertisements for a survey about abortion-seeking experiences through Facebook, Google Ads, and Reddit. Eligible participants were US residents aged 15-49 years who had been pregnant in the past 5 years and had considered abortion for a pregnancy in this period but did not abort. For each platform, we recorded staff time to develop advertisements and manage recruitment, as well as costs related to advertisement buys and social marketing firm support. We summarized the number of views and clicks for each advertisement where possible, and we calculated metrics related to cost per recruited participant and recruitment rate by week for each platform. We assessed differences across platforms using the chi-square and Kruskal-Wallis tests. Results: Overall, study advertisements received 77,464 views in the 1-month period (from Facebook and Google; information not available for Reddit) and 2808 study page views. After clicking on the advertisements, there were 1254 initiations of the eligibility screening survey, which resulted in 98 eligible survey participants (75 recruited from Facebook, 14 from Google Ads, and 9 from Reddit). The cost for each eligible participant in each platform was US \$49.48 for Facebook, US \$265.93 for Google Ads, and US \$182.78 for Reddit. A total of 84\% (66/79) of those who screened eligible from Facebook completed the short survey compared with 73\% (8/11) of those who screened eligible from Reddit and 13\% (7/53) of those who screened eligible from Google Ads. Conclusions: These results suggest that Facebook advertisements may be the most time- and cost-effective strategy to recruit people who considered but did not obtain an abortion in the United States. Adapting and implementing Facebook-based recruitment strategies for research on abortion access could facilitate a more complete understanding of the barriers to abortion care in the United States. ",
doi="10.2196/22854",
url="https://formative.jmir.org/2021/2/e22854",
url="http://www.ncbi.nlm.nih.gov/pubmed/33625368"
}


@Article{info:doi/10.2196/24737,
author="Bressler, Y. Moshe
and Grudnikoff, Eugene
and Bressler, Yaakov
and Tamez, Rebecca
and Zampella, G. John",
title="Risks and Benefits of Using Social Media in Dermatology: Cross-sectional Questionnaire Study",
journal="JMIR Dermatol",
year="2021",
month="Feb",
day="24",
volume="4",
number="1",
pages="e24737",
keywords="social media",
keywords="dermatologist",
keywords="generational differences",
keywords="Instagram",
keywords="Facebook",
keywords="information quality",
keywords="patient education",
keywords="online content",
keywords="risk",
keywords="benefit",
keywords="dermatology",
keywords="cross-sectional",
keywords="survey",
keywords="online health information",
abstract="Background: Dermatological information on social media is often presented by nondermatologists. Increasing the online engagement of trained dermatologists may improve information quality, patient education, and care. Objective: Our study assesses dermatologists' perceptions of social media and patterns of use to identify barriers limiting engagement. Methods: In our cohort study, a 36-item online survey was distributed to dermatologists in the United States; responses were captured on a 1-100 sliding scale. Results: Of 166 initiated surveys, 128 valid responses were submitted. Dermatologists showed greater concern for social media risk-related issues (mean 77.9, SD 15.1) than potential benefits (mean 61.8, SD 16.4; P<.001). Leading concerns were poor patient care, nonevidence-based information, and breaching patient privacy. Benefits included interphysician collaboration, patient education, and public health awareness. The most avid and enthusiastic social media users were millennials (mean total optimism score 67.5, SD 14.9) and baby boomers (mean total optimism score 63.1, SD 11.2) compared with Generation X dermatologists (mean total optimism score 52.2, SD 16.3, P<.001). Of 128 dermatologists, 103 (82.4\%) plan on increasing their social media use (P=.003). Predictors showing an intent to increase future social media use were younger age, integration into professional use, and an optimistic view (r2=.39; P<.001). Conclusions: Dermatologists perceive the risk of social media to be considerable but still intend to increase its use, likely recognizing the value and importance of social media to the field. ",
doi="10.2196/24737",
url="https://derma.jmir.org/2021/1/e24737",
url="http://www.ncbi.nlm.nih.gov/pubmed/37632799"
}


@Article{info:doi/10.2196/23957,
author="Zheng, Chengda
and Xue, Jia
and Sun, Yumin
and Zhu, Tingshao",
title="Public Opinions and Concerns Regarding the Canadian Prime Minister's Daily COVID-19 Briefing: Longitudinal Study of YouTube Comments Using Machine Learning Techniques",
journal="J Med Internet Res",
year="2021",
month="Feb",
day="23",
volume="23",
number="2",
pages="e23957",
keywords="Canada",
keywords="PM Trudeau",
keywords="YouTube",
keywords="machine learning",
keywords="big data",
keywords="infodemiology",
keywords="infodemic",
keywords="public concerns",
keywords="communication",
keywords="concern",
keywords="social media",
keywords="video",
abstract="Background: During the COVID-19 pandemic in Canada, Prime Minister Justin Trudeau provided updates on the novel coronavirus and the government's responses to the pandemic in his daily briefings from March 13 to May 22, 2020, delivered on the official Canadian Broadcasting Corporation (CBC) YouTube channel. Objective: The aim of this study was to examine comments on Canadian Prime Minister Trudeau's COVID-19 daily briefings by YouTube users and track these comments to extract the changing dynamics of the opinions and concerns of the public over time. Methods: We used machine learning techniques to longitudinally analyze a total of 46,732 English YouTube comments that were retrieved from 57 videos of Prime Minister Trudeau's COVID-19 daily briefings from March 13 to May 22, 2020. A natural language processing model, latent Dirichlet allocation, was used to choose salient topics among the sampled comments for each of the 57 videos. Thematic analysis was used to classify and summarize these salient topics into different prominent themes. Results: We found 11 prominent themes, including strict border measures, public responses to Prime Minister Trudeau's policies, essential work and frontline workers, individuals' financial challenges, rental and mortgage subsidies, quarantine, government financial aid for enterprises and individuals, personal protective equipment, Canada and China's relationship, vaccines, and reopening. Conclusions: This study is the first to longitudinally investigate public discourse and concerns related to Prime Minister Trudeau's daily COVID-19 briefings in Canada. This study contributes to establishing a real-time feedback loop between the public and public health officials on social media. Hearing and reacting to real concerns from the public can enhance trust between the government and the public to prepare for future health emergencies. ",
doi="10.2196/23957",
url="https://www.jmir.org/2021/2/e23957",
url="http://www.ncbi.nlm.nih.gov/pubmed/33544690"
}


@Article{info:doi/10.2196/26302,
author="Wang, Hanyin
and Li, Yikuan
and Hutch, Meghan
and Naidech, Andrew
and Luo, Yuan",
title="Using Tweets to Understand How COVID-19--Related Health Beliefs Are Affected in the Age of Social Media: Twitter Data Analysis Study",
journal="J Med Internet Res",
year="2021",
month="Feb",
day="22",
volume="23",
number="2",
pages="e26302",
keywords="COVID-19",
keywords="social media",
keywords="health belief",
keywords="Twitter",
keywords="infodemic",
keywords="infodemiology",
keywords="machine learning",
keywords="natural language processing",
abstract="Background: The emergence of SARS-CoV-2 (ie, COVID-19) has given rise to a global pandemic affecting 215 countries and over 40 million people as of October 2020. Meanwhile, we are also experiencing an infodemic induced by the overabundance of information, some accurate and some inaccurate, spreading rapidly across social media platforms. Social media has arguably shifted the information acquisition and dissemination of a considerably large population of internet users toward higher interactivities. Objective: This study aimed to investigate COVID-19-related health beliefs on one of the mainstream social media platforms, Twitter, as well as potential impacting factors associated with fluctuations in health beliefs on social media. Methods: We used COVID-19-related posts from the mainstream social media platform Twitter to monitor health beliefs. A total of 92,687,660 tweets corresponding to 8,967,986 unique users from January 6 to June 21, 2020, were retrieved. To quantify health beliefs, we employed the health belief model (HBM) with four core constructs: perceived susceptibility, perceived severity, perceived benefits, and perceived barriers. We utilized natural language processing and machine learning techniques to automate the process of judging the conformity of each tweet with each of the four HBM constructs. A total of 5000 tweets were manually annotated for training the machine learning architectures. Results: The machine learning classifiers yielded areas under the receiver operating characteristic curves over 0.86 for the classification of all four HBM constructs. Our analyses revealed a basic reproduction number R0 of 7.62 for trends in the number of Twitter users posting health belief--related content over the study period. The fluctuations in the number of health belief--related tweets could reflect dynamics in case and death statistics, systematic interventions, and public events. Specifically, we observed that scientific events, such as scientific publications, and nonscientific events, such as politicians' speeches, were comparable in their ability to influence health belief trends on social media through a Kruskal-Wallis test (P=.78 and P=.92 for perceived benefits and perceived barriers, respectively). Conclusions: As an analogy of the classic epidemiology model where an infection is considered to be spreading in a population with an R0 greater than 1, we found that the number of users tweeting about COVID-19 health beliefs was amplifying in an epidemic manner and could partially intensify the infodemic. It is ``unhealthy'' that both scientific and nonscientific events constitute no disparity in impacting the health belief trends on Twitter, since nonscientific events, such as politicians' speeches, might not be endorsed by substantial evidence and could sometimes be misleading. ",
doi="10.2196/26302",
url="https://www.jmir.org/2021/2/e26302",
url="http://www.ncbi.nlm.nih.gov/pubmed/33529155"
}


@Article{info:doi/10.2196/24429,
author="Reuter, Katja
and Wilson, L. Melissa
and Moran, Meghan
and Le, NamQuyen
and Angyan, Praveen
and Majmundar, Anuja
and Kaiser, M. Elsi
and Unger, B. Jennifer",
title="General Audience Engagement With Antismoking Public Health Messages Across Multiple Social Media Sites: Comparative Analysis",
journal="JMIR Public Health Surveill",
year="2021",
month="Feb",
day="19",
volume="7",
number="2",
pages="e24429",
keywords="affordance",
keywords="digital",
keywords="dissemination of science",
keywords="Facebook",
keywords="health communication",
keywords="health promotion",
keywords="Instagram",
keywords="online",
keywords="smoking",
keywords="social media",
keywords="tobacco",
keywords="Twitter",
keywords="user engagement",
abstract="Background: Public health organizations have begun to use social media to increase awareness of health harm and positively improve health behavior. Little is known about effective strategies to disseminate health education messages digitally and ultimately achieve optimal audience engagement. Objective: This study aims to assess the difference in audience engagement with identical antismoking health messages on three social media sites (Twitter, Facebook, and Instagram) and with a referring link to a tobacco prevention website cited in these messages. We hypothesized that health messages might not receive the same user engagement on these media, although these messages were identical and distributed at the same time. Methods: We measured the effect of health promotion messages on the risk of smoking among users of three social media sites (Twitter, Facebook, and Instagram) and disseminated 1275 health messages between April 19 and July 12, 2017 (85 days). The identical messages were distributed at the same time and as organic (unpaid) and advertised (paid) messages, each including a link to an educational website with more information about the topic. Outcome measures included message engagement (ie, the click-through rate [CTR] of the social media messages) and educational website engagement (ie, the CTR on the educational website [wCTR]). To analyze the data and model relationships, we used mixed effects negative binomial regression, z-statistic, and the Hosmer-Lemeshow goodness-of-fit test. Results: Comparisons between social media sites showed that CTRs for identical antitobacco health messages differed significantly across social media (P<.001 for all). Instagram showed the statistically significant highest overall mean message engagement (CTR=0.0037; 95\% CI 0.0032-0.0042), followed by Facebook (CTR=0.0026; 95\% CI 0.0022-0.0030) and Twitter (CTR=0.0015; 95\% CI 0.0013-0.0017). Facebook showed the highest as well as the lowest CTR for any individual message. However, the message CTR is not indicative of user engagement with the educational website content. Pairwise comparisons of the social media sites differed with respect to the wCTR (P<.001 for all). Messages on Twitter showed the lowest CTR, but they resulted in the highest level of website engagement (wCTR=0.6308; 95\% CI 0.5640-0.6975), followed by Facebook (wCTR=0.2213; 95\% CI 0.1932-0.2495) and Instagram (wCTR=0.0334; 95\% CI 0.0230-0.0438). We found a statistically significant higher CTR for organic (unpaid) messages (CTR=0.0074; 95\% CI 0.0047-0.0100) compared with paid advertisements (CTR=0.0022; 95\% CI 0.0017-0.0027; P<.001 and P<.001, respectively). Conclusions: Our study provides evidence-based insights to guide the design of health promotion efforts on social media. Future studies should examine the platform-specific impact of psycholinguistic message variations on user engagement, include newer sites such as Snapchat and TikTok, and study the correlation between web-based behavior and real-world health behavior change. The need is urgent in light of increased health-related marketing and misinformation on social media. ",
doi="10.2196/24429",
url="http://publichealth.jmir.org/2021/2/e24429/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33605890"
}


@Article{info:doi/10.2196/23168,
author="Sasikumar, Smriti
and Sulaiman, Omer Hafsa
and Bedi, Simran
and Nozdrin, Mikhail
and Rundell, Caroline
and Zaman, Sadia",
title="Quality of Information and Future Directions. Comment on ``Influence of Mass and Social Media on Psychobehavioral Responses Among Medical Students During the Downward Trend of COVID-19 in Fujian, China: Cross-Sectional Study''",
journal="J Med Internet Res",
year="2021",
month="Feb",
day="18",
volume="23",
number="2",
pages="e23168",
keywords="COVID-19",
keywords="social media",
keywords="mass media",
keywords="information quality",
doi="10.2196/23168",
url="https://www.jmir.org/2021/2/e23168",
url="http://www.ncbi.nlm.nih.gov/pubmed/33599623"
}


@Article{info:doi/10.2196/13731,
author="Reuter, Katja
and Lee, Delphine",
title="Perspectives Toward Seeking Treatment Among Patients With Psoriasis: Protocol for a Twitter Content Analysis",
journal="JMIR Res Protoc",
year="2021",
month="Feb",
day="18",
volume="10",
number="2",
pages="e13731",
keywords="infodemiology",
keywords="infoveillance",
keywords="internet",
keywords="surveillance",
keywords="patient opinion",
keywords="psoriasis, treatment",
keywords="Twitter",
keywords="social media",
keywords="social network",
abstract="Background: Psoriasis is an autoimmune disease estimated to affect more than 6 million adults in the United States. It poses a significant public health problem and contributes to rising health care costs, affecting people's quality of life and ability to work. Previous research showed that nontreatment and undertreatment of patients with psoriasis remain a significant problem. Perspectives of patients toward seeking psoriasis treatment are understudied. Social media offers a new data source of user-generated content. Researchers suggested that the social network Twitter may serve as a rich avenue for exploring how patients communicate about their health issues. Objective: The objective of this study is to conduct a content analysis of Twitter posts (in English) published by users in the United States between February 1, 2016, and October 31, 2018, to examine perspectives that potentially influence the treatment decision among patients with psoriasis. Methods: User-generated Twitter posts that include keywords related to psoriasis will be analyzed using text classifiers to identify themes related to the research questions. We will use Symplur Signals, a health care social media analytics platform, to access the Twitter data. We will use descriptive statistics to analyze the data and identify the most prevalent topics in the Twitter content among people with psoriasis. Results: This study is supported by the National Center for Advancing Translational Science through a Clinical and Translational Science Award award. Study approval was obtained from the institutional review board at the University of Southern California. Data extraction and cleaning are complete. For the time period from February 1, 2016, to October 31, 2018, we obtained 95,040 Twitter posts containing terms related to ``psoriasis'' from users in the United States published in English. After removing duplicates, retweets, and non-English tweets, we found that 75.51\% (52,301/69,264) of the psoriasis-related posts were sent by commercial or bot-like accounts, while 16,963 posts were noncommercial and will be included in the analysis to assess the patient perspective. Analysis was completed in Summer 2020. Conclusions: This protocol paper provides a detailed description of a social media research project including the process of data extraction, cleaning, and analysis. It is our goal to contribute to the development of more transparent social media research efforts. Our findings will shed light on whether Twitter provides a promising data source for garnering patient perspective data about psoriasis treatment decisions. The data will also help to determine whether Twitter might serve as a potential outreach platform for raising awareness of psoriasis and treatment options among patients and implementing related health interventions. International Registered Report Identifier (IRRID): DERR1-10.2196/13731 ",
doi="10.2196/13731",
url="http://www.researchprotocols.org/2021/2/e13731/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33599620"
}


@Article{info:doi/10.2196/23826,
author="Han, Madeline
and Tan, Yi Xin
and Lee, Rachael
and Lee, Kyu Jeong
and Mahendran, Rathi",
title="Impact of Social Media on Health-Related Outcomes Among Older Adults in Singapore: Qualitative Study",
journal="JMIR Aging",
year="2021",
month="Feb",
day="17",
volume="4",
number="1",
pages="e23826",
keywords="aging",
keywords="social media",
keywords="health",
keywords="qualitative research",
keywords="communication",
keywords="mobile phone",
abstract="Background: The worldwide spread of digitalization has led to the harnessing of technology to improve health outcomes. Paying attention to older adults' social needs via social media is one way to promote healthy aging. Although 56\% of older adults are smartphone users, little is known about their use patterns of social media. Objective: This exploratory study aims to determine the experiences of social media apps' use among older adults in Singapore and understand their perceptions of its impact on health-related outcomes. Methods: This study used a qualitative research design with an interpretative approach. Using maximum variation purposive sampling, normal aging older adults (N=16) who were aged between 60 and 80 years and experienced in the use of internet-enabled technology were recruited from an existing community study. Semistructured, in-depth interviews were conducted. Employing a thematic analysis, interviews were transcribed verbatim and analyzed for codes inductively. Results: The following themes and subthemes were identified as key moderators of older adults' experiences on social media apps: (1) personal attitudes: participants were encouraged to use social media due to the increased accessibility, which enabled the ease of contact, but perceptions that the quality of interactions was compromised and its associated risks reduced their use; and (2) social influences: the desire to bond with co-users and the availability of support increased use. In addition, use of social media apps was perceived to positively impact health through its ability to keep older adults cognitively engaged, improve health communication, and increase social connectedness. However, opinions remained mixed on older adults' vulnerability to social media addiction. Conclusions: Personal and social contexts determine older adults' social media use. This study's findings provide practical insights into how social media can be deployed to improve health-related outcomes in older adults. ",
doi="10.2196/23826",
url="http://aging.jmir.org/2021/1/e23826/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33595437"
}


@Article{info:doi/10.2196/20898,
author="Hirvonen, Maija
and Purcell, Carrie
and Elliott, Lawrie
and Bailey, V. Julia
and Simpson, Anne Sharon
and McDaid, Lisa
and Moore, Laurence
and Mitchell, Rebecca Kirstin
and ",
title="Peer-to-Peer Sharing of Social Media Messages on Sexual Health in a School-Based Intervention: Opportunities and Challenges Identified in the STASH Feasibility Trial",
journal="J Med Internet Res",
year="2021",
month="Feb",
day="16",
volume="23",
number="2",
pages="e20898",
keywords="social media",
keywords="sexual health",
keywords="sex education",
keywords="peer education",
keywords="process evaluation",
keywords="school",
keywords="feasibility studies",
keywords="adolescent",
keywords="social networking",
abstract="Background: There is a strong interest in the use of social media to spread positive sexual health messages through social networks of young people. However, research suggests that this potential may be limited by a reluctance to be visibly associated with sexual health content on the web or social media and by the lack of trust in the veracity of peer sources. Objective: The aim of this study was to investigate opportunities and challenges of using social media to facilitate peer-to-peer sharing of sexual health messages within the context of STASH (Sexually Transmitted Infections and Sexual Health), a secondary school-based and peer-led sexual health intervention. Methods: Following training, and as a part of their role, student-nominated peer supporters (aged 14-16 years) invited school friends to trainer-monitored, private Facebook groups. Peer supporters posted curated educational sex and relationship content within these groups. Data came from a feasibility study of the STASH intervention in 6 UK schools. To understand student experiences of the social media component, we used data from 11 semistructured paired and group interviews with peer supporters and their friends (collectively termed students; n=42, aged 14-16 years), a web-based postintervention questionnaire administered to peer supporters (n=88), and baseline and follow-up questionnaires administered to students in the intervention year group (n=680 and n=603, respectively). We carried out a thematic analysis of qualitative data and a descriptive analysis of quantitative data. Results: Message sharing by peer supporters was hindered by variable engagement with Facebook. The trainer-monitored and private Facebook groups were acceptable to student members (peer supporters and their friends) and reassuring to peer supporters but led to engagement that ran parallel to---rather than embedded in---their routine social media use. The offline context of a school-based intervention helped legitimate and augment Facebook posts; however, even where friends were receptive to STASH messages, they did not necessarily engage visibly on social media. Preferences for content design varied; however, humor, color, and text brevity were important. Preferences for social media versus offline message sharing varied. Conclusions: Invitation-only social media groups formed around peer supporters' existing friendship networks hold potential for diffusing messages in peer-based sexual health interventions. Ideally, interactive opportunities should not be limited to single social media platforms and should run alongside offline conversations. There are tensions between offering young people autonomy to engage flexibly and authentically and the need for adult oversight of activities for information accuracy and safeguarding. ",
doi="10.2196/20898",
url="http://www.jmir.org/2021/2/e20898/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33591287"
}


@Article{info:doi/10.2196/23960,
author="Zheng, Katherine
and George, Maureen
and Roehlkepartain, Eugene
and Santelli, John
and Bruzzese, Jean-Marie
and Smaldone, Arlene",
title="Developmental Assets of Adolescents and Young Adults With Chronic Illness and Comorbid Depression: Qualitative Study Using YouTube",
journal="JMIR Ment Health",
year="2021",
month="Feb",
day="16",
volume="8",
number="2",
pages="e23960",
keywords="adolescent development",
keywords="chronic disease",
keywords="depression",
keywords="developmental assets",
keywords="positive youth development",
keywords="YouTube",
abstract="Background: Developmental assets provide a framework for optimizing development among adolescents but have not been studied in adolescents with chronic illness and comorbid depression, which is a group at risk for poor health outcomes. YouTube postings provide valuable insights to understand this understudied population. Objective: This study aims to explore asset development from the perspectives of adolescents and young adults (AYAs) with chronic illness and comorbid depression. Methods: YouTube was searched using 12 chronic illnesses (eg, diabetes) coupled with ``depression'' as keywords. Videos were included if they were uploaded by AYAs aged between 11 and 29 years and discussed living with chronic illness and depression during adolescence. Video transcripts were coded deductively for 40 internal and external assets that constitute the Developmental Assets Framework. Categories not captured by deductive coding were identified using conventional content analysis. Categories and their respective assets were labeled as being discussed either negatively or positively. Results: In total, 31 videos from 16 AYAs met the inclusion criteria. A total of 7 asset categories, support, constructive use of time, boundaries and expectations (external assets), identity, commitment to learning, positive values, and social competence (internal assets), reflecting 25 (13 internal; 12 external) assets, were discussed. Internal assets, particularly relating to identity, were commonly discussed by AYAs either in a negative way or fluctuated between positive and negative perspectives. Conclusions: In this sample of AYAs with chronic illness and comorbid depression, internal assets were commonly discussed in a negative way. Future research is needed to better understand how assets develop and if the Developmental Assets Framework adequately represents the experiences of this population. ",
doi="10.2196/23960",
url="http://mental.jmir.org/2021/2/e23960/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33591288"
}


@Article{info:doi/10.2196/16348,
author="Hassan, Lamiece
and Nenadic, Goran
and Tully, Patricia Mary",
title="A Social Media Campaign (\#datasaveslives) to Promote the Benefits of Using Health Data for Research Purposes: Mixed Methods Analysis",
journal="J Med Internet Res",
year="2021",
month="Feb",
day="16",
volume="23",
number="2",
pages="e16348",
keywords="social media",
keywords="public engagement",
keywords="social network analysis",
keywords="medical research",
abstract="Background: Social media provides the potential to engage a wide audience about scientific research, including the public. However, little empirical research exists to guide health scientists regarding what works and how to optimize impact. We examined the social media campaign \#datasaveslives established in 2014 to highlight positive examples of the use and reuse of health data in research. Objective: This study aims to examine how the \#datasaveslives hashtag was used on social media, how often, and by whom; thus, we aim to provide insights into the impact of a major social media campaign in the UK health informatics research community and further afield. Methods: We analyzed all publicly available posts (tweets) that included the hashtag \#datasaveslives (N=13,895) on the microblogging platform Twitter between September 1, 2016, and August 31, 2017. Using a combination of qualitative and quantitative analyses, we determined the frequency and purpose of tweets. Social network analysis was used to analyze and visualize tweet sharing (retweet) networks among hashtag users. Results: Overall, we found 4175 original posts and 9720 retweets featuring \#datasaveslives by 3649 unique Twitter users. In total, 66.01\% (2756/4175) of the original posts were retweeted at least once. Higher frequencies of tweets were observed during the weeks of prominent policy publications, popular conferences, and public engagement events. Cluster analysis based on retweet relationships revealed an interconnected series of groups of \#datasaveslives users in academia, health services and policy, and charities and patient networks. Thematic analysis of tweets showed that \#datasaveslives was used for a broader range of purposes than indexing information, including event reporting, encouraging participation and action, and showing personal support for data sharing. Conclusions: This study shows that a hashtag-based social media campaign was effective in encouraging a wide audience of stakeholders to disseminate positive examples of health research. Furthermore, the findings suggest that the campaign supported community building and bridging practices within and between the interdisciplinary sectors related to the field of health data science and encouraged individuals to demonstrate personal support for sharing health data. ",
doi="10.2196/16348",
url="http://www.jmir.org/2021/2/e16348/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33591280"
}


@Article{info:doi/10.2196/26392,
author="Basch, H. Corey
and Fera, Joseph
and Pierce, Isabela
and Basch, E. Charles",
title="Promoting Mask Use on TikTok: Descriptive, Cross-sectional Study",
journal="JMIR Public Health Surveill",
year="2021",
month="Feb",
day="12",
volume="7",
number="2",
pages="e26392",
keywords="TikTok",
keywords="COVID-19",
keywords="social media",
keywords="infodemiology",
keywords="infoveillance",
keywords="mask use",
keywords="prevention",
keywords="promotion",
keywords="communication",
keywords="public health",
keywords="cross-sectional",
keywords="content analysis",
keywords="transmission",
abstract="Background: Over the past decade, there has been an increasing secular trend in the number of studies on social media and health. Objective: The purpose of this cross-sectional study was to examine the content and characteristics of TikTok videos that are related to an important aspect of community mitigation---the use of masks as a method for interrupting the transmission of SARS-CoV-2. Methods: In total, 100 trending videos with the hashtag \#WearAMask (ie, a campaign on TikTok), along with 32 videos that were posted by the World Health Organization (WHO) and involved masks in any way (ie, all related WHO videos at the time of this study), were included in our sample. We collected the metadata of each post, and created content categories based on fact sheets that were provided by the WHO and the US Centers for Disease Control and Prevention. We used these fact sheets to code the characteristics of mask use. Results: Videos that were posted on TikTok and had the hashtag \#WearAMask garnered almost 500 million views, and videos that were posted by the WHO garnered almost 57 million views. Although the ratio of the number of trending \#WearAMask videos to the number of WHO videos was around 3:1, the \#WearAMask videos received almost 10 times as many cumulative views as the WHO videos. In total, 68\% (68/100) of the trending \#WearAMask videos involved humor and garnered over 355 million cumulative views. However, only 9\% (3/32) of the WHO videos involved humor. Furthermore, 27\% (27/100) of the trending \#WearAMask videos involved dance and garnered over 130 million cumulative views, whereas none of the WHO videos involved dance. Conclusions: This study is one of the first to describe how TikTok is being used to mitigate the community spread of COVID-19 by promoting mask use. Due to the platform's incredible reach, TikTok has great potential in conveying important public health messages to various segments of the population. ",
doi="10.2196/26392",
url="http://publichealth.jmir.org/2021/2/e26392/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33523823"
}


@Article{info:doi/10.2196/26200,
author="Payton, Ashley
and Woo, P. Benjamin K.",
title="Instagram Content Addressing Pruritic Urticarial Papules and Plaques of Pregnancy: Observational Study",
journal="JMIR Dermatol",
year="2021",
month="Feb",
day="11",
volume="4",
number="1",
pages="e26200",
keywords="pruritic urticarial papules and plaques of pregnancy",
keywords="dermatology",
keywords="rash",
keywords="pregnancy",
keywords="obstetrics",
keywords="dermatosis",
keywords="Instagram",
keywords="social media",
keywords="patient education",
abstract="Background: Pruritic urticarial papules and plaques of pregnancy (PUPPP) is the most commonly diagnosed pregnancy-specific dermatosis. It presents with intense pruritus and can be difficult to manage, which encourages mothers to look to social media for camaraderie and advice. Objective: This study aimed to characterize the sources and thematic content of Instagram posts in order to define influential groups of users. Our goal was to determine the status of online discourse surrounding PUPPP and elucidate any potential space for health care provider intervention via creation of Instagram accounts dedicated to information dissemination for patient populations. Methods: Three hashtag categories were selected (\#PUPPP, \#PUPPPs, and \#PUPPPrash), and the top public posts from each were analyzed and organized by source and by thematic content. The numbers of likes and comments were also recorded. Results: Among the top 150 posts in each hashtag category, only 428 posts in total were eligible for this analysis. Majority (316/428, 73.8\%) of posts were created by mothers who experienced PUPPP. These posts were testimonial accounts in nature. A small fraction of posts (14/428, 3.3\%) were generated by physician accounts. Posts from blogs with extensive followings garnered the most attention in the form of likes and comments. Conclusions: Mothers experiencing PUPPP comprised the majority of accounts posting under the hashtags selected. The most common themes included pictures of the rash and personal testimonies. Posts under blog posts received the most likes and comments on average. There is space for physician and health care specialists to improve their social media presence when it comes to discourse surrounding PUPPP. Patients are seeking out communities on social media, like Instagram, in order to have questions answered and obtain advice on management. Accounts with large followings tend to have more likes and more comments, which encourages information dissemination and awareness. Thus, we suggest that physicians create content and potentially partner with blog-type accounts to improve outreach. ",
doi="10.2196/26200",
url="http://derma.jmir.org/2021/1/e26200/",
url="http://www.ncbi.nlm.nih.gov/pubmed/37632847"
}


@Article{info:doi/10.2196/25431,
author="Jang, Hyeju
and Rempel, Emily
and Roth, David
and Carenini, Giuseppe
and Janjua, Zafar Naveed",
title="Tracking COVID-19 Discourse on Twitter in North America: Infodemiology Study Using Topic Modeling and Aspect-Based Sentiment Analysis",
journal="J Med Internet Res",
year="2021",
month="Feb",
day="10",
volume="23",
number="2",
pages="e25431",
keywords="COVID-19",
keywords="Twitter",
keywords="topic modeling",
keywords="aspect-based sentiment analysis",
keywords="racism",
keywords="anti-Asians",
keywords="Canada",
keywords="North America",
keywords="sentiment analysis",
keywords="social media",
keywords="discourse",
keywords="reaction",
keywords="public health",
abstract="Background: Social media is a rich source where we can learn about people's reactions to social issues. As COVID-19 has impacted people's lives, it is essential to capture how people react to public health interventions and understand their concerns. Objective: We aim to investigate people's reactions and concerns about COVID-19 in North America, especially in Canada. Methods: We analyzed COVID-19--related tweets using topic modeling and aspect-based sentiment analysis (ABSA), and interpreted the results with public health experts. To generate insights on the effectiveness of specific public health interventions for COVID-19, we compared timelines of topics discussed with the timing of implementation of interventions, synergistically including information on people's sentiment about COVID-19--related aspects in our analysis. In addition, to further investigate anti-Asian racism, we compared timelines of sentiments for Asians and Canadians. Results: Topic modeling identified 20 topics, and public health experts provided interpretations of the topics based on top-ranked words and representative tweets for each topic. The interpretation and timeline analysis showed that the discovered topics and their trend are highly related to public health promotions and interventions such as physical distancing, border restrictions, handwashing, staying home, and face coverings. After training the data using ABSA with human-in-the-loop, we obtained 545 aspect terms (eg, ``vaccines,'' ``economy,'' and ``masks'') and 60 opinion terms such as ``infectious'' (negative) and ``professional'' (positive), which were used for inference of sentiments of 20 key aspects selected by public health experts. The results showed negative sentiments related to the overall outbreak, misinformation and Asians, and positive sentiments related to physical distancing. Conclusions: Analyses using natural language processing techniques with domain expert involvement can produce useful information for public health. This study is the first to analyze COVID-19--related tweets in Canada in comparison with tweets in the United States by using topic modeling and human-in-the-loop domain-specific ABSA. This kind of information could help public health agencies to understand public concerns as well as what public health messages are resonating in our populations who use Twitter, which can be helpful for public health agencies when designing a policy for new interventions. ",
doi="10.2196/25431",
url="http://www.jmir.org/2021/2/e25431/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33497352"
}


@Article{info:doi/10.2196/18264,
author="Ma, Yiming
and Liang, Changyong
and Gu, Dongxiao
and Zhao, Shuping
and Yang, Xuejie
and Wang, Xiaoyu",
title="How Social Media Use at Work Affects Improvement of Older People's Willingness to Delay Retirement During Transfer From Demographic Bonus to Health Bonus: Causal Relationship Empirical Study",
journal="J Med Internet Res",
year="2021",
month="Feb",
day="10",
volume="23",
number="2",
pages="e18264",
keywords="social media",
keywords="older workers",
keywords="social support",
keywords="work ability",
keywords="delayed retirement",
abstract="Background: With the increased older population in China and the subsequent reduced labor force, the ``demographic bonus'' is disappearing. The Chinese government proposed a Healthy China strategy in 2017. The transfer of the demographic bonus to a ``health bonus'' extended the working life of people and reduced the negative impact of the population's aging on the labor force structure. Objective: This research focuses on the effect of older workers' social media usage at work on their work ability (related to both physical and mental health) and thus their willingness to delay retirement. Methods: The questionnaire respondents were older than 55 years, and they obtained the questionnaire from social media, from June to July 2018. A total of 1020 valid questionnaires were collected, and SmartPLS 3.28 (SmartPLS GmbH) was used to analyze the data. Effects were analyzed using 2-tailed t tests. Results: (1) Use of social media at work can improve information support (t14=13.318, P<.001), emotional support (t14=13.184, P<.001), and self-efficacy (t14=6.364, P<.001) for older people; (2) information support is the main factor affecting the self-efficacy of older workers (t14=23.304, P<.001), as compared with emotional support (t14=1.799, P=0.07); (3) the impacts of emotional support on work ability (t14=8.876, P<.001) and work stress (t14=9.545, P<.001) are generally higher than those of information support (t14=4.394, P<.001; t14=5.002, P<.001); (4) self-efficacy has an impact on work ability (t14=5.658, P<.001) and work stress (t14=4.717, P<.001); and (5) the impacts of work ability (t14=8.586, P<.001) and work stress (t14=8.579, P<.001) on retirement willingness are greater than those of emotional support (t14=2.112, P=.04) and information support (t14=4.314, P<.001). Conclusions: Our study confirms that the use of social media at work has a positive impact on older workers. Based on the findings, we have put forward proposals to extend people's working lives and help governments implement health bonus policies. In the future, we will compare the different values of willingness to delay retirement among older people in different occupations and different cultures. ",
doi="10.2196/18264",
url="https://www.jmir.org/2021/2/e18264",
url="http://www.ncbi.nlm.nih.gov/pubmed/33565983"
}


@Article{info:doi/10.2196/24585,
author="de Melo, Tiago
and Figueiredo, S. Carlos M.",
title="Comparing News Articles and Tweets About COVID-19 in Brazil: Sentiment Analysis and Topic Modeling Approach",
journal="JMIR Public Health Surveill",
year="2021",
month="Feb",
day="10",
volume="7",
number="2",
pages="e24585",
keywords="COVID-19",
keywords="Twitter",
keywords="infodemiology",
keywords="news",
keywords="sentiment analysis",
keywords="social media",
keywords="Brazil",
keywords="monitoring",
keywords="topic modeling",
keywords="entity recognition",
keywords="text analysis",
abstract="Background: The COVID-19 pandemic is severely affecting people worldwide. Currently, an important approach to understand this phenomenon and its impact on the lives of people consists of monitoring social networks and news on the internet. Objective: The purpose of this study is to present a methodology to capture the main subjects and themes under discussion in news media and social media and to apply this methodology to analyze the impact of the COVID-19 pandemic in Brazil. Methods: This work proposes a methodology based on topic modeling, namely entity recognition, and sentiment analysis of texts to compare Twitter posts and news, followed by visualization of the evolution and impact of the COVID-19 pandemic. We focused our analysis on Brazil, an important epicenter of the pandemic; therefore, we faced the challenge of addressing Brazilian Portuguese texts. Results: In this work, we collected and analyzed 18,413 articles from news media and 1,597,934 tweets posted by 1,299,084 users in Brazil. The results show that the proposed methodology improved the topic sentiment analysis over time, enabling better monitoring of internet media. Additionally, with this tool, we extracted some interesting insights about the evolution of the COVID-19 pandemic in Brazil. For instance, we found that Twitter presented similar topic coverage to news media; the main entities were similar, but they differed in theme distribution and entity diversity. Moreover, some aspects represented negative sentiment toward political themes in both media, and a high incidence of mentions of a specific drug denoted high political polarization during the pandemic. Conclusions: This study identified the main themes under discussion in both news and social media and how their sentiments evolved over time. It is possible to understand the major concerns of the public during the pandemic, and all the obtained information is thus useful for decision-making by authorities. ",
doi="10.2196/24585",
url="http://publichealth.jmir.org/2021/2/e24585/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33480853"
}


@Article{info:doi/10.2196/24517,
author="Basch, H. Corey
and Laforet, E. Priscila
and Hillyer, C. Grace
and Seidel, J. Erica
and Jaime, Christie",
title="Content in YouTube Videos for Rosacea: Cross-sectional Study",
journal="JMIR Dermatol",
year="2021",
month="Feb",
day="10",
volume="4",
number="1",
pages="e24517",
keywords="rosacea",
keywords="YouTube",
keywords="social media",
keywords="skin disease",
keywords="skin",
keywords="chronic",
keywords="dermatology",
abstract="Background: Rosacea is an inflammatory skin disease that is chronic in nature. In addition to the physical symptoms, there are substantial quality of life issues that patients with rosacea experience, largely due to the visible nature in which rosacea manifests. Objective: The purpose of this study was to describe the content related to rosacea in highly viewed English- and Spanish-language videos on YouTube. Methods: We coded identifying information for each video and categories including characteristics of rosacea, clinical solutions, and alternative solutions. The 100 YouTube videos examined were viewed 18.5 million times between 2006 and 2020, and 57.3\% (10,652,665/18,592,742) of these views were of consumer videos. Results: Videos posted by consumers more often promoted or were trying to sell a product or procedure (32/55, 58\% of consumers vs 10/31, 32\% of medical professionals and 4/14, 29\% of television, internet, news, or entertainment sources; P=.03) and more frequently mentioned the use of makeup or other ways to cover up rosacea (30/55, 55\% of consumers vs 6/31, 19\% of medical professionals and 2/14, 14\% of television, internet, news, or entertainment sources; P<.001). Videos sourced from medical professionals more often mentioned medication (17/31, 55\%) than videos uploaded by consumers (14/55, 25\%) or TV, internet, news, or entertainment sources (3/14, 21\%) (P=.01). Conclusions: Given that rosacea is experienced differently for each person, consumer advice that works for one individual may not work for another. There is a need for reliable videos on rosacea to emphasize this and clarify misconceptions. ",
doi="10.2196/24517",
url="http://derma.jmir.org/2021/1/e24517/",
url="http://www.ncbi.nlm.nih.gov/pubmed/37632798"
}


@Article{info:doi/10.2196/22946,
author="Kim, Stephanie
and Mourali, Alia
and Allem, Jon-Patrick
and Unger, B. Jennifer
and Boley Cruz, Tess
and Smiley, L. Sabrina",
title="Instagram Posts Related to Backwoods Cigarillo Blunts: Content Analysis",
journal="JMIR Public Health Surveill",
year="2021",
month="Feb",
day="9",
volume="7",
number="2",
pages="e22946",
keywords="Instagram",
keywords="blunts",
keywords="Backwoods cigarillos",
keywords="smoking",
abstract="Background: Instagram, one of the most popular social media platforms among youth, offers a unique opportunity to examine blunts---partially or fully hollowed-out large cigars, little cigars, and cigarillos that are filled with marijuana. Cigarillo brands like Backwoods (Imperial Tobacco Group Brands LLC) have product features that facilitate blunt making, including a variety of brand-specific flavors that enhance the smoking experience (eg, honey, dark stout). Backwoods has an active online presence with a user-friendly website. Objective: This study examined the extent to which Backwoods cigarillo--related posts on Instagram showed blunt making. Instagram offers a unique opportunity to examine blunt making as Instagram accounts will contain images reflective of behavior occurring without the prime of a researcher. Methods: Data consisted of publicly available Instagram posts with the hashtag \#backwoods collected from August 30 to September 12, 2018. Inclusion criteria for this study included an Instagram post with the hashtag ``\#backwoods''. Rules were established to content analyze posts. Categories included Type of post (ie, photo, video, or both); Blunt-related hashtags (ie, the corresponding post caption contained one or more hashtags like \#blunts, \#cannabis, and \#weed that were identified in previous social media research); Rolling blunts (ie, the post contained an image of one or more individuals rolling a Backwoods cigarillo visibly containing marijuana); and Smoking blunts (ie, the post contained an image of one or more individuals blowing smoke or holding a lit blunt). We coded images for Product flavor reference, where a code of 1 showed a Backwoods cigarillo pack with a brand-specific flavor (eg, honey, dark stout, Russian cr{\`e}me) visible in the blunt-related image, and a code of 0 indicated that it was not visible anywhere in the image. Results: Among all posts (N=1206), 871 (72.2\%) were coded as Blunt-related hashtags. A total of 125 (10.4\%) images were coded as Smoking blunts, and 25 (2.1\%) were coded as Rolling blunts (ie, Backwoods cigarillo explicitly used to roll blunts). Among blunt images, 434 of 836 (51.9\%) were coded as Product flavor (ie, a Backwoods pack with a brand-specific flavor was visible). Conclusions: Most Backwoods cigarillo--related Instagram images were blunt-related, and these blunt-related images showed Backwoods packages indicating flavor preference. Continued monitoring and surveillance of blunt-related posts on Instagram is needed to inform policies and interventions that reduce the risk that youth may experiment with blunts. Specific policies could include restrictions on product features (eg, flavors, perforated lines, attractive resealable foil pouches, sale as singles) that facilitate blunt making. ",
doi="10.2196/22946",
url="http://publichealth.jmir.org/2021/2/e22946/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33560242"
}


@Article{info:doi/10.2196/21463,
author="Chen, Qiang
and Min, Chen
and Zhang, Wei
and Ma, Xiaoyue
and Evans, Richard",
title="Factors Driving Citizen Engagement With Government TikTok Accounts During the COVID-19 Pandemic: Model Development and Analysis",
journal="J Med Internet Res",
year="2021",
month="Feb",
day="4",
volume="23",
number="2",
pages="e21463",
keywords="government social media",
keywords="citizen engagement",
keywords="public health crisis",
keywords="TikTok",
keywords="emotion valence",
keywords="dialogic loop",
keywords="COVID-19",
abstract="Background: During the COVID-19 pandemic, growth in citizen engagement with social media platforms has enabled public health departments to accelerate and improve health information dissemination, developing transparency and trust between governments and citizens. In light of these benefits, it is imperative to learn the antecedents and underlying mechanisms for this to maintain and enhance engagement. Objective: The aim of this study is to determine the factors and influencing mechanisms related to citizen engagement with the TikTok account of the National Health Commission of China during the COVID-19 pandemic. Methods: Using a web crawler, 355 short videos were collected from the Healthy China account on TikTok (with more than 3 million followers throughout China), covering the period from January 21, 2020, to April 25, 2020. The title and video length, as well as the number of likes, shares, and comments were collected for each video. After classifying them using content analysis, a series of negative binomial regression analyses were completed. Results: Among the 355 videos, 154 (43.4\%) related to guidance for clinicians, patients, and ordinary citizens, followed by information concerning the government's handling of the pandemic (n=100, 28.2\%), the latest news about COVID-19 (n=61, 17.2\%), and appreciation toward frontline emergency services (n=40, 11.3\%). Video length, titles, dialogic loop, and content type all influenced the level of citizen engagement. Specifically, video length was negatively associated with the number of likes (incidence rate ratio [IRR]=0.19, P<.001) and comments (IRR=0.39, P<.001). Title length was positively related to the number of shares (IRR=24.25, P=.01), likes (IRR=8.50, P=.03), and comments (IRR=7.85, P=.02). Dialogic loop negatively predicted the number of shares (IRR=0.56, P=.03). In comparison to appreciative information, information about the government's handling of the situation (IRR=5.16, P<.001) and guidelines information (IRR=7.31, P<.001) were positively correlated with the number of shares, while the latest news was negatively related to the number of likes received (IRR=0.46, P=.004). More importantly, the relationship between predictors and citizen engagement was moderated by the emotional valence of video titles. Longer videos with positive titles received a higher number of likes (IRR=21.72, P=.04) and comments (IRR=10.14, P=.047). Furthermore, for short videos related to government handling of the pandemic (IRR=14.48, P=.04) and guidance for stakeholders (IRR=7.59, P=.04), positive titles received a greater number of shares. Videos related to the latest news (IRR=66.69, P=.04) received more likes if the video title displayed higher levels of positive emotion. Conclusions: During the COVID-19 pandemic, videos were frequently published on government social media platforms. Video length, title, dialogic loop, and content type significantly influenced the level of citizen engagement. These relationships were moderated by the emotional valence of the video's title. Our findings have implications for maintaining and enhancing citizen engagement via government social media. ",
doi="10.2196/21463",
url="http://www.jmir.org/2021/2/e21463/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33481756"
}


@Article{info:doi/10.2196/19858,
author="Bapaye, Amol Jay
and Bapaye, Amol Harsh",
title="Demographic Factors Influencing the Impact of Coronavirus-Related Misinformation on WhatsApp: Cross-sectional Questionnaire Study",
journal="JMIR Public Health Surveill",
year="2021",
month="Jan",
day="30",
volume="7",
number="1",
pages="e19858",
keywords="coronavirus",
keywords="COVID-19",
keywords="SARS--CoV--2",
keywords="WhatsApp",
keywords="social media",
keywords="misinformation",
keywords="infodemiology",
keywords="infodemic",
keywords="pandemic",
keywords="medical informatics",
abstract="Background: The risks of misinformation on social networking sites is a global issue, especially in light of the COVID-19 infodemic. WhatsApp is being used as an important source of COVID-19--related information during the current pandemic. Unlike Facebook and Twitter, limited studies have investigated the role of WhatsApp as a source of communication, information, or misinformation during crisis situations. Objective: Our study aimed to evaluate the vulnerability of demographic cohorts in a developing country toward COVID-19--related misinformation shared via WhatsApp. We also aimed to identify characteristics of WhatsApp messages associated with increased credibility of misinformation. Methods: We conducted a web-based questionnaire survey and designed a scoring system based on theories supported by the existing literature. Vulnerability (K) was measured as a ratio of the respondent's score to the maximum score. Respondents were stratified according to age and occupation, and Kmean was calculated and compared among each subgroup using single-factor analysis of variance and Hochberg GT2 tests. The questionnaire evaluated the respondents' opinion of the veracity of coronavirus-related WhatsApp messages. The responses to the false-proven messages were compared using z test between the 2 groups: coronavirus-related WhatsApp messages with an attached link and/or source and those without. Results: We analyzed 1137 responses from WhatsApp users in India. Users aged over 65 years had the highest vulnerability (Kmean=0.38, 95\% CI 0.341-0.419) to misinformation. Respondents in the age group 19-25 years had significantly lower vulnerability (Kmean=0.31, 95\% CI 0.301-0.319) than those aged over 25 years (P<.05). The vulnerability of users employed in elementary occupations was the highest (Kmean=0.38, 95\% CI 0.356-0.404), and it was significantly higher than that of professionals and students (P<.05). Interestingly, the vulnerability of healthcare workers was not significantly different from that of other occupation groups (P>.05). We found that false CRWMs with an attached link and/or source were marked true 6 times more often than false CRWMs without an attached link or source (P<.001). Conclusions: Our study demonstrates that in a developing country, WhatsApp users aged over 65 years and those involved in elementary occupations were found to be the most vulnerable to false information disseminated via WhatsApp. Health care workers, who are otherwise considered as experts with regard to this global health care crisis, also shared this vulnerability to misinformation with other occupation groups. Our findings also indicated that the presence of an attached link and/or source falsely validating an incorrect message adds significant false credibility, making it appear true. These results indicate an emergent need to address and rectify the current usage patterns of WhatsApp users. This study also provides metrics that can be used by health care organizations and government authorities of developing countries to formulate guidelines to contain the spread of WhatsApp-related misinformation. ",
doi="10.2196/19858",
url="http://publichealth.jmir.org/2021/1/e19858/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33444152"
}


@Article{info:doi/10.2196/25314,
author="Klein, Z. Ari
and Magge, Arjun
and O'Connor, Karen
and Flores Amaro, Ivan Jesus
and Weissenbacher, Davy
and Gonzalez Hernandez, Graciela",
title="Toward Using Twitter for Tracking COVID-19: A Natural Language Processing Pipeline and Exploratory Data Set",
journal="J Med Internet Res",
year="2021",
month="Jan",
day="22",
volume="23",
number="1",
pages="e25314",
keywords="natural language processing",
keywords="social media",
keywords="data mining",
keywords="COVID-19",
keywords="coronavirus",
keywords="pandemics",
keywords="epidemiology",
keywords="infodemiology",
abstract="Background: In the United States, the rapidly evolving COVID-19 outbreak, the shortage of available testing, and the delay of test results present challenges for actively monitoring its spread based on testing alone. Objective: The objective of this study was to develop, evaluate, and deploy an automatic natural language processing pipeline to collect user-generated Twitter data as a complementary resource for identifying potential cases of COVID-19 in the United States that are not based on testing and, thus, may not have been reported to the Centers for Disease Control and Prevention. Methods: Beginning January 23, 2020, we collected English tweets from the Twitter Streaming application programming interface that mention keywords related to COVID-19. We applied handwritten regular expressions to identify tweets indicating that the user potentially has been exposed to COVID-19. We automatically filtered out ``reported speech'' (eg, quotations, news headlines) from the tweets that matched the regular expressions, and two annotators annotated a random sample of 8976 tweets that are geo-tagged or have profile location metadata, distinguishing tweets that self-report potential cases of COVID-19 from those that do not. We used the annotated tweets to train and evaluate deep neural network classifiers based on bidirectional encoder representations from transformers (BERT). Finally, we deployed the automatic pipeline on more than 85 million unlabeled tweets that were continuously collected between March 1 and August 21, 2020. Results: Interannotator agreement, based on dual annotations for 3644 (41\%) of the 8976 tweets, was 0.77 (Cohen $\kappa$). A deep neural network classifier, based on a BERT model that was pretrained on tweets related to COVID-19, achieved an F1-score of 0.76 (precision=0.76, recall=0.76) for detecting tweets that self-report potential cases of COVID-19. Upon deploying our automatic pipeline, we identified 13,714 tweets that self-report potential cases of COVID-19 and have US state--level geolocations. Conclusions: We have made the 13,714 tweets identified in this study, along with each tweet's time stamp and US state--level geolocation, publicly available to download. This data set presents the opportunity for future work to assess the utility of Twitter data as a complementary resource for tracking the spread of COVID-19. ",
doi="10.2196/25314",
url="http://www.jmir.org/2021/1/e25314/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33449904"
}


@Article{info:doi/10.2196/20319,
author="Varghese, Elsem Nirosha
and Santoro, Eugenio
and Lugo, Alessandra
and Madrid-Valero, J. Juan
and Ghislandi, Simone
and Torbica, Aleksandra
and Gallus, Silvano",
title="The Role of Technology and Social Media Use in Sleep-Onset Difficulties Among Italian Adolescents: Cross-sectional Study",
journal="J Med Internet Res",
year="2021",
month="Jan",
day="21",
volume="23",
number="1",
pages="e20319",
keywords="sleep-onset difficulties",
keywords="adolescents",
keywords="social media",
keywords="electronic device use",
abstract="Background: The use of technology and social media among adolescents is an increasingly prevalent phenomenon. However, there is a paucity of evidence on the relationship between frequency of use of electronic devices and social media and sleep-onset difficulties among the Italian population. Objective: The aim of this study is to investigate the association between the use of technology and social media, including Facebook and YouTube, and sleep-onset difficulties among adolescents from Lombardy, the most populous region in Italy. Methods: The relationship between use of technology and social media and sleep-onset difficulties was investigated. Data came from the 2013-2014 wave of the Health Behavior in School-aged Children survey, a school-based cross-sectional study conducted on 3172 adolescents aged 11 to 15 years in Northern Italy. Information was collected on difficulties in falling asleep over the last 6 months. We estimated the odds ratios (ORs) for sleep-onset difficulties and corresponding 95\% CIs using logistic regression models after adjustment for major potential confounders. Results: The percentage of adolescents with sleep-onset difficulties was 34.3\% (1081/3151) overall, 29.7\% (483/1625) in boys and 39.2\% (598/1526) in girls. It was 30.3\% (356/1176) in 11-year-olds, 36.2\% (389/1074) in 13-year-olds, and 37.3\% (336/901) in 15-year-olds. Sleep-onset difficulties were more frequent among adolescents with higher use of electronic devices, for general use (OR 1.50 for highest vs lowest tertile of use; 95\% CI 1.21-1.85), use for playing games (OR 1.35; 95\% CI 1.11-1.64), use of online social networks (OR 1.40 for always vs never or rarely; 95\% CI 1.09-1.81), and YouTube (OR 2.00; 95\% CI 1.50-2.66). Conclusions: This study adds novel information about the relationship between sleep-onset difficulties and technology and social media in a representative sample of school-aged children from a geographical location that has not been included in studies of this type previously. Exposure to screen-based devices and online social media is significantly associated with adolescent sleep-onset difficulties. Interventions to create a well-coordinated parent- and school-centered strategy, thereby increasing awareness on the unfavorable effect of evolving technologies on sleep among adolescents, are needed. ",
doi="10.2196/20319",
url="http://www.jmir.org/2021/1/e20319/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33475517"
}


@Article{info:doi/10.2196/17598,
author="Liu, Lisa
and Woo, P. Benjamin K.",
title="Twitter as a Mental Health Support System for Students and Professionals in the Medical Field",
journal="JMIR Med Educ",
year="2021",
month="Jan",
day="19",
volume="7",
number="1",
pages="e17598",
keywords="Twitter",
keywords="social media",
keywords="mental health",
keywords="health professionals",
keywords="community",
keywords="social support",
keywords="depression",
keywords="physician suicide",
doi="10.2196/17598",
url="http://mededu.jmir.org/2021/1/e17598/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33464210"
}


@Article{info:doi/10.2196/21408,
author="Tornberg, N. Haley
and Moezinia, Carine
and Wei, Chapman
and Bernstein, A. Simone
and Wei, Chaplin
and Al-Beyati, Refka
and Quan, Theodore
and Diemert, J. David",
title="Retracted: ``Assessing the Dissemination of COVID-19 Articles Across Social Media With Altmetric and PlumX Metrics: Correlational Study''",
journal="J Med Internet Res",
year="2021",
month="Jan",
day="14",
volume="23",
number="1",
pages="e21408",
keywords="Altmetric",
keywords="PlumX",
keywords="social media",
keywords="impact factor",
keywords="COVID-19",
keywords="information",
keywords="dissemination",
keywords="citation",
abstract="Background: The use of social media assists in the distribution of COVID-19 information to the general public and health professionals. Alternative-level metrics (ie, altmetrics) and PlumX metrics are new bibliometrics that can assess how many times a scientific article has been shared and how much a scientific article has spread within social media platforms. Objective: Our objective was to characterize and compare the traditional bibliometrics (ie, citation count and impact factors) and new bibliometrics (ie, Altmetric Attention Score [AAS] and PlumX score) of the top 100 COVID-19 articles with the highest AASs. Methods: The top 100 articles with highest AASs were identified with Altmetric Explorer in May 2020. The AASs, journal names, and the number of mentions in various social media databases of each article were collected. Citation counts and PlumX Field-Weighted Citation Impact scores were collected from the Scopus database. Additionally, AASs, PlumX scores, and citation counts were log-transformed and adjusted by +1 for linear regression, and Spearman correlation coefficients were used to determine correlations. Results: The median AAS, PlumX score, and citation count were 4922.50, 37.92, and 24.00, respectively. The New England Journal of Medicine published the most articles (18/100, 18\%). The highest number of mentions (985,429/1,022,975, 96.3\%) were found on Twitter, making it the most frequently used social media platform. A positive correlation was observed between AAS and citation count (r2=0.0973; P=.002), and between PlumX score and citation count (r2=0.8911; P<.001). Conclusions: Our study demonstrated that citation count weakly correlated with AASs and strongly correlated with PlumX scores, with regard to COVID-19 articles at this point in time. Altmetric and PlumX metrics should be used to complement traditional citation counts when assessing the dissemination and impact of a COVID-19 article. ",
doi="10.2196/21408",
url="http://www.jmir.org/2021/1/e21408/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33406049"
}


@Article{info:doi/10.2196/18286,
author="Lupton, Deborah",
title="Young People's Use of Digital Health Technologies in the Global North: Narrative Review",
journal="J Med Internet Res",
year="2021",
month="Jan",
day="11",
volume="23",
number="1",
pages="e18286",
keywords="digital health",
keywords="young people",
keywords="Global North",
keywords="social research",
keywords="narrative review",
abstract="Background: A diverse array of digital technologies are available to children and young people living in the Global North to monitor, manage, and promote their health and well-being. Objective: This article provides a narrative literature review of the growing number of social research studies published over the past decade that investigate the types of digital technologies used by children and young people in the Global North, in addition to investigating which of these technologies they find most useful or not useful. Key findings as well as major gaps and directions for future research are identified and discussed. Methods: A comprehensive search of relevant publications listed in Google Scholar was conducted, supported by following citation trails of these publications. The findings are listed under type of digital technology used for health: cross-media, internet, social media, apps and wearable devices, sexual health support and information, and mental health support and information. Results: Many young people in the Global North are active users of digital health technologies. However, it is notable that they still rely on older technologies, such as websites and search engines, to find information. Apps and platforms that may not have been specifically developed for young people as digital health resources often better suit their needs. Young people appreciate the ready availability of information online, the opportunities to learn more about their bodies and health states, and the opportunities to learn how to improve their health and physical fitness. They enjoy being able to connect with peers, and they find emotional support and relief from distress by using social media platforms, YouTube, and online forums. Young people can find the vast reams of information available to them difficult to navigate. They often look to trusted adults to help them make sense of the information they find online and to provide alternative sources of information and support. Face-to-face interactions with these trusted providers remain important to young people. Risks and harms that young people report from digital health use include becoming overly obsessed with their bodies' shape and size when using self-tracking technologies and comparing their bodies with the social media influencers they follow. Conclusions: Further details on how young people are using social media platforms and YouTube as health support resources and for peer-to-peer sharing of information, including attention paid to the content of these resources and the role played by young social media influencers and microcelebrities, would contribute important insights to this body of literature. The role played by visual media, such as GIFs (Graphics Interchange Format) and memes, and social media platforms that have recently become very popular with young people (eg, Snapchat and TikTok) in health-related content creation and sharing requires more attention by social researchers seeking to better understand young people's use of digital devices and software for health and fitness. ",
doi="10.2196/18286",
url="http://www.jmir.org/2021/1/e18286/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33427684"
}


@Article{info:doi/10.2196/25241,
author="Zhang, Xiaotong
and Liu, Jue
and Han, Na
and Yin, Jing",
title="Social Media Use, Unhealthy Lifestyles, and the Risk of Miscarriage Among Pregnant Women During the COVID-19 Pandemic: Prospective Observational Study",
journal="JMIR Public Health Surveill",
year="2021",
month="Jan",
day="5",
volume="7",
number="1",
pages="e25241",
keywords="COVID-19",
keywords="social media use",
keywords="miscarriage",
keywords="cohort study",
keywords="pregnancy",
keywords="pregnant women",
keywords="social media",
keywords="China",
keywords="risk",
keywords="prospective",
keywords="online health information",
abstract="Background: The COVID-19 pandemic has resulted in changes to normal life and disrupted social and economic function worldwide. However, little is known about the impact of social media use, unhealthy lifestyles, and the risk of miscarriage among pregnant women during the COVID-19 pandemic. Objective: This study aims to assess the association between social media use, unhealthy lifestyles, and the risk of miscarriage among pregnant women in the early stage of the COVID-19 pandemic in China. Methods: In this prospective cohort study, 456 singleton pregnant women in mainland China were recruited during January and February 2020. Sociodemographic characteristics, history of previous health, social media use, and current lifestyles were collected at baseline, and we followed up about the occurrence of miscarriage. Log-binomial regression models were used to estimate the risk ratios (RRs) of miscarriage for women with different exposures to COVID-19--specific information. Results: Among all the 456 pregnant women, there were 82 (18.0\%) who did no physical activities, 82 (18.0\%) with inadequate dietary diversity, 174 (38.2\%) with poor sleep quality, and 54 (11.8\%) spending >3 hours on reading COVID-19 news per day. Women with excessive media use (>3 hours) were more likely to be previously pregnant (P=.03), have no physical activity (P=.003), have inadequate dietary diversity (P=.03), and have poor sleep quality (P<.001). The prevalence of miscarriage was 16.0\% (n=73; 95\% CI 12.6\%-19.4\%). Compared with women who spent 0.5-2 hours (25/247, 10.1\%) on reading COVID-19 news per day, miscarriage prevalence in women who spent <0.5 hours (5/23, 21.7\%), 2-3 hours (26/132, 19.7\%), and >3 hours (17/54, 31.5\%) was higher (P<.001). Miscarriage prevalence was also higher in pregnant women with poor sleep quality (39/174, 22.4\% vs 34/282, 12.1\%; P=.003) and a high education level (66/368, 17.9\% vs 7/88, 8.0\%; P=.02). In the multivariable model, poor sleep quality (adjusted RR 2.06, 95\% CI 1.24-3.44; P=.006), 2-3 hours of media use daily (adjusted RR 1.74, 95\% CI 1.02-2.97; P=.04), and >3 hours of media use daily (adjusted RR 2.56, 95\% CI 1.43-4.59; P=.002) were associated with miscarriage. In the sensitivity analysis, results were still stable. Conclusions: Pregnant women with excessive media use were more likely to have no physical activity, inadequate dietary diversity, and poor sleep quality. Excessive media use and poor sleep quality were associated with a higher risk of miscarriage. Our findings highlight the importance of healthy lifestyles during the COVID-19 pandemic. ",
doi="10.2196/25241",
url="https://publichealth.jmir.org/2021/1/e25241",
url="http://www.ncbi.nlm.nih.gov/pubmed/33293263"
}


@Article{info:doi/10.2196/23696,
author="Zhong, Bu
and Jiang, Zhibin
and Xie, Wenjing
and Qin, Xuebing",
title="Association of Social Media Use With Mental Health Conditions of Nonpatients During the COVID-19 Outbreak: Insights from a National Survey Study",
journal="J Med Internet Res",
year="2020",
month="Dec",
day="31",
volume="22",
number="12",
pages="e23696",
keywords="COVID-19",
keywords="mental health",
keywords="social media",
keywords="health information support",
keywords="secondary traumatic stress",
keywords="vicarious trauma",
keywords="social support",
abstract="Background: Considerable research has been devoted to examining the mental health conditions of patients with COVID-19 and medical staff attending to these patients during the COVID-19 pandemic. However, there are few insights concerning how the pandemic may take a toll on the mental health of the general population, and especially of nonpatients (ie, individuals who have not contracted COVID-19). Objective: This study aimed to investigate the association between social media use and mental health conditions in the general population based on a national representative sample during the peak of the COVID-19 outbreak in China. Methods: We formed a national representative sample (N=2185) comprising participants from 30 provinces across China, who were the first to experience the COVID-19 outbreak in the world. We administered a web-based survey to these participants to analyze social media use, health information support received via social media, and possible psychiatric disorders, including secondary traumatic stress (STS) and vicarious trauma (VT). Results: Social media use did not cause mental health issues, but it mediated the levels of traumatic emotions among nonpatients. Participants received health information support via social media, but excessive social media use led to elevated levels of stress ($\beta$=.175; P<.001), anxiety ($\beta$=.224; P<.001), depression ($\beta$=.201; P<.001), STS ($\beta$=.307; P<.001), and VT ($\beta$=.688; P<.001). Geographic location (or geolocation) and lockdown conditions also contributed to more instances of traumatic disorders. Participants living in big cities were more stressed than those living in rural areas (P=.02). Furthermore, participants from small cities or towns were more anxious (P=.01), stressed (P<.001), and depressed (P=.008) than those from rural areas. Obtaining more informational support ($\beta$=.165; P<.001) and emotional support ($\beta$=.144; P<.001) via social media increased their VT levels. Peer support received via social media increased both VT ($\beta$=.332; P<.001) and STS ($\beta$=.130; P<.001) levels. Moreover, geolocation moderated the relationships between emotional support on social media and VT (F2=3.549; P=.029) and the association between peer support and STS (F2=5.059; P=.006). Geolocation also interacted with health information support in predicting STS (F2=5.093; P=.006). Conclusions: COVID-19 has taken a severe toll on the mental health of the general population, including individuals who have no history of psychiatric disorders or coronavirus infection. This study contributes to the literature by establishing the association between social media use and psychiatric disorders among the general public during the COVID-19 outbreak. The study findings suggest that the causes of such psychiatric disorders are complex and multifactorial, and social media use is a potential factor. The findings also highlight the experiences of people in China and can help global citizens and health policymakers to mitigate the effects of psychiatric disorders during this and other public health crises, which should be regarded as a key component of a global pandemic response. ",
doi="10.2196/23696",
url="https://www.jmir.org/2020/12/e23696",
url="http://www.ncbi.nlm.nih.gov/pubmed/33302256"
}


@Article{info:doi/10.2196/18102,
author="Carson, Y. Thaddeus
and Hatzigeorgiou, Christos
and Wyatt, R. Tasha
and Egan, Sarah
and Beidas, O. Sary",
title="Development and Implementation of a Web-Based Learning Environment for an Inpatient Internal Medicine Team: Questionnaire Study",
journal="JMIR Med Educ",
year="2020",
month="Dec",
day="29",
volume="6",
number="2",
pages="e18102",
keywords="inpatient internal medicine",
keywords="academic hospitalist",
keywords="medical education",
keywords="blended learning environment",
keywords="social media",
keywords="online education",
keywords="internal medicine ward",
keywords="internal medicine education",
abstract="Background: The notion of anytime, anyplace communication is characteristic of the current generation of learners. Such communications have facilitated the growth and integration of a blended or hybrid learning platform in multiple educational settings. However, there are limited reports on the use of an anytime, anyplace communication platform in clinical inpatient medical education. Objective: The setting of a high-demand inpatient clinical rotation is ideal for the use of collaborative software, and this integration is expected to positively influence medical education. The purpose of this study is to evaluate medical students' and residents' educational experiences with incorporating a simple, web-based content management and file sharing platform into an internal medicine inpatient rotation. Methods: During an inpatient internal medicine rotation, faculty and learners jointly used collaborative software for educational purposes, and a postrotation survey tool was used to measure the educational influence of the software. Results: Based on the results of the postrotation survey, the integration of a collaborative software application during clinical rotations improved the learning experience. Learning climate, the communication of rotation goals, and self-directed learning all scored favorably, but feedback from the survey participants was mixed. The learners enthusiastically accepted the practical use of this tool for both communication and information sharing. Conclusions: This generation of learners is accustomed to frequent electronic communication. Based on our survey, these learners appear to be highly receptive to this web-based intervention design for improving clinical education during active patient care. Adding effective blended learning features to a traditional clinical setting is achievable. ",
doi="10.2196/18102",
url="http://mededu.jmir.org/2020/2/e18102/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33372895"
}


@Article{info:doi/10.2196/20920,
author="Leis, Angela
and Ronzano, Francesco
and Mayer, Angel Miguel
and Furlong, I. Laura
and Sanz, Ferran",
title="Evaluating Behavioral and Linguistic Changes During Drug Treatment for Depression Using Tweets in Spanish: Pairwise Comparison Study",
journal="J Med Internet Res",
year="2020",
month="Dec",
day="18",
volume="22",
number="12",
pages="e20920",
keywords="depression",
keywords="antidepressant drugs",
keywords="serotonin uptake inhibitors",
keywords="mental health",
keywords="social media",
keywords="infodemiology",
keywords="data mining",
abstract="Background: Depressive disorders are the most common mental illnesses, and they constitute the leading cause of disability worldwide. Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed drugs for the treatment of depressive disorders. Some people share information about their experiences with antidepressants on social media platforms such as Twitter. Analysis of the messages posted by Twitter users under SSRI treatment can yield useful information on how these antidepressants affect users' behavior. Objective: This study aims to compare the behavioral and linguistic characteristics of the tweets posted while users were likely to be under SSRI treatment, in comparison to the tweets posted by the same users when they were less likely to be taking this medication. Methods: In the first step, the timelines of Twitter users mentioning SSRI antidepressants in their tweets were selected using a list of 128 generic and brand names of SSRIs. In the second step, two datasets of tweets were created, the in-treatment dataset (made up of the tweets posted throughout the 30 days after mentioning an SSRI) and the unknown-treatment dataset (made up of tweets posted more than 90 days before or more than 90 days after any tweet mentioning an SSRI). For each user, the changes in behavioral and linguistic features between the tweets classified in these two datasets were analyzed. 186 users and their timelines with 668,842 tweets were finally included in the study. Results: The number of tweets generated per day by the users when they were in treatment was higher than it was when they were in the unknown-treatment period (P=.001). When the users were in treatment, the mean percentage of tweets posted during the daytime (from 8 AM to midnight) increased in comparison to the unknown-treatment period (P=.002). The number of characters and words per tweet was higher when the users were in treatment (P=.03 and P=.02, respectively). Regarding linguistic features, the percentage of pronouns that were first-person singular was higher when users were in treatment (P=.008). Conclusions: Behavioral and linguistic changes have been detected when users with depression are taking antidepressant medication. These features can provide interesting insights for monitoring the evolution of this disease, as well as offering additional information related to treatment adherence. This information may be especially useful in patients who are receiving long-term treatments such as people suffering from depression. ",
doi="10.2196/20920",
url="http://www.jmir.org/2020/12/e20920/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33337338"
}


@Article{info:doi/10.2196/24425,
author="Nsoesie, Okanyene Elaine
and Cesare, Nina
and M{\"u}ller, Martin
and Ozonoff, Al",
title="COVID-19 Misinformation Spread in Eight Countries: Exponential Growth Modeling Study",
journal="J Med Internet Res",
year="2020",
month="Dec",
day="15",
volume="22",
number="12",
pages="e24425",
keywords="misinformation",
keywords="internet",
keywords="COVID-19",
keywords="social media",
keywords="rumors",
abstract="Background: The epidemic of misinformation about COVID-19 transmission, prevention, and treatment has been going on since the start of the pandemic. However, data on the exposure and impact of misinformation is not readily available. Objective: We aim to characterize and compare the start, peak, and doubling time of COVID-19 misinformation topics across 8 countries using an exponential growth model usually employed to study infectious disease epidemics. Methods: COVID-19 misinformation topics were selected from the World Health Organization Mythbusters website. Data representing exposure was obtained from the Google Trends application programming interface for 8 English-speaking countries. Exponential growth models were used in modeling trends for each country. Results: Searches for ``coronavirus AND 5G'' started at different times but peaked in the same week for 6 countries. Searches for 5G also had the shortest doubling time across all misinformation topics, with the shortest time in Nigeria and South Africa (approximately 4-5 days). Searches for ``coronavirus AND ginger'' started at the same time (the week of January 19, 2020) for several countries, but peaks were incongruent, and searches did not always grow exponentially after the initial week. Searches for ``coronavirus AND sun'' had different start times across countries but peaked at the same time for multiple countries. Conclusions: Patterns in the start, peak, and doubling time for ``coronavirus AND 5G'' were different from the other misinformation topics and were mostly consistent across countries assessed, which might be attributable to a lack of public understanding of 5G technology. Understanding the spread of misinformation, similarities and differences across different contexts can help in the development of appropriate interventions for limiting its impact similar to how we address infectious disease epidemics. Furthermore, the rapid proliferation of misinformation that discourages adherence to public health interventions could be predictive of future increases in disease cases. ",
doi="10.2196/24425",
url="http://www.jmir.org/2020/12/e24425/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33264102"
}


@Article{info:doi/10.2196/21418,
author="Valdez, Danny
and ten Thij, Marijn
and Bathina, Krishna
and Rutter, A. Lauren
and Bollen, Johan",
title="Social Media Insights Into US Mental Health During the COVID-19 Pandemic: Longitudinal Analysis of Twitter Data",
journal="J Med Internet Res",
year="2020",
month="Dec",
day="14",
volume="22",
number="12",
pages="e21418",
keywords="social media",
keywords="analytics",
keywords="infodemiology",
keywords="infoveillance",
keywords="COVID-19",
keywords="United States",
keywords="mental health",
keywords="informatics",
keywords="sentiment analysis",
keywords="Twitter",
abstract="Background: The COVID-19 pandemic led to unprecedented mitigation efforts that disrupted the daily lives of millions. Beyond the general health repercussions of the pandemic itself, these measures also present a challenge to the world's mental health and health care systems. Considering that traditional survey methods are time-consuming and expensive, we need timely and proactive data sources to respond to the rapidly evolving effects of health policy on our population's mental health. Many people in the United States now use social media platforms such as Twitter to express the most minute details of their daily lives and social relations. This behavior is expected to increase during the COVID-19 pandemic, rendering social media data a rich field to understand personal well-being. Objective: This study aims to answer three research questions: (1) What themes emerge from a corpus of US tweets about COVID-19? (2) To what extent did social media use increase during the onset of the COVID-19 pandemic? and (3) Does sentiment change in response to the COVID-19 pandemic? Methods: We analyzed 86,581,237 public domain English language US tweets collected from an open-access public repository in three steps. First, we characterized the evolution of hashtags over time using latent Dirichlet allocation (LDA) topic modeling. Second, we increased the granularity of this analysis by downloading Twitter timelines of a large cohort of individuals (n=354,738) in 20 major US cities to assess changes in social media use. Finally, using this timeline data, we examined collective shifts in public mood in relation to evolving pandemic news cycles by analyzing the average daily sentiment of all timeline tweets with the Valence Aware Dictionary and Sentiment Reasoner (VADER) tool. Results: LDA topics generated in the early months of the data set corresponded to major COVID-19--specific events. However, as state and municipal governments began issuing stay-at-home orders, latent themes shifted toward US-related lifestyle changes rather than global pandemic-related events. Social media volume also increased significantly, peaking during stay-at-home mandates. Finally, VADER sentiment analysis scores of user timelines were initially high and stable but decreased significantly, and continuously, by late March. Conclusions: Our findings underscore the negative effects of the pandemic on overall population sentiment. Increased use rates suggest that, for some, social media may be a coping mechanism to combat feelings of isolation related to long-term social distancing. However, in light of the documented negative effect of heavy social media use on mental health, social media may further exacerbate negative feelings in the long-term for many individuals. Thus, considering the overburdened US mental health care structure, these findings have important implications for ongoing mitigation efforts. ",
doi="10.2196/21418",
url="http://www.jmir.org/2020/12/e21418/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33284783"
}


@Article{info:doi/10.2196/16927,
author="Hefler, Marita
and Kerrigan, Vicki
and Grunseit, Anne
and Freeman, Becky
and Kite, James
and Thomas, P. David",
title="Facebook-Based Social Marketing to Reduce Smoking in Australia's First Nations Communities: An Analysis of Reach, Shares, and Likes",
journal="J Med Internet Res",
year="2020",
month="Dec",
day="10",
volume="22",
number="12",
pages="e16927",
keywords="social media",
keywords="tobacco",
keywords="Australia",
keywords="indigenous peoples",
keywords="smoking",
keywords="health promotion",
abstract="Background: Facebook is widely used by Australia's First Nations people and has significant potential to promote health. However, evidence-based guidelines for its use in health promotion are lacking. Smoking prevalence among Australia's First Nations people is nearly 3 times higher than other Australians. Locally designed programs in Aboriginal Community Controlled Health Services (ACCHOs) to reduce smoking often use Facebook. Objective: This study reports on an analysis of the reach and engagement of Facebook posts with smoking prevention and cessation messages posted by ACCHOs in the Northern Territory, Australia. Methods: Each service posted tobacco control content at least weekly for approximately 6 months. Posts were coded for the following variables: service posted, tailored First Nations Australian content, local or nonlocally produced content, video or nonvideo, communication technique, and emotional appeal. The overall reach, shares, and reactions were calculated. Results: Compared with posts developed by the health services, posts with content created by other sources had greater reach (adjusted incident rate ratio [IRR] 1.92, 95\% CI 1.03-3.59). Similarly, reactions to posts (IRR 1.89, 95\% CI 1.40-2.56) and shared posts (IRR 2.17, 95\% CI 1.31-3.61) with content created by other sources also had more reactions, after controlling for reach, as did posts with local First Nations content compared with posts with no First Nations content (IRR 1.71, 95\% CI 1.21-2.34). Conclusions: Facebook posts with nonlocally produced content can be an important component of a social media campaign run by local health organizations. With the exception of nonlocally produced content, we did not find a definitive set of characteristics that were clearly associated with reach, shares, and reactions. Beyond reach, shares, and likes, further research is needed to understand the extent that social media content can influence health behavior. ",
doi="10.2196/16927",
url="http://www.jmir.org/2020/12/e16927/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33300883"
}


@Article{info:doi/10.2196/18371,
author="Willoughby, Fitts Jessica
and Myrick, Gall Jessica
and Gibbons, Stephanie
and Kogan, Clark",
title="Associations Between Emotions, Social Media Use, and Sun Exposure Among Young Women: Ecological Momentary Assessment Study",
journal="JMIR Dermatol",
year="2020",
month="Dec",
day="10",
volume="3",
number="1",
pages="e18371",
keywords="social media",
keywords="skin cancer",
keywords="emotions",
keywords="cancer prevention",
keywords="health communication",
keywords="ecological momentary assessment",
abstract="Background: Research has pointed to a connection between social media use, emotions, and tanning behaviors. However, less is known about the role specific emotions may play in influencing social media use and how emotions and social media use may each be associated with outdoor tanning. Objective: This paper aims to examine the connection between emotions, social media use, and outdoor tanning behaviors among young women, a group particularly important for skin cancer prevention efforts. Methods: We used ecological momentary assessment to collect data from 197 women aged 18 to 25 years 3 times a day for 7 days in July 2018. We collected data from women in 2 states. Results: We found that boredom was associated with increased time spent on social media and that increased time spent on social media was associated with increased time spent outdoors without sun protection. Conclusions: Our results highlight that social media may be a particularly important channel for skin cancer prevention efforts targeting young women, as more social media use was associated with increased time spent outdoors with skin exposed. Researchers should consider the role of emotions in motivating social media use and subsequent tanning behaviors. Additionally, as boredom was associated with social media use, intervention developers would benefit from developing digital and social media interventions that entertain as well as educate. ",
doi="10.2196/18371",
url="http://derma.jmir.org/2020/1/e18371/"
}


@Article{info:doi/10.2196/22609,
author="Alshalan, Raghad
and Al-Khalifa, Hend
and Alsaeed, Duaa
and Al-Baity, Heyam
and Alshalan, Shahad",
title="Detection of Hate Speech in COVID-19--Related Tweets in the Arab Region: Deep Learning and Topic Modeling Approach",
journal="J Med Internet Res",
year="2020",
month="Dec",
day="8",
volume="22",
number="12",
pages="e22609",
keywords="COVID-19",
keywords="coronavirus",
keywords="Twitter",
keywords="hate speech",
keywords="social network analysis",
keywords="social media",
keywords="public health",
keywords="pandemic",
keywords="deep learning",
keywords="non-negative matrix factorization",
keywords="NMF",
keywords="convolutional neural network",
keywords="CNN",
abstract="Background: The massive scale of social media platforms requires an automatic solution for detecting hate speech. These automatic solutions will help reduce the need for manual analysis of content. Most previous literature has cast the hate speech detection problem as a supervised text classification task using classical machine learning methods or, more recently, deep learning methods. However, work investigating this problem in Arabic cyberspace is still limited compared to the published work on English text. Objective: This study aims to identify hate speech related to the COVID-19 pandemic posted by Twitter users in the Arab region and to discover the main issues discussed in tweets containing hate speech. Methods: We used the ArCOV-19 dataset, an ongoing collection of Arabic tweets related to COVID-19, starting from January 27, 2020. Tweets were analyzed for hate speech using a pretrained convolutional neural network (CNN) model; each tweet was given a score between 0 and 1, with 1 being the most hateful text. We also used nonnegative matrix factorization to discover the main issues and topics discussed in hate tweets. Results: The analysis of hate speech in Twitter data in the Arab region identified that the number of non--hate tweets greatly exceeded the number of hate tweets, where the percentage of hate tweets among COVID-19 related tweets was 3.2\% (11,743/547,554). The analysis also revealed that the majority of hate tweets (8385/11,743, 71.4\%) contained a low level of hate based on the score provided by the CNN. This study identified Saudi Arabia as the Arab country from which the most COVID-19 hate tweets originated during the pandemic. Furthermore, we showed that the largest number of hate tweets appeared during the time period of March 1-30, 2020, representing 51.9\% of all hate tweets (6095/11,743). Contrary to what was anticipated, in the Arab region, it was found that the spread of COVID-19--related hate speech on Twitter was weakly related with the dissemination of the pandemic based on the Pearson correlation coefficient (r=0.1982, P=.50). The study also identified the commonly discussed topics in hate tweets during the pandemic. Analysis of the 7 extracted topics showed that 6 of the 7 identified topics were related to hate speech against China and Iran. Arab users also discussed topics related to political conflicts in the Arab region during the COVID-19 pandemic. Conclusions: The COVID-19 pandemic poses serious public health challenges to nations worldwide. During the COVID-19 pandemic, frequent use of social media can contribute to the spread of hate speech. Hate speech on the web can have a negative impact on society, and hate speech may have a direct correlation with real hate crimes, which increases the threat associated with being targeted by hate speech and abusive language. This study is the first to analyze hate speech in the context of Arabic COVID-19--related tweets in the Arab region. ",
doi="10.2196/22609",
url="http://www.jmir.org/2020/12/e22609/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33207310"
}


@Article{info:doi/10.2196/24125,
author="Xu, Qing
and Shen, Ziyi
and Shah, Neal
and Cuomo, Raphael
and Cai, Mingxiang
and Brown, Matthew
and Li, Jiawei
and Mackey, Tim",
title="Characterizing Weibo Social Media Posts From Wuhan, China During the Early Stages of the COVID-19 Pandemic: Qualitative Content Analysis",
journal="JMIR Public Health Surveill",
year="2020",
month="Dec",
day="7",
volume="6",
number="4",
pages="e24125",
keywords="COVID-19",
keywords="infodemiology",
keywords="infoveillance",
keywords="infodemic",
keywords="Weibo",
keywords="social media",
keywords="content analysis",
keywords="China",
keywords="data mining",
keywords="knowledge",
keywords="attitude",
keywords="behavior",
abstract="Background: The COVID-19 pandemic has reached 40 million confirmed cases worldwide. Given its rapid progression, it is important to examine its origins to better understand how people's knowledge, attitudes, and reactions have evolved over time. One method is to use data mining of social media conversations related to information exposure and self-reported user experiences. Objective: This study aims to characterize the knowledge, attitudes, and behaviors of social media users located at the initial epicenter of the outbreak by analyzing data from the Sina Weibo platform in Chinese. Methods: We used web scraping to collect public Weibo posts from December 31, 2019, to January 20, 2020, from users located in Wuhan City that contained COVID-19--related keywords. We then manually annotated all posts using an inductive content coding approach to identify specific information sources and key themes including news and knowledge about the outbreak, public sentiment, and public reaction to control and response measures. Results: We identified 10,159 COVID-19 posts from 8703 unique Weibo users. Among our three parent classification areas, 67.22\% (n=6829) included news and knowledge posts, 69.72\% (n=7083) included public sentiment, and 47.87\% (n=4863) included public reaction and self-reported behavior. Many of these themes were expressed concurrently in the same Weibo post. Subtopics for news and knowledge posts followed four distinct timelines and evidenced an escalation of the outbreak's seriousness as more information became available. Public sentiment primarily focused on expressions of anxiety, though some expressions of anger and even positive sentiment were also detected. Public reaction included both protective and elevated health risk behavior. Conclusions: Between the announcement of pneumonia and respiratory illness of unknown origin in late December 2019 and the discovery of human-to-human transmission on January 20, 2020, we observed a high volume of public anxiety and confusion about COVID-19, including different reactions to the news by users, negative sentiment after being exposed to information, and public reaction that translated to self-reported behavior. These findings provide early insight into changing knowledge, attitudes, and behaviors about COVID-19, and have the potential to inform future outbreak communication, response, and policy making in China and beyond. ",
doi="10.2196/24125",
url="http://publichealth.jmir.org/2020/4/e24125/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33175693"
}


@Article{info:doi/10.2196/18767,
author="Lee, Jooyun
and Park, Hyeoun-Ae
and Park, Ki Seul
and Song, Tae-Min",
title="Using Social Media Data to Understand Consumers' Information Needs and Emotions Regarding Cancer: Ontology-Based Data Analysis Study",
journal="J Med Internet Res",
year="2020",
month="Dec",
day="7",
volume="22",
number="12",
pages="e18767",
keywords="social media",
keywords="ontology",
keywords="cancer",
keywords="health information needs",
keywords="cancer information",
keywords="emotion",
abstract="Background: Analysis of posts on social media is effective in investigating health information needs for disease management and identifying people's emotional status related to disease. An ontology is needed for semantic analysis of social media data. Objective: This study was performed to develop a cancer ontology with terminology containing consumer terms and to analyze social media data to identify health information needs and emotions related to cancer. Methods: A cancer ontology was developed using social media data, collected with a crawler, from online communities and blogs between January 1, 2014 and June 30, 2017 in South Korea. The relative frequencies of posts containing ontology concepts were counted and compared by cancer type. Results: The ontology had 9 superclasses, 213 class concepts, and 4061 synonyms. Ontology-driven natural language processing was performed on the text from 754,744 cancer-related posts. Colon, breast, stomach, cervical, lung, liver, pancreatic, and prostate cancer; brain tumors; and leukemia appeared most in these posts. At the superclass level, risk factor was the most frequent, followed by emotions, symptoms, treatments, and dealing with cancer. Conclusions: Information needs and emotions differed according to cancer type. The observations of this study could be used to provide tailored information to consumers according to cancer type and care process. Attention should be paid to provision of cancer-related information to not only patients but also their families and the general public seeking information on cancer. ",
doi="10.2196/18767",
url="http://www.jmir.org/2020/12/e18767/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33284127"
}


@Article{info:doi/10.2196/20649,
author="Majmundar, Anuja
and Le, NamQuyen
and Moran, Bridgid Meghan
and Unger, B. Jennifer
and Reuter, Katja",
title="Public Response to a Social Media Tobacco Prevention Campaign: Content Analysis",
journal="JMIR Public Health Surveill",
year="2020",
month="Dec",
day="7",
volume="6",
number="4",
pages="e20649",
keywords="social media",
keywords="health campaign",
keywords="tobacco",
keywords="online",
keywords="health communication",
keywords="internet",
keywords="Twitter",
keywords="Facebook",
keywords="Instagram",
abstract="Background: Prior research suggests that social media--based public health campaigns are often targeted by countercampaigns. Objective: Using reactance theory as the theoretical framework, this research characterizes the nature of public response to tobacco prevention messages disseminated via a social media--based campaign. We also examine whether agreement with the prevention messages is associated with comment tone and nature of the contribution to the overall discussion. Methods: User comments to tobacco prevention messages, posted between April 19, 2017 and July 12, 2017, were extracted from Twitter, Facebook, and Instagram. Two coders categorized comments in terms of tone, agreement with message, nature of contribution, mentions of government agency and regulation, promotional or spam comments, and format of comment. Chi-square analyses tested associations between agreement with the message and tone of the public response and the nature of contributions to the discussions. Results: Of the 1242 comments received (Twitter: n=1004; Facebook: n=176; Instagram: n=62), many comments used a negative tone (42.75\%) and disagreed with the health messages (39.77\%), while the majority made healthy contributions to the discussions (84.38\%). Only 0.56\% of messages mentioned government agencies, and only 0.48\% of the comments were antiregulation. Comments employing a positive tone (84.13\%) or making healthy contributions (69.11\%) were more likely to agree with the campaign messages (P=0.01). Comments employing a negative tone (71.25\%) or making toxic contributions (36.26\%) generally disagreed with the messages (P=0.01). Conclusions: The majority of user comments in response to a tobacco prevention campaign made healthy contributions. Our findings encourage the use of social media to promote dialogue about controversial health topics such as smoking. However, toxicity was characteristic of comments that disagreed with the health messages. Managing negative and toxic comments on social media is a crucial issue for social media--based tobacco prevention campaigns to consider. ",
doi="10.2196/20649",
url="http://publichealth.jmir.org/2020/4/e20649/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33284120"
}


@Article{info:doi/10.2196/20926,
author="Oppezzo, Marily
and Tremmel, Jennifer
and Desai, Manisha
and Baiocchi, Michael
and Ramo, Danielle
and Cullen, Mark
and Prochaska, J. Judith",
title="Twitter-Based Social Support Added to Fitbit Self-Monitoring for Decreasing Sedentary Behavior: Protocol for a Randomized Controlled Pilot Trial With Female Patients From a Women's Heart Clinic",
journal="JMIR Res Protoc",
year="2020",
month="Dec",
day="4",
volume="9",
number="12",
pages="e20926",
keywords="support group",
keywords="sedentary behavior",
keywords="eHealth",
keywords="Twitter",
keywords="Fitbit",
keywords="intervention",
keywords="behavior change theory",
keywords="mobile phone",
abstract="Background: Prolonged sitting is an independent risk behavior for the development of chronic disease. With most interventions focusing on physical activity and exercise, there is a separate need for investigation into innovative and accessible interventions to decrease sedentary behavior throughout the day. Twitter is a social media platform with application for health communications and fostering of social support for health behavior change. Objective: This pilot study aims to test the feasibility, acceptability, and preliminary efficacy of delivering daily behavior change strategies within private Twitter groups to foster peer-to-peer support and decrease sedentary behavior throughout the day in women. The Twitter group was combined with a Fitbit for self-monitoring activity and compared to a Fitbit-only control group. Methods: In a 2-group design, participants were randomized to a Twitter + Fitbit treatment group or a Fitbit-only control group. Participants were recruited via the Stanford Research Repository System, screened for eligibility, and then invited to an orientation session. After providing informed consent, they were randomized. All participants received 13 weeks of tailored weekly step goals and a Fitbit. The treatment group participants, placed in a private Twitter support group, received daily automated behavior change ``tweets'' informed by theory and regular automated encouragement via text to communicate with the group. Fitbit data were collected daily throughout the treatment and follow-up period. Web-based surveys and accelerometer data were collected at baseline, treatment end (13 weeks), and at 8.5 weeks after the treatment. Results: The initial study design funding was obtained from the Women's Heart Clinic and the Stanford Clayman Institute. Funding to run this pilot study was received from the National Institutes of Health's National Heart, Lung, and Blood Institute under Award Number K01HL136702. All procedures were approved by Stanford University's Institutional Review Board, \#32127 in 2018, prior to beginning data collection. Recruitment for this study was conducted in May 2019. Of the 858 people screened, 113 met the eligibility criteria, 68 came to an information session, and 45 consented to participate in this pilot study. One participant dropped out of the intervention, and complete follow-up data were obtained from 39 of the 45 participants (87\% of the sample). Data were collected over 6 months from June to December 2019. Feasibility, acceptability, and preliminary efficacy results are being analyzed and will be reported in the winter of 2021. Conclusions: This pilot study is assessing the feasibility, acceptability, and preliminary efficacy of delivering behavior change strategies in a Twitter social support group to decrease sedentary behavior in women. These findings will inform a larger evaluation. With an accessible, tailorable, and flexible platform, Twitter-delivered interventions offer potential for many treatment variations and titrations, thereby testing the effects of different behavior change strategies, peer-group makeups, and health behaviors of interest. Trial Registration: ClinicalTrials.gov NCT02958189, https://clinicaltrials.gov/ct2/show/NCT02958189 International Registered Report Identifier (IRRID): DERR1-10.2196/20926 ",
doi="10.2196/20926",
url="https://www.researchprotocols.org/2020/12/e20926",
url="http://www.ncbi.nlm.nih.gov/pubmed/33275104"
}


@Article{info:doi/10.2196/21499,
author="Xu, Paiheng
and Dredze, Mark
and Broniatowski, A. David",
title="The Twitter Social Mobility Index: Measuring Social Distancing Practices With Geolocated Tweets",
journal="J Med Internet Res",
year="2020",
month="Dec",
day="3",
volume="22",
number="12",
pages="e21499",
keywords="COVID-19",
keywords="social distancing",
keywords="mobility",
keywords="Twitter",
keywords="social media",
keywords="surveillance",
keywords="tracking",
keywords="travel",
keywords="index",
abstract="Background: Social distancing is an important component of the response to the COVID-19 pandemic. Minimizing social interactions and travel reduces the rate at which the infection spreads and ``flattens the curve'' so that the medical system is better equipped to treat infected individuals. However, it remains unclear how the public will respond to these policies as the pandemic continues. Objective: The aim of this study is to present the Twitter Social Mobility Index, a measure of social distancing and travel derived from Twitter data. We used public geolocated Twitter data to measure how much users travel in a given week. Methods: We collected 469,669,925 tweets geotagged in the United States from January 1, 2019, to April 27, 2020. We analyzed the aggregated mobility variance of a total of 3,768,959 Twitter users at the city and state level from the start of the COVID-19 pandemic. Results: We found a large reduction (61.83\%) in travel in the United States after the implementation of social distancing policies. However, the variance by state was high, ranging from 38.54\% to 76.80\%. The eight states that had not issued statewide social distancing orders as of the start of April ranked poorly in terms of travel reduction: Arkansas (45), Iowa (37), Nebraska (35), North Dakota (22), South Carolina (38), South Dakota (46), Oklahoma (50), Utah (14), and Wyoming (53). We are presenting our findings on the internet and will continue to update our analysis during the pandemic. Conclusions: We observed larger travel reductions in states that were early adopters of social distancing policies and smaller changes in states without such policies. The results were also consistent with those based on other mobility data to a certain extent. Therefore, geolocated tweets are an effective way to track social distancing practices using a public resource, and this tracking may be useful as part of ongoing pandemic response planning. ",
doi="10.2196/21499",
url="https://www.jmir.org/2020/12/e21499",
url="http://www.ncbi.nlm.nih.gov/pubmed/33048823"
}


@Article{info:doi/10.2196/23520,
author="Escobar-Viera, G. C{\'e}sar
and Shensa, Ariel
and Sidani, Jaime
and Primack, Brian
and Marshal, P. Michael",
title="Association Between LGB Sexual Orientation and Depression Mediated by Negative Social Media Experiences: National Survey Study of US Young Adults",
journal="JMIR Ment Health",
year="2020",
month="Dec",
day="3",
volume="7",
number="12",
pages="e23520",
keywords="social media",
keywords="depression",
keywords="mental health",
keywords="sexual minorities",
keywords="minority stress",
keywords="GSEM",
keywords="survey",
keywords="young adult",
keywords="adolescent",
keywords="LGBTQ",
abstract="Background: Lesbian, gay, and bisexual (LGB) persons are disproportionately affected by depression and have high social media use rates. Negative social media experiences may modify depressive symptoms among LGB persons. We sought to assess the potential influence of negative social media experiences on the association between LGB orientation and depression. Objective: The aim of this study was to assess the potential influence of negative social media experiences on the association between LGB orientation and depression. Methods: We performed a web-based survey of a national sample of US young adults aged 18-30 years. We assessed the respondents' LGB orientation, negative social media experiences, and depression using the 9-item Patient Health Questionnaire. We used generalized structural equation modeling to assess both the direct and indirect effects (via negative social media experiences) of LGB orientation on depression while controlling for relevant demographic and personal characteristics. Results: We found a conditional indirect effect (ab path) of LGB orientation on depressive symptoms via negative social media experience (a: observed coefficient 0.229; P<.001; bias-corrected bootstrapped 95\% CI 0.162-0.319, and b: observed coefficient 2.158; P<.001; bias-corrected bootstrapped 95\% CI 1.840-2.494). The results show that among LGB respondents, for those who reported negative social media experiences in the past year, a 1 unit increase in these experiences was associated with a 0.494 unit increase in depressive symptomatology. Conclusions: Our results suggest that higher rates of depression among LGB young adults are partially explained by negative social media experiences; these results could help inform future patient/provider conversations about mental health risk and protective factors related to social media use. Reducing these experiences and increasing positive social media experiences among LGB persons may mitigate depressive symptomatology in this population. ",
doi="10.2196/23520",
url="https://mental.jmir.org/2020/12/e23520",
url="http://www.ncbi.nlm.nih.gov/pubmed/33270041"
}


@Article{info:doi/10.2196/23273,
author="Wu, Qiong
and Huang, Yiwen
and Liao, Zijun
and van Velthoven, Helena Michelle
and Wang, Wei
and Zhang, Yanfeng",
title="Effectiveness of WeChat for Improving Exclusive Breastfeeding in Huzhu County China: Randomized Controlled Trial",
journal="J Med Internet Res",
year="2020",
month="Dec",
day="3",
volume="22",
number="12",
pages="e23273",
keywords="breastfeeding",
keywords="exclusive breastfeeding",
keywords="WeChat",
keywords="mHealth",
keywords="randomized controlled trial",
abstract="Background: The benefits of breastfeeding for both infants and mothers have been well recognized. However, the exclusive breastfeeding rate in China is low and decreasing. Mobile technologies have rapidly developed; communication apps such as WeChat (one of the largest social networking platforms in China) are widely used and have the potential to conveniently improve health behaviors. Objective: This study aimed to assess the effectiveness of using WeChat to improve breastfeeding practices. Methods: This 2-arm randomized controlled trial was conducted among pregnant women from May 2019 to April 2020 in Huzhu County, Qinghai Province, China. Pregnant women were eligible to participate if they were aged 18 years or older, were 11 to 37 weeks pregnant with a singleton fetus, had no known illness that could limit breastfeeding after childbirth, used WeChat through their smartphone, and had access to the internet. A total of 344 pregnant women were recruited at baseline, with 170 in the intervention group and 174 in the control group. Women in the intervention group received breastfeeding knowledge and promotion information weekly through a WeChat official account from their third month of pregnancy to 6 months postpartum. The primary outcome of exclusive and predominant breastfeeding rate was measured 0-1 month, 2-3 months, and 4-5 months postpartum. Results: At 0-1 month postpartum, the exclusive breastfeeding rate was significantly higher in the intervention group than that in the control group (81.1\% vs 63.3\%; odds ratio [OR] 2.75, 95\% CI 1.58-4.78; P<.001). Similarly, mothers in the intervention group were more likely to provide predominantly breast milk (OR 2.77, 95\% CI 1.55-4.96; P<.001) and less likely to give dairy products to their children (OR 0.40, 95\% CI 0.21-0.75; P=.005). There was no statistically significant difference for exclusive breastfeeding rate 2-3 months (P=.09) and 4-5 months postpartum (P=.27), though more children in the intervention group were exclusively breastfed than those in the control group 2-3 months postpartum (intervention: 111/152, 73.0\%; control: 96/152, 63.2\%) and 4-5 months postpartum(intervention: 50/108, 46.3\%; control: 46/109, 42.2\%). Conclusions: This study is the first effort to promote exclusive breastfeeding through WeChat in China, which proved to be an effective method of promoting exclusive breastfeeding in early life. WeChat health education can be used in addition to local breastfeeding promotion programs. Trial Registration: Chinese Clinical Trial Registry ChiCTR1800017364; http://www.chictr.org.cn/showproj.aspx?proj=29325 International Registered Report Identifier (IRRID): RR2-10.1186/s12889-019-7676-2 ",
doi="10.2196/23273",
url="https://www.jmir.org/2020/12/e23273",
url="http://www.ncbi.nlm.nih.gov/pubmed/33270026"
}


@Article{info:doi/10.2196/19470,
author="Zeng, Runxi
and Li, Menghan",
title="Social Media Use for Health Communication by the CDC in Mainland China: National Survey Study 2009-2020",
journal="J Med Internet Res",
year="2020",
month="Dec",
day="2",
volume="22",
number="12",
pages="e19470",
keywords="social media",
keywords="public health agencies",
keywords="Center for Disease Control and Prevention",
keywords="China",
keywords="government Weibo",
keywords="COVID-19",
abstract="Background: In recent years, public health incidents that pose a serious threat to public life have occurred frequently in China. The use of social media by public health authorities has helped to reduce these threats by increasing effective risk communication between the government and the public. Objective: The aim of this study is to reveal how China's Center for Disease Control and Prevention (CDC) uses social media to improve three aspects of health communication between the government and the public: adoption, operation, and interaction. Methods: To analyze the 134 CDC government Weibo accounts at the provincial- and prefecture-level administration regions in mainland China, we collected their account data and extracted 1215 Weibo tweets. We also supplemented the data to reveal the overall performance of the CDC's government Weibo use during the COVID-19 crisis. Results: The registration rate of the CDC's government Weibo accounts increased year by year, and the local authorities registered Weibo accounts before the central government authorities. In total, 29.8\% (n=134) of the 450 CDC facilities have registered an account. Among the 134 CDC facilities that have registered Weibo accounts, the registration rate in the eastern region (n=68, 50.7\%) was higher than those in the central region (n=30, 22.4\%) and the western region (n=36, 26.9\%). Nearly 90.0\% of these Weibo accounts had official certification, but there were dropouts in the specific operating process. One-third of the accounts have not been updated for more than 1 year, and the number of Weibo followers was polarized, with a maximum and minimum difference of 1 million. The response rate to users' comments was less than 1\%. Emergency information, multimedia content, and original content were more helpful in promoting communication between the government and the public. Such interaction was partially improved during the COVID-19 pandemic. The CDC updated the daily epidemic situation and provided popular science information for epidemic prevention and control for the public in a timely manner. Conclusions: China's CDC is using more social media to popularize daily health information and has taken the first step to improve communication between the government and the public. However, equal dialogue, two-way interactions, and effective communication with the public still need improvement. ",
doi="10.2196/19470",
url="https://www.jmir.org/2020/12/e19470",
url="http://www.ncbi.nlm.nih.gov/pubmed/33151892"
}


@Article{info:doi/10.2196/25070,
author="Acquaviva, D. Kimberly
and Mugele, Josh
and Abadilla, Natasha
and Adamson, Tyler
and Bernstein, L. Samantha
and Bhayani, K. Rakhee
and B{\"u}chi, Elisabeth Annina
and Burbage, Darcy
and Carroll, L. Christopher
and Davis, P. Samantha
and Dhawan, Natasha
and Eaton, Alice
and English, Kim
and Grier, T. Jennifer
and Gurney, K. Mary
and Hahn, S. Emily
and Haq, Heather
and Huang, Brendan
and Jain, Shikha
and Jun, Jin
and Kerr, T. Wesley
and Keyes, Timothy
and Kirby, R. Amelia
and Leary, Marion
and Marr, Mollie
and Major, Ajay
and Meisel, V. Jason
and Petersen, A. Erika
and Raguan, Barak
and Rhodes, Allison
and Rupert, D. Deborah
and Sam-Agudu, A. Nadia
and Saul, Naledi
and Shah, R. Jarna
and Sheldon, Kennedy Lisa
and Sinclair, T. Christian
and Spencer, Kerry
and Strand, H. Natalie
and Streed Jr, G. Carl
and Trudell, M. Avery",
title="Documenting Social Media Engagement as Scholarship: A New Model for Assessing Academic Accomplishment for the Health Professions",
journal="J Med Internet Res",
year="2020",
month="Dec",
day="2",
volume="22",
number="12",
pages="e25070",
keywords="social media",
keywords="promotion",
keywords="tenure",
keywords="health professions",
keywords="scholarship",
keywords="medicine",
keywords="research",
keywords="accomplishment",
keywords="crowdsource",
keywords="contribution",
keywords="innovation",
keywords="education",
keywords="dissemination",
abstract="Background: The traditional model of promotion and tenure in the health professions relies heavily on formal scholarship through teaching, research, and service. Institutions consider how much weight to give activities in each of these areas and determine a threshold for advancement. With the emergence of social media, scholars can engage wider audiences in creative ways and have a broader impact. Conventional metrics like the h-index do not account for social media impact. Social media engagement is poorly represented in most curricula vitae (CV) and therefore is undervalued in promotion and tenure reviews. Objective: The objective was to develop crowdsourced guidelines for documenting social media scholarship. These guidelines aimed to provide a structure for documenting a scholar's general impact on social media, as well as methods of documenting individual social media contributions exemplifying innovation, education, mentorship, advocacy, and dissemination. Methods: To create unifying guidelines, we created a crowdsourced process that capitalized on the strengths of social media and generated a case example of successful use of the medium for academic collaboration. The primary author created a draft of the guidelines and then sought input from users on Twitter via a publicly accessible Google Document. There was no limitation on who could provide input and the work was done in a democratic, collaborative fashion. Contributors edited the draft over a period of 1 week (September 12-18, 2020). The primary and secondary authors then revised the draft to make it more concise. The guidelines and manuscript were then distributed to the contributors for edits and adopted by the group. All contributors were given the opportunity to serve as coauthors on the publication and were told upfront that authorship would depend on whether they were able to document the ways in which they met the 4 International Committee of Medical Journal Editors authorship criteria. Results: We developed 2 sets of guidelines: Guidelines for Listing All Social Media Scholarship Under Public Scholarship (in Research/Scholarship Section of CV) and Guidelines for Listing Social Media Scholarship Under Research, Teaching, and Service Sections of CV. Institutions can choose which set fits their existing CV format. Conclusions: With more uniformity, scholars can better represent the full scope and impact of their work. These guidelines are not intended to dictate how individual institutions should weigh social media contributions within promotion and tenure cases. Instead, by providing an initial set of guidelines, we hope to provide scholars and their institutions with a common format and language to document social media scholarship. ",
doi="10.2196/25070",
url="https://www.jmir.org/2020/12/e25070",
url="http://www.ncbi.nlm.nih.gov/pubmed/33263554"
}


@Article{info:doi/10.2196/21886,
author="Sobowale, Kunmi
and Hilliard, Heather
and Ignaszewski, J. Martha
and Chokroverty, Linda",
title="Real-Time Communication: Creating a Path to COVID-19 Public Health Activism in Adolescents Using Social Media",
journal="J Med Internet Res",
year="2020",
month="Dec",
day="1",
volume="22",
number="12",
pages="e21886",
keywords="social media",
keywords="digital health",
keywords="COVID-19",
keywords="adolescent",
keywords="public health",
keywords="disaster",
keywords="communication",
keywords="affordances",
doi="10.2196/21886",
url="https://www.jmir.org/2020/12/e21886",
url="http://www.ncbi.nlm.nih.gov/pubmed/33226956"
}


@Article{info:doi/10.2196/23575,
author="Zhang, Weina
and Liu, Lu
and Cheng, Qijin
and Chen, Yan
and Xu, Dong
and Gong, Wenjie",
title="The Relationship Between Images Posted by New Mothers on WeChat Moments and Postpartum Depression: Cohort Study",
journal="J Med Internet Res",
year="2020",
month="Nov",
day="30",
volume="22",
number="11",
pages="e23575",
keywords="social media",
keywords="WeChat",
keywords="WeChat Moments",
keywords="postpartum depression",
abstract="Background: As social media posts reflect users' emotions, WeChat Moments, the most popular social media platform in China, may offer a glimpse into postpartum depression in the population. Objective: This study aimed to investigate the features of the images that mothers posted on WeChat Moments after childbirth and to explore the correlation between these features and the mothers' risk of postpartum depression. Methods: We collected the data of 419 mothers after delivery, including their demographics, factors associated with postpartum depression, and images posted on WeChat Moments. Postpartum depression was measured using the Edinburgh Postnatal Depression Scale. Descriptive analyses were performed to assess the following: content of the images, presence of people, the people's facial expressions, and whether or not memes were posted on WeChat Moments. Logistic regression analyses were used to identify the image features associated with postpartum depression. Results: Compared with pictures of other people, we found that pictures of their children comprised the majority (3909/6887, 56.8\%) of the pictures posted by the mothers on WeChat Moments. Among the posts showing facial expressions or memes, more positive than negative emotions were expressed. Women who posted selfies during the postpartum period were more likely to have postpartum depression (P=.003; odds ratio 2.27, 95\% CI 1.33-3.87). Conclusions: The vast majority of mothers posted images conveying positive emotions during the postpartum period, but these images may have masked their depression. New mothers who have posted selfies may be at a higher risk of postpartum depression. Trial Registration: International Clinical Trials Registry Platform ChiCTR-ROC-16009255; http://www.chictr.org.cn/showproj.aspx?proj=15699 ",
doi="10.2196/23575",
url="http://www.jmir.org/2020/11/e23575/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33252343"
}


@Article{info:doi/10.2196/21660,
author="Singh, Tavleen
and Roberts, Kirk
and Cohen, Trevor
and Cobb, Nathan
and Wang, Jing
and Fujimoto, Kayo
and Myneni, Sahiti",
title="Social Media as a Research Tool (SMaaRT) for Risky Behavior Analytics: Methodological Review",
journal="JMIR Public Health Surveill",
year="2020",
month="Nov",
day="30",
volume="6",
number="4",
pages="e21660",
keywords="social media",
keywords="infodemiology",
keywords="infoveillance",
keywords="online health communities",
keywords="risky health behaviors",
keywords="data mining",
keywords="machine learning",
keywords="natural language processing",
keywords="text mining",
abstract="Background: Modifiable risky health behaviors, such as tobacco use, excessive alcohol use, being overweight, lack of physical activity, and unhealthy eating habits, are some of the major factors for developing chronic health conditions. Social media platforms have become indispensable means of communication in the digital era. They provide an opportunity for individuals to express themselves, as well as share their health-related concerns with peers and health care providers, with respect to risky behaviors. Such peer interactions can be utilized as valuable data sources to better understand inter-and intrapersonal psychosocial mediators and the mechanisms of social influence that drive behavior change. Objective: The objective of this review is to summarize computational and quantitative techniques facilitating the analysis of data generated through peer interactions pertaining to risky health behaviors on social media platforms. Methods: We performed a systematic review of the literature in September 2020 by searching three databases---PubMed, Web of Science, and Scopus---using relevant keywords, such as ``social media,'' ``online health communities,'' ``machine learning,'' ``data mining,'' etc. The reporting of the studies was directed by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Two reviewers independently assessed the eligibility of studies based on the inclusion and exclusion criteria. We extracted the required information from the selected studies. Results: The initial search returned a total of 1554 studies, and after careful analysis of titles, abstracts, and full texts, a total of 64 studies were included in this review. We extracted the following key characteristics from all of the studies: social media platform used for conducting the study, risky health behavior studied, the number of posts analyzed, study focus, key methodological functions and tools used for data analysis, evaluation metrics used, and summary of the key findings. The most commonly used social media platform was Twitter, followed by Facebook, QuitNet, and Reddit. The most commonly studied risky health behavior was nicotine use, followed by drug or substance abuse and alcohol use. Various supervised and unsupervised machine learning approaches were used for analyzing textual data generated from online peer interactions. Few studies utilized deep learning methods for analyzing textual data as well as image or video data. Social network analysis was also performed, as reported in some studies. Conclusions: Our review consolidates the methodological underpinnings for analyzing risky health behaviors and has enhanced our understanding of how social media can be leveraged for nuanced behavioral modeling and representation. The knowledge gained from our review can serve as a foundational component for the development of persuasive health communication and effective behavior modification technologies aimed at the individual and population levels. ",
doi="10.2196/21660",
url="http://publichealth.jmir.org/2020/4/e21660/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33252345"
}


@Article{info:doi/10.2196/18666,
author="Sugawara, Yuya
and Murakami, Masayasu
and Narimatsu, Hiroto",
title="Use of Social Media by Hospitals and Clinics in Japan: Descriptive Study",
journal="JMIR Med Inform",
year="2020",
month="Nov",
day="27",
volume="8",
number="11",
pages="e18666",
keywords="social media",
keywords="internet",
keywords="hospitals",
keywords="health promotion",
keywords="Japan",
abstract="Background: The use of social media by hospitals has become widespread in the United States and Western European countries. However, in Japan, the extent to which hospitals and clinics use social media is unknown. Furthermore, recent revisions to the Medical Care Act may subject social media content to regulation. Objective: The purpose of this study was to examine social media use in Japanese hospitals and clinics. We investigated the adoption of social media, analyzed social media content, and compared content with medical advertising guidelines. Methods: We randomly sampled 300 hospitals and 300 clinics from a list of medical institutions that was compiled by the Ministry of Health, Labour and Welfare. We performed web and social media (Facebook and Twitter) searches using the hospital and clinic names to determine whether they had social media accounts. We collected Facebook posts and Twitter tweets and categorized them based on their content (eg, health promotion, participation in academic meetings and publications, public relations or news announcements, and recruitment). We compared the collected content with medical advertising guidelines. Results: We found that 26.0\% (78/300) of the hospitals and 7.7\% (23/300) of the clinics used Facebook, Twitter, or both. Public relations or news announcements accounted for 53.99\% (724/1341) of the Facebook posts by hospitals and 58.4\% (122/209) of the Facebook posts by clinics. In hospitals, 16/1341 (1.19\%) Facebook posts and 6/574 (1.0\%) tweets and in clinics, 8/209 (3.8\%) Facebook posts and 15/330 (4.5\%) tweets could conflict medical advertising guidelines. Conclusions: Fewer hospitals and clinics in Japan use social media as compared to other countries. Social media were mainly used for public relations. Some content disseminated by medical institutions could conflict with medical advertising guidelines. This study may serve as a reference for medical institutions to guide social media usage and may help improve medical website advertising in Japan. ",
doi="10.2196/18666",
url="https://medinform.jmir.org/2020/11/e18666",
url="http://www.ncbi.nlm.nih.gov/pubmed/33245281"
}


@Article{info:doi/10.2196/22152,
author="Wang, Junze
and Zhou, Ying
and Zhang, Wei
and Evans, Richard
and Zhu, Chengyan",
title="Concerns Expressed by Chinese Social Media Users During the COVID-19 Pandemic: Content Analysis of Sina Weibo Microblogging Data",
journal="J Med Internet Res",
year="2020",
month="Nov",
day="26",
volume="22",
number="11",
pages="e22152",
keywords="coronavirus",
keywords="COVID-19",
keywords="social media",
keywords="public health",
keywords="Sina Weibo",
keywords="public opinion",
keywords="citizen concerns",
abstract="Background: The COVID-19 pandemic has created a global health crisis that is affecting economies and societies worldwide. During times of uncertainty and unexpected change, people have turned to social media platforms as communication tools and primary information sources. Platforms such as Twitter and Sina Weibo have allowed communities to share discussion and emotional support; they also play important roles for individuals, governments, and organizations in exchanging information and expressing opinions. However, research that studies the main concerns expressed by social media users during the pandemic is limited. Objective: The aim of this study was to examine the main concerns raised and discussed by citizens on Sina Weibo, the largest social media platform in China, during the COVID-19 pandemic. Methods: We used a web crawler tool and a set of predefined search terms (New Coronavirus Pneumonia, New Coronavirus, and COVID-19) to investigate concerns raised by Sina Weibo users. Textual information and metadata (number of likes, comments, retweets, publishing time, and publishing location) of microblog posts published between December 1, 2019, and July 32, 2020, were collected. After segmenting the words of the collected text, we used a topic modeling technique, latent Dirichlet allocation (LDA), to identify the most common topics posted by users. We analyzed the emotional tendencies of the topics, calculated the proportional distribution of the topics, performed user behavior analysis on the topics using data collected from the number of likes, comments, and retweets, and studied the changes in user concerns and differences in participation between citizens living in different regions of mainland China. Results: Based on the 203,191 eligible microblog posts collected, we identified 17 topics and grouped them into 8 themes. These topics were pandemic statistics, domestic epidemic, epidemics in other countries worldwide, COVID-19 treatments, medical resources, economic shock, quarantine and investigation, patients' outcry for help, work and production resumption, psychological influence, joint prevention and control, material donation, epidemics in neighboring countries, vaccine development, fueling and saluting antiepidemic action, detection, and study resumption. The mean sentiment was positive for 11 topics and negative for 6 topics. The topic with the highest mean of retweets was domestic epidemic, while the topic with the highest mean of likes was quarantine and investigation. Conclusions: Concerns expressed by social media users are highly correlated with the evolution of the global pandemic. During the COVID-19 pandemic, social media has provided a platform for Chinese government departments and organizations to better understand public concerns and demands. Similarly, social media has provided channels to disseminate information about epidemic prevention and has influenced public attitudes and behaviors. Government departments, especially those related to health, can create appropriate policies in a timely manner through monitoring social media platforms to guide public opinion and behavior during epidemics. ",
doi="10.2196/22152",
url="http://www.jmir.org/2020/11/e22152/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33151894"
}


@Article{info:doi/10.2196/21504,
author="Chang, Angela
and Schulz, Johannes Peter
and Tu, ShengTsung
and Liu, Tingchi Matthew",
title="Communicative Blame in Online Communication of the COVID-19 Pandemic: Computational Approach of Stigmatizing Cues and Negative Sentiment Gauged With Automated Analytic Techniques",
journal="J Med Internet Res",
year="2020",
month="Nov",
day="25",
volume="22",
number="11",
pages="e21504",
keywords="placing blame",
keywords="culprits",
keywords="sentiment analysis",
keywords="infodemic analysis",
keywords="political grievances",
keywords="COVID-19",
keywords="communication",
keywords="pandemic",
keywords="social media",
keywords="negativity",
keywords="infodemic",
keywords="infodemiology",
keywords="infoveillance",
keywords="blame",
keywords="stigma",
abstract="Background: Information about a new coronavirus emerged in 2019 and rapidly spread around the world, gaining significant public attention and attracting negative bias. The use of stigmatizing language for the purpose of blaming sparked a debate. Objective: This study aims to identify social stigma and negative sentiment toward the blameworthy agents in social communities. Methods: We enabled a tailored text-mining platform to identify data in their natural settings by retrieving and filtering online sources, and constructed vocabularies and learning word representations from natural language processing for deductive analysis along with the research theme. The data sources comprised of ten news websites, eleven discussion forums, one social network, and two principal media sharing networks in Taiwan. A synthesis of news and social networking analytics was present from December 30, 2019, to March 31, 2020. Results: We collated over 1.07 million Chinese texts. Almost two-thirds of the texts on COVID-19 came from news services (n=683,887, 63.68\%), followed by Facebook (n=297,823, 27.73\%), discussion forums (n=62,119, 5.78\%), and Instagram and YouTube (n=30,154, 2.81\%). Our data showed that online news served as a hotbed for negativity and for driving emotional social posts. Online information regarding COVID-19 associated it with China---and a specific city within China through references to the ``Wuhan pneumonia''---potentially encouraging xenophobia. The adoption of this problematic moniker had a high frequency, despite the World Health Organization guideline to avoid biased perceptions and ethnic discrimination. Social stigma is disclosed through negatively valenced responses, which are associated with the most blamed targets. Conclusions: Our sample is sufficiently representative of a community because it contains a broad range of mainstream online media. Stigmatizing language linked to the COVID-19 pandemic shows a lack of civic responsibility that encourages bias, hostility, and discrimination. Frequently used stigmatizing terms were deemed offensive, and they might have contributed to recent backlashes against China by directing blame and encouraging xenophobia. The implications ranging from health risk communication to stigma mitigation and xenophobia concerns amid the COVID-19 outbreak are emphasized. Understanding the nomenclature and biased terms employed in relation to the COVID-19 outbreak is paramount. We propose solidarity with communication professionals in combating the COVID-19 outbreak and the infodemic. Finding solutions to curb the spread of virus bias, stigma, and discrimination is imperative. ",
doi="10.2196/21504",
url="http://www.jmir.org/2020/11/e21504/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33108306"
}


@Article{info:doi/10.2196/20550,
author="Xue, Jia
and Chen, Junxiang
and Hu, Ran
and Chen, Chen
and Zheng, Chengda
and Su, Yue
and Zhu, Tingshao",
title="Twitter Discussions and Emotions About the COVID-19 Pandemic: Machine Learning Approach",
journal="J Med Internet Res",
year="2020",
month="Nov",
day="25",
volume="22",
number="11",
pages="e20550",
keywords="machine learning",
keywords="Twitter data",
keywords="COVID-19",
keywords="infodemic",
keywords="infodemiology",
keywords="infoveillance",
keywords="public discussion",
keywords="public sentiment",
keywords="Twitter",
keywords="social media",
keywords="virus",
abstract="Background: It is important to measure the public response to the COVID-19 pandemic. Twitter is an important data source for infodemiology studies involving public response monitoring. Objective: The objective of this study is to examine COVID-19--related discussions, concerns, and sentiments using tweets posted by Twitter users. Methods: We analyzed 4 million Twitter messages related to the COVID-19 pandemic using a list of 20 hashtags (eg, ``coronavirus,'' ``COVID-19,'' ``quarantine'') from March 7 to April 21, 2020. We used a machine learning approach, Latent Dirichlet Allocation (LDA), to identify popular unigrams and bigrams, salient topics and themes, and sentiments in the collected tweets. Results: Popular unigrams included ``virus,'' ``lockdown,'' and ``quarantine.'' Popular bigrams included ``COVID-19,'' ``stay home,'' ``corona virus,'' ``social distancing,'' and ``new cases.'' We identified 13 discussion topics and categorized them into 5 different themes: (1) public health measures to slow the spread of COVID-19, (2) social stigma associated with COVID-19, (3) COVID-19 news, cases, and deaths, (4) COVID-19 in the United States, and (5) COVID-19 in the rest of the world. Across all identified topics, the dominant sentiments for the spread of COVID-19 were anticipation that measures can be taken, followed by mixed feelings of trust, anger, and fear related to different topics. The public tweets revealed a significant feeling of fear when people discussed new COVID-19 cases and deaths compared to other topics. Conclusions: This study showed that Twitter data and machine learning approaches can be leveraged for an infodemiology study, enabling research into evolving public discussions and sentiments during the COVID-19 pandemic. As the situation rapidly evolves, several topics are consistently dominant on Twitter, such as confirmed cases and death rates, preventive measures, health authorities and government policies, COVID-19 stigma, and negative psychological reactions (eg, fear). Real-time monitoring and assessment of Twitter discussions and concerns could provide useful data for public health emergency responses and planning. Pandemic-related fear, stigma, and mental health concerns are already evident and may continue to influence public trust when a second wave of COVID-19 occurs or there is a new surge of the current pandemic. ",
doi="10.2196/20550",
url="http://www.jmir.org/2020/11/e20550/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33119535"
}


@Article{info:doi/10.2196/22600,
author="Saha, Koustuv
and Torous, John
and Caine, D. Eric
and De Choudhury, Munmun",
title="Psychosocial Effects of the COVID-19 Pandemic: Large-scale Quasi-Experimental Study on Social Media",
journal="J Med Internet Res",
year="2020",
month="Nov",
day="24",
volume="22",
number="11",
pages="e22600",
keywords="social media",
keywords="Twitter",
keywords="language",
keywords="psychosocial effects",
keywords="mental health",
keywords="transfer learning",
keywords="depression",
keywords="anxiety",
keywords="stress",
keywords="social support",
keywords="emotions",
keywords="COVID-19",
keywords="coronavirus",
keywords="crisis",
abstract="Background: The COVID-19 pandemic has caused several disruptions in personal and collective lives worldwide. The uncertainties surrounding the pandemic have also led to multifaceted mental health concerns, which can be exacerbated with precautionary measures such as social distancing and self-quarantining, as well as societal impacts such as economic downturn and job loss. Despite noting this as a ``mental health tsunami'', the psychological effects of the COVID-19 crisis remain unexplored at scale. Consequently, public health stakeholders are currently limited in identifying ways to provide timely and tailored support during these circumstances. Objective: Our study aims to provide insights regarding people's psychosocial concerns during the COVID-19 pandemic by leveraging social media data. We aim to study the temporal and linguistic changes in symptomatic mental health and support expressions in the pandemic context. Methods: We obtained about 60 million Twitter streaming posts originating from the United States from March 24 to May 24, 2020, and compared these with about 40 million posts from a comparable period in 2019 to attribute the effect of COVID-19 on people's social media self-disclosure. Using these data sets, we studied people's self-disclosure on social media in terms of symptomatic mental health concerns and expressions of support. We employed transfer learning classifiers that identified the social media language indicative of mental health outcomes (anxiety, depression, stress, and suicidal ideation) and support (emotional and informational support). We then examined the changes in psychosocial expressions over time and language, comparing the 2020 and 2019 data sets. Results: We found that all of the examined psychosocial expressions have significantly increased during the COVID-19 crisis---mental health symptomatic expressions have increased by about 14\%, and support expressions have increased by about 5\%, both thematically related to COVID-19. We also observed a steady decline and eventual plateauing in these expressions during the COVID-19 pandemic, which may have been due to habituation or due to supportive policy measures enacted during this period. Our language analyses highlighted that people express concerns that are specific to and contextually related to the COVID-19 crisis. Conclusions: We studied the psychosocial effects of the COVID-19 crisis by using social media data from 2020, finding that people's mental health symptomatic and support expressions significantly increased during the COVID-19 period as compared to similar data from 2019. However, this effect gradually lessened over time, suggesting that people adapted to the circumstances and their ``new normal.'' Our linguistic analyses revealed that people expressed mental health concerns regarding personal and professional challenges, health care and precautionary measures, and pandemic-related awareness. This study shows the potential to provide insights to mental health care and stakeholders and policy makers in planning and implementing measures to mitigate mental health risks amid the health crisis. ",
doi="10.2196/22600",
url="http://www.jmir.org/2020/11/e22600/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33156805"
}


@Article{info:doi/10.2196/20044,
author="Niburski, Kacper
and Niburski, Oskar",
title="Impact of Trump's Promotion of Unproven COVID-19 Treatments and Subsequent Internet Trends: Observational Study",
journal="J Med Internet Res",
year="2020",
month="Nov",
day="20",
volume="22",
number="11",
pages="e20044",
keywords="COVID-19",
keywords="behavioral economics",
keywords="public health",
keywords="behavior",
keywords="economics",
keywords="media",
keywords="influence",
keywords="infodemic",
keywords="infodemiology",
keywords="infoveillance",
keywords="Twitter",
keywords="analysis",
keywords="trend",
abstract="Background: Individuals with large followings can influence public opinions and behaviors, especially during a pandemic. In the early days of the pandemic, US president Donald J Trump has endorsed the use of unproven therapies. Subsequently, a death attributed to the wrongful ingestion of a chloroquine-containing compound occurred. Objective: We investigated Donald J Trump's speeches and Twitter posts, as well as Google searches and Amazon purchases, and television airtime for mentions of hydroxychloroquine, chloroquine, azithromycin, and remdesivir. Methods: Twitter sourcing was catalogued with Factba.se, and analytics data, both past and present, were analyzed with Tweet Binder to assess average analytics data on key metrics. Donald J Trump's time spent discussing unverified treatments on the United States' 5 largest TV stations was catalogued with the Global Database of Events, Language, and Tone, and his speech transcripts were obtained from White House briefings. Google searches and shopping trends were analyzed with Google Trends. Amazon purchases were assessed using Helium 10 software. Results: From March 1 to April 30, 2020, Donald J Trump made 11 tweets about unproven therapies and mentioned these therapies 65 times in White House briefings, especially touting hydroxychloroquine and chloroquine. These tweets had an impression reach of 300\% above Donald J Trump's average. Following these tweets, at least 2\% of airtime on conservative networks for treatment modalities like azithromycin and continuous mentions of such treatments were observed on stations like Fox News. Google searches and purchases increased following his first press conference on March 19, 2020, and increased again following his tweets on March 21, 2020. The same is true for medications on Amazon, with purchases for medicine substitutes, such as hydroxychloroquine, increasing by 200\%. Conclusions: Individuals in positions of power can sway public purchasing, resulting in undesired effects when the individuals' claims are unverified. Public health officials must work to dissuade the use of unproven treatments for COVID-19. ",
doi="10.2196/20044",
url="http://www.jmir.org/2020/11/e20044/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33151895"
}


@Article{info:doi/10.2196/24012,
author="Zhang, Boyu
and Zaman, Anis
and Silenzio, Vincent
and Kautz, Henry
and Hoque, Ehsan",
title="The Relationships of Deteriorating Depression and Anxiety With Longitudinal Behavioral Changes in Google and YouTube Use During COVID-19: Observational Study",
journal="JMIR Ment Health",
year="2020",
month="Nov",
day="23",
volume="7",
number="11",
pages="e24012",
keywords="mental health",
keywords="anxiety",
keywords="depression",
keywords="Google Search",
keywords="YouTube",
keywords="pandemic",
keywords="COVID-19",
abstract="Background: Depression and anxiety disorders among the global population have worsened during the COVID-19 pandemic. Yet, current methods for screening these two issues rely on in-person interviews, which can be expensive, time-consuming, and blocked by social stigma and quarantines. Meanwhile, how individuals engage with online platforms such as Google Search and YouTube has undergone drastic shifts due to COVID-19 and subsequent lockdowns. Such ubiquitous daily behaviors on online platforms have the potential to capture and correlate with clinically alarming deteriorations in depression and anxiety profiles of users in a noninvasive manner. Objective: The goal of this study is to examine, among college students in the United States, the relationships of deteriorating depression and anxiety conditions with the changes in user behaviors when engaging with Google Search and YouTube during COVID-19. Methods: This study recruited a cohort of undergraduate students (N=49) from a US college campus during January 2020 (prior to the pandemic) and measured the anxiety and depression levels of each participant. The anxiety level was assessed via the General Anxiety Disorder-7 (GAD-7). The depression level was assessed via the Patient Health Questionnaire-9 (PHQ-9). This study followed up with the same cohort during May 2020 (during the pandemic), and the anxiety and depression levels were assessed again. The longitudinal Google Search and YouTube history data of all participants were anonymized and collected. From individual-level Google Search and YouTube histories, we developed 5 features that can quantify shifts in online behaviors during the pandemic. We then assessed the correlations of deteriorating depression and anxiety profiles with each of these features. We finally demonstrated the feasibility of using the proposed features to build predictive machine learning models. Results: Of the 49 participants, 49\% (n=24) of them reported an increase in the PHQ-9 depression scores; 53\% (n=26) of them reported an increase in the GAD-7 anxiety scores. The results showed that a number of online behavior features were significantly correlated with deteriorations in the PHQ-9 scores (r ranging between --0.37 and 0.75, all P values less than or equal to .03) and the GAD-7 scores (r ranging between --0.47 and 0.74, all P values less than or equal to .03). Simple machine learning models were shown to be useful in predicting the change in anxiety and depression scores (mean squared error ranging between 2.37 and 4.22, R2 ranging between 0.68 and 0.84) with the proposed features. Conclusions: The results suggested that deteriorating depression and anxiety conditions have strong correlations with behavioral changes in Google Search and YouTube use during the COVID-19 pandemic. Though further studies are required, our results demonstrate the feasibility of using pervasive online data to establish noninvasive surveillance systems for mental health conditions that bypasses many disadvantages of existing screening methods. ",
doi="10.2196/24012",
url="http://mental.jmir.org/2020/11/e24012/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33180743"
}


@Article{info:doi/10.2196/21501,
author="Chu, Wei-Min
and Shieh, Gow-Jen
and Wu, Shi-Liang
and Sheu, Huey-Herng Wayne",
title="Use of Facebook by Academic Medical Centers in Taiwan During the COVID-19 Pandemic: Observational Study",
journal="J Med Internet Res",
year="2020",
month="Nov",
day="20",
volume="22",
number="11",
pages="e21501",
keywords="COVID-19",
keywords="social media",
keywords="Facebook",
keywords="medical centers",
keywords="Taiwan",
keywords="communication",
keywords="video post",
keywords="survey",
keywords="health promotion",
keywords="engagement",
abstract="Background: The battle against COVID-19 remains ongoing, and social media has played an important role during the crisis for both communication and health promotion, particularly for health care organizations. Taiwan's success during the COVID-19 outbreak is well known and the use of social media is one of the key contributing factors to that success. Objective: This nationwide observational study in Taiwan aimed to explore the use of Facebook by academic medical centers during the COVID-19 pandemic. Methods: We conducted a nationwide observational study of all Facebook fan page posts culled from the official accounts of all medical centers in Taiwan from December 2019 to April 2020. All Facebook posts were categorized into either COVID-19--related posts or non--COVID-19--related posts. COVID-19--related posts were split into 4 categories: policy of Taiwan's Center for Disease Control (TCDC), gratitude notes, news and regulations from hospitals, and education. Data from each post was also recorded as follows: date of post, headline, number of ``likes,'' number of messages left, number of shares, video or non-video post, and date of search. Results: The Facebook fan pages of 13 academic medical centers, with a total of 1816 posts, were analyzed. From January 2020, the percentage of COVID-19 posts increased rapidly, from 21\% (January 2020) to 56.3\% (April 2020). The trends of cumulative COVID-19 posts and reported confirmed cases were significantly related (Pearson correlation coefficient=0.93, P<.001). Pages from private hospitals had more COVID-19 posts (362 versus 289), as well as more video posts (72 posts, 19.9\% versus 36 posts, 12.5\%, P=.011), when compared to public hospitals. However, Facebook pages from public hospitals had significantly more ``likes,'' comments, and shares per post (314, 5, 14, respectively, P<.001). Additionally, medical centers from different regions displayed different strategies for using video posts on Facebook. Conclusions: Social media has been a useful tool for communication during the COVID-19 pandemic. This nationwide observational study has helped demonstrate the value of Facebook for academic medical centers in Taiwan, along with its engagement efficacy. We believe that the experience of Taiwan and the knowledge it can share will be helpful to health care organizations worldwide during our global battle against COVID-19. ",
doi="10.2196/21501",
url="http://www.jmir.org/2020/11/e21501/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33119536"
}


@Article{info:doi/10.2196/17903,
author="Garcia-Rudolph, Alejandro
and Saur{\'i}, Joan
and Cegarra, Blanca
and Bernabeu Guitart, Montserrat",
title="Discovering the Context of People With Disabilities: Semantic Categorization Test and Environmental Factors Mapping of Word Embeddings from Reddit",
journal="JMIR Med Inform",
year="2020",
month="Nov",
day="20",
volume="8",
number="11",
pages="e17903",
keywords="disability",
keywords="Reddit",
keywords="social media",
keywords="word2vec",
keywords="semantic categorization",
keywords="silhouette",
keywords="activities of daily life",
keywords="aspects of daily life",
keywords="context",
keywords="embeddings",
abstract="Background: The World Health Organization's International Classification of Functioning Disability and Health (ICF) conceptualizes disability not solely as a problem that resides in the individual, but as a health experience that occurs in a context. Word embeddings build on the idea that words that occur in similar contexts tend to have similar meanings. In spite of both sharing ``context'' as a key component, word embeddings have been scarcely applied in disability. In this work, we propose social media (particularly, Reddit) to link them. Objective: The objective of our study is to train a model for generating word associations using a small dataset (a subreddit on disability) able to retrieve meaningful content. This content will be formally validated and applied to the discovery of related terms in the corpus of the disability subreddit that represent the physical, social, and attitudinal environment (as defined by a formal framework like the ICF) of people with disabilities. Methods: Reddit data were collected from pushshift.io with the pushshiftr R package as a wrapper. A word2vec model was trained with the wordVectors R package using the disability subreddit comments, and a preliminary validation was performed using a subset of Mikolov analogies. We used Van Overschelde's updated and expanded version of the Battig and Montague norms to perform a semantic categories test. Silhouette coefficients were calculated using cosine distance from the wordVectors R package. For each of the 5 ICF environmental factors (EF), we selected representative subcategories addressing different aspects of daily living (ADLs); then, for each subcategory, we identified specific terms extracted from their formal ICF definition and ran the word2vec model to generate their nearest semantic terms, validating the obtained nearest semantic terms using public evidence. Finally, we applied the model to a specific subcategory of an EF involved in a relevant use case in the field of rehabilitation. Results: We analyzed 96,314 comments posted between February 2009 and December 2019, by 10,411 Redditors. We trained word2vec and identified more than 30 analogies (eg, breakfast -- 8 am + 8 pm = dinner). The semantic categorization test showed promising results over 60 categories; for example, s(A relative)=0.562, s(A sport)=0.475 provided remarkable explanations for low s values. We mapped the representative subcategories of all EF chapters and obtained the closest terms for each, which we confirmed with publications. This allowed immediate access (? 2 seconds) to the terms related to ADLs, ranging from apps ``to know accessibility before you go'' to adapted sports (boccia). For example, for the support and relationships EF subcategory, the closest term discovered by our model was ``resilience,'' recently regarded as a key feature of rehabilitation, not yet having one unified definition. Our model discovered 10 closest terms, which we validated with publications, contributing to the ``resilience'' definition. Conclusions: This study opens up interesting opportunities for the exploration and discovery of the use of a word2vec model that has been trained with a small disability dataset, leading to immediate, accurate, and often unknown (for authors, in many cases) terms related to ADLs within the ICF framework. ",
doi="10.2196/17903",
url="http://medinform.jmir.org/2020/11/e17903/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33216006"
}


@Article{info:doi/10.2196/15347,
author="Homan, Michael Christopher
and Schrading, Nicolas J.
and Ptucha, W. Raymond
and Cerulli, Catherine
and Ovesdotter Alm, Cecilia",
title="Quantitative Methods for Analyzing Intimate Partner Violence in Microblogs: Observational Study",
journal="J Med Internet Res",
year="2020",
month="Nov",
day="19",
volume="22",
number="11",
pages="e15347",
keywords="intimate partner violence",
keywords="social media",
keywords="natural language processing",
abstract="Background: Social media is a rich, virtually untapped source of data on the dynamics of intimate partner violence, one that is both global in scale and intimate in detail. Objective: The aim of this study is to use machine learning and other computational methods to analyze social media data for the reasons victims give for staying in or leaving abusive relationships. Methods: Human annotation, part-of-speech tagging, and machine learning predictive models, including support vector machines, were used on a Twitter data set of 8767 \#WhyIStayed and \#WhyILeft tweets each. Results: Our methods explored whether we can analyze micronarratives that include details about victims, abusers, and other stakeholders, the actions that constitute abuse, and how the stakeholders respond. Conclusions: Our findings are consistent across various machine learning methods, which correspond to observations in the clinical literature, and affirm the relevance of natural language processing and machine learning for exploring issues of societal importance in social media. ",
doi="10.2196/15347",
url="http://www.jmir.org/2020/11/e15347/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33211021"
}


@Article{info:doi/10.2196/23019,
author="Al-Hasan, Abrar
and Khuntia, Jiban
and Yim, Dobin",
title="Threat, Coping, and Social Distance Adherence During COVID-19: Cross-Continental Comparison Using an Online Cross-Sectional Survey",
journal="J Med Internet Res",
year="2020",
month="Nov",
day="18",
volume="22",
number="11",
pages="e23019",
keywords="COVID-19",
keywords="adherence",
keywords="coping appraisal",
keywords="threat appraisal",
keywords="protection motivation theory",
keywords="social distancing",
keywords="information sources",
keywords="social media",
keywords="knowledge",
keywords="coping",
keywords="threat",
keywords="protection",
keywords="motivation",
keywords="cross-sectional",
keywords="survey",
abstract="Background: Social distancing is an effective preventative policy for COVID-19 that is enforced by governments worldwide. However, significant variations are observed in adherence to social distancing across individuals and countries. Due to the lack of treatment, rapid spread, and prevalence of COVID-19, panic and fear associated with the disease causes great stress. Subsequent effects will be a variation around the coping and mitigation strategies for different individuals following different paths to manage the situation. Objective: This study aims to explore how threat and coping appraisal processes work as mechanisms between information and citizens' adherence to COVID-19--related recommendations (ie, how the information sources and social media influence threat and coping appraisal processes with COVID-19 and how the threat and coping appraisal processes influence adherence to policy guidelines). In addition, this study aims to explore how citizens in three different countries (the United States, Kuwait, and South Korea), randomly sampled, are effectively using the mechanisms. Methods: Randomly sampled online survey data collected by a global firm in May 2020 from 162 citizens of the United States, 185 of Kuwait, and 71 of South Korea were analyzed, resulting in a total sample size of 418. A seemingly unrelated regression model, controlling for several counterfactuals, was used for analysis. The study's focal estimated effects were compared across the three countries using the weighted distance between the parameter estimates. Results: The seemingly unrelated regression model estimation results suggested that, overall, the intensity of information source use for the COVID-19 pandemic positively influenced the threat appraisal for the disease (P<.001). Furthermore, the intensity of social media use for the COVID-19 pandemic positively influenced the coping appraisal for the disease (P<.001). Higher COVID-19 threat appraisal had a positive effect on social distancing adherence (P<.001). Higher COVID-19 coping appraisal had a positive effect on social distancing adherence (P<.001). Higher intensity of COVID-19 knowledge positively influenced social distancing adherence (P<.001). There were country-level variations. Broadly, we found that the United States had better results than South Korea and Kuwait in leveraging the information to threat and coping appraisal to the adherence process, indicating that individuals in countries like the United States and South Korea may be more pragmatic to appraise the situation before making any decisions. Conclusions: This study's findings suggest that the mediation of threat and coping strategies are essential, in varying effects, to shape the information and social media strategies for adherence outcomes. Accordingly, coordinating public service announcements along with information source outlets such as mainstream media (eg, TV and newspaper) as well as social media (eg, Facebook and Twitter) to inform citizens and, at the same time, deliver balanced messages about the threat and coping appraisal is critical in implementing a staggered social distancing and sheltering strategy. ",
doi="10.2196/23019",
url="http://www.jmir.org/2020/11/e23019/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33119538"
}


@Article{info:doi/10.2196/21329,
author="Alanazi, Eisa
and Alashaikh, Abdulaziz
and Alqurashi, Sarah
and Alanazi, Aued",
title="Identifying and Ranking Common COVID-19 Symptoms From Tweets in Arabic: Content Analysis",
journal="J Med Internet Res",
year="2020",
month="Nov",
day="18",
volume="22",
number="11",
pages="e21329",
keywords="health",
keywords="informatics",
keywords="social networks",
keywords="Twitter",
keywords="anosmia",
keywords="Arabic",
keywords="COVID-19",
keywords="symptom",
abstract="Background: A substantial amount of COVID-19--related data is generated by Twitter users every day. Self-reports of COVID-19 symptoms on Twitter can reveal a great deal about the disease and its prevalence in the community. In particular, self-reports can be used as a valuable resource to learn more about common symptoms and whether their order of appearance differs among different groups in the community. These data may be used to develop a COVID-19 risk assessment system that is tailored toward a specific group of people. Objective: The aim of this study was to identify the most common symptoms reported by patients with COVID-19, as well as the order of symptom appearance, by examining tweets in Arabic. Methods: We searched Twitter posts in Arabic for personal reports of COVID-19 symptoms from March 1 to May 27, 2020. We identified 463 Arabic users who had tweeted about testing positive for COVID-19 and extracted the symptoms they associated with the disease. Furthermore, we asked them directly via personal messaging to rank the appearance of the first 3 symptoms they had experienced immediately before (or after) their COVID-19 diagnosis. Finally, we tracked their Twitter timeline to identify additional symptoms that were mentioned within {\textpm}5 days from the day of the first tweet on their COVID-19 diagnosis. In total, 270 COVID-19 self-reports were collected, and symptoms were (at least partially) ranked. Results: The collected self-reports contained 893 symptoms from 201 (74\%) male and 69 (26\%) female Twitter users. The majority (n=270, 82\%) of the tracked users were living in Saudi Arabia (n=125, 46\%) and Kuwait (n=98, 36\%). Furthermore, 13\% (n=36) of the collected reports were from asymptomatic individuals. Of the 234 users with symptoms, 66\% (n=180) provided a chronological order of appearance for at least 3 symptoms. Fever (n=139, 59\%), headache (n=101, 43\%), and anosmia (n=91, 39\%) were the top 3 symptoms mentioned in the self-reports. Additionally, 28\% (n=65) reported that their COVID-19 experience started with a fever, 15\% (n=34) with a headache, and 12\% (n=28) with anosmia. Of the 110 symptomatic cases from Saudi Arabia, the most common 3 symptoms were fever (n=65, 59\%), anosmia (n=46, 42\%), and headache (n=42, 38\%). Conclusions: This study identified the most common symptoms of COVID-19 from tweets in Arabic. These symptoms can be further analyzed in clinical settings and may be incorporated into a real-time COVID-19 risk estimator. ",
doi="10.2196/21329",
url="http://www.jmir.org/2020/11/e21329/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33119539"
}


@Article{info:doi/10.2196/20656,
author="Li, Mengyao
and Liu, Li
and Yang, Yilong
and Wang, Yang
and Yang, Xiaoshi
and Wu, Hui",
title="Psychological Impact of Health Risk Communication and Social Media on College Students During the COVID-19 Pandemic: Cross-Sectional Study",
journal="J Med Internet Res",
year="2020",
month="Nov",
day="18",
volume="22",
number="11",
pages="e20656",
keywords="COVID-19",
keywords="anxiety",
keywords="panic",
keywords="health risk",
keywords="communication",
keywords="social media",
abstract="Background: The outbreak of COVID-19 began in 2019 and is expected to impact the psychological health of college students. Few studies have investigated the associations among health risk communication, social media, and psychological symptoms during a major pandemic. Objective: The aim of this research was to assess the prevalence of psychological symptoms among college students and explore their associations with health risk communication and social media. Methods: A web-based survey was distributed through the Wenjuanxing platform among Chinese college students from March 3-15, 2020. In addition to demographics, information on health risk communication and social media was collected, and the Symptom Checklist 90 Phobia and Health Anxiety Inventory subscale was used to assess psychological symptoms among 1676 college students in China. Multivariable logistic regression was performed to examine these independent risk factors. Results: The prevalence of panic and health anxiety was 17.2\% (288/1676) and 24.3\% (408/1676), respectively. Regarding risk communication, understanding the risk of COVID-19 (odds ratio [OR] 0.480, 95\% CI 0.367-0.627) was a protective factor against panic. Knowledge of prognosis (OR 0.708, 95\% CI 0.551-0.910), preventive measures (OR 0.380, 95\% CI 0.195-0.742), and wearing face masks (OR 0.445, 95\% CI 0.230-0.862) were shown to be protective factors in predicting health anxiety. Perceived lethality (OR 1.860, 95\% CI 1.408-2.459), being affected by the global spread (OR 1.936, 95\% CI 1.405-2.669), and impact on social contacts (OR 1.420, 95\% CI 1.118-1.802) were identified as significant risk factors associated with health anxiety. In terms of social media, trust in mainstream media (OR 0.613, 95\% CI 0.461-0.816) was considered to be a protective factor against health anxiety. Conclusions: There was a high prevalence of psychological symptoms among college students. Health risk communication and social media use were important in predicting psychological symptoms, especially health anxiety. Scientific and evidence-based information should be reported by social media platforms. Web-based consultation and intervention measures should be the focus of future studies. ",
doi="10.2196/20656",
url="http://www.jmir.org/2020/11/e20656/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33108308"
}


@Article{info:doi/10.2196/23922,
author="Mohamad, Emma
and Tham, Sern Jen
and Ayub, Hadi Suffian
and Hamzah, Rezal Mohammad
and Hashim, Hasrul
and Azlan, Anis Arina",
title="Relationship Between COVID-19 Information Sources and Attitudes in Battling the Pandemic Among the Malaysian Public: Cross-Sectional Survey Study",
journal="J Med Internet Res",
year="2020",
month="Nov",
day="12",
volume="22",
number="11",
pages="e23922",
keywords="COVID-19",
keywords="information source",
keywords="confidence",
keywords="media",
keywords="social media",
keywords="government",
keywords="Malaysia",
keywords="online information",
keywords="survey",
abstract="Background: There are multiple media platforms and various resources available for information on COVID-19. Identifying people's preferences is key to building public confidence and planning for successful national health intervention strategies. Objective: This study examines the sources of information for COVID-19 used by the Malaysian public and identifies those that are associated with building public confidence and positive perceptions toward the Malaysian government. Methods: A cross-sectional online survey of 4850 Malaysian residents was conducted. Participant demographics, media use, information sources, and attitudes surrounding COVID-19 were assessed. Descriptive statistics and multiple logistic regression analyses were conducted to gauge the relationship between demographics, information sources, and attitudes toward COVID-19. Results: Malaysians primarily used television and internet news portals to access information on COVID-19. The Malaysian Ministry of Health was the most preferred source of COVID-19 information. Respondents who referred to the Ministry of Health, television, and the Malaysian National Security Council for information were more likely to believe that the country could win the battle against COVID-19 and that the government was handling the health crisis well compared to those who referred to other information sources. Those who used the World Health Organization, friends, YouTube, family, and radio as sources of information were less likely to harbor confidence and positive belief toward combating COVID-19. Conclusions: Managing information and sustaining public confidence is important during a pandemic. Health authorities should pay considerable attention to the use of appropriate media channels and sources to allow for more effective dissemination of critical information to the public. ",
doi="10.2196/23922",
url="http://www.jmir.org/2020/11/e23922/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33151897"
}


@Article{info:doi/10.2196/20532,
author="Alqabandi, Naeema
and Al-Ozairi, Ebaa
and Ahmed, Adel
and Ross, L. Edgar
and Jamison, N. Robert",
title="Secondary Impact of Social Media via Text Message Screening for Type 2 Diabetes Risk in Kuwait: Survey Study",
journal="JMIR Diabetes",
year="2020",
month="Nov",
day="12",
volume="5",
number="4",
pages="e20532",
keywords="SMS",
keywords="Short text message interventions",
keywords="mHealth",
keywords="smartphone",
keywords="Type 2 diabetes mellitus",
keywords="prevention",
abstract="Background: Type 2 diabetes mellitus (T2DM) is an international problem of alarming epidemic proportions. T2DM can develop due to multiple factors, and it usually begins with prediabetes. Fortunately, this disease can be prevented by following a healthy lifestyle. However, many health care systems fail to properly educate the public on disease prevention and to offer support in embracing behavioral interventions to prevent diabetes. SMS messaging has been combined with cost-effective ways to reach out to the population at risk for medical comorbidities. To our knowledge, the use of nationwide SMS messaging in the Middle East as a screening tool to identify individuals who might be at risk of developing T2DM has not been reported in the literature. Objective: The primary aim of this study was to assess the feasibility of conducting a series of SMS messaging campaigns directed at random smartphone users in Kuwait for the detection and prevention of T2DM. It was predicted that 1\% of those receiving the text message would find it relevant and participate in the study. The secondary aim of this study was to assess the incidence of participation of those who were forwarded the initial text message by family members and friends. Methods: In this study, 5 separate text message screening campaigns were launched inviting recipients to answer 6 questions to determine the risk of developing T2DM. If subjects agreed to participate, a link to the prediabetes screening test devised by the Centers for Disease Control and Prevention was automatically transmitted to their mobile devices. Those identified as high risk were invited to participate in a diabetes prevention program. Results: A total of 180,000 SMSs were sent to approximately 6\% of the adult population in Kuwait. Of these, 0.14\% (260/180,000) of the individuals who received the SMS agreed to participate, of whom 58.8\% (153/260) completed the screening. Surprisingly, additional surveys were completed by 367 individuals who were invited via circulated SMS messages forwarded by family members and friends. Altogether, 23.3\% (121/520) qualified and agreed to participate in a diabetes prevention program. The majority of those who chose to participate in the prevention program were overweight, aged 45-65 years, and reported being less physically active than those who chose not to participate ($\chi$22=42.1, P<.001). Conclusions: Although health care screening via text messaging was found to have limited effectiveness by itself, it exhibited increased reach through shared second-party social media messaging. Despite the fact a subpopulation at possible risk of developing T2DM could be reached via text messaging, most responders were informed about the screening campaign by family and friends. Future research should be designed to tap into the benefits of social media use in health risk campaigns. ",
doi="10.2196/20532",
url="https://diabetes.jmir.org/2020/4/e20532",
url="http://www.ncbi.nlm.nih.gov/pubmed/33180021"
}


@Article{info:doi/10.2196/22612,
author="Burke, Colin
and Bloss, Cinnamon",
title="Social Media Surveillance in Schools: Rethinking Public Health Interventions in the Digital Age",
journal="J Med Internet Res",
year="2020",
month="Nov",
day="12",
volume="22",
number="11",
pages="e22612",
keywords="social media",
keywords="surveillance",
keywords="privacy",
keywords="public health",
keywords="students",
keywords="schools",
keywords="social media surveillance",
keywords="school safety",
keywords="mental health",
keywords="adolescents",
doi="10.2196/22612",
url="http://www.jmir.org/2020/11/e22612/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33179599"
}


@Article{info:doi/10.2196/21978,
author="Boon-Itt, Sakun
and Skunkan, Yukolpat",
title="Public Perception of the COVID-19 Pandemic on Twitter: Sentiment Analysis and Topic Modeling Study",
journal="JMIR Public Health Surveill",
year="2020",
month="Nov",
day="11",
volume="6",
number="4",
pages="e21978",
keywords="COVID-19",
keywords="Twitter",
keywords="social media",
keywords="infoveillance",
keywords="infodemiology",
keywords="infodemic",
keywords="data",
keywords="health informatics",
keywords="mining",
keywords="perception",
keywords="topic modeling",
abstract="Background: COVID-19 is a scientifically and medically novel disease that is not fully understood because it has yet to be consistently and deeply studied. Among the gaps in research on the COVID-19 outbreak, there is a lack of sufficient infoveillance data. Objective: The aim of this study was to increase understanding of public awareness of COVID-19 pandemic trends and uncover meaningful themes of concern posted by Twitter users in the English language during the pandemic. Methods: Data mining was conducted on Twitter to collect a total of 107,990 tweets related to COVID-19 between December 13 and March 9, 2020. The analyses included frequency of keywords, sentiment analysis, and topic modeling to identify and explore discussion topics over time. A natural language processing approach and the latent Dirichlet allocation algorithm were used to identify the most common tweet topics as well as to categorize clusters and identify themes based on the keyword analysis. Results: The results indicate three main aspects of public awareness and concern regarding the COVID-19 pandemic. First, the trend of the spread and symptoms of COVID-19 can be divided into three stages. Second, the results of the sentiment analysis showed that people have a negative outlook toward COVID-19. Third, based on topic modeling, the themes relating to COVID-19 and the outbreak were divided into three categories: the COVID-19 pandemic emergency, how to control COVID-19, and reports on COVID-19. Conclusions: Sentiment analysis and topic modeling can produce useful information about the trends in the discussion of the COVID-19 pandemic on social media as well as alternative perspectives to investigate the COVID-19 crisis, which has created considerable public awareness. This study shows that Twitter is a good communication channel for understanding both public concern and public awareness about COVID-19. These findings can help health departments communicate information to alleviate specific public concerns about the disease. ",
doi="10.2196/21978",
url="http://publichealth.jmir.org/2020/4/e21978/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33108310"
}


@Article{info:doi/10.2196/21582,
author="Plackett, Ruth
and Kaushal, Aradhna
and Kassianos, P. Angelos
and Cross, Aaron
and Lewins, Douglas
and Sheringham, Jessica
and Waller, Jo
and von Wagner, Christian",
title="Use of Social Media to Promote Cancer Screening and Early Diagnosis: Scoping Review",
journal="J Med Internet Res",
year="2020",
month="Nov",
day="9",
volume="22",
number="11",
pages="e21582",
keywords="social media",
keywords="review",
keywords="cancer",
keywords="campaign",
keywords="health promotion",
keywords="public health",
keywords="early detection of cancer",
keywords="cancer screening",
keywords="health care disparities",
abstract="Background: Social media is commonly used in public health interventions to promote cancer screening and early diagnosis, as it can rapidly deliver targeted public health messages to large numbers of people. However, there is currently little understanding of the breadth of social media interventions and evaluations, whether they are effective, and how they might improve outcomes. Objective: This scoping review aimed to map the evidence for social media interventions to improve cancer screening and early diagnosis, including their impact on behavior change and how they facilitate behavior change. Methods: Five databases and the grey literature were searched to identify qualitative and quantitative evaluations of social media interventions targeting cancer screening and early diagnosis. Two reviewers independently reviewed each abstract. Data extraction was carried out by one author and verified by a second author. Data on engagement was extracted using an adapted version of the key performance indicators and metrics related to social media use in health promotion. Insights, exposure, reach, and differing levels of engagement, including behavior change, were measured. The behavior change technique taxonomy was used to identify how interventions facilitated behavior change. Results: Of the 23 publications and reports included, the majority (16/23, 70\%) evaluated national cancer awareness campaigns (eg, breast cancer awareness month). Most interventions delivered information via Twitter (13/23, 57\%), targeted breast cancer (12/23, 52\%), and measured exposure, reach, and low- to medium-level user engagement, such as number of likes (9/23, 39\%). There were fewer articles about colorectal and lung cancer than about breast and prostate cancer campaigns. One study found that interventions had less reach and engagement from ethnic minority groups. A small number of articles (5/23, 22\%) suggested that some types of social media interventions might improve high-level engagement, such as intended and actual uptake of screening. Behavior change techniques, such as providing social support and emphasizing the consequences of cancer, were used to engage users. Many national campaigns delivered fundraising messages rather than actionable health messages. Conclusions: The limited evidence suggests that social media interventions may improve cancer screening and early diagnosis. Use of evaluation frameworks for social media interventions could help researchers plan more robust evaluations that measure behavior change. We need a greater understanding of who engages with these interventions to know whether social media can be used to reduce some health inequalities in cancer screening and early diagnosis. International Registered Report Identifier (IRRID): RR2-10.1136/bmjopen-2019-033592 ",
doi="10.2196/21582",
url="http://www.jmir.org/2020/11/e21582/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33164907"
}


@Article{info:doi/10.2196/21684,
author="Yu, Nan
and Pan, Shuya
and Yang, Chia-chen
and Tsai, Jiun-Yi",
title="Exploring the Role of Media Sources on COVID-19--Related Discrimination Experiences and Concerns Among Asian People in the United States: Cross-Sectional Survey Study",
journal="J Med Internet Res",
year="2020",
month="Nov",
day="6",
volume="22",
number="11",
pages="e21684",
keywords="COVID-19",
keywords="discrimination",
keywords="Asians",
keywords="Asian Americans",
keywords="media source",
keywords="social media",
keywords="prejudice\emspace",
abstract="Background: Media coverage and scholarly research have reported that Asian people who reside in the United States have been the targets of racially motivated incidents during the COVID-19 pandemic. Objective: This study aimed to examine the types of discrimination and worries experienced by Asians and Asian Americans living in the United States during the pandemic, as well as factors that were associated with everyday discrimination experience and concerns about future discrimination that the Asian community may face. Methods: A cross-sectional online survey was conducted. A total of 235 people who identified themselves as Asian or Asian American and resided in the United States completed the questionnaire. Results: Our study suggested that up to a third of Asians surveyed had experienced some type of discrimination. Pooling the responses ``very often,'' ``often,'' and ``sometimes,'' the percentages for each experienced discrimination type ranged between 14\%-34\%. In total, 49\%-58\% of respondents expressed concerns about discrimination in the future. The most frequently experienced discrimination types, as indicated by responses ``very often'' and ``often,'' were ``people act as if they think you are dangerous'' (25/235, 11\%) and ``being treated with less courtesy or respect'' (24/235, 10\%). About 14\% (32/235) of individuals reported very often, often, or sometimes being threatened or harassed. In addition, social media use was significantly associated with a higher likelihood of experiencing discrimination ($\beta$=.18, P=.01) and having concerns about future episodes of discrimination the community may face ($\beta$=.20, P=.005). Use of print media was also positively associated with experiencing discrimination ($\beta$=.31, P<.001). Conclusions: Our study provided important empirical evidence regarding the various types of discrimination Asians residing in the United States experienced or worried about during the COVID-19 pandemic. The relationship between media sources and the perception of racial biases in this group was also identified. We noted the role of social media in reinforcing the perception of discrimination experience and concerns about future discrimination among Asians during this outbreak. Our results indicate several practical implications for public health agencies. To reduce discrimination against Asians during the pandemic, official sources and public health professionals should be cognizant of the possible impacts of stigmatizing cues in media reports on activating racial biases. Furthermore, Asians or Asian Americans could also be informed that using social media to obtain COVID-19 information is associated with an increase in concerns about future discrimination, and thus they may consider approaching this media source with caution. ",
doi="10.2196/21684",
url="http://www.jmir.org/2020/11/e21684/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33108307"
}


@Article{info:doi/10.2196/21963,
author="Gao, Yankun
and Xie, Zidian
and Sun, Li
and Xu, Chenliang
and Li, Dongmei",
title="Electronic Cigarette--Related Contents on Instagram: Observational Study and Exploratory Analysis",
journal="JMIR Public Health Surveill",
year="2020",
month="Nov",
day="5",
volume="6",
number="4",
pages="e21963",
keywords="electronic cigarettes",
keywords="infodemiology",
keywords="Instagram",
keywords="user engagement",
keywords="exploratory",
keywords="smoking",
keywords="e-cig",
keywords="social media",
keywords="vape",
keywords="vaping",
keywords="risk",
keywords="public health",
abstract="Background: Instagram is a popular social networking platform for users to upload pictures sharing their experiences. Instagram has been widely used by vaping companies and stores to promote electronic cigarettes (e-cigarettes), as well as by public health entities to communicate the risks of e-cigarette use (vaping) to the public. Objective: We aimed to characterize current vaping-related content on Instagram through descriptive analyses. Methods: From Instagram, 42,951 posts were collected using vaping-related hashtags in November 2019. The posts were grouped as (1) pro-vaping, (2) vaping warning, (3) neutral to vaping, and (4) not related to vaping based on the attitudes to vaping expressed within the posts. From these Instagram posts and the corresponding 18,786 unique Instagram user accounts, 200 pro-vaping and 200 vaping-warning posts as well as 200 pro-vaping and 200 vaping-warning user accounts were randomly selected for hand coding. Furthermore, follower counts and media counts of the Instagram user accounts as well as the ``like'' counts and hashtags of the posts were compared between pro-vaping and vaping-warning groups. Results: There were more posts in the pro-vaping group (41,412 posts) than there were in the vaping-warning group (1539 posts). The majority of pro-vaping images were product display images (163/200, 81.5\%), and the most popular image type in vaping-warning posts was educational (95/200, 47.5\%). The highest proportion of pro-vaping user account type was vaping store (110/189, 58.1\%), and the store account type had the highest mean number of posts (10.33 posts/account). The top 3 vaping-warning user account types were personal (79/155, 51\%), vaping-warning community (37/155, 23.9\%), and community (35/155, 22.6\%), of which the vaping-warning community had the highest mean number of posts (3.68 posts/account). Pro-vaping user accounts had more followers (median 850) and media (median 232) than vaping-warning user accounts had (follower count: median 191; media count: 92). Pro-vaping posts had more ``likes'' (median 22) and hashtags (mean 20.39) than vaping-warning posts had (``like'' count: median 12; hashtags: mean 7.16). Conclusions: Instagram is dominated by pro-vaping content, and pro-vaping posts and user accounts seem to have more user engagement than vaping-warning accounts have. These results highlight the importance of regulating e-cigarette posts on social media and the urgency of identifying effective communication content and message delivery methods with the public about the health effects of e-cigarettes to ameliorate the epidemic of vaping in youth. ",
doi="10.2196/21963",
url="http://publichealth.jmir.org/2020/4/e21963/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33151157"
}


@Article{info:doi/10.2196/15577,
author="McCausland, Kahlia
and Maycock, Bruce
and Leaver, Tama
and Wolf, Katharina
and Freeman, Becky
and Thomson, Katie
and Jancey, Jonine",
title="E-Cigarette Promotion on Twitter in Australia: Content Analysis of Tweets",
journal="JMIR Public Health Surveill",
year="2020",
month="Nov",
day="5",
volume="6",
number="4",
pages="e15577",
keywords="electronic cigarette",
keywords="e-cigarette",
keywords="electronic nicotine delivery systems",
keywords="vaping",
keywords="vape",
keywords="social media",
keywords="twitter",
keywords="content analysis",
keywords="public health",
keywords="public policy",
abstract="Background: The sale of electronic cigarettes (e-cigarettes) containing nicotine is prohibited in all Australian states and territories; yet, the growing availability and convenience of the internet enable the promotion and exposure of e-cigarettes across countries. Social media's increasing pervasiveness has provided a powerful avenue to market products and influence social norms and risk behaviors. At present, there is no evidence of how e-cigarettes and vaping are promoted on social media in Australia. Objective: This study aimed to investigate how e-cigarettes are portrayed and promoted on Twitter through a content analysis of vaping-related tweets containing an image posted and retweeted by Australian users and how the portrayal and promotion have emerged and trended over time. Methods: In total, we analyzed 1303 tweets and accompanying images from 2012, 2014, 2016, and 2018 collected through the Tracking Infrastructure for Social Media Analysis (TrISMA), a contemporary technical and organizational infrastructure for the tracking of public communication by Australian users of social media, via a list of 15 popular e-cigarette--related terms. Results: Despite Australia's cautious approach toward e-cigarettes and the limited evidence supporting them as an efficacious smoking cessation aid, it is evident that there is a concerted effort by some Twitter users to promote these devices as a health-conducive (91/129, 70.5\%), smoking cessation product (266/1303, 20.41\%). Further, Twitter is being used in an attempt to circumvent Australian regulation and advocate for a more liberal approach to personal vaporizers (90/1303, 6.90\%). A sizeable proportion of posts was dedicated to selling or promoting vape products (347/1303, 26.63\%), and 19.95\% (260/1303) were found to be business listings. These posts used methods to try and expand their clientele further than immediate followers by touting competitions and giveaways, with those wanting to enter having to perform a sequence of steps such as liking, tagging, and reposting, ultimately exposing the post among the user's network and to others not necessarily interested in vaping. Conclusions: The borderless nature of social media presents a clear challenge for enforcing Article 13 of the World Health Organization Framework Convention on Tobacco Control, which requires all ratifying nations to implement a ban on tobacco advertising, promotion, and sponsorship. Countering the advertising and promotion of these products is a public health challenge that will require cross-border cooperation with other World Health Organization Framework Convention on Tobacco Control parties. Further research aimed at developing strategies to counter the advertising and promotion of e-cigarettes is therefore needed. ",
doi="10.2196/15577",
url="http://publichealth.jmir.org/2020/4/e15577/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33151159"
}


@Article{info:doi/10.2196/20528,
author="Mayer, Gwendolyn
and Alvarez, Simone
and Gronewold, Nadine
and Schultz, Jobst-Hendrik",
title="Expressions of Individualization on the Internet and Social Media: Multigenerational Focus Group Study",
journal="J Med Internet Res",
year="2020",
month="Nov",
day="4",
volume="22",
number="11",
pages="e20528",
keywords="focus groups",
keywords="discussion",
keywords="qualitative research",
keywords="generation",
keywords="baby boomers",
keywords="generation x",
keywords="generation y",
keywords="digital natives",
keywords="identity",
keywords="self",
keywords="media use",
keywords="internet research",
keywords="social media",
abstract="Background: Growing individualization within the past decades has been described as a fundamental shift in society. Studies have reported how the digital age promotes new forms of individualism with self-tracking technologies and self-presentation in social networks. Potential harmful effects on the mental health of young adults have already been at the forefront of research. However, 2 questions that remain unanswered are how emotional experiences and expressions of self-relatedness differ among generations in their usage of the internet and social media, and if an increasing individualism can be observed by this. Objective: The aim of this study is to examine whether the use of the internet and social media has led people to be more concerned about themselves than former generations. The potential consequences of mental and emotional distress among different age groups are analyzed. Methods: A focus-group approach was chosen to study the following age groups: Baby Boomers (those born in 1950-1965), Generation X (those born in 1966-1980), and Digital Natives (those born in 1981-2000). We organized 6 focus groups with 36 participants who discussed their private usage of the internet and social media, different devices, platforms and functions, communication behavior, and self-tracking. We applied inductive category formation and followed the Standards for Reporting Qualitative Research (SRQR) checklist. Results: We found differences in the 3 studied generations regarding the reasons for their use of the internet and social media, the effects of this use, personal feelings and experiences, expressions of self-relatedness, and social relationships. The Baby Boomers voiced a wish to stay autonomous while being in contact with their personal network. Generation X included enthusiastic members who appreciate self-tracking for curiosity and fascination, as well as people who felt fears about data surveillance. The Digital Natives reported a wish to optimize their own body by self-tracking while being faced with norms and expectations that were communicated via the internet and social media. Conclusions: All generations expressed self-relatedness, yet by different means. The Baby Boomers expressed less individualism than Generation X and the Digital Natives, who felt the highest strain due to social comparisons. However, all generations reported specific, potentially problematic consequences for their mental health. Age-specific coping strategies are necessary to promote a mentally healthy way of using the internet and social media. ",
doi="10.2196/20528",
url="https://www.jmir.org/2020/11/e20528",
url="http://www.ncbi.nlm.nih.gov/pubmed/33146622"
}


@Article{info:doi/10.2196/17247,
author="Sch{\"a}fer, Florent
and Faviez, Carole
and Voillot, Pam{\'e}la
and Foulqui{\'e}, Pierre
and Najm, Matthieu
and Jeanne, Jean-Fran{\c{c}}ois
and Fagherazzi, Guy
and Sch{\"u}ck, St{\'e}phane
and Le Nev{\'e}, Boris",
title="Mapping and Modeling of Discussions Related to Gastrointestinal Discomfort in French-Speaking Online Forums: Results of a 15-Year Retrospective Infodemiology Study",
journal="J Med Internet Res",
year="2020",
month="Nov",
day="3",
volume="22",
number="11",
pages="e17247",
keywords="gastrointestinal discomfort",
keywords="disorders of gut-brain interactions",
keywords="social media",
keywords="infodemiology",
keywords="topic modeling",
abstract="Background: Gastrointestinal (GI) discomfort is prevalent and known to be associated with impaired quality of life. Real-world information on factors of GI discomfort and solutions used by people is, however, limited. Social media, including online forums, have been considered a new source of information to examine the health of populations in real-life settings. Objective: The aims of this retrospective infodemiology study are to identify discussion topics, characterize users, and identify perceived determinants of GI discomfort in web-based messages posted by users of French social media. Methods: Messages related to GI discomfort posted between January 2003 and August 2018 were extracted from 14 French-speaking general and specialized publicly available online forums. Extracted messages were cleaned and deidentified. Relevant medical concepts were determined on the basis of the Medical Dictionary for Regulatory Activities and vernacular terms. The identification of discussion topics was carried out by using a correlated topic model on the basis of the latent Dirichlet allocation. A nonsupervised clustering algorithm was applied to cluster forum users according to the reported symptoms of GI discomfort, discussion topics, and activity on online forums. Users' age and gender were determined by linear regression and application of a support vector machine, respectively, to characterize the identified clusters according to demographic parameters. Perceived factors of GI discomfort were classified by a combined method on the basis of syntactic analysis to identify messages with causality terms and a second topic modeling in a relevant segment of phrases. Results: A total of 198,866 messages associated with GI discomfort were included in the analysis corpus after extraction and cleaning. These messages were posted by 36,989 separate web users, most of them being women younger than 40 years. Everyday life, diet, digestion, abdominal pain, impact on the quality of life, and tips to manage stress were among the most discussed topics. Segmentation of users identified 5 clusters corresponding to chronic and acute GI concerns. Diet topic was associated with each cluster, and stress was strongly associated with abdominal pain. Psychological factors, food, and allergens were perceived as the main causes of GI discomfort by web users. Conclusions: GI discomfort is actively discussed by web users. This study reveals a complex relationship between food, stress, and GI discomfort. Our approach has shown that identifying web-based discussion topics associated with GI discomfort and its perceived factors is feasible and can serve as a complementary source of real-world evidence for caregivers. ",
doi="10.2196/17247",
url="https://www.jmir.org/2020/11/e17247",
url="http://www.ncbi.nlm.nih.gov/pubmed/33141087"
}


@Article{info:doi/10.2196/17595,
author="Sharma, Estelle Anjana
and Mann, Ziva
and Cherian, Roy
and Del Rosario, Bing Jan
and Yang, Janine
and Sarkar, Urmimala",
title="Recommendations From the Twitter Hashtag \#DoctorsAreDickheads: Qualitative Analysis",
journal="J Med Internet Res",
year="2020",
month="Oct",
day="28",
volume="22",
number="10",
pages="e17595",
keywords="social media",
keywords="patient engagement",
keywords="Twitter messaging",
keywords="missed diagnosis",
keywords="internet",
keywords="physician patient relationship",
abstract="Background: The social media site Twitter has 145 million daily active users worldwide and has become a popular forum for users to communicate their health care concerns and experiences as patients. In the fall of 2018, a hashtag titled \#DoctorsAreDickheads emerged, with almost 40,000 posts calling attention to health care experiences. Objective: This study aims to identify common health care conditions and conceptual themes represented within the phenomenon of this viral Twitter hashtag. Methods: We analyzed a random sample of 5.67\% (500/8818) available tweets for qualitative analysis between October 15 and December 31, 2018, when the hashtag was the most active. Team coders reviewed the same 20.0\% (100/500) tweets and the remainder individually. We abstracted the user's health care role and clinical conditions from the tweet and user profile, and used phenomenological content analysis to identify prevalent conceptual themes through sequential open coding, memoing, and discussion of concepts until an agreement was reached. Results: Our final sample comprised 491 tweets and unique Twitter users. Of this sample, 50.5\% (248/491) were from patients or patient advocates, 9.6\% (47/491) from health care professionals, 4.3\% (21/491) from caregivers, 3.7\% (18/491) from academics or researchers, 1.0\% (5/491) from journalists or media, and 31.6\% (155/491) from non--health care individuals or other. The most commonly mentioned clinical conditions were chronic pain, mental health, and musculoskeletal conditions (mainly Ehlers-Danlos syndrome). We identified 3 major themes: disbelief in patients' experience and knowledge that contributes to medical errors and harm, the power inequity between patients and providers, and metacommentary on the meaning and impact of the \#DoctorsAreDickheads hashtag. Conclusions: People publicly disclose personal and often troubling health care experiences on Twitter. This adds new accountability for the patient-provider interaction, highlights how harmful communication affects diagnostic safety, and shapes the public's viewpoint of how clinicians behave. Hashtags such as this offer valuable opportunities to learn from patient experiences. Recommendations include developing best practices for providers to improve communication, supporting patients through challenging diagnoses, and promoting patient engagement. ",
doi="10.2196/17595",
url="http://www.jmir.org/2020/10/e17595/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33112246"
}


@Article{info:doi/10.2196/20336,
author="Lutfeali, Samina
and Ward, Tisheya
and Greene, Tenay
and Arshonsky, Josh
and Seixas, Azizi
and Dalton, Madeline
and Bragg, A. Marie",
title="Understanding the Extent of Adolescents' Willingness to Engage With Food and Beverage Companies' Instagram Accounts: Experimental Survey Study",
journal="JMIR Public Health Surveill",
year="2020",
month="Oct",
day="27",
volume="6",
number="4",
pages="e20336",
keywords="social media",
keywords="Instagram",
keywords="social media marketing",
keywords="food industry",
keywords="adolescents",
keywords="adolescent health",
abstract="Background: Social media platforms have created a new advertising frontier, yet little is known about the extent to which this interactive form of advertising shapes adolescents' online relationships with unhealthy food brands. Objective: We aimed to understand the extent to which adolescents' preferences for Instagram food ads are shaped by the presence of comments and varying numbers of ``likes.'' We hypothesized that adolescents would show the highest preferences for ads with more ``likes'' and comments. We predicted that these differences would be greater among adolescents who were ``heavy social media users'' (ie, >3 hours daily) vs ``light social media users'' (ie, <3 hours daily). Methods: We recruited Black and non-Latinx White adolescents (aged 13-17 years; N=832) from Dynata, a firm that maintains online participant panels. Participants completed an online survey in which they were randomized to view and rate Instagram food ads that either did or did not show comments. Within each condition, adolescents were randomized to view 4 images that had high (>10,000), medium (1000-10,000), or low (<100) numbers of ``likes.'' Adolescents reported ad preferences and willingness to engage with the brand. Results: Adolescents rated ads with medium or high numbers of ``likes'' higher than ads with few ``likes'' (P=.001 and P=.002, respectively). Heavy social media users (>3 hours/day) were 6.366 times more willing to comment on ads compared to light users (P<.001). Conclusions: Adolescents interact with brands in ways that mimic interactions with friends on social media, which is concerning when brands promote unhealthy products. Adolescents also preferred ads with many ``likes,'' demonstrating the power of social norms in shaping behavior. As proposed in 2019, the Children's Online Privacy and Protection Act should expand online advertising restrictions to include adolescents aged 12 to 16 years. ",
doi="10.2196/20336",
url="https://publichealth.jmir.org/2020/4/e20336",
url="http://www.ncbi.nlm.nih.gov/pubmed/33107836"
}


@Article{info:doi/10.2196/19171,
author="Utter, Kierstin
and Waineo, Eva
and Bell, M. Capricia
and Quaal, L. Harrison
and Levine, L. Diane",
title="Instagram as a Window to Societal Perspective on Mental Health, Gender, and Race: Observational Pilot Study",
journal="JMIR Ment Health",
year="2020",
month="Oct",
day="27",
volume="7",
number="10",
pages="e19171",
keywords="mental health",
keywords="Instagram",
keywords="social media",
keywords="stigma",
keywords="gender",
keywords="race",
keywords="depression",
abstract="Background: Gender and race are known to impact attitudes toward mental health topics and help-seeking behavior. Men and minorities are more likely to cite stigma as a reason for not seeking help for mental health concerns, which is of particular relevance given the high rate of suicide in men and challenges of historic proportion currently facing minority communities. Instagram provides a platform to discuss mental health, though a lack of male and minority representation may further alienate these populations. Objective: We aimed to investigate whether men and nonwhite individuals are underrepresented in Instagram photos tagged with \#mentalhealth (compared to photos tagged with \#health) to better understand how gender and race-based representations are manifested on this popular social media platform and discuss the implications. Methods: Three investigators of different genders and racial backgrounds met on nine different days via teleconference to analyze a total of 215 publicly available Instagram photos tagged with \#mentalhealth and 215 with \#health. These photos were generated using Instagram's search function, and search results were sorted by most recently published at the time of data collection. For each photo, the three investigators recorded their observations about the gender (male versus female) and race (white versus nonwhite versus racially unclassifiable) of subjects featured in the photo, which they did not discuss with other investigators. Chi-squared analysis was performed on each investigator's data set to compare the frequency of male versus female and white versus nonwhite subjects identified in each hashtag category. Kappa interrater agreement was calculated for each investigator pair, category (gender or race), and hashtag. Results: All three investigators observed significantly more female as compared to male subjects in photos tagged with \#mentalhealth (X2=14.4, P<.001 for all investigators) while observing no significant difference between numbers of male and female subjects in photos tagged with \#health (X2=1.533, P=.22; X2=1.241, P=.27; X2=0.096, P=.76). All three investigators identified significantly more white than nonwhite subjects in photos tagged with both \#health and \#mentalhealth (X2 values range from 11.912 to 98.927, P<.001 for all). Kappa interrater agreement revealed almost perfect agreement for gender (kappa=0.908-0.992) with the agreement for race ranging from 0.614 to 0.822, depending on hashtag and rater pair. Conclusions: Women are featured more frequently than men in Instagram photos tagged with \#mentalhealth. The topic of \#health, meanwhile, is not gendered this way. Low visibility of mental health among men may both represent and exacerbate existing stigma and barriers to care. White subjects are featured significantly more frequently than nonwhite subjects in photos tagged with both \#mentalhealth and \#health. Directed interventions using the Instagram platform may be indicated to increase the visibility of underrepresented groups and break the cycle of stigma. ",
doi="10.2196/19171",
url="http://mental.jmir.org/2020/10/e19171/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33107831"
}


@Article{info:doi/10.2196/22810,
author="Darmawan, Ida
and Bakker, Caitlin
and Brockman, A. Tabetha
and Patten, A. Christi
and Eder, Milton",
title="The Role of Social Media in Enhancing Clinical Trial Recruitment: Scoping Review",
journal="J Med Internet Res",
year="2020",
month="Oct",
day="26",
volume="22",
number="10",
pages="e22810",
keywords="social media",
keywords="clinical trial",
keywords="recruitment methods",
keywords="enrollment methods",
keywords="review",
abstract="Background: Recruiting participants into clinical trials continues to be a challenge, which can result in study delay or termination. Recent studies have used social media to enhance recruitment outcomes. An assessment of the literature on the use of social media for this purpose is required. Objective: This study aims to answer the following questions: (1) How is the use of social media, in combination with traditional approaches to enhance clinical trial recruitment and enrollment, represented in the literature? and (2) Do the data on recruitment and enrollment outcomes presented in the literature allow for comparison across studies? Methods: We conducted a comprehensive literature search across 7 platforms to identify clinical trials that combined social media and traditional methods to recruit patients. Study and participant characteristics, recruitment methods, and recruitment outcomes were evaluated and compared. Results: We identified 2371 titles and abstracts through our systematic search. Of these, we assessed 95 full papers and determined that 33 studies met the inclusion criteria. A total of 17 studies reported enrollment outcomes, of which 9 achieved or exceeded their enrollment target. The proportion of participants enrolled from social media in these studies ranged from 0\% to 49\%. Across all 33 studies, the proportion of participants recruited and enrolled from social media varied greatly. A total of 9 studies reported higher enrollment rates from social media than any other methods, and 4 studies reported the lowest cost per enrolled participant from social media. Conclusions: While the assessment of the use of social media to improve clinical trial participation is hindered by reporting inconsistencies, preliminary data suggest that social media can increase participation and reduce per-participant cost. The adoption of consistent standards for reporting recruitment and enrollment outcomes is required to advance our understanding and use of social media to support clinical trial success. ",
doi="10.2196/22810",
url="http://www.jmir.org/2020/10/e22810/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33104015"
}


@Article{info:doi/10.2196/22624,
author="Chandrasekaran, Ranganathan
and Mehta, Vikalp
and Valkunde, Tejali
and Moustakas, Evangelos",
title="Topics, Trends, and Sentiments of Tweets About the COVID-19 Pandemic: Temporal Infoveillance Study",
journal="J Med Internet Res",
year="2020",
month="Oct",
day="23",
volume="22",
number="10",
pages="e22624",
keywords="coronavirus",
keywords="infodemiology",
keywords="infoveillance",
keywords="infodemic",
keywords="twitter",
keywords="COVID-19",
keywords="social media",
keywords="sentiment analysis",
keywords="trends",
keywords="topic modeling",
keywords="disease surveillance",
abstract="Background: With restrictions on movement and stay-at-home orders in place due to the COVID-19 pandemic, social media platforms such as Twitter have become an outlet for users to express their concerns, opinions, and feelings about the pandemic. Individuals, health agencies, and governments are using Twitter to communicate about COVID-19. Objective: The aims of this study were to examine key themes and topics of English-language COVID-19--related tweets posted by individuals and to explore the trends and variations in how the COVID-19--related tweets, key topics, and associated sentiments changed over a period of time from before to after the disease was declared a pandemic. Methods: Building on the emergent stream of studies examining COVID-19--related tweets in English, we performed a temporal assessment covering the time period from January 1 to May 9, 2020, and examined variations in tweet topics and sentiment scores to uncover key trends. Combining data from two publicly available COVID-19 tweet data sets with those obtained in our own search, we compiled a data set of 13.9 million English-language COVID-19--related tweets posted by individuals. We use guided latent Dirichlet allocation (LDA) to infer themes and topics underlying the tweets, and we used VADER (Valence Aware Dictionary and sEntiment Reasoner) sentiment analysis to compute sentiment scores and examine weekly trends for 17 weeks. Results: Topic modeling yielded 26 topics, which were grouped into 10 broader themes underlying the COVID-19--related tweets. Of the 13,937,906 examined tweets, 2,858,316 (20.51\%) were about the impact of COVID-19 on the economy and markets, followed by spread and growth in cases (2,154,065, 15.45\%), treatment and recovery (1,831,339, 13.14\%), impact on the health care sector (1,588,499, 11.40\%), and governments response (1,559,591, 11.19\%). Average compound sentiment scores were found to be negative throughout the examined time period for the topics of spread and growth of cases, symptoms, racism, source of the outbreak, and political impact of COVID-19. In contrast, we saw a reversal of sentiments from negative to positive for prevention, impact on the economy and markets, government response, impact on the health care industry, and treatment and recovery. Conclusions: Identification of dominant themes, topics, sentiments, and changing trends in tweets about the COVID-19 pandemic can help governments, health care agencies, and policy makers frame appropriate responses to prevent and control the spread of the pandemic. ",
doi="10.2196/22624",
url="http://www.jmir.org/2020/10/e22624/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33006937"
}


@Article{info:doi/10.2196/17522,
author="Chen, Jinsong
and Ho, Elsie
and Jiang, Yannan
and Whittaker, Robyn
and Yang, Tingzhong
and Bullen, Christopher",
title="Mobile Social Network--Based Smoking Cessation Intervention for Chinese Male Smokers: Pilot Randomized Controlled Trial",
journal="JMIR Mhealth Uhealth",
year="2020",
month="Oct",
day="23",
volume="8",
number="10",
pages="e17522",
keywords="mHealth",
keywords="mobile smoking cessation",
keywords="social network-based intervention",
keywords="smoking cessation",
keywords="public health",
keywords="gamified health interventions",
abstract="Background: Around 2 million Chinese people, mostly men, die annually from tobacco-related diseases; yet, fewer than 8\% of Chinese smokers ever receive any smoking cessation support. Objective: This study aimed to test the preliminary effectiveness and feasibility for a mobile social network (WeChat)--based smoking cessation intervention (SCAMPI program) among Chinese male smokers. Methods: Chinese male smokers aged 25-44 years were recruited online from WeChat, the most widely used social media platform in China. Individuals using other smoking cessation interventions or who lacked capacity to provide online informed consent were excluded. Participants were randomly assigned (1:1) to intervention or control groups. Neither participants nor researchers were masked to assignment. The trial was fully online. All data were collected via WeChat. The intervention group received access to the full-version SCAMPI program, a Chinese-language smoking cessation program based on the Behaviour Change Wheel framework and relevant cessation guidelines. Specific intervention functions used in the program include: planning to help users make quitting plans, calculator to record quitting benefits, calendar to record progress, gamification to facilitate quitting, information about smoking harms, motivational messages to help users overcome urges, standardized tests for users to assess their levels of nicotine dependence and lung health, as well as a social platform to encourage social support between users. The control group had access to a static WeChat page of contacts for standard smoking cessation care. Both groups received incentive credit payments for participating. The primary outcome was 30-day biochemically verified smoking abstinence at 6 weeks after randomization, with missing data treated as not quitting. Secondary outcomes were other smoking status measures, reduction of cigarette consumption, study feasibility (recruitment and retention rate), and acceptability of and satisfaction with the program. Results: The program recorded 5736 visitors over a 13-day recruitment period. We recruited 80 participants who were randomly allocated to two arms (n=40 per arm). At 6 weeks, 36 of 40 (90\%) intervention participants and 35 of 40 (88\%) control participants provided complete self-reported data on their daily smoking status via WeChat. Biochemically verified smoking abstinence at 6 weeks was determined for 10 of 40 (25\%) intervention participants and 2 of 40 (5\%) control participants (RR=5, 95\% CI 1.2-21.4, P=.03). In the intervention group, the calculator function, motivational messages, and health tests were underused (less than once per week per users). Participants rated their satisfaction with the intervention program as 4.56 out of 5.00. Conclusions: Our program is a novel, accessible, and acceptable smoking cessation intervention for Chinese male smokers. A future trial with a greater sample size and longer follow-up will identify if it is as effective as these preliminary data suggest. Trial Registration: ANZCTR registry, ACTRN12618001089224; https://tinyurl.com/y536n7sx International Registered Report Identifier (IRRID): RR2-18071 ",
doi="10.2196/17522",
url="http://mhealth.jmir.org/2020/10/e17522/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33095184"
}


@Article{info:doi/10.2196/18762,
author="Lee, Sylvia
and Torok, Michelle
and Shand, Fiona
and Chen, Nicola
and McGillivray, Lauren
and Burnett, Alexander
and Larsen, Erik Mark
and Mok, Katherine",
title="Performance, Cost-Effectiveness, and Representativeness of Facebook Recruitment to Suicide Prevention Research: Online Survey Study",
journal="JMIR Ment Health",
year="2020",
month="Oct",
day="22",
volume="7",
number="10",
pages="e18762",
keywords="research subject recruitment",
keywords="social media",
keywords="suicide",
abstract="Background: Researchers are increasingly using social media advertisements to recruit participants because of their many advantages over traditional methods. Although there is growing evidence for the effectiveness and cost-effectiveness of social media recruitment in the health sciences, no studies have yet examined this in the context of suicide prevention, which remains to be a highly stigmatized and sensitive topic. Objective: This study aims to recruit a general community sample to complete a survey on suicide literacy, stigma, and risk via Facebook advertisements. Specifically, we aim to establish the performance of the advertisements, cost-effectiveness, sample representativeness, and the impact of gender-specific advertising on recruiting men into the study. Methods: From June 2017 to March 2019, we released Facebook advertisements targeted at adults 18 years or older, residing in the New South Wales (NSW) trial or control regions, and involved in the LifeSpan suicide prevention trial. Cost-effectiveness was examined descriptively using metrics provided by Facebook. Chi-square analyses were conducted to determine demographic differences between our sample and the general NSW population as well as the impact of gender-specific advertisements on gender engagement. Results: The 14 Facebook advertisement campaigns reached a total of 675,199 people, yielding 25,993 link clicks and resulting in 9603 individuals initiating the survey (7487 completions) at an overall cost of Aus \$2.81 (US \$2.01) per participant. There was an overrepresentation of younger (P=.003), female (P=.003), highly educated (P<.001) participants and mental health conditions (P<.001) compared with the total NSW population. The use of male-specific advertisements resulted in a significantly higher proportion of men completing the survey relative to gender-neutral advertisements (38.2\% vs 24.6\%; P<.001). Conclusions: This study demonstrates the potential of Facebook to be an effective, low-cost strategy for recruiting a large sample of general community participants for suicide prevention research. Strategies to improve sample representativeness warrant further investigation in future research. ",
doi="10.2196/18762",
url="http://mental.jmir.org/2020/10/e18762/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33090115"
}


@Article{info:doi/10.2196/19804,
author="Wang, Di
and Lyu, Chen Joanne
and Zhao, Xiaoyu",
title="Public Opinion About E-Cigarettes on Chinese Social Media: A Combined Study of Text Mining Analysis and Correspondence Analysis",
journal="J Med Internet Res",
year="2020",
month="Oct",
day="14",
volume="22",
number="10",
pages="e19804",
keywords="e-cigarettes",
keywords="public opinion",
keywords="social media",
keywords="infodemiology",
keywords="infoveillance",
keywords="regulation",
keywords="China",
abstract="Background: Electronic cigarettes (e-cigarettes) have become increasingly popular. China has accelerated its legislation on e-cigarettes in recent years by issuing two policies to regulate their use: the first on August 26, 2018, and the second on November 1, 2019. Social media provide an efficient platform to access information on the public opinion of e-cigarettes. Objective: To gain insight into how policies have influenced the reaction of the Chinese public to e-cigarettes, this study aims to understand what the Chinese public say about e-cigarettes and how the focus of discussion might have changed in the context of policy implementation. Methods: This study uses a combination of text mining and correspondence analysis to content analyze 1160 e-cigarette--related questions and their corresponding answers from Zhihu, China's largest question-and-answer platform and one of the country's most trustworthy social media sources. From January 1, 2017, to December 31, 2019, Python was used to text mine the most frequently used words and phrases in public e-cigarette discussions on Zhihu. The correspondence analysis was used to examine the similarities and differences between high-frequency words and phrases across 3 periods (ie, January 1, 2017, to August 27, 2018; August 28, 2018, to October 31, 2019; and November 1, 2019, to January 1, 2020). Results: The results of the study showed that the consistent themes across time were comparisons with traditional cigarettes, health concerns, and how to choose e-cigarette products. The issuance of government policies on e-cigarettes led to a change in the focus of public discussion. The discussion of e-cigarettes in period 1 mainly focused on the use and experience of e-cigarettes. In period 2, the public's attention was not only on the substances related to e-cigarettes but also on the smoking cessation functions of e-cigarettes. In period 3, the public shifted their attention to the e-cigarette industry and government policy on the banning of e-cigarette sales to minors. Conclusions: Social media are an informative source, which can help policy makers and public health professionals understand the public's concerns over and understanding of e-cigarettes. When there was little regulation, public discussion was greatly influenced by industry claims about e-cigarettes; however, once e-cigarette policies were issued, these policies, to a large extent, set the agenda for public discussion. In addition, media reporting of these policies might have greatly influenced the way e-cigarette policies were discussed. Therefore, monitoring e-cigarette discussions on social media and responding to them in a timely manner will both help improve the public's e-cigarette literacy and facilitate the implementation of e-cigarette--related policies. ",
doi="10.2196/19804",
url="http://www.jmir.org/2020/10/e19804/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33052127"
}


@Article{info:doi/10.2196/17543,
author="McCausland, Kahlia
and Maycock, Bruce
and Leaver, Tama
and Wolf, Katharina
and Freeman, Becky
and Jancey, Jonine",
title="E-Cigarette Advocates on Twitter: Content Analysis of Vaping-Related Tweets",
journal="JMIR Public Health Surveill",
year="2020",
month="Oct",
day="14",
volume="6",
number="4",
pages="e17543",
keywords="electronic nicotine delivery systems",
keywords="electronic cigarettes",
keywords="e-cigarette",
keywords="infodemiology",
keywords="infoveillance",
keywords="vaping",
keywords="Twitter",
keywords="social media",
keywords="public health",
keywords="content analysis",
abstract="Background: As the majority of Twitter content is publicly available, the platform has become a rich data source for public health surveillance, providing insights into emergent phenomena, such as vaping. Although there is a growing body of literature that has examined the content of vaping-related tweets, less is known about the people who generate and disseminate these messages and the role of e-cigarette advocates in the promotion of these devices. Objective: This study aimed to identify key conversation trends and patterns over time, and discern the core voices, message frames, and sentiment surrounding e-cigarette discussions on Twitter. Methods: A random sample of data were collected from Australian Twitter users who referenced at least one of 15 identified e-cigarette related keywords during 2012, 2014, 2016, or 2018. Data collection was facilitated by TrISMA (Tracking Infrastructure for Social Media Analysis) and analyzed by content analysis. Results: A sample of 4432 vaping-related tweets posted and retweeted by Australian users was analyzed. Positive sentiment (3754/4432, 84.70\%) dominated the discourse surrounding e-cigarettes, and vape retailers and manufacturers (1161/4432, 26.20\%), the general public (1079/4432, 24.35\%), and e-cigarette advocates (1038/4432, 23.42\%) were the most prominent posters. Several tactics were used by e-cigarette advocates to communicate their beliefs, including attempts to frame e-cigarettes as safer than traditional cigarettes, imply that federal government agencies lack sufficient competence or evidence for the policies they endorse about vaping, and denounce as propaganda ``gateway'' claims of youth progressing from e-cigarettes to combustible tobacco. Some of the most common themes presented in tweets were advertising or promoting e-cigarette products (2040/4432, 46.03\%), promoting e-cigarette use or intent to use (970/4432, 21.89\%), and discussing the potential of e-cigarettes to be used as a smoking cessation aid or tobacco alternative (716/4432, 16.16\%), as well as the perceived health and safety benefits and consequences of e-cigarette use (681/4432, 15.37\%). Conclusions: Australian Twitter content does not reflect the country's current regulatory approach to e-cigarettes. Rather, the conversation on Twitter generally encourages e-cigarette use, promotes vaping as a socially acceptable practice, discredits scientific evidence of health risks, and rallies around the idea that e-cigarettes should largely be outside the bounds of health policy. The one-sided nature of the discussion is concerning, as is the lack of disclosure and transparency, especially among vaping enthusiasts who dominate the majority of e-cigarette discussions on Twitter, where it is unclear if comments are endorsed, sanctioned, or even supported by the industry. ",
doi="10.2196/17543",
url="http://publichealth.jmir.org/2020/4/e17543/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33052130"
}


@Article{info:doi/10.2196/14081,
author="O'Sullivan, Jane
and McCarrick, Cathleen
and Tierney, Paul
and O'Connor, B. Donal
and Collins, Jack
and Franklin, Robert",
title="Identification of Informed Consent in Patient Videos on Social Media: Prospective Study",
journal="JMIR Med Educ",
year="2020",
month="Oct",
day="13",
volume="6",
number="2",
pages="e14081",
keywords="social media",
keywords="patient consent",
keywords="patient footage",
keywords="ethics",
keywords="YouTube",
keywords="patient video",
keywords="medical education",
abstract="Background: The American Medical Association Code of Medical Ethics states that any clinical image taken for public education forms part of the patient's records. Hence, a patient's informed consent is required to collect, share, and distribute their image. Patients must be informed of the intended use of the clinical image and the intended audience as part of the informed consent. Objective: This paper aimed to determine whether a random selection of instructional videos containing footage of central venous catheter insertion on real patients on YouTube (Google LLC) would mention the presence of informed consent to post the video on social media. Methods: We performed a prospective evaluation by 2 separate researchers of the first 125 videos on YouTube with the search term ``central line insertion.'' After duplicates were deleted and exclusion criteria applied, 41 videos of patients undergoing central line insertion were searched for reference to patient consent. In the case of videos of indeterminate consent status, the posters were contacted privately through YouTube to clarify the status of consent to both film and disseminate the video on social media. A period of 2 months was provided to respond to initial contact. Furthermore, YouTube was contacted to clarify company policy. The primary outcome was to determine if videos on YouTube were amended to include details of consent at 2 months postcontact. The secondary outcome was a response to the initial email at 2 months. Results: The researchers compiled 143 videos. Of 41 videos that contained footage of patient procedures, 41 were of indeterminate consent status and 23 contained identifiable patient footage. From the 41 posters that were contacted, 3 responded to initial contact and none amended the video to document consent status. Response from YouTube is pending. Conclusions: There are instructional videos for clinicians on social media that contain footage of patients undergoing medical procedures and do not have any verification of informed consent. While this study investigated a small sample of available videos, the problem appears ubiquitous and should be studied more extensively. ",
doi="10.2196/14081",
url="http://mededu.jmir.org/2020/2/e14081/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33048058"
}


@Article{info:doi/10.2196/21597,
author="Gozzi, Nicol{\`o}
and Tizzani, Michele
and Starnini, Michele
and Ciulla, Fabio
and Paolotti, Daniela
and Panisson, Andr{\'e}
and Perra, Nicola",
title="Collective Response to Media Coverage of the COVID-19 Pandemic on Reddit and Wikipedia: Mixed-Methods Analysis",
journal="J Med Internet Res",
year="2020",
month="Oct",
day="12",
volume="22",
number="10",
pages="e21597",
keywords="social media",
keywords="news coverage",
keywords="digital epidemiology",
keywords="infodemiology",
keywords="infoveillance",
keywords="infodemic",
keywords="data science",
keywords="topic modeling",
keywords="pandemic",
keywords="COVID-19",
keywords="Reddit",
keywords="Wikipedia",
keywords="information",
keywords="response",
keywords="risk perception",
keywords="behavior",
abstract="Background: The exposure and consumption of information during epidemic outbreaks may alter people's risk perception and trigger behavioral changes, which can ultimately affect the evolution of the disease. It is thus of utmost importance to map the dissemination of information by mainstream media outlets and the public response to this information. However, our understanding of this exposure-response dynamic during the COVID-19 pandemic is still limited. Objective: The goal of this study is to characterize the media coverage and collective internet response to the COVID-19 pandemic in four countries: Italy, the United Kingdom, the United States, and Canada. Methods: We collected a heterogeneous data set including 227,768 web-based news articles and 13,448 YouTube videos published by mainstream media outlets, 107,898 user posts and 3,829,309 comments on the social media platform Reddit, and 278,456,892 views of COVID-19--related Wikipedia pages. To analyze the relationship between media coverage, epidemic progression, and users' collective web-based response, we considered a linear regression model that predicts the public response for each country given the amount of news exposure. We also applied topic modelling to the data set using nonnegative matrix factorization. Results: Our results show that public attention, quantified as user activity on Reddit and active searches on Wikipedia pages, is mainly driven by media coverage; meanwhile, this activity declines rapidly while news exposure and COVID-19 incidence remain high. Furthermore, using an unsupervised, dynamic topic modeling approach, we show that while the levels of attention dedicated to different topics by media outlets and internet users are in good accordance, interesting deviations emerge in their temporal patterns. Conclusions: Overall, our findings offer an additional key to interpret public perception and response to the current global health emergency and raise questions about the effects of attention saturation on people's collective awareness and risk perception and thus on their tendencies toward behavioral change. ",
doi="10.2196/21597",
url="http://www.jmir.org/2020/10/e21597/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32960775"
}


@Article{info:doi/10.2196/19684,
author="Li, Xiaojing
and Liu, Qinliang",
title="Social Media Use, eHealth Literacy, Disease Knowledge, and Preventive Behaviors in the COVID-19 Pandemic: Cross-Sectional Study on Chinese Netizens",
journal="J Med Internet Res",
year="2020",
month="Oct",
day="9",
volume="22",
number="10",
pages="e19684",
keywords="social media",
keywords="media use",
keywords="COVID-19",
keywords="pandemic",
keywords="disease knowledge",
keywords="eHealth literacy",
keywords="public health",
keywords="preventive behaviors",
abstract="Background: Since its outbreak in January 2020, COVID-19 has quickly spread worldwide and has become a global pandemic. Social media platforms have been recognized as important tools for health-promoting practices in public health, and the use of social media is widespread among the public. However, little is known about the effects of social media use on health promotion during a pandemic such as COVID-19. Objective: In this study, we aimed to explore the predictive role of social media use on public preventive behaviors in China during the COVID-19 pandemic and how disease knowledge and eHealth literacy moderated the relationship between social media use and preventive behaviors. Methods: A national web-based cross-sectional survey was conducted by a proportionate probability sampling among 802 Chinese internet users (``netizens'') in February 2020. Descriptive statistics, Pearson correlations, and hierarchical multiple regressions were employed to examine and explore the relationships among all the variables. Results: Almost half the 802 study participants were male (416, 51.9\%), and the average age of the participants was 32.65 years. Most of the 802 participants had high education levels (624, 77.7\%), had high income >{\textyen}5000 (US \$736.29) (525, 65.3\%), were married (496, 61.8\%), and were in good health (486, 60.6\%). The average time of social media use was approximately 2 to 3 hours per day (mean 2.34 hours, SD 1.11), and the most frequently used media types were public social media (mean score 4.49/5, SD 0.78) and aggregated social media (mean score 4.07/5, SD 1.07). Social media use frequency ($\beta$=.20, P<.001) rather than time significantly predicted preventive behaviors for COVID-19. Respondents were also equipped with high levels of disease knowledge (mean score 8.15/10, SD 1.43) and eHealth literacy (mean score 3.79/5, SD 0.59). Disease knowledge ($\beta$=.11, P=.001) and eHealth literacy ($\beta$=.27, P<.001) were also significant predictors of preventive behaviors. Furthermore, eHealth literacy (P=.038) and disease knowledge (P=.03) positively moderated the relationship between social media use frequency and preventive behaviors, while eHealth literacy ($\beta$=.07) affected this relationship positively and disease knowledge ($\beta$=--.07) affected it negatively. Different social media types differed in predicting an individual's preventive behaviors for COVID-19. Aggregated social media ($\beta$=.22, P<.001) was the best predictor, followed by public social media ($\beta$=.14, P<.001) and professional social media ($\beta$=.11, P=.002). However, official social media ($\beta$=.02, P=.597) was an insignificant predictor. Conclusions: Social media is an effective tool to promote behaviors to prevent COVID-19 among the public. Health literacy is essential for promotion of individual health and influences the extent to which the public engages in preventive behaviors during a pandemic. Our results not only enrich the theoretical paradigm of public health management and health communication but also have practical implications in pandemic control for China and other countries. ",
doi="10.2196/19684",
url="http://www.jmir.org/2020/10/e19684/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33006940"
}


@Article{info:doi/10.2196/20558,
author="Rao, Qingmao
and Zhang, Zuyue
and Lv, Yalan
and Zhao, Yong
and Bai, Li
and Hou, Xiaorong",
title="Factors Associated With Influential Health-Promoting Messages on Social Media: Content Analysis of Sina Weibo",
journal="JMIR Med Inform",
year="2020",
month="Oct",
day="9",
volume="8",
number="10",
pages="e20558",
keywords="health-promoting messages",
keywords="social media",
keywords="Sina Weibo",
keywords="influence",
keywords="framing effects",
keywords="health communication",
abstract="Background: Social media is a powerful tool for the dissemination of health messages. However, few studies have focused on the factors that improve the influence of health messages on social media. Objective: To explore the influence of goal-framing effects, information organizing, and the use of pictures or videos in health-promoting messages, we conducted a case study of Sina Weibo, a popular social media platform in China. Methods: Literature review and expert discussion were used to determine the health themes of childhood obesity, smoking, and cancer. Web crawler technology was employed to capture data on health-promoting messages. We used the number of retweets, comments, and likes to evaluate the influence of a message. Statistical analysis was then conducted after manual coding. Specifically, binary logistic regression was used for the data analyses. Results: We crawled 20,799 Sina Weibo messages and selected 389 health-promoting messages for this study. Results indicated that the use of gain-framed messages could improve the influence of messages regarding childhood obesity (P<.001), smoking (P=.03), and cancer (P<.001). Statistical expressions could improve the influence of messages about childhood obesity (P=.02), smoking (P=.002), and cancer (P<.001). However, the use of videos significantly improved the influence of health-promoting messages only for the smoking-related messages (P=.009). Conclusions: The findings suggested that gain-framed messages and statistical expressions can be successful strategies to improve the influence of messages. Moreover, appropriate pictures and videos should be added as much as possible when generating health-promoting messages. ",
doi="10.2196/20558",
url="http://medinform.jmir.org/2020/10/e20558/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33034569"
}


@Article{info:doi/10.2196/22005,
author="Feliciano, T. Josemari
and Salmi, Liz
and Blotner, Charlie
and Hayden, Adam
and Nduom, K. Edjah
and Kwan, M. Bethany
and Katz, S. Matthew
and Claus, B. Elizabeth",
title="Brain Tumor Discussions on Twitter (\#BTSM): Social Network Analysis",
journal="J Med Internet Res",
year="2020",
month="Oct",
day="8",
volume="22",
number="10",
pages="e22005",
keywords="brain tumors",
keywords="social media",
keywords="health care",
keywords="patient support",
keywords="network analysis",
abstract="Background: The Brain Tumor Social Media (\#BTSM) Twitter hashtag was founded in February 2012 as a disease-specific hashtag for patients with brain tumor. Objective: To understand \#BTSM's role as a patient support system, we describe user descriptors, growth, interaction, and content sharing. Methods: We analyzed all tweets containing \#BTSM from 2012 to 2018 using the Symplur Signals platform to obtain data and to describe Symplur-defined user categories, tweet content, and trends in use over time. We created a network plot with all publicly available retweets involving \#BTSM in 2018 to visualize key stakeholders and their connections to other users. Results: From 2012 to 2018, 59,764 unique users participated in \#BTSM, amassing 298,904 tweets. The yearly volume of \#BTSM tweets increased by 264.57\% from 16,394 in 2012 to 43,373 in 2018 with \#BTSM constantly trending in the top 15 list of disease hashtags, as well the top 15 list of tweet chats. Patient advocates generated the most \#BTSM tweets (33.13\%), while advocacy groups, caregivers, doctors, and researchers generated 7.01\%, 4.63\%, 3.86\%, and 3.37\%, respectively. Physician use, although still low, has increased over time. The 2018 network plot of retweets including \#BTSM identifies a number of key stakeholders from the patient advocate, patient organization, and medical researcher domains and reveals the extent of their reach to other users. Conclusions: From its start in 2012, \#BTSM has grown exponentially over time. We believe its growth suggests its potential as a global source of brain tumor information on Twitter for patients, advocates, patient organizations as well as health care professionals and researchers. ",
doi="10.2196/22005",
url="http://www.jmir.org/2020/10/e22005/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33030435"
}


@Article{info:doi/10.2196/23021,
author="Pozzar, Rachel
and Hammer, J. Marilyn
and Underhill-Blazey, Meghan
and Wright, A. Alexi
and Tulsky, A. James
and Hong, Fangxin
and Gundersen, A. Daniel
and Berry, L. Donna",
title="Threats of Bots and Other Bad Actors to Data Quality Following Research Participant Recruitment Through Social Media: Cross-Sectional Questionnaire",
journal="J Med Internet Res",
year="2020",
month="Oct",
day="7",
volume="22",
number="10",
pages="e23021",
keywords="social media",
keywords="internet",
keywords="methods",
keywords="data accuracy",
keywords="fraud",
abstract="Background: Recruitment of health research participants through social media is becoming more common. In the United States, 80\% of adults use at least one social media platform. Social media platforms may allow researchers to reach potential participants efficiently. However, online research methods may be associated with unique threats to sample validity and data integrity. Limited research has described issues of data quality and authenticity associated with the recruitment of health research participants through social media, and sources of low-quality and fraudulent data in this context are poorly understood. Objective: The goal of the research was to describe and explain threats to sample validity and data integrity following recruitment of health research participants through social media and summarize recommended strategies to mitigate these threats. Our experience designing and implementing a research study using social media recruitment and online data collection serves as a case study. Methods: Using published strategies to preserve data integrity, we recruited participants to complete an online survey through the social media platforms Twitter and Facebook. Participants were to receive \$15 upon survey completion. Prior to manually issuing remuneration, we reviewed completed surveys for indicators of fraudulent or low-quality data. Indicators attributable to respondent error were labeled suspicious, while those suggesting misrepresentation were labeled fraudulent. We planned to remove cases with 1 fraudulent indicator or at least 3 suspicious indicators. Results: Within 7 hours of survey activation, we received 271 completed surveys. We classified 94.5\% (256/271) of cases as fraudulent and 5.5\% (15/271) as suspicious. In total, 86.7\% (235/271) provided inconsistent responses to verifiable items and 16.2\% (44/271) exhibited evidence of bot automation. Of the fraudulent cases, 53.9\% (138/256) provided a duplicate or unusual response to one or more open-ended items and 52.0\% (133/256) exhibited evidence of inattention. Conclusions: Research findings from several disciplines suggest studies in which research participants are recruited through social media are susceptible to data quality issues. Opportunistic individuals who use virtual private servers to fraudulently complete research surveys for profit may contribute to low-quality data. Strategies to preserve data integrity following research participant recruitment through social media are limited. Development and testing of novel strategies to prevent and detect fraud is a research priority. ",
doi="10.2196/23021",
url="http://www.jmir.org/2020/10/e23021/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33026360"
}


@Article{info:doi/10.2196/21383,
author="Osadchiy, Vadim
and Jiang, Tommy
and Mills, Nelson Jesse
and Eleswarapu, Venkata Sriram",
title="Low Testosterone on Social Media: Application of Natural Language Processing to Understand Patients' Perceptions of Hypogonadism and Its Treatment",
journal="J Med Internet Res",
year="2020",
month="Oct",
day="7",
volume="22",
number="10",
pages="e21383",
keywords="hypogonadism",
keywords="natural language processing",
keywords="Reddit",
keywords="social media",
keywords="testosterone replacement therapy",
keywords="Twitter",
abstract="Background: Despite the results of the Testosterone Trials, physicians remain uncomfortable treating men with hypogonadism. Discouraged, men increasingly turn to social media to discuss medical concerns. Objective: The goal of the research was to apply natural language processing (NLP) techniques to social media posts for identification of themes of discussion regarding low testosterone and testosterone replacement therapy (TRT) in order to inform how physicians may better evaluate and counsel patients. Methods: We retrospectively extracted posts from the Reddit community r/Testosterone from December 2015 through May 2019. We applied an NLP technique called the meaning extraction method with principal component analysis (MEM/PCA) to computationally derive discussion themes. We then performed a prospective analysis of Twitter data (tweets) that contained the terms low testosterone, low T, and testosterone replacement from June through September 2019. Results: A total of 199,335 Reddit posts and 6659 tweets were analyzed. MEM/PCA revealed dominant themes of discussion: symptoms of hypogonadism, seeing a doctor, results of laboratory tests, derogatory comments and insults, TRT medications, and cardiovascular risk. More than 25\% of Reddit posts contained the term doctor, and more than 5\% urologist. Conclusions: This study represents the first NLP evaluation of the social media landscape surrounding hypogonadism and TRT. Although physicians traditionally limit their practices to within their clinic walls, the ubiquity of social media demands that physicians understand what patients discuss online. Physicians may do well to bring up online discussions during clinic consultations for low testosterone to pull back the curtain and dispel myths. ",
doi="10.2196/21383",
url="https://www.jmir.org/2020/10/e21383",
url="http://www.ncbi.nlm.nih.gov/pubmed/33026354"
}


@Article{info:doi/10.2196/22374,
author="Ahmed, Wasim
and L{\'o}pez Segu{\'i}, Francesc
and Vidal-Alaball, Josep
and Katz, S. Matthew",
title="COVID-19 and the ``Film Your Hospital'' Conspiracy Theory: Social Network Analysis of Twitter Data",
journal="J Med Internet Res",
year="2020",
month="Oct",
day="5",
volume="22",
number="10",
pages="e22374",
keywords="COVID-19",
keywords="coronavirus",
keywords="Twitter",
keywords="misinformation",
keywords="fake news",
keywords="social network analysis",
keywords="public health",
keywords="social media",
abstract="Background: During the COVID-19 pandemic, a number of conspiracy theories have emerged. A popular theory posits that the pandemic is a hoax and suggests that certain hospitals are ``empty.'' Research has shown that accepting conspiracy theories increases the likelihood that an individual may ignore government advice about social distancing and other public health interventions. Due to the possibility of a second wave and future pandemics, it is important to gain an understanding of the drivers of misinformation and strategies to mitigate it. Objective: This study set out to evaluate the \#FilmYourHospital conspiracy theory on Twitter, attempting to understand the drivers behind it. More specifically, the objectives were to determine which online sources of information were used as evidence to support the theory, the ratio of automated to organic accounts in the network, and what lessons can be learned to mitigate the spread of such a conspiracy theory in the future. Methods: Twitter data related to the \#FilmYourHospital hashtag were retrieved and analyzed using social network analysis across a 7-day period from April 13-20, 2020. The data set consisted of 22,785 tweets and 11,333 Twitter users. The Botometer tool was used to identify accounts with a higher probability of being bots. Results: The most important drivers of the conspiracy theory are ordinary citizens; one of the most influential accounts is a Brexit supporter. We found that YouTube was the information source most linked to by users. The most retweeted post belonged to a verified Twitter user, indicating that the user may have had more influence on the platform. There was a small number of automated accounts (bots) and deleted accounts within the network. Conclusions: Hashtags using and sharing conspiracy theories can be targeted in an effort to delegitimize content containing misinformation. Social media organizations need to bolster their efforts to label or remove content that contains misinformation. Public health authorities could enlist the assistance of influencers in spreading antinarrative content. ",
doi="10.2196/22374",
url="http://www.jmir.org/2020/10/e22374/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32936771"
}


@Article{info:doi/10.2196/19618,
author="Teng, Shasha
and Khong, Wei Kok
and Pahlevan Sharif, Saeed
and Ahmed, Amr",
title="YouTube Video Comments on Healthy Eating: Descriptive and Predictive Analysis",
journal="JMIR Public Health Surveill",
year="2020",
month="Oct",
day="1",
volume="6",
number="4",
pages="e19618",
keywords="YouTube comments",
keywords="text mining",
keywords="healthy eating",
keywords="clustering",
keywords="structural equation modeling",
abstract="Background: Poor nutrition and food selection lead to health issues such as obesity, cardiovascular disease, diabetes, and cancer. This study of YouTube comments aims to uncover patterns of food choices and the factors driving them, in addition to exploring the sentiments of healthy eating in networked communities. Objective: The objectives of the study are to explore the determinants, motives, and barriers to healthy eating behaviors in online communities and provide insight into YouTube video commenters' perceptions and sentiments of healthy eating through text mining techniques. Methods: This paper applied text mining techniques to identify and categorize meaningful healthy eating determinants. These determinants were then incorporated into hypothetically defined constructs that reflect their thematic and sentimental nature in order to test our proposed model using a variance-based structural equation modeling procedure. Results: With a dataset of 4654 comments extracted from YouTube videos in the context of Malaysia, we apply a text mining method to analyze the perceptions and behavior of healthy eating. There were 10 clusters identified with regard to food ingredients, food price, food choice, food portion, well-being, cooking, and culture in the concept of healthy eating. The structural equation modeling results show that clusters are positively associated with healthy eating with all P values less than .001, indicating a statistical significance of the study results. People hold complex and multifaceted beliefs about healthy eating in the context of YouTube videos. Fruits and vegetables are the epitome of healthy foods. Despite having a favorable perception of healthy eating, people may not purchase commonly recognized healthy food if it has a premium price. People associate healthy eating with weight concerns. Food taste, variety, and availability are identified as reasons why Malaysians cannot act on eating healthily. Conclusions: This study offers significant value to the existing literature of health-related studies by investigating the rich and diverse social media data gleaned from YouTube. This research integrated text mining analytics with predictive modeling techniques to identify thematic constructs and analyze the sentiments of healthy eating. ",
doi="10.2196/19618",
url="https://publichealth.jmir.org/2020/4/e19618",
url="http://www.ncbi.nlm.nih.gov/pubmed/33001036"
}


@Article{info:doi/10.2196/21204,
author="Gabarron, Elia
and Larbi, Dillys
and Dorronzoro, Enrique
and Hasvold, Erlend Per
and Wynn, Rolf
and {\AA}rsand, Eirik",
title="Factors Engaging Users of Diabetes Social Media Channels on Facebook, Twitter, and Instagram: Observational Study",
journal="J Med Internet Res",
year="2020",
month="Sep",
day="29",
volume="22",
number="9",
pages="e21204",
keywords="social media",
keywords="Facebook",
keywords="Twitter",
keywords="Instagram",
keywords="diabetes",
keywords="engagement",
abstract="Background: Diabetes patient associations and diabetes-specific patient groups around the world are present on social media. Although active participation and engagement in these diabetes social media groups has been mostly linked to positive effects, very little is known about the content that is shared on these channels or the post features that engage their users the most. Objective: The objective of this study was to analyze (1) the content and features of posts shared over a 3-year period on 3 diabetes social media channels (Facebook, Twitter, and Instagram) of a diabetes association, and (2) users' engagement with these posts (likes, comments, and shares). Methods: All social media posts published from the Norwegian Diabetes Association between January 1, 2017, and December 31, 2019, were extracted. Two independent reviewers classified the posts into 7 categories based on their content. The interrater reliability was calculated using Cohen kappa. Regression analyses were carried out to analyze the effects of content topic, social media channel, and post features on users' engagement (likes, comments, and shares). Results: A total of 1449 messages were posted. Posts of interviews and personal stories received 111\% more likes, 106\% more comments, and 112\% more shares than miscellaneous posts (all P<.001). Messages posted about awareness days and other celebrations were 41\% more likely to receive likes than miscellaneous posts (P<.001). Conversely, posts on research and innovation received 31\% less likes (P<.001), 35\% less comments (P=.02), and 25\% less shares (P=.03) than miscellaneous posts. Health education posts received 38\% less comments (P=.003) but were shared 39\% more than miscellaneous posts (P=.007). With regard to social media channel, Facebook and Instagram posts were both 35 times more likely than Twitter posts to receive likes, and 60 times and almost 10 times more likely to receive comments, respectively (P<.001). Compared to text-only posts, those with videos had 3 times greater chance of receiving likes, almost 4 times greater chance of receiving comments, and 2.5 times greater chance of being shared (all P<.001). Including both videos and emoji in posts increased the chances of receiving likes by almost 7 times (P<.001). Adding an emoji to posts increased their chances of receiving likes and being shared by 71\% and 144\%, respectively (P<.001). Conclusions: Diabetes social media users seem to be least engaged in posts with content topics that a priori could be linked to greater empowerment: research and innovation on diabetes, and health education. Diabetes social media groups, public health authorities, and other stakeholders interested in sharing research and innovation content and promoting health education on social media should consider including videos and emoji in their posts, and publish on popular and visual-based social media channels, such as Facebook and Instagram, to increase user engagement. International Registered Report Identifier (IRRID): RR2-10.1186/s12913-018-3178-7 ",
doi="10.2196/21204",
url="http://www.jmir.org/2020/9/e21204/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32990632"
}


@Article{info:doi/10.2196/21849,
author="K{\"u}hnle, Lara
and M{\"u}cke, Urs
and Lechner, M. Werner
and Klawonn, Frank
and Grigull, Lorenz",
title="Development of a Social Network for People Without a Diagnosis (RarePairs): Evaluation Study",
journal="J Med Internet Res",
year="2020",
month="Sep",
day="29",
volume="22",
number="9",
pages="e21849",
keywords="rare disease",
keywords="diagnostic support tool",
keywords="prototype",
keywords="social network",
keywords="machine learning",
keywords="artificial intelligence",
abstract="Background: Diagnostic delay in rare disease (RD) is common, occasionally lasting up to more than 20 years. In attempting to reduce it, diagnostic support tools have been studied extensively. However, social platforms have not yet been used for systematic diagnostic support. This paper illustrates the development and prototypic application of a social network using scientifically developed questions to match individuals without a diagnosis. Objective: The study aimed to outline, create, and evaluate a prototype tool (a social network platform named RarePairs), helping patients with undiagnosed RDs to find individuals with similar symptoms. The prototype includes a matching algorithm, bringing together individuals with similar disease burden in the lead-up to diagnosis. Methods: We divided our project into 4 phases. In phase 1, we used known data and findings in the literature to understand and specify the context of use. In phase 2, we specified the user requirements. In phase 3, we designed a prototype based on the results of phases 1 and 2, as well as incorporating a state-of-the-art questionnaire with 53 items for recognizing an RD. Lastly, we evaluated this prototype with a data set of 973 questionnaires from individuals suffering from different RDs using 24 distance calculating methods. Results: Based on a step-by-step construction process, the digital patient platform prototype, RarePairs, was developed. In order to match individuals with similar experiences, it uses answer patterns generated by a specifically designed questionnaire (Q53). A total of 973 questionnaires answered by patients with RDs were used to construct and test an artificial intelligence (AI) algorithm like the k-nearest neighbor search. With this, we found matches for every single one of the 973 records. The cross-validation of those matches showed that the algorithm outperforms random matching significantly. Statistically, for every data set the algorithm found at least one other record (match) with the same diagnosis. Conclusions: Diagnostic delay is torturous for patients without a diagnosis. Shortening the delay is important for both doctors and patients. Diagnostic support using AI can be promoted differently. The prototype of the social media platform RarePairs might be a low-threshold patient platform, and proved suitable to match and connect different individuals with comparable symptoms. This exchange promoted through RarePairs might be used to speed up the diagnostic process. Further studies include its evaluation in a prospective setting and implementation of RarePairs as a mobile phone app. ",
doi="10.2196/21849",
url="http://www.jmir.org/2020/9/e21849/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32990634"
}


@Article{info:doi/10.2196/21416,
author="Ruan, Brandon
and Yilmaz, Yusuf
and Lu, Daniel
and Lee, Mark
and Chan, M. Teresa",
title="Defining the Digital Self: A Qualitative Study to Explore the Digital Component of Professional Identity in the Health Professions",
journal="J Med Internet Res",
year="2020",
month="Sep",
day="29",
volume="22",
number="9",
pages="e21416",
keywords="professional identity",
keywords="social media",
keywords="digital identity",
keywords="health care professionals",
keywords="e-professionalism",
abstract="Background: Recent medical education literature pertaining to professional identity development fails to reflect the impact social media has on professional identity theory. Social media is transforming the field of medicine, as the web-based medium is now an avenue for professional development and socialization for medical students and residents. Research regarding identity development in social media has been primarily confined to electronic professionalism through best practice guidelines. However, this neglects other potential aspects pertinent to digital identity that have not yet been explored. Objective: This study aims to define the properties and development of the digital self and its interactions with the current professional identity development theory. Methods: A qualitative study was conducted using thematic analysis. A total of 17 participants who are social media education and knowledge translation experts were interviewed. The initial participants were from emergency medicine, and a snowball sampling method was used following their respective web-based semistructured interviews to enable global recruitment of other participants from interprofessional disciplines. The research team consisted of a diverse group of researchers including one current social media knowledge translation physician clinician educator, one postdoctoral researcher who is regularly engaged in social media knowledge translation, and 3 nonphysician research assistants who are not social media users. Half of the team conducted the initial coding and analysis, whereas the other 2 investigators audited the procedures followed. Results: A total of 4 themes were identified that pertain to digital identity. In the first theme, origins of initial digital identity formation were found to be derived from perceived needs in professional roles (eg, as a medical student or resident). The second theme consisted of the cultivation of digital identity, in which digital identity was developed parallel to professional identity. The third theme that emerged was the management between the professional and personal components of digital identity. Participants initially preferred keeping these components completely separate; however, attempts to do so were inadequate while the integration of both components provided benefits. The fourth theme was the management of real-life identity and digital identity. Participants preferred real-life identity to be wholly represented on the web. Instances of misalignment resulted in identity conflict, compromising one of the identities. Conclusions: Social media introduces new features to professional identity in the digital world. The formation of digital identity, its development, and reconciliation with other identities were features captured in our analysis. The virtual component of professional identity must not be neglected but instead further explored, as educational institutions continue to give more importance to navigating professional identity development. ",
doi="10.2196/21416",
url="http://www.jmir.org/2020/9/e21416/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32990636"
}


@Article{info:doi/10.2196/18407,
author="Bruen, Jane Ashley
and Wall, Abbie
and Haines-Delmont, Alina
and Perkins, Elizabeth",
title="Exploring Suicidal Ideation Using an Innovative Mobile App-Strength Within Me: The Usability and Acceptability of Setting up a Trial Involving Mobile Technology and Mental Health Service Users",
journal="JMIR Ment Health",
year="2020",
month="Sep",
day="28",
volume="7",
number="9",
pages="e18407",
keywords="mobile applications",
keywords="smartphone",
keywords="mobile phone",
keywords="mHealth",
keywords="mental health",
keywords="suicide",
keywords="social media",
abstract="Background: Suicide is a growing global public health problem that has resulted in an increase in the demand for psychological services to address mental health issues. It is expected that 1 in 6 people on a waiting list for mental health services will attempt suicide. Although suicidal ideation has been shown to be linked to a higher risk of death by suicide, not everybody openly discloses their suicidal thoughts or plans to friends and family or seeks professional help before suicide. Therefore, new methods are needed to track suicide risk in real time together with a better understanding of the ways in which people communicate or express their suicidality. Considering the dynamic nature and challenges in understanding suicide ideation and suicide risk, mobile apps could be better suited to prevent suicide as they have the ability to collect real-time data. Objective: This study aims to report the practicalities and acceptability of setting up and trialing digital technologies within an inpatient mental health setting in the United Kingdom and highlight their implications for future studies. Methods: Service users were recruited from 6 inpatient wards in the north west of England. Service users who were eligible to participate and provided consent were given an iPhone and Fitbit for 7 days and were asked to interact with a novel phone app, Strength Within Me (SWiM). Interaction with the app involved journaling (recording daily activities, how this made them feel, and rating their mood) and the option to create safety plans for emotions causing difficulties (identifying strategies that helped with these emotions). Participants also had the option to allow the study to access their personal Facebook account to monitor their social media use and activity. In addition, clinical data (ie, assessments conducted by trained researchers targeting suicidality, depression, and sleep) were also collected. Results: Overall, 43.0\% (80/186 response rate) of eligible participants were recruited for the study. Of the total sample, 67 participants engaged in journaling, with the average number of entries per user being 8.2 (SD 8.7). Overall, only 24 participants created safety plans and the most common difficult emotion to be selected was feeling sad (n=21). This study reports on the engagement with the SWiM app, the technical difficulties the research team faced, the importance of building key relationships, and the implications of using Facebook as a source to detect suicidality. Conclusions: To develop interventions that can be delivered in a timely manner, prediction of suicidality must be given priority. This paper has raised important issues and highlighted lessons learned from implementing a novel mobile app to detect the risk of suicidality for service users in an inpatient setting. ",
doi="10.2196/18407",
url="http://mental.jmir.org/2020/9/e18407/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32985995"
}


@Article{info:doi/10.2196/16800,
author="Zhang, Ni
and Drake, A. Stacy
and Ding, Kele",
title="Message Appeals on an Instagram Account Promoting Seat Belt Use That Attract Adolescents and Young Adults: Elaboration-Likelihood Perspective Study",
journal="JMIR Form Res",
year="2020",
month="Sep",
day="28",
volume="4",
number="9",
pages="e16800",
keywords="rational appeal",
keywords="ego appeal",
keywords="social appeal",
keywords="fun appeal",
keywords="positive emotional appeal",
keywords="fear appeal",
keywords="social media",
keywords="youth",
keywords="adolescents",
keywords="health information",
keywords="car safety",
abstract="Background: Adolescents and young adults demonstrate the highest rate of unrestrained motor vehicle fatalities, making the promotion of seat belt restraint a priority for public health practitioners. Because social media use among adolescents and young adults has proliferated in recent years, it is critical to explore how to use this tool to promote seat belt use among this population. Social media posts can contain various types of information within each post and this information can be communicated using different modalities. Objective: In this study, based on the elaboration likelihood model, we aimed to examine how adolescents and young adults reacted to different appeals in various components of posts in the pilot of a promotion intervention on the Instagram BuckleUp4Life account. Methods: Using thematic analysis, we examined different appeals in 3 components (photo, text, and caption) of 199 posts in BuckleUp4Life and compared the number of likes for different appeals. Results: We found that 6 appeals were used in the posts: rational, ego, social, fun, positive emotional, and fear appeals. The results of our study showed that in photos, fun appeals were the most popular. Rational and positive emotional appeals were the most appealing in text and captions. Regardless of the location of the components (photo, text, or captions), rational appeal was the most popular appeal. Conclusions: Based on the findings of our study, we recommend that public health practitioners utilize fun photos with rational and positive emotional appeals in text and captions rather than fear or social appeals, when promoting seat belt use through social media, especially Instagram. ",
doi="10.2196/16800",
url="http://formative.jmir.org/2020/9/e16800/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32985998"
}


@Article{info:doi/10.2196/22767,
author="Tsai, Jiun-Yi
and Phua, Joe
and Pan, Shuya
and Yang, Chia-chen",
title="Intergroup Contact, COVID-19 News Consumption, and the Moderating Role of Digital Media Trust on Prejudice Toward Asians in the United States: Cross-Sectional Study",
journal="J Med Internet Res",
year="2020",
month="Sep",
day="25",
volume="22",
number="9",
pages="e22767",
keywords="COVID-19",
keywords="prejudice",
keywords="news exposure",
keywords="news trust",
keywords="infodemic",
keywords="media bias",
keywords="racism",
keywords="social media use",
keywords="intergroup contact",
keywords="regression",
keywords="moderation analysis",
keywords="cross-sectional survey",
abstract="Background: The perceived threat of a contagious virus may lead people to be distrustful of immigrants and out-groups. Since the COVID-19 outbreak, the salient politicized discourses of blaming Chinese people for spreading the virus have fueled over 2000 reports of anti-Asian racial incidents and hate crimes in the United States. Objective: The study aims to investigate the relationships between news consumption, trust, intergroup contact, and prejudicial attitudes toward Asians and Asian Americans residing in the United States during the COVID-19 pandemic. We compare how traditional news, social media use, and biased news exposure cultivate racial attitudes, and the moderating role of media use and trust on prejudice against Asians is examined. Methods: A cross-sectional study was completed in May 2020. A total of 430 US adults (mean age 36.75, SD 11.49 years; n=258, 60\% male) participated in an online survey through Amazon's Mechanical Turk platform. Respondents answered questions related to traditional news exposure, social media use, perceived trust, and their top three news channels for staying informed about the novel coronavirus. In addition, intergroup contact and racial attitudes toward Asians were assessed. We performed hierarchical regression analyses to test the associations. Moderation effects were estimated using simple slopes testing with a 95\% bootstrap confidence interval approach. Results: Participants who identified as conservatives ($\beta$=.08, P=.02), had a personal infection history ($\beta$=.10, P=.004), and interacted with Asian people frequently in their daily lives ($\beta$=.46, P<.001) reported more negative attitudes toward Asians after controlling for sociodemographic variables. Relying more on traditional news media ($\beta$=.08, P=.04) and higher levels of trust in social media ($\beta$=.13, P=.007) were positively associated with prejudice against Asians. In contrast, consuming news from left-leaning outlets ($\beta$=--.15, P=.001) and neutral outlets ($\beta$=--.13, P=.003) was linked to less prejudicial attitudes toward Asians. Among those who had high trust in social media, exposure had a negative relationship with prejudice. At high levels of trust in digital websites and apps, frequent use was related to less unfavorable attitudes toward Asians. Conclusions: Experiencing racial prejudice among the Asian population during a challenging pandemic can cause poor psychological outcomes and exacerbate health disparities. The results suggest that conservative ideology, personal infection history, frequency of intergroup contact, traditional news exposure, and trust in social media emerge as positive predictors of prejudice against Asians and Asian Americans, whereas people who get COVID-19 news from left-leaning and balanced outlets show less prejudice. For those who have more trust in social media and digital news, frequent use of these two sources is associated with lower levels of prejudice. Our findings highlight the need to reshape traditional news discourses and use social media and mobile news apps to develop credible messages for combating racial prejudice against Asians. ",
doi="10.2196/22767",
url="http://www.jmir.org/2020/9/e22767/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32924948"
}


@Article{info:doi/10.2196/23153,
author="Clavier, Thomas
and Popoff, Benjamin
and Selim, Jean
and Beuzelin, Marion
and Roussel, Melanie
and Compere, Vincent
and Veber, Benoit
and Besnier, Emmanuel",
title="Association of Social Network Use With Increased Anxiety Related to the COVID-19 Pandemic in Anesthesiology, Intensive Care, and Emergency Medicine Teams: Cross-Sectional Web-Based Survey Study",
journal="JMIR Mhealth Uhealth",
year="2020",
month="Sep",
day="24",
volume="8",
number="9",
pages="e23153",
keywords="social network",
keywords="nurse",
keywords="physician",
keywords="anxiety",
keywords="emergency medicine, anesthesiology, critical care medicine",
keywords="coronavirus disease 2019",
keywords="mental health",
keywords="COVID-19",
abstract="Background: Critical care teams are on the front line of managing the COVID-19 pandemic, which is stressful for members of these teams. Objective: Our objective was to assess whether the use of social networks is associated with increased anxiety related to the COVID-19 pandemic among members of critical care teams. Methods: We distributed a web-based survey to physicians, residents, registered and auxiliary nurses, and nurse anesthetists providing critical care (anesthesiology, intensive care, or emergency medicine) in several French hospitals. The survey evaluated the respondents' use of social networks, their sources of information on COVID-19, and their levels of anxiety and information regarding COVID-19 on analog scales from 0 to 10. Results: We included 641 respondents in the final analysis; 553 (86.3\%) used social networks, spending a median time of 60 minutes (IQR 30-90) per day on these networks. COVID-19--related anxiety was higher in social network users than in health care workers who did not use these networks (median 6, IQR 5-8 vs median 5, IQR 3-7) in univariate (P=.02) and multivariate (P<.001) analyses, with an average anxiety increase of 10\% in social network users. Anxiety was higher among health care workers using social networks to obtain information on COVID-19 than among those using other sources (median 6, IQR 5-8 vs median 6, IQR 4-7; P=.04). Social network users considered that they were less informed about COVID-19 than those who did not use social networks (median 8, IQR 7-9 vs median 7, IQR 6-8; P<.01). Conclusions: Our results suggest that social networks contribute to increased anxiety in critical care teams. To protect their mental health, critical care professionals should consider limiting their use of these networks during the COVID-19 pandemic. ",
doi="10.2196/23153",
url="http://mhealth.jmir.org/2020/9/e23153/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32924946"
}


@Article{info:doi/10.2196/16752,
author="Ahmed, L. Kelli
and Simon, R. Andrea
and Dempsey, R. Jack
and Samaco, C. Rodney
and Goin-Kochel, P. Robin",
title="Evaluating Two Common Strategies for Research Participant Recruitment Into Autism Studies: Observational Study",
journal="J Med Internet Res",
year="2020",
month="Sep",
day="24",
volume="22",
number="9",
pages="e16752",
keywords="autism spectrum disorder",
keywords="participant recruitment",
keywords="social media",
keywords="Facebook",
keywords="radio",
keywords="genetic studies",
abstract="Background: Ongoing research is necessary to better understand the causes of autism spectrum disorder (ASD), the developmental outcomes for individuals diagnosed with ASD, and the efficacy of the interventions. However, it is often difficult to recruit sufficient numbers of participants for studies, and despite the prevalence of ASD (currently estimated to affect 1 in 54 children), little research has focused on how to efficiently recruit participants with ASD. Objective: The aim of this study was to determine the efficacy of two different paid advertisements---social media and radio advertising---in recruiting participants for a study enrolling people with ASD and their family members by examining the number of participants enrolled, the cost per participant, and the geographic reach of each type of advertising. Methods: We examined participant enrollment in a study following nonoverlapping paid advertisements on a popular FM radio station (aired in three cities across two states) and Facebook (six advertisements that ran in five cities across two states). The total paid investment in the radio campaign was \$12,030 and that in the Facebook campaign was \$2950. Following the advertising campaigns, 1391 participants in the study who were affiliated with the Houston, Texas, site received email invitations to participate in a brief survey about the ways in which they learned about the study (eg, social media, medical provider, website) and which of these were most influential in their decisions to participate; 374 (26.8\%) of the participants completed this survey. Results: Social media advertising outperformed radio in all three parameters examined by enrolling more participants (338 vs 149), with a lower average cost per participant (\$8.73 vs \$80.74) and a wider geographic reach, based on a comparison of the number of zip codes within and outside of Texas for questionnaire respondents who rated social media as the most influential method of contact (n=367, $\chi$21=5.85, P=.02). Of the 374 survey participants, 139 (37.2\%) reported that they had seen the study on social media prior to enrollment, while only 9 (2.4\%) said they heard about it via radio. Conclusions: Our findings suggest that advertising on social media can efficiently reach a large pool of potential participants with ASD, increasing the likelihood of meeting study enrollment goals. Researchers should consider allocating at least some portion of recruitment dollars to social media platforms as a means of quickly and inexpensively reaching out to their target populations, including for studies with in-person procedures. ",
doi="10.2196/16752",
url="http://www.jmir.org/2020/9/e16752/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32969826"
}


@Article{info:doi/10.2196/19219,
author="Burns, Jade
and Johnstone, Keith
and Chavanduka, Tanaka
and Jamison, Cornelius
and Pena, Valery
and Stephenson, Rob
and Darbes, Lynae",
title="Evaluation of the Sexual Health Behaviors of Black Male Adolescents and Young Adults Through Social Media Platforms: Web-Based Survey Study",
journal="JMIR Public Health Surveill",
year="2020",
month="Sep",
day="22",
volume="6",
number="3",
pages="e19219",
keywords="social media",
keywords="survey",
keywords="adolescent",
keywords="young adult",
keywords="Black",
keywords="males",
keywords="sexual health",
keywords="service delivery",
abstract="Background: Social media platforms such as Facebook, Instagram, and Twitter, which have millions of users who interact and communicate every day, have been effective in promoting sexual health interventions and in disseminating reproductive health education. They have also been shown to be useful in health promotion and have been used to track several key metrics (eg, comments, posts) among users of all demographics. However, there is a lack of research on the impact and reach of these social media platforms as a community-based tool for disseminating sexual health information and for increasing engagement among Black adolescents and young adults, which is a targeted high-risk population. Objective: The purpose of this study was to determine the social media platforms and banner advertisements that affected engagement among Black male adolescents and young adults in participating in web-based health surveys. Methods: A web-based survey was conducted from March 2019 to July 2019 to assess sexual health and health behaviors in a convenience sample of Black male adolescents and young adults in the age range of 18-24 years (N=170). Social media metrics from Facebook, Instagram, and Twitter were monitored. This cross-sectional survey comprised several categories, including basic personal information, drug-related risk behaviors, health care, sexual reproductive health questions, attitudes, norms, and perceived control, mental health, violence-related risk behaviors, and social media preferences. Results: Social media advertisements on the Black Male Opinion survey reached approximately 146,412 individuals. Our primary finding of the web-based survey engagement was that referral (eg, group chat, indirect social media sharing) led to as the greatest proportion of recruitment, with Twitter and YouTube as the preferred sites to receive sexual health information. Conclusions: Recognizing the variety of technologies being used among Black male young adults and adolescents can help the community, researchers, and health care providers understand the web-based engagement of this high-risk population. This information may also promote culturally sensitive, customized marketing on sexual health information for this population. ",
doi="10.2196/19219",
url="http://publichealth.jmir.org/2020/3/e19219/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32693387"
}


@Article{info:doi/10.2196/18306,
author="Wolffsohn, S. James
and Leteneux-Pantais, Claudia
and Chiva-Razavi, Sima
and Bentley, Sarah
and Johnson, Chloe
and Findley, Amy
and Tolley, Chloe
and Arbuckle, Rob
and Kommineni, Jyothi
and Tyagi, Nishith",
title="Social Media Listening to Understand the Lived Experience of Presbyopia: Systematic Search and Content Analysis Study",
journal="J Med Internet Res",
year="2020",
month="Sep",
day="21",
volume="22",
number="9",
pages="e18306",
keywords="presbyopia",
keywords="near vision",
keywords="social media",
keywords="social media listening",
keywords="infodemiology",
abstract="Background: Presbyopia is defined as the age-related deterioration of near vision over time which is experienced in over 80\% of people aged 40 years or older. Individuals with presbyopia have difficulty with tasks that rely on near vision. It is not currently possible to stop or reverse the aging process that causes presbyopia; generally, it is corrected with glasses, contact lenses, surgery, or the use of a magnifying glass. Objective: This study aimed to explore how individuals used social media to describe their experience of presbyopia with regard to the symptoms experienced and the impacts of presbyopia on their quality of life. Methods: Social media sources including Twitter, forums, blogs, and news outlets were searched using a predefined search string relating to symptoms and impacts of presbyopia. The data that were downloaded, based on the keywords, underwent manual review to identify relevant data points. Relevant posts were further manually analyzed through a process of data tagging, categorization, and clustering. Key themes relating to symptoms, impacts, treatment, and lived experiences were identified. Results: A total of 4456 social media posts related to presbyopia were identified between May 2017 and August 2017. Using a random sampling methodology, we selected 2229 (50.0\%) posts for manual review, with 1470 (65.9\%) of these 2229 posts identified as relevant to the study objectives. Twitter was the most commonly used channel for discussions on presbyopia compared to forums and blogs. The majority of relevant posts originated in Spain (559/1470, 38.0\%) and the United States (426/1470, 29.0\%). Of the relevant posts, 270/1470 (18.4\%) were categorized as posts written by individuals who have presbyopia, of which 37 of the 270 posts (13.7\%) discussed symptoms. On social media, individuals with presbyopia most frequently reported experiencing difficulty reading small print (24/37, 64.9\%), difficulty focusing on near objects (15/37, 40.5\%), eye strain (12/37, 32.4\%), headaches (9/37, 24.3\%), and blurred vision (8/37, 21.6\%). 81 of the 270 posts (30.0\%) discussed impacts of presbyopia---emotional burden (57/81, 70.4\%), functional or daily living impacts (46/81, 56.8\%), such as difficulty reading (46/81, 56.8\%) and using electronic devices (21/81, 25.9\%), and impacts on work (3/81, 3.7\%). Conclusions: Findings from this social media listening study provided insight into how people with presbyopia discuss their condition online and highlight the impact of presbyopia on individuals' quality of life. The social media listening methodology can be used to generate insights into the lived experience of a condition, but it is recommended that this research be combined with prospective qualitative research for added rigor and for confirmation of the relevance of the findings. ",
doi="10.2196/18306",
url="http://www.jmir.org/2020/9/e18306/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32955443"
}


@Article{info:doi/10.2196/21916,
author="Bergman, G. Brandon
and Wu, Weiyi
and Marsch, A. Lisa
and Crosier, S. Benjamin
and DeLise, C. Timothy
and Hassanpour, Saeed",
title="Associations Between Substance Use and Instagram Participation to Inform Social Network--Based Screening Models: Multimodal Cross-Sectional Study",
journal="J Med Internet Res",
year="2020",
month="Sep",
day="16",
volume="22",
number="9",
pages="e21916",
keywords="substance use",
keywords="social network sites",
keywords="health risk",
keywords="screening",
keywords="machine learning",
keywords="social media",
keywords="Instagram",
keywords="alcohol",
keywords="drug",
abstract="Background: Technology-based computational strategies that leverage social network site (SNS) data to detect substance use are promising screening tools but rely on the presence of sufficient data to detect risk if it is present. A better understanding of the association between substance use and SNS participation may inform the utility of these technology-based screening tools. Objective: This paper aims to examine associations between substance use and Instagram posts and to test whether such associations differ as a function of age, gender, and race/ethnicity. Methods: Participants with an Instagram account were recruited primarily via Clickworker (N=3117). With participant permission and Instagram's approval, participants' Instagram photo posts were downloaded with an application program interface. Participants' past-year substance use was measured with an adapted version of the National Institute on Drug Abuse Quick Screen. At-risk drinking was defined as at least one past-year instance having ``had more than a few alcoholic drinks a day,'' drug use was defined as any use of nonprescription drugs, and prescription drug use was defined as any nonmedical use of prescription medications. We used logistic regression to examine the associations between substance use and any Instagram posts and negative binomial regression to examine the associations between substance use and number of Instagram posts. We examined whether age (18-25, 26-38, 39+ years), gender, and race/ethnicity moderated associations in both logistic and negative binomial models. All differences noted were significant at the .05 level. Results: Compared with no at-risk drinking, any at-risk drinking was associated with both a higher likelihood of any Instagram posts and a higher number of posts, except among Hispanic/Latino individuals, in whom at-risk drinking was associated with a similar number of posts. Compared with no drug use, any drug use was associated with a higher likelihood of any posts but was associated with a similar number of posts. Compared with no prescription drug use, any prescription drug use was associated with a similar likelihood of any posts and was associated with a lower number of posts only among those aged 39 years and older. Of note, main effects showed that being female compared with being male and being Hispanic/Latino compared with being White were significantly associated with both a greater likelihood of any posts and a greater number of posts. Conclusions: Researchers developing computational substance use risk detection models using Instagram or other SNS data may wish to consider our findings showing that at-risk drinking and drug use were positively associated with Instagram participation, while prescription drug use was negatively associated with Instagram participation for middle- and older-aged adults. As more is learned about SNS behaviors among those who use substances, researchers may be better positioned to successfully design and interpret innovative risk detection approaches. ",
doi="10.2196/21916",
url="http://www.jmir.org/2020/9/e21916/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32936081"
}


@Article{info:doi/10.2196/18146,
author="Cleal, Bryan
and Willaing, Ingrid
and Hoybye, T. Mette
and Thomsen, H. Henrik",
title="Facebook as a Medium for the Support and Enhancement of Ambulatory Care for People With Diabetes: Qualitative Realist Evaluation of a Real-World Trial",
journal="JMIR Diabetes",
year="2020",
month="Sep",
day="14",
volume="5",
number="3",
pages="e18146",
keywords="online patient-provider interaction",
keywords="social media",
keywords="Facebook",
keywords="realistic evaluation",
abstract="Background: There is a growing focus on the potential uses, benefits, and limitations of social media in the context of health care communication. In this study, we have sought to evaluate an initiative pioneered at a hospital in Denmark that uses Facebook to support and enhance patient-provider communication about diabetes. Objective: This paper aims to evaluate the success of the trial according to its initial objectives and to assess its potential scalability. Methods: The study was undertaken in a clinic for diabetes and hormonal diseases at a large regional hospital in Denmark. Using a realist evaluation approach, we identified 4 key components in the program theory of the initiative, which we formulated as context-mechanism-outcome configurations (eg, complex and iterative chains of causality). These configurations informed data gathering and analysis. Primary data sources were the activity and content in the Facebook group, in the form of posts, likes, and comments, and interviews with patients (n=26) and staff (n=6) at the clinic. Results: New developments in diabetes technology were the most popular posts in the forum, judged by number of likes and comments. Otherwise, information specific to the clinic received the most attention. All 4 components of the program theory were compromised to varying degrees, either as a result of failings in the anticipated mechanisms of change or contextual factors derived from the mode of implementation. Conclusions: Social media serves well as a conduit for imagining positive change, but this can be a strength and weakness when attempting to enact change via concrete interventions, where stakeholder expectations may be unreasonably high or incompatible. Nonetheless, such initiatives may possess intangible benefits difficult to measure in terms of cost-effectiveness. ",
doi="10.2196/18146",
url="http://diabetes.jmir.org/2020/3/e18146/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32924958"
}


@Article{info:doi/10.2196/19694,
author="Cott{\'e}, Fran{\c{c}}ois-Emery
and Voillot, Pam{\'e}la
and Bennett, Bryan
and Falissard, Bruno
and Tzourio, Christophe
and Foulqui{\'e}, Pierre
and Gaudin, Anne-Fran{\c{c}}oise
and Lemasson, Herv{\'e}
and Grumberg, Valentine
and McDonald, Laura
and Faviez, Carole
and Sch{\"u}ck, St{\'e}phane",
title="Exploring the Health-Related Quality of Life of Patients Treated With Immune Checkpoint Inhibitors: Social Media Study",
journal="J Med Internet Res",
year="2020",
month="Sep",
day="11",
volume="22",
number="9",
pages="e19694",
keywords="health-related quality of life",
keywords="immunotherapy",
keywords="patients with cancer",
keywords="social media use",
keywords="measures",
keywords="real world",
abstract="Background: Immune checkpoint inhibitors (ICIs) are increasingly used to treat several types of tumors. Impact of this emerging therapy on patients' health-related quality of life (HRQoL) is usually collected in clinical trials through standard questionnaires. However, this might not fully reflect HRQoL of patients under real-world conditions. In parallel, users' narratives from social media represent a potential new source of research concerning HRQoL. Objective: The aim of this study is to assess and compare coverage of ICI-treated patients' HRQoL domains and subdomains in standard questionnaires from clinical trials and in real-world setting from social media posts. Methods: A retrospective study was carried out by collecting social media posts in French language written by internet users mentioning their experiences with ICIs between January 2011 and August 2018. Automatic and manual extractions were implemented to create a corpus where domains and subdomains of HRQoL were classified. These annotations were compared with domains covered by 2 standard HRQoL questionnaires, the EORTC QLQ-C30 and the FACT-G. Results: We identified 150 users who described their own experience with ICI (89/150, 59.3\%) or that of their relative (61/150, 40.7\%), with 137 users (91.3\%) reporting at least one HRQoL domain in their social media posts. A total of 8 domains and 42 subdomains of HRQoL were identified: Global health (1 subdomain; 115 patients), Symptoms (13; 76), Emotional state (10; 49), Role (7; 22), Physical activity (4; 13), Professional situation (3; 9), Cognitive state (2; 2), and Social state (2; 2). The QLQ-C30 showed a wider global coverage of social media HRQoL subdomains than the FACT-G, 45\% (19/42) and 29\% (12/42), respectively. For both QLQ-C30 and FACT-G questionnaires, coverage rates were particularly suboptimal for Symptoms (68/123, 55.3\% and 72/123, 58.5\%, respectively), Emotional state (7/49, 14\% and 24/49, 49\%, respectively), and Role (17/22, 77\% and 15/22, 68\%, respectively). Conclusions: Many patients with cancer are using social media to share their experiences with immunotherapy. Collecting and analyzing their spontaneous narratives are helpful to capture and understand their HRQoL in real-world setting. New measures of HRQoL are needed to provide more in-depth evaluation of Symptoms, Emotional state, and Role among patients with cancer treated with immunotherapy. ",
doi="10.2196/19694",
url="http://www.jmir.org/2020/9/e19694/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32915159"
}


@Article{info:doi/10.2196/19895,
author="Song, Jiahe
and Xu, Pei
and Paradice, B. David",
title="Health Goal Attainment of Patients With Chronic Diseases in Web-Based Patient Communities: Content and Survival Analysis",
journal="J Med Internet Res",
year="2020",
month="Sep",
day="11",
volume="22",
number="9",
pages="e19895",
keywords="web-based patient communities",
keywords="self-reflection",
keywords="social support",
keywords="goal attainment",
keywords="web-based chronic disease management",
keywords="survival analysis",
abstract="Background: Activities directed at attaining health goals are a major part of the daily lives of those fighting chronic diseases. A proliferating population of patients with chronic diseases are participating in web-based patient communities, wherein they can exchange health information and pursue health goals with others virtually. Objective: In this study, we aimed to understand the effect of participation in social media--enabled web-based patient communities on health goal attainment. In particular, we studied the antecedents of health goal attainment in terms of social support and self-reflection in web-based patient communities. Methods: This data set consists of web-based health management activities of 392 patients across 13 health support groups, that is, groups with medical issues such as high blood pressure, diabetes, and breast cancer; the data of the activities were collected from a leading web-based patient community. Content analysis was used to code the social interactions among the patients on the web-based platform. Cox regression for survival analysis was used to model the hazard ratio of health goal attainment. Results: Our analysis indicated that emotional support from web-based patient communities can increase patients' probability of achieving their goals (hazard ratio 1.957, 95\% CI 1.416-2.706; P<.001) while informational support does not appear to be effective (P=.06). In addition, health-related self-reflection increases the patients' likelihood of goal attainment through web-based patient communities (hazard ratio 1.937, 95\% CI 1.318-2.848; P<.001), but leisure-oriented self-reflection reduces this likelihood (hazard ratio 0.588, 95\% CI 0.442-0.784; P<.001). Conclusions: Social media--enabled web-based platforms assist health goal management via both social interaction and personal discipline. This study extends the understanding of web-based patient communities by investigating the effects of both social and cognitive factors on goal attainment. In particular, our study advocates that health goals relating to chronic conditions can be better managed when patients use the facilities of web-based health communities strategically. ",
doi="10.2196/19895",
url="http://www.jmir.org/2020/9/e19895/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32915152"
}


@Article{info:doi/10.2196/18662,
author="Hasegawa, Shin
and Suzuki, Teppei
and Yagahara, Ayako
and Kanda, Reiko
and Aono, Tatsuo
and Yajima, Kazuaki
and Ogasawara, Katsuhiko",
title="Changing Emotions About Fukushima Related to the Fukushima Nuclear Power Station Accident---How Rumors Determined People's Attitudes: Social Media Sentiment Analysis",
journal="J Med Internet Res",
year="2020",
month="Sep",
day="2",
volume="22",
number="9",
pages="e18662",
keywords="Fukushima nuclear accident",
keywords="Twitter messaging",
keywords="radiation",
keywords="radioactivity",
keywords="radioactive hazard release",
keywords="information dissemination",
keywords="belief in rumors",
keywords="disaster medicine",
keywords="infodemiology",
keywords="infoveillance",
keywords="infodemic",
abstract="Background: Public interest in radiation rose after the Tokyo Electric Power Company (TEPCO) Fukushima Daiichi Nuclear Power Station accident was caused by an earthquake off the Pacific coast of Tohoku on March 11, 2011. Various reports on the accident and radiation were spread by the mass media, and people displayed their emotional reactions, which were thought to be related to information about the Fukushima accident, on Twitter, Facebook, and other social networking sites. Fears about radiation were spread as well, leading to harmful rumors about Fukushima and the refusal to test children for radiation. It is believed that identifying the process by which people emotionally responded to this information, and hence became gripped by an increased aversion to Fukushima, might be useful in risk communication when similar disasters and accidents occur in the future. There are few studies surveying how people feel about radiation in Fukushima and other regions in an unbiased form. Objective: The purpose of this study is to identify how the feelings of local residents toward radiation changed according to Twitter. Methods: We used approximately 19 million tweets in Japanese containing the words ``radiation'' (???), ``radioactivity'' (???), and ``radioactive substances'' (?????) that were posted to Twitter over a 1-year period following the Fukushima nuclear accident. We used regional identifiers contained in tweets (ie, nouns, proper nouns, place names, postal codes, and telephone numbers) to categorize them according to their prefecture, and then analyzed the feelings toward those prefectures from the semantic orientation of the words contained in individual tweets (ie, positive impressions or negative impressions). Results: Tweets about radiation increased soon after the earthquake and then decreased, and feelings about radiation  trended positively. We determined that, on average, tweets associating Fukushima Prefecture with radiation show more positive feelings than those about other prefectures, but have trended negatively over time. We also found that as other tweets have trended positively, only bots and retweets about Fukushima Prefecture have trended negatively. Conclusions: The number of tweets about radiation has decreased overall, and feelings about radiation have trended positively. However, the fact that tweets about Fukushima Prefecture trended negatively, despite decreasing in percentage, suggests that negative feelings toward Fukushima Prefecture have become more extreme. We found that while the bots and retweets that were not about Fukushima Prefecture gradually trended toward positive feelings, the bots and retweets about Fukushima Prefecture trended toward negative feelings. ",
doi="10.2196/18662",
url="https://www.jmir.org/2020/9/e18662",
url="http://www.ncbi.nlm.nih.gov/pubmed/32876574"
}


@Article{info:doi/10.2196/18458,
author="Zhou, Mingjie
and Li, Fugui
and Wang, Yanhong
and Chen, Shuang
and Wang, Kexin",
title="Compensatory Social Networking Site Use, Family Support, and Depression Among College Freshman: Three-Wave Panel Study",
journal="J Med Internet Res",
year="2020",
month="Sep",
day="2",
volume="22",
number="9",
pages="e18458",
keywords="freshmen",
keywords="introversion",
keywords="compensatory use of SNS",
keywords="depression",
keywords="family support",
keywords="social media",
abstract="Background: Freshmen were found to use social networking sites (SNS) as a useful medium to effectively adjust to college life, which hints at a tendency to resort to SNS for social compensation. However, the compensatory use of SNS is usually problematic. Objective: This study explores why a subgroup of freshmen developed depressive symptoms while socially adjusting to college by investigating the antecedent role of introversion, the explanatory role of compensatory use of SNS, and the protective role of perceived family support. The study is among the first to point out the relevance of the compensatory use of SNS in explaining the indirect association between introversion and depression with a longitudinal design. Methods: A 3-wave panel sample of freshmen (N=1137) is used to examine the moderated mediation model. Results: We found that introversion at Wave 1 positively predicted compensatory use of SNS at Wave 2 and subsequently increased depression at Wave 3 (unstandardized B=0.07, SE 0.02, P<.001, 95\% CI 0.04-0.10; unstandardized B=0.09, SE 0.01, P<.001, 95\% CI 0.06-0.12). The moderated mediation model further examined the buffering role of perceived family support within the link between introversion and compensatory SNS use (index=0.0031, SE 0.0015, 95\% CI 0.0003-0.0062). Unexpectedly, we found that family support in Wave 1 decreased compensatory SNS use for less introverted freshmen in Wave 2 and further decreased depression in Wave 3. Conclusions: Unexpectedly, our findings uncover an enhancing effect, rather than a buffering effect, of family support by embedding its effect within the relationship between introversion and compensatory SNS use. Appreciating the differences in the casual pathways for freshmen with different levels of introversion clarifies how SNS affect young adults' lives. ",
doi="10.2196/18458",
url="https://www.jmir.org/2020/9/e18458",
url="http://www.ncbi.nlm.nih.gov/pubmed/32795999"
}


@Article{info:doi/10.2196/21419,
author="Doogan, Caitlin
and Buntine, Wray
and Linger, Henry
and Brunt, Samantha",
title="Public Perceptions and Attitudes Toward COVID-19 Nonpharmaceutical Interventions Across Six Countries: A Topic Modeling Analysis of Twitter Data",
journal="J Med Internet Res",
year="2020",
month="Sep",
day="3",
volume="22",
number="9",
pages="e21419",
keywords="COVID-19",
keywords="SARS-CoV-2",
keywords="topic modeling",
keywords="nonpharmaceutical interventions",
keywords="social media",
keywords="public health",
keywords="machine learning",
keywords="social distancing",
keywords="lockdown",
keywords="face masks",
keywords="infodemiology",
abstract="Background: Nonpharmaceutical interventions (NPIs) (such as wearing masks and social distancing) have been implemented by governments around the world to slow the spread of COVID-19. To promote public adherence to these regimes, governments need to understand the public perceptions and attitudes toward NPI regimes and the factors that influence them. Twitter data offer a means to capture these insights. Objective: The objective of this study is to identify tweets about COVID-19 NPIs in six countries and compare the trends in public perceptions and attitudes toward NPIs across these countries. The aim is to identify factors that influenced public perceptions and attitudes about NPI regimes during the early phases of the COVID-19 pandemic. Methods: We analyzed 777,869 English language tweets about COVID-19 NPIs in six countries (Australia, Canada, New Zealand, Ireland, the United Kingdom, and the United States). The relationship between tweet frequencies and case numbers was assessed using a Pearson correlation analysis. Topic modeling was used to isolate tweets about NPIs. A comparative analysis of NPIs between countries was conducted. Results: The proportion of NPI-related topics, relative to all topics, varied between countries. The New Zealand data set displayed the greatest attention to NPIs, and the US data set showed the lowest. The relationship between tweet frequencies and case numbers was statistically significant only for Australia (r=0.837, P<.001) and New Zealand (r=0.747, P<.001). Topic modeling produced 131 topics related to one of 22 NPIs, grouped into seven NPI categories: Personal Protection (n=15), Social Distancing (n=9), Testing and Tracing (n=10), Gathering Restrictions (n=18), Lockdown (n=42), Travel Restrictions (n=14), and Workplace Closures (n=23). While less restrictive NPIs gained widespread support, more restrictive NPIs were perceived differently across countries. Four characteristics of these regimes were seen to influence public adherence to NPIs: timeliness of implementation, NPI campaign strategies, inconsistent information, and enforcement strategies. Conclusions: Twitter offers a means to obtain timely feedback about the public response to COVID-19 NPI regimes. Insights gained from this analysis can support government decision making, implementation, and communication strategies about NPI regimes, as well as encourage further discussion about the management of NPI programs for global health events, such as the COVID-19 pandemic. ",
doi="10.2196/21419",
url="https://www.jmir.org/2020/9/e21419",
url="http://www.ncbi.nlm.nih.gov/pubmed/32784190"
}


@Article{info:doi/10.2196/19746,
author="Ahmed, Wasim
and Jagsi, Reshma
and Gutheil, G. Thomas
and Katz, S. Matthew",
title="Public Disclosure on Social Media of Identifiable Patient Information by Health Professionals: Content Analysis of Twitter Data",
journal="J Med Internet Res",
year="2020",
month="Sep",
day="1",
volume="22",
number="9",
pages="e19746",
keywords="Social Media",
keywords="Twitter",
keywords="Patient Information",
keywords="Confidentiality",
keywords="Health Professionals",
abstract="Background: Respecting patient privacy and confidentiality is critical for doctor-patient relationships and public trust in medical professionals. The frequency of potentially identifiable disclosures online during periods of active engagement is unknown. Objective: The objective of this study was to quantify potentially identifiable content shared on social media by physicians and other health care providers using the hashtag \#ShareAStoryInOneTweet. Methods: We accessed and searched Twitter's API using Symplur software for tweets that included the hashtag \#ShareAStoryInOneTweet. We identified 1206 tweets by doctors, nurses, and other health professionals out of 43,374 tweets shared in May 2018. Tweet content was evaluated in January 2019 to determine the incidence of instances where names or potentially identifiable information about patients were shared; content analysis of tweets in which information about others had been disclosed was performed. The study also evaluated whether participants raised concerns about privacy breaches and estimated the frequency of deleted tweets. The study used dual, blinded coding for a 10\% sample to estimate intercoder reliability using Cohen $\kappa$ statistic for identifying the potential identifiability of tweet content. Results: Health care professionals (n=656) disclosing information about others included 486 doctors (74.1\%) and 98 nurses (14.9\%). Health care professionals sharing stories about patient care disclosed the time frame in 95 tweets (95/754, 12.6\%) and included patient names in 15 tweets (15/754, 2.0\%). It is estimated that friends or families could likely identify the clinical scenario described in 242 of the 754 tweets (32.1\%). Among 348 tweets about potentially living patients, it was estimated that 162 (46.6\%) were likely identifiable by patients. Intercoder reliability in rating the potential identifiability demonstrated 86.8\% agreement, with a Cohen $\kappa$ of 0.8 suggesting substantial agreement. We also identified 78 out of 754 tweets (6.5\%) that had been deleted on the website but were still viewable in the analytics software data set. Conclusions: During periods of active sharing online, nurses, physicians, and other health professionals may sometimes share more information than patients or families might expect. More study is needed to determine whether similar events arise frequently and to understand how to best ensure that patients' rights are adequately respected. ",
doi="10.2196/19746",
url="https://www.jmir.org/2020/9/e19746",
url="http://www.ncbi.nlm.nih.gov/pubmed/32870160"
}


@Article{info:doi/10.2196/17830,
author="M{\"u}ller, Martin
and Schneider, Manuel
and Salath{\'e}, Marcel
and Vayena, Effy",
title="Assessing Public Opinion on CRISPR-Cas9: Combining Crowdsourcing and Deep Learning",
journal="J Med Internet Res",
year="2020",
month="Aug",
day="31",
volume="22",
number="8",
pages="e17830",
keywords="CRISPR",
keywords="natural language processing",
keywords="sentiment analysis",
keywords="digital methods",
keywords="infodemiology",
keywords="infoveillace",
keywords="empirical bioethics",
keywords="social media",
abstract="Background: The discovery of the CRISPR-Cas9--based gene editing method has opened unprecedented new potential for biological and medical engineering, sparking a growing public debate on both the potential and dangers of CRISPR applications. Given the speed of technology development and the almost instantaneous global spread of news, it is important to follow evolving debates without much delay and in sufficient detail, as certain events may have a major long-term impact on public opinion and later influence policy decisions. Objective: Social media networks such as Twitter have shown to be major drivers of news dissemination and public discourse. They provide a vast amount of semistructured data in almost real-time and give direct access to the content of the conversations. We can now mine and analyze such data quickly because of recent developments in machine learning and natural language processing. Methods: Here, we used Bidirectional Encoder Representations from Transformers (BERT), an attention-based transformer model, in combination with statistical methods to analyze the entirety of all tweets ever published on CRISPR since the publication of the first gene editing application in 2013. Results: We show that the mean sentiment of tweets was initially very positive, but began to decrease over time, and that this decline was driven by rare peaks of strong negative sentiments. Due to the high temporal resolution of the data, we were able to associate these peaks with specific events and to observe how trending topics changed over time. Conclusions: Overall, this type of analysis can provide valuable and complementary insights into ongoing public debates, extending the traditional empirical bioethics toolset. ",
doi="10.2196/17830",
url="http://www.jmir.org/2020/8/e17830/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32865499"
}


@Article{info:doi/10.2196/18714,
author="Wu, Nancy
and Brazeau, Anne-Sophie
and Nakhla, Meranda
and Chan, Deborah
and Da Costa, Deborah
and Mukerji, Geetha
and Butalia, Sonia
and Pacaud, Daniele
and Henderson, M{\'e}lanie
and Panagiotopoulos, Constadina
and Rahme, Elham
and Dasgupta, Kaberi",
title="Type 1 Diabetes Mellitus Virtual Patient Network as a Peer Support Community: Protocol for Social Network Analysis and Content Analysis",
journal="JMIR Res Protoc",
year="2020",
month="Aug",
day="31",
volume="9",
number="8",
pages="e18714",
keywords="type 1 diabetes",
keywords="youth",
keywords="social network analysis",
keywords="content analysis",
keywords="social media",
abstract="Background: Type 1 Diabetes Mellitus Virtual Patient Network (T1DM-VPN) is a private Facebook group for youths with type 1 diabetes mellitus (T1DM) in Canada intended to facilitate peer-to-peer support. It was built on the finding that stigma is prevalent among youth with T1DM and impedes self-management. Objective: We aim to determine if T1DM-VPN provides support as intended and to ascertain what type of members provide support. Specifically, we will (1) identify text consistent with any one of 5 social support categories, (2) describe the network by visualizing its structure and reporting basic engagement statistics, and (3) determine whether being a designated peer leader is related to a member's centrality (ie, importance in the network) and how frequently they offer social support. Methods: We will manually extract interaction data from the Facebook group (posts, comments, likes/reactions, seen) generated from June 21, 2017 (addition of first member), to March 1, 2020. Two researchers will independently code posts and comments according to an existing framework of 5 social support categories---informational, emotional, esteem, network, and tangible---with an additional framework for nonsocial support categories. We will calculate how frequently each code is used. We will also report basic engagement statistics (eg, number of posts made per person-month) and generate a visualization of the network. We will identify stable time intervals in the history of T1DM-VPN by modeling monthly membership growth as a Poisson process. Within each interval, each member's centrality will be calculated and standardized to that of the most central member. We will use a centrality formula that considers both breadth and depth of connections (centrality = 0.8 {\texttimes} total No. of connections + 0.2 {\texttimes} total No. of interactions). Finally, we will construct multivariate linear regression models to assess whether peer leader status predicts member centrality and the frequency of offering social support. Other variables considered for inclusion in the models are gender and age at diagnosis. Results: T1DM-VPN was launched in June 2017. As of March 1, 2020, it has 196 patient-members. This research protocol received ethics approval from the McGill University Health Centre Research Ethics Board on May 20, 2020. Baseline information about each group member was collected upon addition into the group, and collection of interaction data is ongoing as of May 2020. Conclusions: This content analysis and social network analysis study of a virtual patient network applies epidemiological methods to account for dynamic growth and activity. The results will allow for an understanding of the topics of importance to youth with T1DM and how a virtual patient network evolves over time. This work is intended to serve as a foundation for future action to help youth improve their experience of living with diabetes. International Registered Report Identifier (IRRID): PRR1-10.2196/18714 ",
doi="10.2196/18714",
url="http://www.researchprotocols.org/2020/8/e18714/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32865502"
}


@Article{info:doi/10.2196/16388,
author="Arias-de la Torre, Jorge
and Puigdomenech, Elisa
and Garc{\'i}a, Xavier
and Valderas, M. Jose
and Eiroa-Orosa, Jose Francisco
and Fern{\'a}ndez-Villa, Tania
and Molina, J. Antonio
and Mart{\'i}n, Vicente
and Serrano-Blanco, Antoni
and Alonso, Jordi
and Espallargues, Mireia",
title="Relationship Between Depression and the Use of Mobile Technologies and Social Media Among Adolescents: Umbrella Review",
journal="J Med Internet Res",
year="2020",
month="Aug",
day="26",
volume="22",
number="8",
pages="e16388",
keywords="mobile technologies and social media",
keywords="depression",
keywords="adolescents",
keywords="review",
abstract="Background: Despite the relevance of mobile technologies and social media (MTSM) for adolescents, their association with depressive disorders in this population remains unclear. While there are previous reviews that have identified the use of MTSM as a risk factor for developing depression, other reviews have indicated their possible preventive effect. Objective: The aim of this review was to synthesize the current evidence on the association between MTSM use and the development or prevention of depressive disorders in adolescents. Methods: An umbrella review was conducted using information published up to June 2019 from PubMed/MEDLINE, PsycINFO, Web of Science, and The Cochrane Library. Systematic reviews focusing on the adolescent population (up to 20 years old) and depression and its potential relationship with MTSM use were included. Screening of titles, abstracts, and full texts was performed. After selecting the reviews and given the heterogeneity of the outcome variables and exposures, a narrative synthesis of the results was carried out. Results: The search retrieved 338 documents, from which 7 systematic reviews (3 meta-analyses) were selected for data extraction. There were 11-70 studies and 5582-46,015 participants included in the 7 reviews. All reviews included quantitative research, and 2 reviews also included qualitative studies. A statistically significant association between social media and developing depressive symptoms was reported in 2 reviews, while 5 reviews reported mixed results. Conclusions: Excessive social comparison and personal involvement when using MTSM could be associated with the development of depressive symptomatology. Nevertheless, MTSM might promote social support and even become a point of assistance for people with depression. Due to the mixed results, prospective research could be valuable for providing stronger evidence. ",
doi="10.2196/16388",
url="http://www.jmir.org/2020/8/e16388/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32663157"
}


@Article{info:doi/10.2196/20794,
author="Mackey, Ken Tim
and Li, Jiawei
and Purushothaman, Vidya
and Nali, Matthew
and Shah, Neal
and Bardier, Cortni
and Cai, Mingxiang
and Liang, Bryan",
title="Big Data, Natural Language Processing, and Deep Learning to Detect and Characterize Illicit COVID-19 Product Sales: Infoveillance Study on Twitter and Instagram",
journal="JMIR Public Health Surveill",
year="2020",
month="Aug",
day="25",
volume="6",
number="3",
pages="e20794",
keywords="COVID-19",
keywords="coronavirus",
keywords="infectious disease",
keywords="social media",
keywords="surveillance",
keywords="infoveillance",
keywords="infodemiology",
keywords="infodemic",
keywords="fraud",
keywords="cybercrime",
abstract="Background: The coronavirus disease (COVID-19) pandemic is perhaps the greatest global health challenge of the last century. Accompanying this pandemic is a parallel ``infodemic,'' including the online marketing and sale of unapproved, illegal, and counterfeit COVID-19 health products including testing kits, treatments, and other questionable ``cures.'' Enabling the proliferation of this content is the growing ubiquity of internet-based technologies, including popular social media platforms that now have billions of global users. Objective: This study aims to collect, analyze, identify, and enable reporting of suspected fake, counterfeit, and unapproved COVID-19--related health care products from Twitter and Instagram. Methods: This study is conducted in two phases beginning with the collection of COVID-19--related Twitter and Instagram posts using a combination of web scraping on Instagram and filtering the public streaming Twitter application programming interface for keywords associated with suspect marketing and sale of COVID-19 products. The second phase involved data analysis using natural language processing (NLP) and deep learning to identify potential sellers that were then manually annotated for characteristics of interest. We also visualized illegal selling posts on a customized data dashboard to enable public health intelligence. Results: We collected a total of 6,029,323 tweets and 204,597 Instagram posts filtered for terms associated with suspect marketing and sale of COVID-19 health products from March to April for Twitter and February to May for Instagram. After applying our NLP and deep learning approaches, we identified 1271 tweets and 596 Instagram posts associated with questionable sales of COVID-19--related products. Generally, product introduction came in two waves, with the first consisting of questionable immunity-boosting treatments and a second involving suspect testing kits. We also detected a low volume of pharmaceuticals that have not been approved for COVID-19 treatment. Other major themes detected included products offered in different languages, various claims of product credibility, completely unsubstantiated products, unapproved testing modalities, and different payment and seller contact methods. Conclusions: Results from this study provide initial insight into one front of the ``infodemic'' fight against COVID-19 by characterizing what types of health products, selling claims, and types of sellers were active on two popular social media platforms at earlier stages of the pandemic. This cybercrime challenge is likely to continue as the pandemic progresses and more people seek access to COVID-19 testing and treatment. This data intelligence can help public health agencies, regulatory authorities, legitimate manufacturers, and technology platforms better remove and prevent this content from harming the public. ",
doi="10.2196/20794",
url="http://publichealth.jmir.org/2020/3/e20794/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32750006"
}


@Article{info:doi/10.2196/15697,
author="Eke, Ransome
and Li, Tong
and Bond, Kiersten
and Ho, Arlene
and Graves, Lisa",
title="Viewing Trends and Users' Perceptions of the Effect of Sleep-Aiding Music on YouTube: Quantification and Thematic Content Analysis",
journal="J Med Internet Res",
year="2020",
month="Aug",
day="24",
volume="22",
number="8",
pages="e15697",
keywords="insomnia",
keywords="sleep deprivation",
keywords="YouTube",
keywords="utilization",
keywords="pattern",
keywords="perception",
keywords="content analysis",
abstract="Background: Sleep plays an essential role in the psychological and physiological functioning of humans. A report from the Centers for Disease Control and Prevention (CDC) found that sleep duration was significantly reduced among US adults in 2012 compared to 1985. Studies have described a significant association between listening to soothing music and an improvement in sleep quality and sleep duration. YouTube is a platform where users can access sleep-aiding music videos. No literature exists pertaining to the use of sleep-aiding music on YouTube. Objective: This study aimed to examine the patterns of viewing sleep-aiding music videos on YouTube. We also performed a content analysis of the comments left on sleep-aiding music video posts, to describe the perception of users regarding the effects of these music videos on their sleep quality. Methods: We searched for sleep-aiding music videos published on YouTube between January 1, 2012, and December 31, 2017. We sorted videos by view number (highest to lowest) and used a targeted sampling approach to select eligible videos for qualitative content analysis. To perform the content analysis, we imported comments into a mixed-method analytical software. We summarized variables including total views, likes, dislikes, play duration, and age of published music videos. All descriptive statistics were completed with SAS statistical software. Results: We found a total of 238 sleep-aiding music videos on YouTube that met the inclusion criteria. The total view count was 1,467,747,018 and the total playtime was 84,252 minutes. The median play length was 186 minutes (IQR 122 to 480 minutes) and the like to dislike ratio was approximately 9 to 1. In total, 135 (56.7\%) videos had over 1 million views, and 124 (52.1\%) of the published sleep-aiding music videos had stayed active for 1 to 2 years. Overall, 4023 comments were extracted from 20 selected sleep-aiding music videos. Five overarching themes emerged in the reviewed comments, including viewers experiencing a sleep problem, perspective on the positive impact of the sleep-aiding music videos, no effect of the sleep-aiding music videos, time to initiation of sleep or sleep duration, and location of viewers. The overall $\kappa$ statistic for the codes was 0.87 (range 0.85-0.96). Conclusions: This is the first study to examine the patterns of viewing sleep-aiding music videos on YouTube. We observed a substantial increase in the number of people using sleep-aiding music videos, with a wide variation in viewer location. This study supports the hypothesis that listening to soothing music has a positive impact on sleep habits. ",
doi="10.2196/15697",
url="http://www.jmir.org/2020/8/e15697/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32831182"
}


@Article{info:doi/10.2196/17048,
author="Hswen, Yulin
and Hawkins, B. Jared
and Sewalk, Kara
and Tuli, Gaurav
and Williams, R. David
and Viswanath, K.
and Subramanian, V. S.
and Brownstein, S. John",
title="Racial and Ethnic Disparities in Patient Experiences in the United States: 4-Year Content Analysis of Twitter",
journal="J Med Internet Res",
year="2020",
month="Aug",
day="21",
volume="22",
number="8",
pages="e17048",
keywords="racial disparities",
keywords="race",
keywords="patient experience",
keywords="policy",
keywords="social media",
keywords="digital epidemiology",
keywords="social determinants of health",
keywords="health disparities",
keywords="health inequities",
abstract="Background: Racial and ethnic minority groups often face worse patient experiences compared with the general population, which is directly related to poorer health outcomes within these minority populations. Evaluation of patient experience among racial and ethnic minority groups has been difficult due to lack of representation in traditional health care surveys. Objective: This study aims to assess the feasibility of Twitter for identifying racial and ethnic disparities in patient experience across the United States from 2013 to 2016. Methods: In total, 851,973 patient experience tweets with geographic location information from the United States were collected from 2013 to 2016. Patient experience tweets included discussions related to care received in a hospital, urgent care, or any other health institution. Ordinary least squares multiple regression was used to model patient experience sentiment and racial and ethnic groups over the 2013 to 2016 period and in relation to the implementation of the Patient Protection and Affordable Care Act (ACA) in 2014. Results: Racial and ethnic distribution of users on Twitter was highly correlated with population estimates from the United States Census Bureau's 5-year survey from 2016 (r2=0.99; P<.001). From 2013 to 2016, the average patient experience sentiment was highest for White patients, followed by Asian/Pacific Islander, Hispanic/Latino, and American Indian/Alaska Native patients. A reduction in negative patient experience sentiment on Twitter for all racial and ethnic groups was seen from 2013 to 2016. Twitter users who identified as Hispanic/Latino showed the greatest improvement in patient experience, with a 1.5 times greater increase (P<.001) than Twitter users who identified as White. Twitter users who identified as Black had the highest increase in patient experience postimplementation of the ACA (2014-2016) compared with preimplementation of the ACA (2013), and this change was 2.2 times (P<.001) greater than Twitter users who identified as White. Conclusions: The ACA mandated the implementation of the measurement of patient experience of care delivery. Considering that quality assessment of care is required, Twitter may offer the ability to monitor patient experiences across diverse racial and ethnic groups and inform the evaluation of health policies like the ACA. ",
doi="10.2196/17048",
url="http://www.jmir.org/2020/8/e17048/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32821062"
}


@Article{info:doi/10.2196/22590,
author="Hung, Man
and Lauren, Evelyn
and Hon, S. Eric
and Birmingham, C. Wendy
and Xu, Julie
and Su, Sharon
and Hon, D. Shirley
and Park, Jungweon
and Dang, Peter
and Lipsky, S. Martin",
title="Social Network Analysis of COVID-19 Sentiments: Application of Artificial Intelligence",
journal="J Med Internet Res",
year="2020",
month="Aug",
day="18",
volume="22",
number="8",
pages="e22590",
keywords="COVID-19",
keywords="coronavirus",
keywords="sentiment",
keywords="social network",
keywords="Twitter",
keywords="infodemiology",
keywords="infodemic",
keywords="pandemic",
keywords="crisis",
keywords="public health",
keywords="business economy",
keywords="artificial intelligence",
abstract="Background: The coronavirus disease (COVID-19) pandemic led to substantial public discussion. Understanding these discussions can help institutions, governments, and individuals navigate the pandemic. Objective: The aim of this study is to analyze discussions on Twitter related to COVID-19 and to investigate the sentiments toward COVID-19. Methods: This study applied machine learning methods in the field of artificial intelligence to analyze data collected from Twitter. Using tweets originating exclusively in the United States and written in English during the 1-month period from March 20 to April 19, 2020, the study examined COVID-19--related discussions. Social network and sentiment analyses were also conducted to determine the social network of dominant topics and whether the tweets expressed positive, neutral, or negative sentiments. Geographic analysis of the tweets was also conducted. Results: There were a total of 14,180,603 likes, 863,411 replies, 3,087,812 retweets, and 641,381 mentions in tweets during the study timeframe. Out of 902,138 tweets analyzed, sentiment analysis classified 434,254 (48.2\%) tweets as having a positive sentiment, 187,042 (20.7\%) as neutral, and 280,842 (31.1\%) as negative. The study identified 5 dominant themes among COVID-19--related tweets: health care environment, emotional support, business economy, social change, and psychological stress. Alaska, Wyoming, New Mexico, Pennsylvania, and Florida were the states expressing the most negative sentiment while Vermont, North Dakota, Utah, Colorado, Tennessee, and North Carolina conveyed the most positive sentiment. Conclusions: This study identified 5 prevalent themes of COVID-19 discussion with sentiments ranging from positive to negative. These themes and sentiments can clarify the public's response to COVID-19 and help officials navigate the pandemic. ",
doi="10.2196/22590",
url="http://www.jmir.org/2020/8/e22590/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32750001"
}


@Article{info:doi/10.2196/18401,
author="Zhu, M. Jane
and Sarker, Abeed
and Gollust, Sarah
and Merchant, Raina
and Grande, David",
title="Characteristics of Twitter Use by State Medicaid Programs in the United States: Machine Learning Approach",
journal="J Med Internet Res",
year="2020",
month="Aug",
day="17",
volume="22",
number="8",
pages="e18401",
keywords="medicaid",
keywords="public health",
keywords="health communication",
keywords="community engagement",
keywords="social media",
abstract="Background: Twitter is a potentially valuable tool for public health officials and state Medicaid programs in the United States, which provide public health insurance to 72 million Americans. Objective: We aim to characterize how Medicaid agencies and managed care organization (MCO) health plans are using Twitter to communicate with the public. Methods: Using Twitter's public application programming interface, we collected 158,714 public posts (``tweets'') from active Twitter profiles of state Medicaid agencies and MCOs, spanning March 2014 through June 2019. Manual content analyses identified 5 broad categories of content, and these coded tweets were used to train supervised machine learning algorithms to classify all collected posts. Results: We identified 15 state Medicaid agencies and 81 Medicaid MCOs on Twitter. The mean number of followers was 1784, the mean number of those followed was 542, and the mean number of posts was 2476. Approximately 39\% of tweets came from just 10 accounts. Of all posts, 39.8\% (63,168/158,714) were classified as general public health education and outreach; 23.5\% (n=37,298) were about specific Medicaid policies, programs, services, or events; 18.4\% (n=29,203) were organizational promotion of staff and activities; and 11.6\% (n=18,411) contained general news and news links. Only 4.5\% (n=7142) of posts were responses to specific questions, concerns, or complaints from the public. Conclusions: Twitter has the potential to enhance community building, beneficiary engagement, and public health outreach, but appears to be underutilized by the Medicaid program. ",
doi="10.2196/18401",
url="http://www.jmir.org/2020/8/e18401/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32804085"
}


@Article{info:doi/10.2196/18518,
author="Ukoha, Chukwuma",
title="How Health Care Organizations Approach Social Media Measurement: Qualitative Study",
journal="JMIR Form Res",
year="2020",
month="Aug",
day="14",
volume="4",
number="8",
pages="e18518",
keywords="health care organization",
keywords="social media",
keywords="measurement",
keywords="benchmarking",
keywords="metrics",
keywords="analytics tools",
abstract="Background: Many health care organizations use social media to support a variety of activities. To ensure continuous improvement in social media performance, health care organizations must measure their social media. Objective: The purpose of this study is to explore how health care organizations approach social media measurement and to elucidate the tools they employ. Methods: In this exploratory qualitative research, Australian health care organizations that use social media, varying in size and locality, were invited to participate in the study. Data were collected through semistructured interviews, and the transcripts were analyzed using thematic analysis. Results: The study identified health care organizations' approaches to social media measurement. While some measured their social media frequently, others used infrequent measurements, and a few did not measure theirs at all. Those that measured their social media used one or a combination of the following yardsticks: personal benchmarking, peer benchmarking, and metric benchmarking. The metrics tracked included one or more of the following: reach, engagement, and conversion rates. The tools employed to measure social media were either inbuilt or add-on analytics tools. Although many participants showed great interest in measuring their social media, they still had some unanswered questions. Conclusions: The lack of a consensus approach to measurement suggests that, unlike other industries, social media measurement in health care settings is at a nascent stage. There is a need to improve knowledge, sophistication, and integration of social media strategy through the application of theoretical and analytical knowledge to help resolve the current challenge of effective social media measurement. This study calls for social media training in health care organizations. Such training must focus on how to use relevant tools and how to measure their use effectively. ",
doi="10.2196/18518",
url="http://formative.jmir.org/2020/8/e18518/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32795994"
}


@Article{info:doi/10.2196/18350,
author="Nasralah, Tareq
and El-Gayar, Omar
and Wang, Yong",
title="Social Media Text Mining Framework for Drug Abuse: Development and Validation Study With an Opioid Crisis Case Analysis",
journal="J Med Internet Res",
year="2020",
month="Aug",
day="13",
volume="22",
number="8",
pages="e18350",
keywords="drug abuse",
keywords="social media",
keywords="infodemiology",
keywords="infoveillance",
keywords="text mining",
keywords="opioid crisis",
abstract="Background: Social media are considered promising and viable sources of data for gaining insights into various disease conditions and patients' attitudes, behaviors, and medications. They can be used to recognize communication and behavioral themes of problematic use of prescription drugs. However, mining and analyzing social media data have challenges and limitations related to topic deduction and data quality. As a result, we need a structured approach to analyze social media content related to drug abuse in a manner that can mitigate the challenges and limitations surrounding the use of such data. Objective: This study aimed to develop and evaluate a framework for mining and analyzing social media content related to drug abuse. The framework is designed to mitigate challenges and limitations related to topic deduction and data quality in social media data analytics for drug abuse. Methods: The proposed framework started with defining different terms related to the keywords, categories, and characteristics of the topic of interest. We then used the Crimson Hexagon platform to collect data based on a search query informed by a drug abuse ontology developed using the identified terms. We subsequently preprocessed the data and examined the quality using an evaluation matrix. Finally, a suitable data analysis approach could be used to analyze the collected data. Results: The framework was evaluated using the opioid epidemic as a drug abuse case analysis. We demonstrated the applicability of the proposed framework to identify public concerns toward the opioid epidemic and the most discussed topics on social media related to opioids. The results from the case analysis showed that the framework could improve the discovery and identification of topics in social media domains characterized by a plethora of highly diverse terms and lack of a commonly available dictionary or language by the community, such as in the case of opioid and drug abuse. Conclusions: The proposed framework addressed the challenges related to topic detection and data quality. We demonstrated the applicability of the proposed framework to identify the common concerns toward the opioid epidemic and the most discussed topics on social media related to opioids. ",
doi="10.2196/18350",
url="https://www.jmir.org/2020/8/e18350",
url="http://www.ncbi.nlm.nih.gov/pubmed/32788147"
}


@Article{info:doi/10.2196/19222,
author="Min, Kyoung-Bok
and Song, Sung-Hee
and Min, Jin-Young",
title="Topic Modeling of Social Networking Service Data on Occupational Accidents in Korea: Latent Dirichlet Allocation Analysis",
journal="J Med Internet Res",
year="2020",
month="Aug",
day="13",
volume="22",
number="8",
pages="e19222",
keywords="topic modeling",
keywords="occupational accident",
keywords="social media",
keywords="knowledge",
keywords="workplace",
keywords="accident",
keywords="model",
keywords="analysis",
keywords="safety",
abstract="Background: In most industrialized societies, regulations, inspections, insurance, and legal options are established to support workers who suffer injury, disease, or death in relation to their work; in practice, these resources are imperfect or even unavailable due to workplace or employer obstruction. Thus, limitations exist to identify unmet needs in occupational safety and health information. Objective: The aim of this study was to explore hidden issues related to occupational accidents by examining social network services (SNS) data using topic modeling. Methods: Based on the results of a Google search for the phrases occupational accident, industrial accident and occupational diseases, a total of 145 websites were selected. From among these websites, we collected 15,244 documents on queries related to occupational accidents between 2002 and 2018. To transform unstructured text into structure data, natural language processing of the Korean language was conducted. We performed the latent Dirichlet allocation (LDA) as a topic model using a Python library. A time-series linear regression analysis was also conducted to identify yearly trends for the given documents. Results: The results of the LDA model showed 14 topics with 3 themes: workers' compensation benefits (Theme 1), illicit agreements with the employer (Theme 2), and fatal and non-fatal injuries and vulnerable workers (Theme 3). Theme 1 represented the largest cluster (52.2\%) of the collected documents and included keywords related to workers' compensation (ie, company, occupational injury, insurance, accident, approval, and compensation) and keywords describing specific compensation benefits such as medical expense benefits, temporary incapacity benefits, and disability benefits. In the yearly trend, Theme 1 gradually decreased; however, other themes showed an overall increasing pattern. Certain queries (ie, musculoskeletal system, critical care, and foreign workers) showed no significant variation in the number of queries. Conclusions: We conducted LDA analysis of SNS data of occupational accident--related queries and discovered that the primary concerns of workers posting about occupational injuries and diseases were workers' compensation benefits, fatal and non-fatal injuries, vulnerable workers, and illicit agreements with employers. While traditional systems focus mainly on quantitative monitoring of occupational accidents, qualitative aspects formulated by topic modeling from unstructured SNS queries may be valuable to address inequalities and improve occupational health and safety. ",
doi="10.2196/19222",
url="http://www.jmir.org/2020/8/e19222/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32663156"
}


@Article{info:doi/10.2196/17582,
author="Zhang, Yan
and Cao, Bolin
and Wang, Yifan
and Peng, Tai-Quan
and Wang, Xiaohua",
title="When Public Health Research Meets Social Media: Knowledge Mapping From 2000 to 2018",
journal="J Med Internet Res",
year="2020",
month="Aug",
day="13",
volume="22",
number="8",
pages="e17582",
keywords="social media",
keywords="public health",
keywords="infodemiology",
keywords="infoveillance",
keywords="topic modeling",
keywords="research theme",
keywords="research method",
abstract="Background: Social media has substantially changed how people confront health issues. However, a comprehensive understanding of how social media has altered the foci and methods in public health research remains lacking. Objective: This study aims to examine research themes, the role of social media, and research methods in social media--based public health research published from 2000 to 2018. Methods: A dataset of 3419 valid studies was developed by searching a list of relevant keywords in the Web of Science and PubMed databases. In addition, this study employs an unsupervised text-mining technique and topic modeling to extract research themes of the published studies. Moreover, the role of social media and research methods adopted in those studies were analyzed. Results: This study identifies 25 research themes, covering different diseases, various population groups, physical and mental health, and other significant issues. Social media assumes two major roles in public health research: produce substantial research interest for public health research and furnish a research context for public health research. Social media provides substantial research interest for public health research when used for health intervention, human-computer interaction, as a platform of social influence, and for disease surveillance, risk assessment, or prevention. Social media acts as a research context for public health research when it is mere reference, used as a platform to recruit participants, and as a platform for data collection. While both qualitative and quantitative methods are frequently used in this emerging area, cutting edge computational methods play a marginal role. Conclusions: Social media enables scholars to study new phenomena and propose new research questions in public health research. Meanwhile, the methodological potential of social media in public health research needs to be further explored. ",
doi="10.2196/17582",
url="http://www.jmir.org/2020/8/e17582/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32788156"
}


@Article{info:doi/10.2196/17478,
author="Visweswaran, Shyam
and Colditz, B. Jason
and O'Halloran, Patrick
and Han, Na-Rae
and Taneja, B. Sanya
and Welling, Joel
and Chu, Kar-Hai
and Sidani, E. Jaime
and Primack, A. Brian",
title="Machine Learning Classifiers for Twitter Surveillance of Vaping: Comparative Machine Learning Study",
journal="J Med Internet Res",
year="2020",
month="Aug",
day="12",
volume="22",
number="8",
pages="e17478",
keywords="vaping",
keywords="social media",
keywords="infodemiology",
keywords="infoveillance",
keywords="machine learning",
keywords="deep learning",
abstract="Background: Twitter presents a valuable and relevant social media platform to study the prevalence of information and sentiment on vaping that may be useful for public health surveillance. Machine learning classifiers that identify vaping-relevant tweets and characterize sentiments in them can underpin a Twitter-based vaping surveillance system. Compared with traditional machine learning classifiers that are reliant on annotations that are expensive to obtain, deep learning classifiers offer the advantage of requiring fewer annotated tweets by leveraging the large numbers of readily available unannotated tweets. Objective: This study aims to derive and evaluate traditional and deep learning classifiers that can identify tweets relevant to vaping, tweets of a commercial nature, and tweets with provape sentiments. Methods: We continuously collected tweets that matched vaping-related keywords over 2 months from August 2018 to October 2018. From this data set of tweets, a set of 4000 tweets was selected, and each tweet was manually annotated for relevance (vape relevant or not), commercial nature (commercial or not), and sentiment (provape or not). Using the annotated data, we derived traditional classifiers that included logistic regression, random forest, linear support vector machine, and multinomial naive Bayes. In addition, using the annotated data set and a larger unannotated data set of tweets, we derived deep learning classifiers that included a convolutional neural network (CNN), long short-term memory (LSTM) network, LSTM-CNN network, and bidirectional LSTM (BiLSTM) network. The unannotated tweet data were used to derive word vectors that deep learning classifiers can leverage to improve performance. Results: LSTM-CNN performed the best with the highest area under the receiver operating characteristic curve (AUC) of 0.96 (95\% CI 0.93-0.98) for relevance, all deep learning classifiers including LSTM-CNN performed better than the traditional classifiers with an AUC of 0.99 (95\% CI 0.98-0.99) for distinguishing commercial from noncommercial tweets, and BiLSTM performed the best with an AUC of 0.83 (95\% CI 0.78-0.89) for provape sentiment. Overall, LSTM-CNN performed the best across all 3 classification tasks. Conclusions: We derived and evaluated traditional machine learning and deep learning classifiers to identify vaping-related relevant, commercial, and provape tweets. Overall, deep learning classifiers such as LSTM-CNN had superior performance and had the added advantage of requiring no preprocessing. The performance of these classifiers supports the development of a vaping surveillance system. ",
doi="10.2196/17478",
url="https://www.jmir.org/2020/8/e17478",
url="http://www.ncbi.nlm.nih.gov/pubmed/32784184"
}


@Article{info:doi/10.2196/16969,
author="Yoo, Whi Dong
and Birnbaum, L. Michael
and Van Meter, R. Anna
and Ali, F. Asra
and Arenare, Elizabeth
and Abowd, D. Gregory
and De Choudhury, Munmun",
title="Designing a Clinician-Facing Tool for Using Insights From Patients' Social Media Activity: Iterative Co-Design Approach",
journal="JMIR Ment Health",
year="2020",
month="Aug",
day="12",
volume="7",
number="8",
pages="e16969",
keywords="social media",
keywords="psychotic disorders",
keywords="information technology",
abstract="Background: Recent research has emphasized the need for accessing information about patients to augment mental health patients' verbal reports in clinical settings. Although it has not been introduced in clinical settings, computational linguistic analysis on social media has proved it can infer mental health attributes, implying a potential use as collateral information at the point of care. To realize this potential and make social media insights actionable to clinical decision making, the gaps between computational linguistic analysis on social media and the current work practices of mental health clinicians must be bridged. Objective: This study aimed to identify information derived from patients' social media data that can benefit clinicians and to develop a set of design implications, via a series of low-fidelity (lo-fi) prototypes, on how to deliver the information at the point of care. Methods: A team of clinical researchers and human-computer interaction (HCI) researchers conducted a long-term co-design activity for over 6 months. The needs-affordances analysis framework was used to refine the clinicians' potential needs, which can be supported by patients' social media data. On the basis of those identified needs, the HCI researchers iteratively created 3 different lo-fi prototypes. The prototypes were shared with both groups of researchers via a videoconferencing software for discussion and feedback. During the remote meetings, potential clinical utility, potential use of the different prototypes in a treatment setting, and areas of improvement were discussed. Results: Our first prototype was a card-type interface that supported treatment goal tracking. Each card included attribute levels: depression, anxiety, social activities, alcohol, and drug use. This version confirmed what types of information are helpful but revealed the need for a glanceable dashboard that highlights the trends of these information. As a result, we then developed the second prototype, an interface that shows the clinical state and trend. We found that focusing more on the changes since the last visit without visual representation can be more compatible with clinicians' work practices. In addition, the second phase of needs-affordances analysis identified 3 categories of information relevant to patients with schizophrenia: symptoms related to psychosis, symptoms related to mood and anxiety, and social functioning. Finally, we developed the third prototype, a clinical summary dashboard that showed changes from the last visit in plain texts and contrasting colors. Conclusions: This exploratory co-design research confirmed that mental health attributes inferred from patients' social media data can be useful for clinicians, although it also revealed a gap between computational social media analyses and clinicians' expectations and conceptualizations of patients' mental health states. In summary, the iterative co-design process crystallized design directions for the future interface, including how we can organize and provide symptom-related information in a way that minimizes the clinicians' workloads. ",
doi="10.2196/16969",
url="http://mental.jmir.org/2020/8/e16969/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32784180"
}


@Article{info:doi/10.2196/17449,
author="Ash, I. Garrett
and Robledo, S. David
and Ishii, Momoko
and Pittman, Brian
and DeMartini, S. Kelly
and O'Malley, S. Stephanie
and Redeker, S. Nancy
and Fucito, M. Lisa",
title="Using Web-Based Social Media to Recruit Heavy-Drinking Young Adults for Sleep Intervention: Prospective Observational Study",
journal="J Med Internet Res",
year="2020",
month="Aug",
day="11",
volume="22",
number="8",
pages="e17449",
keywords="substance abuse",
keywords="social media",
keywords="alcohol drinking",
keywords="sleep",
keywords="mobile phone",
abstract="Background: Novel alcohol prevention strategies are needed for heavy-drinking young adults. Sleep problems are common among young adults who drink heavily and are a risk factor for developing an alcohol use disorder (AUD). Young adults, interested in the connection between sleep and alcohol, are open to getting help with their sleep. Therefore, sleep interventions may offer an innovative solution. This study evaluates social media advertising for reaching young adults and recruiting them for a new alcohol prevention program focused on sleep. Objective: This study aims to evaluate the effectiveness and cost of using Facebook, Instagram, and Snapchat advertising to reach young adults who drink heavily for a sleep intervention; characterize responders' sleep, alcohol use, and related concerns and interests; and identify the most appealing advertising content. Methods: In study 1, advertisements targeting young adults with sleep concerns, heavy alcohol use, or interest in participating in a sleep program ran over 3 months. Advertisements directed volunteers to a brief web-based survey to determine initial sleep program eligibility and characterize the concerns or interests that attracted them to click the advertisement. In study 2, three advertisements ran simultaneously for 2 days to enable us to compare the effectiveness of specific advertising themes. Results: In study 1, advertisements generated 13,638 clicks, 909 surveys, and 27 enrolled volunteers in 3 months across the social media platforms. Fees averaged US \$0.27 per click, US \$3.99 per completed survey, US \$11.43 per volunteer meeting initial screening eligibility, and US \$106.59 per study enrollee. On average, those who completed the web-based survey were 21.1 (SD 2.3) years of age, and 69.4\% (631/909) were female. Most reported sleep concerns (725/909, 79.8\%) and an interest in the connection between sleep and alcohol use (547/909, 60.2\%), but few had drinking concerns (49/909, 5.4\%). About one-third (317/909, 34.9\%) were identified as being at risk for developing an AUD based on a validated alcohol screener. Among this subsample, 8.5\% (27/317) met the final criteria and were enrolled in the trial. Some volunteers also referred additional volunteers by word of mouth. In study 2, advertisements targeting sleep yielded a higher response rate than advertisements targeting alcohol use (0.91\% vs 0.56\% click rate, respectively; P<.001). Conclusions: Social media advertisements designed to target young adults with sleep concerns reached those who also drank alcohol heavily, despite few being concerned about their drinking. Moreover, advertisements focused on sleep were more effective than those focused on drinking. Compared with previous studies, cost-effectiveness was moderate for engagement (impressions to clicks), excellent for conversion (clicks to survey completion), and reasonable for enrollment. These data demonstrate the utility of social media advertising focused on sleep to reach young adults who drink heavily and recruit them for intervention. ",
doi="10.2196/17449",
url="https://www.jmir.org/2020/8/e17449",
url="http://www.ncbi.nlm.nih.gov/pubmed/32780027"
}


@Article{info:doi/10.2196/16761,
author="Vargas Meza, Xanat
and Yamanaka, Toshimasa",
title="Food Communication and its Related Sentiment in Local and Organic Food Videos on YouTube",
journal="J Med Internet Res",
year="2020",
month="Aug",
day="10",
volume="22",
number="8",
pages="e16761",
keywords="social networks",
keywords="framing",
keywords="semantic analysis",
keywords="sentiment analysis",
keywords="organic",
keywords="local",
keywords="food",
keywords="YouTube",
abstract="Background: Local and organic foods have shown increased importance and market size in recent years. However, attitudes, sentiment, and habits related to such foods in the context of video social networks have not been thoroughly researched. Given that such media have become some of the most important venues of internet traffic, it is relevant to investigate how sustainable food is communicated through such video social networks. Objective: This study aimed to explore the diffusion paths of local and organic foods on YouTube, providing a review of trends, coincidences, and differences among video discourses. Methods: A combined methodology involving webometric, framing, semantic, and sentiment analyses was employed. Results: We reported the results for the following two groups: organic and local organic videos. Although the content of 923 videos mostly included the ``Good Mother'' (organic and local organic: 282/808, 34.9\% and 311/866, 35.9\%, respectively), ``Natural Goodness'' (220/808, 27.2\% and 253/866, 29.2\%), and ``Undermining of Foundations'' (153/808, 18.9\% and 180/866, 20.7\%) frames, organic videos were more framed in terms of ``Frankenstein'' food (organic and local organic: 68/808, 8.4\% and 27/866, 3.1\%, respectively), with genetically modified organisms being a frequent topic among the comments. Organic videos (N=448) were better connected in terms of network metrics than local organic videos (N=475), which were slightly more framed regarding ``Responsibility'' (organic and local organic: 42/808, 5.1\% and 57/866, 6.5\%, respectively) and expressed more positive sentiment (M ranks for organic and local organic were 521.2 and 564.54, respectively, Z=2.15, P=.03). Conclusions: The results suggest that viewers considered sustainable food as part of a complex system and in a positive light and that food framed as artificial and dangerous sometimes functions as a counterpoint to promote organic food. ",
doi="10.2196/16761",
url="https://www.jmir.org/2020/8/e16761",
url="http://www.ncbi.nlm.nih.gov/pubmed/32773370"
}


@Article{info:doi/10.2196/16239,
author="Dauphin, Cassy
and Clark, Nikia
and Cadzow, Renee
and Saad-Harfouche, Frances
and Rodriguez, Elisa
and Glaser, Kathryn
and Kiviniemi, Marc
and Keller, Maria
and Erwin, Deborah",
title="\#BlackBreastsMatter: Process Evaluation of Recruitment and Engagement of Pregnant African American Women for a Social Media Intervention Study to Increase Breastfeeding",
journal="J Med Internet Res",
year="2020",
month="Aug",
day="10",
volume="22",
number="8",
pages="e16239",
keywords="breastfeeding",
keywords="breast cancer education",
keywords="African American mothers",
keywords="Facebook",
keywords="mobile phone, social media",
abstract="Background: In the United States, there are lower rates of breastfeeding among African American mothers, particularly those who are younger women. Recent epidemiological studies have shown a strong association of more aggressive types of breast cancer (estrogen receptor negative) among African American women, with a higher risk in African American women who did not breastfeed their children. Objective: This study aims to describe the process evaluation of recruitment and educational strategies to engage pregnant African American participants for a pilot study designed to determine whether social media messaging about breast cancer risk reduction through breastfeeding may positively influence breastfeeding rates. Methods: This pilot study is conducted in collaboration with a local Women, Infants, and Children (WIC) organization and hospital and prenatal clinics of a local health care network. To engage African American women to enroll in the study, several methods and monitoring processes were explored, including WIC electronic text-based messages sent out to all phones of current WIC recipients (referred to as e-blasts); keyword responses to texts from flyers and posters in local community-based organizations, hospitals, and prenatal clinics; keyword responses using electronic links posted in established Facebook groups; and snowball recruitment of other pregnant women by current participants through Facebook. Once enrolled, participants were randomized to 2 study conditions: (1) an intervention group receiving messages about breast cancer risk reduction and breastfeeding or (2) a control group receiving breastfeeding-only messages. Data were obtained through electronic monitoring, SurveyMonkey, qualitative responses on Facebook, focus groups, and interviews. Results: More than 3000 text messages were sent and received through WIC e-blasts and keyword responses from flyers. A total of 472 women were recruited through WIC e-blast, and 161 responded to flyers and contacts through the local health care network, community-based organizations, Facebook, and friend referrals. A total of 633 women were assessed for eligibility to participate in the study. A total of 288 pregnant African American women were enrolled, consented, and completed presurvey assessments (102.8\% of the goal), and 22 participants attended focus groups or interviews reporting on their experiences with Facebook and the educational messages. Conclusions: This process evaluation suggests that using electronic, smartphone apps with social media holds promise for both recruitment and conduct of health education intervention studies for pregnant African American women. Providing messaging and resources through social media to reinforce and educate women about breastfeeding and potentially provide lactation support is intriguing. Convenience (for researchers and participants) is an attribute of social media for this demographic of women and worthy of further research as an educational tool. Trial Registration: ClinicalTrials.gov NCT03680235; https://clinicaltrials.gov/ct2/show/NCT03680235 ",
doi="10.2196/16239",
url="https://www.jmir.org/2020/8/e16239",
url="http://www.ncbi.nlm.nih.gov/pubmed/32773377"
}


@Article{info:doi/10.2196/15378,
author="Martin, Philippe
and Cousin, Lorraine
and Gottot, Serge
and Bourmaud, Aurelie
and de La Rochebrochard, Elise
and Alberti, Corinne",
title="Participatory Interventions for Sexual Health Promotion for Adolescents and Young Adults on the Internet: Systematic Review",
journal="J Med Internet Res",
year="2020",
month="Jul",
day="31",
volume="22",
number="7",
pages="e15378",
keywords="sexual health",
keywords="health promotion",
keywords="internet",
keywords="participatory interventions",
keywords="adolescents and young adults",
keywords="methods",
abstract="Background: The World Health Organization recommends the development of participatory sexuality education. In health promotion, web-based participatory interventions have great potential in view of the internet's popularity among young people. Objective: The aim of this review is to describe existing published studies on online participatory intervention methods used to promote the sexual health of adolescents and young adults. Methods: We conducted a systematic review based on international scientific and grey literature. We used the PubMed search engine and Aurore database for the search. Articles were included if they reported studies on participatory intervention, included the theme of sexual health, were conducted on the internet (website, social media, online gaming system), targeted populations aged between 10 and 24 years, and had design, implementation, and evaluation methods available. We analyzed the intervention content, study implementation, and evaluation methods for all selected articles. Results: A total of 60 articles were included, which described 37 interventions; several articles were published about the same intervention. Process results were published in many articles (n=40), in contrast to effectiveness results (n=23). Many of the 37 interventions were developed on websites (n=20). The second most used medium is online social networks (n=13), with Facebook dominating this group (n=8). Online peer interaction is the most common participatory component promoted by interventions (n=23), followed by interaction with a professional (n=16). Another participatory component is game-type activity (n=10). Videos were broadcast for more than half of the interventions (n=20). In total, 43\% (n=16) of the interventions were based on a theoretical model, with many using the Information-Motivation-Behavioral Skills model (n=7). Less than half of the interventions have been evaluated for effectiveness (n=17), while one-third (n=12) reported plans to do so and one-fifth (n=8) did not indicate any plan for effectiveness evaluation. The randomized controlled trial is the most widely used study design (n=16). Among the outcomes (evaluated or planned for evaluation), sexual behaviors are the most evaluated (n=14), followed by condom use (n=11), and sexual health knowledge (n=8). Conclusions: Participatory online interventions for young people's sexual health have shown their feasibility, practical interest, and attractiveness, but their effectiveness has not yet been sufficiently evaluated. Online peer interaction, the major participatory component, is not sufficiently conceptualized and defined as a determinant of change or theoretical model component. One potential development would be to build a conceptual model integrating online peer interaction and support as a component. ",
doi="10.2196/15378",
url="http://www.jmir.org/2020/7/e15378/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32735217"
}


@Article{info:doi/10.2196/18474,
author="Pretorius, Kelly
and Choi, Eunju
and Kang, Sookja
and Mackert, Michael",
title="Sudden Infant Death Syndrome on Facebook: Qualitative Descriptive Content Analysis to Guide Prevention Efforts",
journal="J Med Internet Res",
year="2020",
month="Jul",
day="30",
volume="22",
number="7",
pages="e18474",
keywords="sudden infant death",
keywords="SIDS",
keywords="infant mortality",
keywords="safe sleep",
keywords="social media",
keywords="social support",
keywords="health communication",
keywords="maternal health",
keywords="qualitative research",
keywords="health care providers",
abstract="Background: Sudden unexpected infant death (SUID), which includes the diagnosis of sudden infant death syndrome (SIDS), is a leading cause of infant mortality in the United States. Despite prevention efforts, many parents continue to create unsafe infant sleep environments and use potentially dangerous infant sleep and monitoring devices, ultimately leading to sleep-related infant deaths. Analyzing Facebook conversations regarding SIDS may offer a unique maternal perspective to guide future research and prevention efforts. Objective: This study aims to describe and analyze conversations among mothers engaged in discussions about SIDS on a Facebook mother's group. We were interested in understanding maternal knowledge of SIDS, identifying information sources for SIDS, describing actual infant sleep practices, exploring opinions regarding infant sleep products and monitoring devices, and discovering evidence of provider communication regarding SIDS. Methods: We extracted and analyzed 20 posts and 912 comments from 512 mothers who participated in a specific Facebook mother's group and engaged in conversations about SIDS. There were 2 reviewers who coded the data using qualitative descriptive content analysis. Themes were induced after discussion among researchers and after the study objectives were addressed. Results: The theme of social support emerged, specifically informational and emotional support. A variety of informational sources for SIDS and safe sleep were identified, as was a continuum of infant sleep practices (ranging from unsafe to safe sleep per the American Academy of Pediatrics standards). There was widespread discussion regarding infant sleep products and monitoring devices. Embedded within conversations were (1) confusion among commonly used medical terminology, (2) the practice of unsafe infant sleep, (3) inconsistency in provider communication about SIDS, and (4) maternal anxiety regarding SIDS. Conclusions: We uncovered new findings in this analysis, such as the commonality of infant sleep products and monitoring devices and widespread maternal anxiety regarding SIDS. Additionally, mothers who participated in the Facebook group provided and received informational and emotional support regarding SIDS via this social media format. Such results can guide future prevention efforts by informing health communication regarding SUID and safe sleep. Future provider and public health agency communication on the topic of SUID and safe sleep should be simple and clear, address infant sleep products and monitoring devices, address maternal anxiety regarding SIDS, and address the common practice of unsafe sleep. ",
doi="10.2196/18474",
url="http://www.jmir.org/2020/7/e18474/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32729842"
}


@Article{info:doi/10.2196/16337,
author="Panzarasa, Pietro
and Griffiths, J. Christopher
and Sastry, Nishanth
and De Simoni, Anna",
title="Social Medical Capital: How Patients and Caregivers Can Benefit From Online Social Interactions",
journal="J Med Internet Res",
year="2020",
month="Jul",
day="28",
volume="22",
number="7",
pages="e16337",
keywords="online health communities",
keywords="self-care",
keywords="social networks",
keywords="social capital",
keywords="open and closed structures",
keywords="social cohesion",
keywords="brokerage",
doi="10.2196/16337",
url="http://www.jmir.org/2020/7/e16337/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32720910"
}


@Article{info:doi/10.2196/18779,
author="Park, Kyung Bu
and Kim, Yoon Ji
and Rogers, E. Valerie",
title="Development and Usability Evaluation of a Facebook-Based Intervention Program for Childhood Cancer Patients: Mixed Methods Study",
journal="J Med Internet Res",
year="2020",
month="Jul",
day="28",
volume="22",
number="7",
pages="e18779",
keywords="pediatric cancer patients",
keywords="childhood cancer",
keywords="social network site",
keywords="Facebook",
keywords="usability",
abstract="Background: Childhood cancers previously considered to be incurable now have 5-year survival rates up to 84\%. Nevertheless, these patients remain at risk of morbidity and mortality from therapy-related complications. Thus, patient education and self-management strategies for promoting a healthy lifestyle are of tantamount importance for improving short- and long-term health outcomes. A Facebook-based ``Healthy Teens for Soaam'' (a Korean term for childhood cancers) program was developed to help improve knowledge and self-management practices of teens with cancer related to their disease and treatment. Objective: The two-fold purpose of this usability study was (1) to describe the process of developing an 8-week Facebook-based intervention program for teens with cancer, and (2) to evaluate its usability to refine the program. Methods: Multiple phases and methods were employed to develop and evaluate the usability of the program. Study phases included: (1) needs assessment through focus group interviews and qualitative content analysis, (2) development of module content, (3) expert review and feedback on module content, (4) Facebook-based program development, (5) usability evaluation by heuristic evaluation, (6) usability evaluation by targeted end-user testing, and (7) modification and final version of the program. Usability of the final version was confirmed through feedback loops of these phases. Results: Based on 6 focus group discussion sessions, it was determined that teens with cancer were interested in seeing stories of successful childhood cancer cases and self-management after discharge, and preferred multimedia content over text. Therefore, each Facebook module was redesigned to include multimedia materials such as relevant video clips tailored for teens. Usability assessed by heuristic evaluation and user testing revealed several critical usability issues, which were then revised. Potential end users tested the final program and perceived it to be usable and useful for teens with cancer. Conclusions: To our knowledge, ``Healthy Teens for Soaam'' is the first Facebook-based intervention program for teens with cancer. We actively worked with current childhood cancer patients and survivors to develop and improve this program, achieved good usability, and met the expressed needs and preferences of target end users. This 8-week Facebook-based educational program for teens with cancer, developed as the first step of an upcoming intervention study, will be useful for improving knowledge and self-management strategies of teens. ",
doi="10.2196/18779",
url="http://www.jmir.org/2020/7/e18779/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32720897"
}


@Article{info:doi/10.2196/17894,
author="Wang, Zixin
and Yang, Xue
and Mo, H. Phoenix K.
and Fang, Yuan
and Ip, Mary Tsun Kwan
and Lau, F. Joseph T.",
title="Influence of Social Media on Sexualized Drug Use and Chemsex Among Chinese Men Who Have Sex With Men: Observational Prospective Cohort Study",
journal="J Med Internet Res",
year="2020",
month="Jul",
day="24",
volume="22",
number="7",
pages="e17894",
keywords="influence of social media",
keywords="sexualized drug use",
keywords="chemsex",
keywords="men who have sex with men",
keywords="prospective observational cohort study",
abstract="Background: Sexualized drug use (SDU; the use of any psychoactive substance before or during sexual intercourse) is prevalent among men who have sex with men (MSM) and may aggravate the worsening HIV epidemic in this key population. Objective: This observational prospective cohort study investigated factors predicting the occurrence of SDU within a 6-month follow-up period among a sample of MSM in Hong Kong. We hypothesized that perceptions related to SDU would mediate the association between the influence of social media/gay social networking apps and SDU during the follow-up period. Methods: Participants were Chinese-speaking men in Hong Kong, China who had anal intercourse with at least one man in the past year. Among 600 participants who completed the baseline telephone survey, 407 (67.8\%) completed another telephone survey 6 months later. Logistic regression models and path analysis were fitted. Results: At Month 6, 6.9\% (28/407) and 4.4\% (18/407) of participants reported SDU and chemsex during the follow-up period. After adjustment for significant baseline background variables (use of pre-exposure prophylaxis; history of HIV and other sexually transmitted infections; anal intercourse with nonregular male sex partners, condomless anal intercourse with men, multiple male sex partnerships, and SDU at baseline), three constructs of the Theory of Planned Behavior (TPB) were significantly associated with SDU during the follow-up period: (1) positive attitudes toward SDU (adjusted odds ratio [AOR] 1.19, 95\% CI 1.05-1.36), (2) perceived support for SDU from significant others (AOR 1.15, 95\% CI 1.01-1.30), and (3) perceived behavioral control of refraining from SDU (AOR 0.76, 95\% CI 0.59-0.98). Exposure to information supporting SDU on social media and gay social networking apps was also significantly associated with SDU (AOR 1.11, 95\% CI 1.01-1.22). Bootstrapping analyses indicated that social media influence was indirectly associated with SDU through TPB-related perceptions of SDU ($\beta$=.04; B=.002, 95\% CI 0.001-0.01). Conclusions: Social media and gay social networking apps may be a major source of influence on MSM's perceptions and actual behaviors related to SDU. ",
doi="10.2196/17894",
url="http://www.jmir.org/2020/7/e17894/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32706705"
}


@Article{info:doi/10.2196/17296,
author="Jenkins, L. Eva
and Ilicic, Jasmina
and Barklamb, M. Amy
and McCaffrey, A. Tracy",
title="Assessing the Credibility and Authenticity of Social Media Content for Applications in Health Communication: Scoping Review",
journal="J Med Internet Res",
year="2020",
month="Jul",
day="23",
volume="22",
number="7",
pages="e17296",
keywords="review",
keywords="trust",
keywords="social media",
keywords="nutrition science",
keywords="health",
keywords="communication",
keywords="health communication",
abstract="Background: Nutrition science is currently facing issues regarding the public's perception of its credibility, with social media (SM) influencers increasingly becoming a key source for nutrition-related information with high engagement rates. Source credibility and, to an extent, authenticity have been widely studied in marketing and communications but have not yet been considered in the context of nutrition or health communication. Thus, an investigation into the factors that impact perceived source and message credibility and authenticity is of interest to inform health communication on SM. Objective: This study aims to explore the factors that impact message and source credibility (which includes trustworthiness and expertise) or authenticity judgments on SM platforms to better inform nutrition science SM communication best practices. Methods: A total of 6 databases across a variety of disciplines were searched in March 2019. The inclusion criteria were experimental studies, studies focusing on microblogs, studies focusing on healthy adult populations, and studies focusing on either source credibility or authenticity. Exclusion criteria were studies involving participants aged under 18 years and clinical populations, gray literature, blogs, WeChat conversations, web-based reviews, non-English papers, and studies not involving participants' perceptions. Results: Overall, 22 eligible papers were included, giving a total of 25 research studies. Among these studies, Facebook and Twitter were the most common SM platforms investigated. The most effective communication style differed depending on the SM platform. Factors reported to impact credibility included language used online, expertise heuristics, and bandwagon heuristics. No papers were found that assessed authenticity. Conclusions: Credibility and authenticity are important concepts studied extensively in the marketing and communications disciplines; however, further research is required in a health context. Instagram is a less-researched platform in comparison with Facebook and Twitter. ",
doi="10.2196/17296",
url="http://www.jmir.org/2020/7/e17296/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32706675"
}


@Article{info:doi/10.2196/16212,
author="Alsisi, Ali Elaf
and Al-Ashaab, Ahmed
and Abualfaraa, Ahmed Wadhah",
title="The Development of a Smart Health Awareness Message Framework Based on the Use of Social Media: Quantitative Study",
journal="J Med Internet Res",
year="2020",
month="Jul",
day="23",
volume="22",
number="7",
pages="e16212",
keywords="social media",
keywords="health promotion and social media",
keywords="health awareness",
keywords="health promotion",
keywords="eHealth",
keywords="technology acceptance theory",
abstract="Background: Social media has recently provided a remarkable means of delivering health information broadly and in a cost-effective way. Despite its benefits, some difficulties are encountered in attempting to influence the public to change their behavior in response to social media health messages. Objective: This study aimed to explore the factors that affect individuals' acceptance of using social media as a tool for receiving health awareness messages and adapting such content accordingly by developing a smart health awareness message framework. Methods: A quantitative method was adapted to validate the hypotheses and proposed framework through the development of a survey based on the technology acceptance model with the extension of other constructs. The survey was distributed on the web to 701 participants from different countries via Qualtrics software; it generated 391 completed questionnaires, and the response rate was 55.8\% (391/701). Results: Of the 391 respondents, 121 (30.9\%) used social media platforms often during the week, and 27 participants (6.9\%) did not use social media. In addition, 24.0\% (94/391) of the respondents used these platforms to seek health information. On the basis of the results, perceived usefulness ($\beta$=.37; P<.001), gain-framed message ($\beta$=.04; P<.001), and loss-framed message ($\beta$=.08; P<.001) were seen to positively and significantly influence people's intention to use social media as a means to spread information about health promotion. The proposed smart health awareness message framework identifies 64.2\% of the variance in intention to use, 55.4\% of the variance of perceived usefulness, and 26.2\% of the variance of perceived ease of use. Conclusions: This study sheds light on the factors that are associated with people's intention to use and adopt social media in the health promotion domain. The findings reveal that the intention of using social media for health awareness purposes is positively impacted by the perception of usefulness of social media and the design of health messages. Future research might seek to explore other factors that relate to people's behavior. This point of view will assist health organizations in developing their health messages more effectively and to be patient friendly. ",
doi="10.2196/16212",
url="https://www.jmir.org/2020/7/e16212",
url="http://www.ncbi.nlm.nih.gov/pubmed/32459627"
}


@Article{info:doi/10.2196/15121,
author="Elliott, A. Sarah
and Dyson, P. Michele
and Wilkes, V. Gilbert
and Zimmermann, L. Gabrielle
and Chambers, T. Christine
and Wittmeier, DM Kristy
and Russell, J. Dianne
and Scott, D. Shannon
and Thomson, Denise
and Hartling, Lisa",
title="Considerations for Health Researchers Using Social Media for Knowledge Translation: Multiple Case Study",
journal="J Med Internet Res",
year="2020",
month="Jul",
day="23",
volume="22",
number="7",
pages="e15121",
keywords="social media",
keywords="knowledge translation",
keywords="health research",
keywords="engagement",
keywords="dissemination",
keywords="exchange",
keywords="evaluation",
abstract="Background: Despite extensive literature describing the use of social media in health research, a gap exists around best practices in establishing, implementing, and evaluating an effective social media knowledge translation (KT) and exchange strategies. Objective: This study aims to examine successes, challenges, and lessons learned from using social media within health research and to create practical considerations to guide other researchers. Methods: The Knowledge Translation Platform of the Alberta Strategy for Patient-Oriented Research SUPPORT Unit formed a national working group involving platform staff, academics, and a parent representative with experience using social media for health research. We collected and analyzed 4 case studies that used a variety of social media platforms and evaluation methods. The case studies covered a spectrum of initiatives from participant recruitment and data collection to dissemination, engagement, and evaluation. Methods and findings from each case study as well as barriers and facilitators encountered were summarized. Through iterative discussions, we converged on recommendations and considerations for health researchers planning to use social media for KT. Results: We provide recommendations for elements to consider when developing a social media KT strategy: (1) set a clear goal and identify a theory, framework, or model that aligns with the project goals and objectives; (2) understand the intended audience (use social network mapping to learn what platforms and social influences are available); (3) choose a platform or platforms that meet the needs of the intended audience and align well with the research team's capabilities (can you tap into an existing network, and what mode of communication does it support?); (4) tailor messages to meet user needs and platform requirements (eg, plain language and word restrictions); (5) consider timing, frequency, and duration of messaging as well as the nature of interactions (ie, social filtering and negotiated awareness); (6) ensure adequate resources and personnel are available (eg, content creators, project coordinators, communications experts, and audience stakeholder or patient advocate); (7) develop an evaluation plan a priori driven by goals and types of data available (ie, quantitative and qualitative); and (8) consider ethical approvals needed (driven by evaluation and type of data collection). Conclusions: In the absence of a comprehensive framework to guide health researchers using social media for KT, we provide several key considerations. Future research will help validate the proposed components and create a body of evidence around best practices for using and evaluating social media as part of a KT strategy ",
doi="10.2196/15121",
url="http://www.jmir.org/2020/7/e15121/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32706653"
}


@Article{info:doi/10.2196/12619,
author="Cavallo, David
and Lim, Rock
and Ishler, Karen
and Pagano, Maria
and Perovsek, Rachel
and Albert, Elizabeth
and Koopman Gonzalez, Sarah
and Trapl, Erika
and Flocke, Susan",
title="Effectiveness of Social Media Approaches to Recruiting Young Adult Cigarillo Smokers: Cross-Sectional Study",
journal="J Med Internet Res",
year="2020",
month="Jul",
day="22",
volume="22",
number="7",
pages="e12619",
keywords="adolescent, young adult",
keywords="tobacco products",
keywords="social media",
keywords="research subject recruitment",
abstract="Background: The prevalence of social media use among youth and young adults suggests it is an appropriate platform for study recruitment from this population. Previous studies have examined the use of social media for recruitment, but few have compared platforms, and none, to our knowledge, have attempted to recruit cigarillo users. Objective: The purpose of this study was to examine the effectiveness of different social media platforms and advertisement images for recruiting cigarillo users aged 14-28 years to complete a cigarillo use survey. Methods: We obtained objective data for advertisement impressions for a 39-week social media recruitment campaign. Advertisements were targeted to users based on their age, geography, and interests. Effectiveness was defined as the percentage of approved surveys per advertising impression. Chi-square tests were performed to compare the effectiveness of different advertisement images and platforms. Results: Valid survey completers (n=1089) were predominately older (25-28 years old, n=839, 77\%). Of the 1089 survey completers, 568 (52\%) identified as male, 335 (31\%) as African American, and 196 (18\%) as Hispanic. Advertisements delivered via Facebook/Instagram were more effective than Twitter; 311/1,027,738 (0.03\%) vs 661/2,998,715 (0.02\%); $\chi$21=21.45, N=4,026,453); P<.001. Across platforms, ads featuring exclusively an image of cigarillos were more effective (397/682,994, 0.06\%) than ads with images of individuals smoking (254/1,308,675, 0.02\%), individuals not smoking (239/1,393,134, .02\%), and groups not smoking (82/641,650, 0.01\%); $\chi$23133.73, N=4,026,453; P<.001. Conclusions: The campaign was effective in recruiting a diverse sample representative of relevant racial/ethnic categories. Advertisements on Facebook were more effective than Twitter. Advertisements that featured an image of a cigarillo were consistently the most effective and should be considered by others recruiting cigarillo users via social media. ",
doi="10.2196/12619",
url="https://www.jmir.org/2020/7/e12619",
url="http://www.ncbi.nlm.nih.gov/pubmed/32459629"
}


@Article{info:doi/10.2196/20469,
author="He, Shuhan
and Ojo, Ayotomiwa
and Beckman, L. Adam
and Gondi, Suhas
and Ranney, Megan
and Betz, Marian
and Faust, S. Jeremy
and Choo, Esther
and Kass, Dara
and Raja, S. Ali",
title="The Story of \#GetMePPE and GetUsPPE.org to Mobilize Health Care Response to COVID-19 : Rapidly Deploying Digital Tools for Better Health Care",
journal="J Med Internet Res",
year="2020",
month="Jul",
day="20",
volume="22",
number="7",
pages="e20469",
keywords="digital health",
keywords="getusppe",
keywords="getmeppe",
keywords="COVID-19",
keywords="personal protective equipment",
keywords="protection",
keywords="Twitter",
keywords="pandemic",
keywords="health care worker",
doi="10.2196/20469",
url="https://www.jmir.org/2020/7/e20469",
url="http://www.ncbi.nlm.nih.gov/pubmed/32530813"
}


@Article{info:doi/10.2196/19982,
author="Lin, Yulan
and Hu, Zhijian
and Alias, Haridah
and Wong, Ping Li",
title="Influence of Mass and Social Media on Psychobehavioral Responses Among Medical Students During the Downward Trend of COVID-19 in Fujian, China: Cross-Sectional Study",
journal="J Med Internet Res",
year="2020",
month="Jul",
day="20",
volume="22",
number="7",
pages="e19982",
keywords="psychobehavioral",
keywords="COVID-19",
keywords="mass media",
keywords="social media",
keywords="medical students",
keywords="China",
abstract="Background: An extensive amount of information related to the novel coronavirus (COVID-19) pandemic was disseminated by mass and social media in China. To date, there is limited evidence on how this infodemic may influence psychobehavioral responses to the crisis. Objective: The aim of this study is to assess the psychobehavioral responses to the COVID-19 outbreak and examine their associations with mass and social media exposure. Methods: A cross-sectional study among medical and health sciences students from the Fujian Medical University in Fuzhou, China, was conducted between April 6-22, 2020. Results: A total of 2086 completed responses were received. Multivariable analyses demonstrated that four constructs of the Health Belief Model (HBM)---higher perception of susceptibility (odds ratio [OR] 1.44; 95\% CI 1.07-1.94), severity (OR 1.32; 95\% CI 1.10-1.59), self-efficacy (OR 1.61; 95\% CI 1.21-2.15), and perceived control or intention to carry out prevention measures (OR 1.32; 95\% CI 1.09-1.59)---were significantly associated with a higher mass media exposure score, whereas only three constructs---higher perception of severity (OR 1.43; 95\% CI 1.19-1.72), self-efficacy (OR 1.85; 95\% CI 1.38-2.48), and perceived control or intention to carry out prevention measures (OR 1.32; 95\% CI 1.08-1.58)---were significantly associated with a higher social media exposure score. Lower emotional consequences and barriers to carry out prevention measures were also significantly associated with greater mass and social media exposure. Our findings on anxiety levels revealed that 38.1\% (n=795; 95\% CI 36.0-40.2) of respondents reported moderate-to-severe anxiety. A lower anxiety level was significantly associated with higher mass and social media exposure in the univariable analyses; however, the associations were not significant in the multivariable analyses. Conclusions: In essence, both mass and social media are useful means of disseminating health messages and contribute to the betterment of psychobehavioral responses to COVID-19. Our findings stress the importance of the credibility of information shared through mass and social media outlets and viable strategies to counter misinformation during a pandemic. ",
doi="10.2196/19982",
url="https://www.jmir.org/2020/7/e19982",
url="http://www.ncbi.nlm.nih.gov/pubmed/32584779"
}


@Article{info:doi/10.2196/16962,
author="Liu, Hejing
and Li, Qiudan
and Zhan, Yongcheng
and Zhang, Zhu
and Zeng, D. Daniel
and Leischow, J. Scott",
title="Characterizing Social Media Messages Related to Underage JUUL E-Cigarette Buying and Selling: Cross-Sectional Analysis of Reddit Subreddits",
journal="J Med Internet Res",
year="2020",
month="Jul",
day="20",
volume="22",
number="7",
pages="e16962",
keywords="JUUL",
keywords="e-cigarette",
keywords="Reddit",
keywords="cross-sectional analysis",
keywords="electronic nicotine delivery system",
keywords="underage JUUL use",
abstract="Background: Stopping the epidemic of e-cigarette use among youth has become the common goal of both regulatory authorities and health departments. JUUL is currently the most popular e-cigarette brand on the market. Young people usually obtain and exchange information about JUUL with the help of social media platforms. Along with the rising prevalence of JUUL, posts about underage JUUL buying and selling have appeared on social media platforms such as Reddit, which sharply increase the risk of minors being exposed to JUUL. Objective: This study aims to analyze Reddit messages about JUUL buying and selling among the users of the UnderageJuul subreddit, and to further summarize the characteristics of those messages. The findings and insights can contribute to a better understanding of the patterns of underage JUUL use, and help public health officials provide timely education and guidance to minors who have intentions of accessing JUUL. Methods: We used a novel cross-subreddit method to analyze the Reddit messages on 2 subreddits. From July 9, 2017, to January 7, 2018, we collected data from the UnderageJuul subreddit, which was created for underage JUUL use discussion. The data set included 716 threads, 2935 comments, and 844 Reddit users (ie, Redditors). We collected our second data set, comprising 23,840 threads and 162,106 comments posted between July 9, 2017, and January 8, 2019, from the JUUL subreddit. We conducted analyses including the following: (1) annotation of users with buying/selling intention, (2) posting patterns discovery and topic comparison, and (3) posting activeness observation of discovered Redditors. Term frequency--inverse document frequency and regular expression-enhanced keyword search methods were applied during the content analysis to extract the posting patterns. The public posting records of the discovered users on the JUUL subreddit during the year after the UnderageJuul subreddit was shut down were analyzed to determine whether they were still active and interested in obtaining JUUL. Results: Our study revealed the following: (1) Among the 716 threads on the UnderageJuul subreddit, there were 214 threads related to JUUL sale and 168 threads related to JUUL purchase, which accounted for 53.5\% (382/714) of threads. (2) Among the 844 Redditors of the UnderageJuul subreddit, 23.82\% (201/844) of users were annotated with buying intention, and 21.10\% (178/844) of users were annotated with selling intention. There were 34 users with buying/selling intention that self-reported as being <21 years old. (3) The most common key phrases used in selling threads were ``WTS,'' ``want to sell,'' ``for sale,'' and ``selling'' (154/214, 72.0\%). The most common key phrases used in buying threads were ``look for/get JUUL/pods'' (58/168, 34.5\%) and ``WTB'' (53/168, 31.5\%). (4) The most important concern that UnderageJuul Redditors had in obtaining JUULs was the price (311/1306, 23.81\%), followed by the delivery service (68/1306, 5.21\%). (5) The most popular flavors among the users with buying/selling intention were mango, cucumber, and mint. The flavor preferences remained consistent on both subreddits. Adverse symptoms related to the mango flavor were reported by 3 users on the JUUL subreddit. (6) In total, 24.4\% (49/201) of users wanted to buy JUULs and 46.6\% (83/178) of users wanted to sell JUULs, including 11 self-reported underage users, who also participated in the discussions on the JUUL subreddit. (7) Within one year of the UnderageJuul subreddit shutting down, there were 40 users who continued to post 186 threads on the JUUL subreddit, including 10 threads indicating buying/selling willingness that were posted shortly after the UnderageJuul subreddit was closed. Conclusions: There were overlapping users active in the JUUL and UnderageJuul subreddits. The buying/selling-related content appeared in multiple venues with certain posting patterns from July 9, 2017, to January 7, 2018. Such content might lead to a high risk of health problems for minors, such as nicotine addiction. Based on these findings, this study provided some insights and suggestions that might contribute to the decision-making processes of regulators and public health officials. ",
doi="10.2196/16962",
url="http://www.jmir.org/2020/7/e16962/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32706661"
}


@Article{info:doi/10.2196/20493,
author="Sesagiri Raamkumar, Aravind
and Tan, Guan Soon
and Wee, Lin Hwee",
title="Use of Health Belief Model--Based Deep Learning Classifiers for COVID-19 Social Media Content to Examine Public Perceptions of Physical Distancing: Model Development and Case Study",
journal="JMIR Public Health Surveill",
year="2020",
month="Jul",
day="14",
volume="6",
number="3",
pages="e20493",
keywords="health belief model",
keywords="physical distancing",
keywords="COVID-19",
keywords="text classification",
keywords="deep learning",
keywords="recurrent neural network",
keywords="social media",
abstract="Background: Public health authorities have been recommending interventions such as physical distancing and face masks, to curtail the transmission of coronavirus disease (COVID-19) within the community. Public perceptions toward such interventions should be identified to enable public health authorities to effectively address valid concerns. The Health Belief Model (HBM) has been used to characterize user-generated content from social media during previous outbreaks, with the aim of understanding the health behaviors of the public. Objective: This study is aimed at developing and evaluating deep learning--based text classification models for classifying social media content posted during the COVID-19 outbreak, using the four key constructs of the HBM. We will specifically focus on content related to the physical distancing interventions put forth by public health authorities. We intend to test the model with a real-world case study. Methods: The data set for this study was prepared by analyzing Facebook comments that were posted by the public in response to the COVID-19--related posts of three public health authorities: the Ministry of Health of Singapore (MOH), the Centers for Disease Control and Prevention, and Public Health England. The comments made in the context of physical distancing were manually classified with a Yes/No flag for each of the four HBM constructs: perceived severity, perceived susceptibility, perceived barriers, and perceived benefits. Using a curated data set of 16,752 comments, gated recurrent unit--based recurrent neural network models were trained and validated for text classification. Accuracy and binary cross-entropy loss were used to evaluate the model. Specificity, sensitivity, and balanced accuracy were used to evaluate the classification results in the MOH case study. Results: The HBM text classification models achieved mean accuracy rates of 0.92, 0.95, 0.91, and 0.94 for the constructs of perceived susceptibility, perceived severity, perceived benefits, and perceived barriers, respectively. In the case study with MOH Facebook comments, specificity was above 96\% for all HBM constructs. Sensitivity was 94.3\% and 90.9\% for perceived severity and perceived benefits, respectively. In addition, sensitivity was 79.6\% and 81.5\% for perceived susceptibility and perceived barriers, respectively. The classification models were able to accurately predict trends in the prevalence of the constructs for the time period examined in the case study. Conclusions: The deep learning--based text classifiers developed in this study help to determine public perceptions toward physical distancing, using the four key constructs of HBM. Health officials can make use of the classification model to characterize the health behaviors of the public through the lens of social media. In future studies, we intend to extend the model to study public perceptions of other important interventions by public health authorities. ",
doi="10.2196/20493",
url="https://publichealth.jmir.org/2020/3/e20493",
url="http://www.ncbi.nlm.nih.gov/pubmed/32540840"
}


@Article{info:doi/10.2196/16649,
author="Gao, Shuqing
and He, Lingnan
and Chen, Yue
and Li, Dan
and Lai, Kaisheng",
title="Public Perception of Artificial Intelligence in Medical Care: Content Analysis of Social Media",
journal="J Med Internet Res",
year="2020",
month="Jul",
day="13",
volume="22",
number="7",
pages="e16649",
keywords="artificial intelligence",
keywords="public perception",
keywords="social media",
keywords="content analysis",
keywords="medical care",
abstract="Background: High-quality medical resources are in high demand worldwide, and the application of artificial intelligence (AI) in medical care may help alleviate the crisis related to this shortage. The development of the medical AI industry depends to a certain extent on whether industry experts have a comprehensive understanding of the public's views on medical AI. Currently, the opinions of the general public on this matter remain unclear. Objective: The purpose of this study is to explore the public perception of AI in medical care through a content analysis of social media data, including specific topics that the public is concerned about; public attitudes toward AI in medical care and the reasons for them; and public opinion on whether AI can replace human doctors. Methods: Through an application programming interface, we collected a data set from the Sina Weibo platform comprising more than 16 million users throughout China by crawling all public posts from January to December 2017. Based on this data set, we identified 2315 posts related to AI in medical care and classified them through content analysis. Results: Among the 2315 identified posts, we found three types of AI topics discussed on the platform: (1) technology and application (n=987, 42.63\%), (2) industry development (n=706, 30.50\%), and (3) impact on society (n=622, 26.87\%). Out of 956 posts where public attitudes were expressed, 59.4\% (n=568), 34.4\% (n=329), and 6.2\% (n=59) of the posts expressed positive, neutral, and negative attitudes, respectively. The immaturity of AI technology (27/59, 46\%) and a distrust of related companies (n=15, 25\%) were the two main reasons for the negative attitudes. Across 200 posts that mentioned public attitudes toward replacing human doctors with AI, 47.5\% (n=95) and 32.5\% (n=65) of the posts expressed that AI would completely or partially replace human doctors, respectively. In comparison, 20.0\% (n=40) of the posts expressed that AI would not replace human doctors. Conclusions: Our findings indicate that people are most concerned about AI technology and applications. Generally, the majority of people held positive attitudes and believed that AI doctors would completely or partially replace human ones. Compared with previous studies on medical doctors, the general public has a more positive attitude toward medical AI. Lack of trust in AI and the absence of the humanistic care factor are essential reasons why some people still have a negative attitude toward medical AI. We suggest that practitioners may need to pay more attention to promoting the credibility of technology companies and meeting patients' emotional needs instead of focusing merely on technical issues. ",
doi="10.2196/16649",
url="http://www.jmir.org/2020/7/e16649/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32673231"
}


@Article{info:doi/10.2196/13954,
author="Buente, Wayne
and Dalisay, Francis
and Pokhrel, Pallav
and Kramer, Kurihara Hanae
and Pagano, Ian",
title="An Instagram-Based Study to Understand Betel Nut Use Culture in Micronesia: Exploratory Content Analysis",
journal="J Med Internet Res",
year="2020",
month="Jul",
day="9",
volume="22",
number="7",
pages="e13954",
keywords="betel nut",
keywords="areca catechu",
keywords="areca",
keywords="cancer",
keywords="health",
keywords="Guam",
keywords="Micronesia",
keywords="Instagram",
keywords="mobile phone",
keywords="culture",
abstract="Background: A 2012 World Health Organization report recognizes betel nut use as an urgent public health threat faced by the Western Pacific region. However, compared with other addictive substances, little is known about how betel nuts are depicted on social media platforms. In particular, image-based social media platforms can be powerful tools for health communication. Studying the content of substance use on visual social media may provide valuable insights into public health interventions. Objective: This study aimed to explore and document the ways that betel nut is portrayed on the photo-sharing site Instagram. The analysis focuses on the hashtag \#pugua, which refers to the local term for betel nut in Guam and other parts of Micronesia. Methods: An exploratory content analysis of 242 Instagram posts tagged \#pugua was conducted based on previous research on substance use and Instagram and betel nut practices in Micronesia. In addition, the study examined the social engagement of betel nut content on the image-based platform. Results: The study findings revealed content themes referencing the betel nut or betel nut tree, betel nut preparation practices, and the unique social and cultural context surrounding betel nut activity in Guam and Micronesia. In addition, certain practices and cultural themes encouraged social engagement on Instagram. Conclusions: The findings from this study emphasize the cultural relevance of betel nut use in Micronesia. These findings provide a basis for empirically testing hypotheses related to the etiological roles of cultural identity and pride in shaping betel nut use behavior among Micronesians, particularly youths and young adults. Such research is likely to inform the development of culturally relevant betel nut prevention and cessation programs. ",
doi="10.2196/13954",
url="https://www.jmir.org/2020/7/e13954",
url="http://www.ncbi.nlm.nih.gov/pubmed/32673220"
}


@Article{info:doi/10.2196/17338,
author="Green, M. Brian
and Van Horn, Tente Katelyn
and Gupte, Ketki
and Evans, Megan
and Hayes, Sara
and Bhowmick, Amrita",
title="Assessment of Adaptive Engagement and Support Model for People With Chronic Health Conditions in Online Health Communities: Combined Content Analysis",
journal="J Med Internet Res",
year="2020",
month="Jul",
day="7",
volume="22",
number="7",
pages="e17338",
keywords="social media",
keywords="social support",
keywords="health education",
keywords="qualitative research",
keywords="patient empowerment",
abstract="Background: With the pervasiveness of social media, online health communities (OHCs) are an important tool for facilitating information sharing and support among people with chronic health conditions. Importantly, OHCs offer insight into conversations about the lived experiences of people with particular health conditions. Little is known about the aspects of OHCs that are important to maintain safe and productive conversations that support health. Objective: This study aimed to assess the provision of social support and the role of active moderation in OHCs developed in accordance with and managed by an adaptive engagement model. This study also aimed to identify key elements of the model that are central to the development, maintenance, and adaptation of OHCs for people with chronic health conditions. Methods: This study used combined content analysis, a mixed methods approach, to analyze sampled Facebook post comments from 6 OHCs to understand how key aspects of the adaptive engagement model facilitate different types of social support. OHCs included in this study are for people living with multiple sclerosis, migraine, irritable bowel syndrome, rheumatoid arthritis, lung cancer, and prostate cancer. An exploratory approach was used in the analysis, and initial codes were grouped into thematic categories and then confirmed through thematic network analysis using the Dedoose qualitative analysis software tool. Thematic categories were compared for similarities and differences for each of the 6 OHCs and by topic discussed. Results: Data on the reach and engagement of the Facebook posts and the analysis of the sample of 5881 comments demonstrate that people with chronic health conditions want to engage on the web and find value in supporting and sharing their experiences with others. Most comments made in these Facebook posts were expressions of social support for others living with the same health condition (3405/5881, 57.89\%). Among the comments with an element of support, those where community members validated the knowledge or experiences of others were most frequent (1587/3405, 46.61\%), followed by the expression of empathy and understanding (1089/3405, 31.98\%). Even among posts with more factual content, such as insurance coverage issues, user comments still had frequent expressions of support for others (80/213, 37.5\%). Conclusions: The analysis of this OHC adaptive engagement model in action shows that the foundational elements---social support, engagement, and moderation---can effectively be used to provide a rich and dynamic community experience for individuals with chronic health conditions. Social support is demonstrated in a variety of ways, including sharing information or validating information shared by others, expressions of empathy, and sharing encouraging statements with others. ",
doi="10.2196/17338",
url="https://www.jmir.org/2020/7/e17338",
url="http://www.ncbi.nlm.nih.gov/pubmed/32492651"
}


@Article{info:doi/10.2196/17758,
author="Ram{\'i}rez-Cifuentes, Diana
and Freire, Ana
and Baeza-Yates, Ricardo
and Punt{\'i}, Joaquim
and Medina-Bravo, Pilar
and Velazquez, Alejandro Diego
and Gonfaus, Maria Josep
and Gonz{\`a}lez, Jordi",
title="Detection of Suicidal Ideation on Social Media: Multimodal, Relational, and Behavioral Analysis",
journal="J Med Internet Res",
year="2020",
month="Jul",
day="7",
volume="22",
number="7",
pages="e17758",
keywords="social media",
keywords="mental health",
keywords="suicidal ideation",
keywords="risk assessment",
keywords="machine learning",
abstract="Background: Suicide risk assessment usually involves an interaction between doctors and patients. However, a significant number of people with mental disorders receive no treatment for their condition due to the limited access to mental health care facilities; the reduced availability of clinicians; the lack of awareness; and stigma, neglect, and discrimination surrounding mental disorders. In contrast, internet access and social media usage have increased significantly, providing experts and patients with a means of communication that may contribute to the development of methods to detect mental health issues among social media users. Objective: This paper aimed to describe an approach for the suicide risk assessment of Spanish-speaking users on social media. We aimed to explore behavioral, relational, and multimodal data extracted from multiple social platforms and develop machine learning models to detect users at risk. Methods: We characterized users based on their writings, posting patterns, relations with other users, and images posted. Wealso evaluated statistical and deep learning approaches to handle multimodal data for the detection of users with signs of suicidalideation (suicidal ideation risk group). Our methods were evaluated over a dataset of 252 users annotated by clinicians. To evaluatethe performance of our models, we distinguished 2 control groups: users who make use of suicide-related vocabulary (focusedcontrol group) and generic random users (generic control group). Results: We identified significant statistical differences between the textual and behavioral attributes of each of the controlgroups compared with the suicidal ideation risk group. At a 95\% CI, when comparing the suicidal ideation risk group and thefocused control group, the number of friends (P=.04) and median tweet length (P=.04) were significantly different. The mediannumber of friends for a focused control user (median 578.5) was higher than that for a user at risk (median 372.0). Similarly, themedian tweet length was higher for focused control users, with 16 words against 13 words of suicidal ideation risk users. Ourfindings also show that the combination of textual, visual, relational, and behavioral data outperforms the accuracy of using eachmodality separately. We defined text-based baseline models based on bag of words and word embeddings, which were outperformedby our models, obtaining an increase in accuracy of up to 8\% when distinguishing users at risk from both types of control users. Conclusions: The types of attributes analyzed are significant for detecting users at risk, and their combination outperforms theresults provided by generic, exclusively text-based baseline models. After evaluating the contribution of image-based predictivemodels, we believe that our results can be improved by enhancing the models based on textual and relational features. Thesemethods can be extended and applied to different use cases related to other mental disorders. ",
doi="10.2196/17758",
url="https://www.jmir.org/2020/7/e17758",
url="http://www.ncbi.nlm.nih.gov/pubmed/32673256"
}


@Article{info:doi/10.2196/15607,
author="Bardus, Marco
and El Rassi, Rola
and Chahrour, Mohamad
and Akl, W. Elie
and Raslan, Sattar Abdul
and Meho, I. Lokman
and Akl, A. Elie",
title="The Use of Social Media to Increase the Impact of Health Research: Systematic Review",
journal="J Med Internet Res",
year="2020",
month="Jul",
day="6",
volume="22",
number="7",
pages="e15607",
keywords="social media",
keywords="research",
keywords="bibliometrics",
keywords="Altmetrics",
keywords="journal impact factor",
keywords="translational medical research",
abstract="Background: Academics in all disciplines increasingly use social media to share their publications on the internet, reaching out to different audiences. In the last few years, specific indicators of social media impact have been developed (eg, Altmetrics), to complement traditional bibliometric indicators (eg, citation count and h-index). In health research, it is unclear whether social media impact also translates into research impact. Objective: The primary aim of this study was to systematically review the literature on the impact of using social media on the dissemination of health research. The secondary aim was to assess the correlation between Altmetrics and traditional citation-based metrics. Methods: We conducted a systematic review to identify studies that evaluated the use of social media to disseminate research published in health-related journals. We specifically looked at studies that described experimental or correlational studies linking the use of social media with outcomes related to bibliometrics. We searched the Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica dataBASE (EMBASE), and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases using a predefined search strategy (International Prospective Register of Systematic Reviews: CRD42017057709). We conducted independent and duplicate study selection and data extraction. Given the heterogeneity of the included studies, we summarized the findings through a narrative synthesis. Results: Of a total of 18,624 retrieved citations, we included 51 studies: 7 (14\%) impact studies (answering the primary aim) and 44 (86\%) correlational studies (answering the secondary aim). Impact studies reported mixed results with several limitations, including the use of interventions of inappropriately low intensity and short duration. The majority of correlational studies suggested a positive association between traditional bibliometrics and social media metrics (eg, number of mentions) in health research. Conclusions: We have identified suggestive yet inconclusive evidence on the impact of using social media to increase the number of citations in health research. Further studies with better design are needed to assess the causal link between social media impact and bibliometrics. ",
doi="10.2196/15607",
url="https://www.jmir.org/2020/7/e15607",
url="http://www.ncbi.nlm.nih.gov/pubmed/32628113"
}


@Article{info:doi/10.2196/20472,
author="Campos-Castillo, Celeste
and Laestadius, I. Linnea",
title="Racial and Ethnic Digital Divides in Posting COVID-19 Content on Social Media Among US Adults: Secondary Survey Analysis",
journal="J Med Internet Res",
year="2020",
month="Jul",
day="3",
volume="22",
number="7",
pages="e20472",
keywords="COVID-19",
keywords="digital divides",
keywords="user characteristics",
keywords="race",
keywords="ethnicity",
keywords="algorithm bias",
keywords="social media",
keywords="bias",
keywords="surveillance",
keywords="public health",
abstract="Background: Public health surveillance experts are leveraging user-generated content on social media to track the spread and effects of COVID-19. However, racial and ethnic digital divides, which are disparities among people who have internet access and post on social media, can bias inferences. This bias is particularly problematic in the context of the COVID-19 pandemic because due to structural inequalities, members of racial and ethnic minority groups are disproportionately vulnerable to contracting the virus and to the deleterious economic and social effects from mitigation efforts. Further, important demographic intersections with race and ethnicity, such as gender and age, are rarely investigated in work characterizing social media users; however, they reflect additional axes of inequality shaping differential exposure to COVID-19 and its effects. Objective: The aim of this study was to characterize how the race and ethnicity of US adults are associated with their odds of posting COVID-19 content on social media and how gender and age modify these odds. Methods: We performed a secondary analysis of a survey conducted by the Pew Research Center from March 19 to 24, 2020, using a national probability sample (N=10,510). Respondents were recruited from an online panel, where panelists without an internet-enabled device were given one to keep at no cost. The binary dependent variable was responses to an item asking whether respondents ``used social media to share or post information about the coronavirus.'' We used survey-weighted logistic regressions to estimate the odds of responding in the affirmative based on the race and ethnicity of respondents (white, black, Latino, other race/ethnicity), adjusted for covariates measuring sociodemographic background and COVID-19 experiences. We examined how gender (female, male) and age (18 to 30 years, 31 to 50 years, 51 to 64 years, and 65 years and older) intersected with race and ethnicity by estimating interactions. Results: Respondents who identified as black (odds ratio [OR] 1.29, 95\% CI 1.02-1.64; P=.03), Latino (OR 1.66, 95\% CI 1.36-2.04; P<.001), or other races/ethnicities (OR 1.33, 95\% CI 1.02-1.72; P=.03) had higher odds than respondents who identified as white of reporting that they posted COVID-19 content on social media. Women had higher odds of posting than men regardless of race and ethnicity (OR 1.58, 95\% CI 1.39-1.80; P<.001). Among men, respondents who identified as black, Latino, or members of other races/ethnicities were significantly more likely to post than respondents who identified as white. Older adults (65 years or older) had significantly lower odds (OR 0.73, 95\% CI 0.57-0.94; P=.01) of posting compared to younger adults (18-29 years), particularly among those identifying as other races/ethnicities. Latino respondents were the most likely to report posting across all age groups. Conclusions: In the United States, members of racial and ethnic minority groups are most likely to contribute to COVID-19 content on social media, particularly among groups traditionally less likely to use social media (older adults and men). The next step is to ensure that data collection procedures capture this diversity by encompassing a breadth of search criteria and social media platforms. ",
doi="10.2196/20472",
url="https://www.jmir.org/2020/7/e20472",
url="http://www.ncbi.nlm.nih.gov/pubmed/32568726"
}


@Article{info:doi/10.2196/18441,
author="Myneni, Sahiti
and Lewis, Brittney
and Singh, Tavleen
and Paiva, Kristi
and Kim, Min Seon
and Cebula, V. Adrian
and Villanueva, Gloria
and Wang, Jing",
title="Diabetes Self-Management in the Age of Social Media: Large-Scale Analysis of Peer Interactions Using Semiautomated Methods",
journal="JMIR Med Inform",
year="2020",
month="Jun",
day="30",
volume="8",
number="6",
pages="e18441",
keywords="diabetes",
keywords="self-management",
keywords="social media",
keywords="digital health",
abstract="Background: Online communities have been gaining popularity as support venues for chronic disease management. User engagement, information exposure, and social influence mechanisms can play a significant role in the utility of these platforms. Objective: In this paper, we characterize peer interactions in an online community for chronic disease management. Our objective is to identify key communications and study their prevalence in online social interactions. Methods: The American Diabetes Association Online community is an online social network for diabetes self-management. We analyzed 80,481 randomly selected deidentified peer-to-peer messages from 1212 members, posted between June 1, 2012, and May 30, 2019. Our mixed methods approach comprised qualitative coding and automated text analysis to identify, visualize, and analyze content-specific communication patterns underlying diabetes self-management. Results: Qualitative analysis revealed that ``social support'' was the most prevalent theme (84.9\%), followed by ``readiness to change'' (18.8\%), ``teachable moments'' (14.7\%), ``pharmacotherapy'' (13.7\%), and ``progress'' (13.3\%). The support vector machine classifier resulted in reasonable accuracy with a recall of 0.76 and precision 0.78 and allowed us to extend our thematic codes to the entire data set. Conclusions: Modeling health-related communication through high throughput methods can enable the identification of specific content related to sustainable chronic disease management, which facilitates targeted health promotion. ",
doi="10.2196/18441",
url="https://medinform.jmir.org/2020/6/e18441",
url="http://www.ncbi.nlm.nih.gov/pubmed/32602843"
}


@Article{info:doi/10.2196/17073,
author="Black, C. Joshua
and Margolin, R. Zachary
and Olson, A. Richard
and Dart, C. Richard",
title="Online Conversation Monitoring to Understand the Opioid Epidemic: Epidemiological Surveillance Study",
journal="JMIR Public Health Surveill",
year="2020",
month="Jun",
day="29",
volume="6",
number="2",
pages="e17073",
keywords="epidemiological surveillance",
keywords="infoveillance",
keywords="infodemiology",
keywords="opioids",
keywords="social media",
keywords="misuse",
keywords="abuse",
keywords="addiction",
keywords="overdose",
keywords="death",
abstract="Background: Between 2016 and 2017, the national mortality rate involving opioids continued its escalation; opioid deaths rose from 42,249 to 47,600, bringing the public health crisis to a new height. Considering that 69\% of adults in the United States use online social media sites, a resource that builds a more complete understanding of prescription drug misuse and abuse could supplement traditional surveillance instruments. The Food and Drug Administration has identified 5 key risks and consequences of opioid drugs---misuse, abuse, addiction, overdose, and death. Identifying posts that discuss these key risks could lead to novel information that is not typically captured by traditional surveillance systems. Objective: The goal of this study was to describe the trends of online posts (frequency over time) involving abuse, misuse, addiction, overdose, and death in the United States and to describe the types of websites that host these discussions. Internet posts that mentioned fentanyl, hydrocodone, oxycodone, or oxymorphone were examined. Methods: Posts that did not refer to personal experiences were removed, after which 3.1 million posts remained. A stratified sample of 61,000 was selected. Unstructured data were classified into 5 key risks by manually coding for key outcomes of misuse, abuse, addiction, overdose, and death. Sampling probabilities of the coded posts were used to estimate the total post volume for each key risk. Results: Addiction and misuse were the two most commonly discussed key risks for hydrocodone, oxycodone, and oxymorphone. For fentanyl, overdose and death were the most discussed key risks. Fentanyl had the highest estimated number of misuse-, overdose-, and death-related mentions (41,808, 42,659, and 94,169, respectively). Oxycodone had the highest estimated number of abuse- and addiction-related mentions (3548 and 12,679, respectively). The estimated volume of online posts for fentanyl increased by more than 10-fold in late 2017 and 2018. The odds of discussing fentanyl overdose (odds ratios [OR] 4.32, 95\% CI 2.43-7.66) and death (OR 5.05, 95\% CI 3.10-8.21) were higher for social media, while the odds of discussing fentanyl abuse (OR 0.10, 95\% CI 0.04-0.22) and addiction (OR 0.24, 95\% CI 0.15-0.38) were higher for blogs and forums. Conclusions: Of the 5 FDA-defined key risks, fentanyl overdose and death has dominated discussion in recent years, while discussion of oxycodone, hydrocodone, and oxymorphone has decreased. As drug-related deaths continue to increase, an understanding of the motivations, circumstances, and consequences of drug abuse would assist in developing policy responses. Furthermore, content was notably different based on media origin, and studies that exclusively use either social media sites (such as Twitter) or blogs and forums could miss important content. This study sets out sustainable, ongoing methodology for surveilling internet postings regarding these drugs. ",
doi="10.2196/17073",
url="http://publichealth.jmir.org/2020/2/e17073/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32597786"
}


@Article{info:doi/10.2196/17570,
author="Valentine, Lee
and McEnery, Carla
and O'Sullivan, Shaunagh
and Gleeson, John
and Bendall, Sarah
and Alvarez-Jimenez, Mario",
title="Young People's Experience of a Long-Term Social Media--Based Intervention for First-Episode Psychosis: Qualitative Analysis",
journal="J Med Internet Res",
year="2020",
month="Jun",
day="26",
volume="22",
number="6",
pages="e17570",
keywords="social media",
keywords="social networking",
keywords="youth",
keywords="young adult",
keywords="psychotic disorders",
keywords="mHealth",
keywords="qualitative research",
abstract="Background: Digital mental health interventions present a unique opportunity to address the lack of social connection and loneliness experienced by young people with first-episode psychosis (FEP). The first generation of digital interventions, however, is associated with high attrition rates. Social media presents an opportunity to target this issue. A new generation of digital intervention has harnessed the popularity of social media to both promote engagement and foster social connectedness in youth mental health interventions. Despite their potential, little is known about how young people engage with, and experience, social media--based interventions as well as the optimal design, implementation, and management needed to ensure young people with psychosis receive benefit. Objective: This study aimed to explore how young people engage with, and experience, a long-term social media--based mental health intervention designed to address social functioning in individuals with FEP. Methods: This qualitative study was based on 12 interviews with young people who used Horyzons, a long-term social media--based mental health intervention, as part of a previous randomized controlled trial. A semistructured phenomenological interview guide with open-ended questions was used to explore young people's subjective experience of the intervention. All interviews were recorded and transcribed verbatim. Data were analyzed using interpretative phenomenological analysis. Results: A total of 4 superordinate themes emerged during the analysis including (1) shared experience as the catalyst for a cocreated social space, (2) the power of peer support, (3) an upbeat environment, and (4) experiences that interrupt being in Horyzons. Conclusions: We found that Horyzon's therapeutic social network fostered a connection and an understanding among young people. It also aided in the creation of an embodied experience that afforded young people with FEP a sense of self-recognition and belonging over the long term. However, although we found that most young people had strong positive experiences of a social connection on Horyzons, we also found that they experienced significant barriers that could substantively interrupt their ability to use the platform. We found that social anxiety, paranoia, internalized stigma, lack of autonomy, and social protocol confusion interfered with young people's usage of the platform. From a design perspective, digital interventions are flexible and thus equipped to begin addressing these implications by providing customizable and personalized treatment options that account for varying levels of social connection and psychological need that could otherwise interrupt young people's usage of social media--based interventions. ",
doi="10.2196/17570",
url="https://www.jmir.org/2020/6/e17570",
url="http://www.ncbi.nlm.nih.gov/pubmed/32384056"
}


@Article{info:doi/10.2196/17365,
author="Pan, Wenjing
and Feng, Bo
and Shen, Cuihua",
title="Examining Social Capital, Social Support, and Language Use in an Online Depression Forum: Social Network and Content Analysis",
journal="J Med Internet Res",
year="2020",
month="Jun",
day="24",
volume="22",
number="6",
pages="e17365",
keywords="social capital",
keywords="social support",
keywords="social network analysis",
keywords="computerized text analysis",
keywords="communication accommodation",
keywords="language style matching",
keywords="online support forums",
keywords="depression",
keywords="mental health",
abstract="Background: The use of peer-to-peer online support groups and communities has grown into a social phenomenon. Many people use online support groups and communities to seek and provide social support. It is essential to examine how users' participation behaviors may contribute to different outcomes. Objective: This study aimed to (1) use the structural positions of online depression forum users in their reply network to predict received support and (2) examine their language use reflecting their health conditions. Methods: A total of 2061 users and their 62,274 replies posted on a depression forum from July 2004 to July 2014 were extracted using a web crawler written in Python. The content of the forum users' posts and replies and their reply patterns were examined. A social network analysis method was used to build the reply networks of users. The computerized text analysis method was used to measure features of the forum users' language styles. Results: Forum users' bridging social capital (operationalized as network betweenness) was positively associated with the level of communication accommodation in their received replies (P=.04). Forum users' bonding social capital (operationalized as network constraint) was negatively associated with the level of communication accommodation in their received replies (P<.001). The forum users' change in their use of self-referent words and words expressing negative emotions were examined as linguistic proxies for their health conditions and mental states. The results revealed a general negative association between the number of received replies and the degree of decrease in the use of words expressing negative emotion (P=.007). Conclusions: The structural positions of online depression forum users in the reply network are associated with different participation outcomes in the users. Thus, receiving replies can be beneficial to online depression forum users. ",
doi="10.2196/17365",
url="https://www.jmir.org/2020/6/e17365",
url="http://www.ncbi.nlm.nih.gov/pubmed/32579125"
}


@Article{info:doi/10.2196/20712,
author="Berman, A. Claire
and Kacanek, Deborah
and Nichamin, Mindy
and Wilson, Dominique
and Davtyan, Mariam
and Salomon, Liz
and Patel, Kunjal
and Reznick, Megan
and Tassiopoulos, Katherine
and Lee, Sonia
and Bauermeister, Jose
and Paul, Mary
and Aldape, Theresa
and Seage III, R. George",
title="Using Social Media and Technology to Communicate in Pediatric HIV Research: Qualitative Study With Young Adults Living With or Exposed to Perinatal HIV",
journal="JMIR Pediatr Parent",
year="2020",
month="Jun",
day="23",
volume="3",
number="1",
pages="e20712",
keywords="pediatric HIV",
keywords="perinatal HIV",
keywords="youth",
keywords="young adults",
keywords="social media",
keywords="study retention",
keywords="COVID-19",
abstract="Background: As young adults living with perinatal HIV (PHIV) or perinatal HIV exposure but uninfected (PHEU) grow older and manage the challenges and competing demands of young adulthood, new approaches are needed to facilitate their retention in longitudinal research and clinical care beyond in-person clinic visits. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the novel virus that causes coronavirus disease (COVID-19), emerged in the United States in January 2020 and has underscored this need; studies are adapting to remote communication with and data collection from participants. However, there are limited data on communication preferences among young adults who are living with PHIV or PHEU. Objective: The objectives of this qualitative study were to describe participants' perceptions and use of social media and technology in their personal lives and in the context of participating in longitudinal pediatric HIV research and to describe the implications of the use of technology and social media for communication and retention purposes within a longitudinal pediatric study about HIV. Methods: We conducted 6 focus group discussions with 31 young adults living with PHIV and 13 in-depth interviews with 6 young adults living with PHIV and 7 living with PHEU. We asked about their preferences for the use of social media and digital technology in the Adolescent Master Protocol, a US-based longitudinal cohort study of youth affected by HIV. Results: Participants' willingness to use social media platforms, telephone calls, SMS text messages, and video calls within the context of HIV research varied due to fears of HIV stigma and inadvertent disclosure. However, trusting relationships with clinical staff positively impacted their willingness to use these platforms. Conclusions: Our findings offer insight into how pediatric studies and clinics can communicate with participants as they age, even as new technologies and social media platforms emerge and replace old ones. For optimal retention, pediatric clinical staff should consider communication approaches offering flexible and tailored options for young adults participating in HIV research. ",
doi="10.2196/20712",
url="http://pediatrics.jmir.org/2020/1/e20712/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32540839"
}


@Article{info:doi/10.2196/17650,
author="Li, Genghao
and Li, Bing
and Huang, Langlin
and Hou, Sibing",
title="Automatic Construction of a Depression-Domain Lexicon Based on Microblogs: Text Mining Study",
journal="JMIR Med Inform",
year="2020",
month="Jun",
day="23",
volume="8",
number="6",
pages="e17650",
keywords="depression detection",
keywords="depression diagnosis",
keywords="social media",
keywords="automatic construction",
keywords="domain-specific lexicon",
keywords="depression lexicon",
keywords="label propagation",
abstract="Background: According to a World Health Organization report in 2017, there was almost one patient with depression among every 20 people in China. However, the diagnosis of depression is usually difficult in terms of clinical detection owing to slow observation, high cost, and patient resistance. Meanwhile, with the rapid emergence of social networking sites, people tend to share their daily life and disclose inner feelings online frequently, making it possible to effectively identify mental conditions using the rich text information. There are many achievements regarding an English web-based corpus, but for research in China so far, the extraction of language features from web-related depression signals is still in a relatively primary stage. Objective: The purpose of this study was to propose an effective approach for constructing a depression-domain lexicon. This lexicon will contain language features that could help identify social media users who potentially have depression. Our study also compared the performance of detection with and without our lexicon. Methods: We autoconstructed a depression-domain lexicon using Word2Vec, a semantic relationship graph, and the label propagation algorithm. These two methods combined performed well in a specific corpus during construction. The lexicon was obtained based on 111,052 Weibo microblogs from 1868 users who were depressed or nondepressed. During depression detection, we considered six features, and we used five classification methods to test the detection performance. Results: The experiment results showed that in terms of the F1 value, our autoconstruction method performed 1\% to 6\% better than baseline approaches and was more effective and steadier. When applied to detection models like logistic regression and support vector machine, our lexicon helped the models outperform by 2\% to 9\% and was able to improve the final accuracy of potential depression detection. Conclusions: Our depression-domain lexicon was proven to be a meaningful input for classification algorithms, providing linguistic insights on the depressive status of test subjects. We believe that this lexicon will enhance early depression detection in people on social media. Future work will need to be carried out on a larger corpus and with more complex methods. ",
doi="10.2196/17650",
url="http://medinform.jmir.org/2020/6/e17650/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32574151"
}


@Article{info:doi/10.2196/17496,
author="Chen, Long
and Lu, Xinyi
and Yuan, Jianbo
and Luo, Joyce
and Luo, Jiebo
and Xie, Zidian
and Li, Dongmei",
title="A Social Media Study on the Associations of Flavored Electronic Cigarettes With Health Symptoms: Observational Study",
journal="J Med Internet Res",
year="2020",
month="Jun",
day="22",
volume="22",
number="6",
pages="e17496",
keywords="e-cigarette",
keywords="social media",
keywords="eHealth",
abstract="Background: In recent years, flavored electronic cigarettes (e-cigarettes) have become popular among teenagers and young adults. Discussions about e-cigarettes and e-cigarette use (vaping) experiences are prevalent online, making social media an ideal resource for understanding the health risks associated with e-cigarette flavors from the users' perspective. Objective: This study aimed to investigate the potential associations between electronic cigarette liquid (e-liquid) flavors and the reporting of health symptoms using social media data. Methods: A dataset consisting of 2.8 million e-cigarette--related posts was collected using keyword filtering from Reddit, a social media platform, from January 2013 to April 2019. Temporal analysis for nine major health symptom categories was used to understand the trend of public concerns related to e-cigarettes. Sentiment analysis was conducted to obtain the proportions of positive and negative sentiment scores for all reported health symptom categories. Topic modeling was applied to reveal the topics related to e-cigarettes and health symptoms. Furthermore, generalized estimating equation (GEE) models were used to quantitatively measure potential associations between e-liquid flavors and the reporting of health symptoms. Results: Temporal analysis showed that the Respiratory category was consistently the most discussed health symptom category among all categories related to e-cigarettes on Reddit, followed by the Throat category. Sentiment analysis showed higher proportions of positive sentiment scores for all reported health symptom categories, except for the Cancer category. Topic modeling conducted on all health-related posts showed that 17 of the top 100 topics were flavor related. GEE models showed different associations between the reporting of health symptoms and e-liquid flavor categories, for example, lower association of the Beverage flavors with Respiratory compared with other flavors and higher association of the Fruit flavors with Cardiovascular than other flavors. Conclusions: This study identified different potential associations between e-liquid flavors and the reporting of health symptoms using social media data. The results of this study provide valuable information for further investigation of the health effects associated with different e-liquid flavors. ",
doi="10.2196/17496",
url="http://www.jmir.org/2020/6/e17496/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32568093"
}


@Article{info:doi/10.2196/19276,
author="Wahbeh, Abdullah
and Nasralah, Tareq
and Al-Ramahi, Mohammad
and El-Gayar, Omar",
title="Mining Physicians' Opinions on Social Media to Obtain Insights Into COVID-19: Mixed Methods Analysis",
journal="JMIR Public Health Surveill",
year="2020",
month="Jun",
day="18",
volume="6",
number="2",
pages="e19276",
keywords="pandemic",
keywords="coronavirus",
keywords="COVID-19",
keywords="social media",
keywords="infodemiology",
keywords="infoveillance",
keywords="medical professionals",
keywords="opinion analysis",
abstract="Background: The coronavirus disease (COVID-19) pandemic is considered to be the most daunting public health challenge in decades. With no effective treatments and with time needed to develop a vaccine, alternative approaches are being used to control this pandemic. Objective: The objective of this paper was to identify topics, opinions, and recommendations about the COVID-19 pandemic discussed by medical professionals on the Twitter social medial platform. Methods: Using a mixed methods approach blending the capabilities of social media analytics and qualitative analysis, we analyzed COVID-19--related tweets posted by medical professionals and examined their content. We used qualitative analysis to explore the collected data to identify relevant tweets and uncover important concepts about the pandemic using qualitative coding. Unsupervised and supervised machine learning techniques and text analysis were used to identify topics and opinions. Results: Data were collected from 119 medical professionals on Twitter about the coronavirus pandemic. A total of 10,096 English tweets were collected from the identified medical professionals between December 1, 2019 and April 1, 2020. We identified eight topics, namely actions and recommendations, fighting misinformation, information and knowledge, the health care system, symptoms and illness, immunity, testing, and infection and transmission. The tweets mainly focused on needed actions and recommendations (2827/10,096, 28\%) to control the pandemic. Many tweets warned about misleading information (2019/10,096, 20\%) that could lead to infection of more people with the virus. Other tweets discussed general knowledge and information (911/10,096, 9\%) about the virus as well as concerns about the health care systems and workers (909/10,096, 9\%). The remaining tweets discussed information about symptoms associated with COVID-19 (810/10,096, 8\%), immunity (707/10,096, 7\%), testing (605/10,096, 6\%), and virus infection and transmission (503/10,096, 5\%). Conclusions: Our findings indicate that Twitter and social media platforms can help identify important and useful knowledge shared by medical professionals during a pandemic. ",
doi="10.2196/19276",
url="http://publichealth.jmir.org/2020/2/e19276/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32421686"
}


@Article{info:doi/10.2196/19981,
author="Tao, Zhuo-Ying
and Chu, Guang
and McGrath, Colman
and Hua, Fang
and Leung, Yan Yiu
and Yang, Wei-Fa
and Su, Yu-Xiong",
title="Nature and Diffusion of COVID-19--related Oral Health Information on Chinese Social Media: Analysis of Tweets on Weibo",
journal="J Med Internet Res",
year="2020",
month="Jun",
day="15",
volume="22",
number="6",
pages="e19981",
keywords="COVID-19",
keywords="dentistry",
keywords="oral health",
keywords="online health",
keywords="social media",
keywords="tweet",
keywords="Weibo",
keywords="China",
keywords="health information",
abstract="Background: Social media has become increasingly important as a source of information for the public and is widely used for health-related information. The outbreak of the coronavirus disease (COVID-19) has exerted a negative impact on dental practices. Objective: The aim of this study is to analyze the nature and diffusion of COVID-19--related oral health information on the Chinese social media site Weibo. Methods: A total of 15,900 tweets related to oral health and dentistry information from Weibo during the COVID-19 outbreak in China (December 31, 2019, to March 16, 2020) were included in our study. Two researchers coded 1000 of the total tweets in advance, and two main thematic categories with eight subtypes were refined. The included tweets were analyzed over time and geographic region, and coded into eight thematic categories. Additionally, the time distributions of tweets containing information about dental services, needs of dental treatment, and home oral care during the COVID-19 epidemic were further analyzed. Results: People reacted rapidly to the emerging severe acute respiratory syndrome coronavirus 2 threat to dental services, and a large amount of COVID-19--related oral health information was tweeted on Weibo. The time and geographic distribution of tweets shared similarities with epidemiological data of the COVID-19 outbreak in China. Tweets containing home oral care and dental services content were the most frequently exchanged information (n=4803/15,900, 30.20\% and n=4478, 28.16\%, respectively). Significant differences of public attention were found between various types of bloggers in dental services--related tweets (P<.001), and the tweets from the government and media engaged the most public attention. The distributions of tweets containing information about dental services, needs of dental treatment, and home oral care information dynamically changed with time. Conclusions: Our study overviewed and analyzed social media data on the dental services and oral health information during the COVID-19 epidemic, thus, providing insights for government organizations, media, and dental professionals to better facilitate oral health communication and efficiently shape public concern through social media when routine dental services are unavailable during an unprecedented event. The study of the nature and distribution of social media can serve as a useful adjunct tool to help make public health policies. ",
doi="10.2196/19981",
url="http://www.jmir.org/2020/6/e19981/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32501808"
}


@Article{info:doi/10.2196/16002,
author="Simeon, Rosiane
and Dewidar, Omar
and Trawin, Jessica
and Duench, Stephanie
and Manson, Heather
and Pardo Pardo, Jordi
and Petkovic, Jennifer
and Hatcher Roberts, Janet
and Tugwell, Peter
and Yoganathan, Manosila
and Presseau, Justin
and Welch, Vivian",
title="Behavior Change Techniques Included in Reports of Social Media Interventions for Promoting Health Behaviors in Adults: Content Analysis Within a Systematic Review",
journal="J Med Internet Res",
year="2020",
month="Jun",
day="11",
volume="22",
number="6",
pages="e16002",
keywords="health behavior",
keywords="taxonomy",
keywords="social media",
keywords="health promotion",
keywords="public health",
abstract="Background: Social media are an increasingly commonly used platform for delivering health promotion interventions. Although recent research has focused on the effectiveness of social media interventions for health promotion, very little is known about the optimal content within such interventions, and the active ingredients to promote health behavior change using social media are not clear. Identifying which behavior change techniques (BCTs) are reported may help to clarify the content of interventions using a generalizable terminology that may facilitate future intervention development. Objective: This study aimed to identify which BCTs are reported in social media interventions for promoting health behavior change in adults. Methods: We included 71 studies conducted with adult participants (aged ?18 years) and for which social media intervention was considered interactive in a Cochrane review of the effectiveness of such interventions. We developed a coding manual informed by the Behavior Change Technique Taxonomy version 1 (BCTTv1) to identify BCTs in the included studies. We identified BCTs in all study arms (including control) and described BCTs in the group and self-directed components of studies. We characterized the dose of delivery for each BCT by low and high intensity. We used descriptive analyses to characterize the reported BCTs. Results: Our data consisted of 71 studies published from 2001 to 2017, mainly conducted in high-income countries (n=65). Most studies (n=31) used tailored, interactive websites to deliver the intervention; Facebook was the most used mainstream platform. In developing our coding manual, we adapted some BCTTv1 instructions to better capture unique nuances of how BCTs were operationalized in social media with respect to likes, retweets, smiles, congratulations, and badges. Social support (unspecified), instruction on how to perform the behavior, and credible source were most frequently identified BCTs in intervention arms of studies and group-delivery settings, whereas instruction on how to perform the behavior was most commonly applied in self-directed components of studies, control arms, and individual participant settings. Instruction on how to perform the behavior was also the most frequently reported BCT in both intervention and control arms simultaneously. Instruction on how to perform the behavior, social support (unspecified), self-monitoring of behavior, information about health consequences, and credible source were identified in the top 5 BCTs delivered with the highest intensity. Conclusions: This study within a review provides a detailed description of the BCTs and their dose to promote behavior change in web-based, interactive social media interventions. Clarifying active ingredients in social media interventions and the intensity of their delivery may help to develop future interventions that can more clearly build upon the existing evidence. ",
doi="10.2196/16002",
url="http://www.jmir.org/2020/6/e16002/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32525482"
}


@Article{info:doi/10.2196/15973,
author="Khasawneh, Amro
and Chalil Madathil, Kapil
and Dixon, Emma
and Wi?niewski, Pamela
and Zinzow, Heidi
and Roth, Rebecca",
title="Examining the Self-Harm and Suicide Contagion Effects of the Blue Whale Challenge on YouTube and Twitter: Qualitative Study",
journal="JMIR Ment Health",
year="2020",
month="Jun",
day="5",
volume="7",
number="6",
pages="e15973",
keywords="suicide",
keywords="suicidal ideation",
keywords="self-mutilation",
keywords="mental health",
keywords="self-injurious behavior",
keywords="behavioral symptoms",
abstract="Background: Research suggests that direct exposure to suicidal behaviors and acts of self-harm through social media may increase suicidality through imitation and modeling, particularly in more vulnerable populations. One example of a social media phenomenon that demonstrates how self-harming behavior could potentially be propagated is the blue whale challenge. In this challenge, adolescents and young adults are encouraged to engage in self-harm and eventually kill themselves.  Objective: This paper aimed to investigate the way individuals portray the blue whale challenge on social media, with an emphasis on factors that could pose a risk to vulnerable populations. Methods: We first used a thematic analysis approach to code 60 publicly posted YouTube videos, 1112 comments on those videos, and 150 Twitter posts that explicitly referenced the blue whale challenge. We then deductively coded the YouTube videos based on the Suicide Prevention Resource Center (SPRC) safe messaging guidelines as a metric for the contagion risk associated with each video. Results: The thematic analysis revealed that social media users post about the blue whale challenge to raise awareness and discourage participation, express sorrow for the participants, criticize the participants, or describe a relevant experience. The deductive coding of the YouTube videos showed that most of the videos violated at least 50\% of the SPRC safe and effective messaging guidelines. Conclusions: These posts might have the problematic effect of normalizing the blue whale challenge through repeated exposure, modeling, and reinforcement of self-harming and suicidal behaviors, especially among vulnerable populations such as adolescents. More effort is needed to educate social media users and content generators on safe messaging guidelines and factors that encourage versus discourage contagion effects. ",
doi="10.2196/15973",
url="https://mental.jmir.org/2020/6/e15973",
url="http://www.ncbi.nlm.nih.gov/pubmed/32515741"
}


@Article{info:doi/10.2196/17184,
author="Oser, K. Tamara
and Oser, M. Sean
and Parascando, A. Jessica
and Grisolano, Ann Lee
and Krishna, Bangalore Kanthi
and Hale, E. Daniel
and Litchman, Michelle
and Majidi, Shideh
and Haidet, Paul",
title="Challenges and Successes in Raising a Child With Type 1 Diabetes and Autism Spectrum Disorder: Mixed Methods Study",
journal="J Med Internet Res",
year="2020",
month="Jun",
day="3",
volume="22",
number="6",
pages="e17184",
keywords="type 1 diabetes",
keywords="autism spectrum disorder",
keywords="child",
keywords="blogs",
keywords="social media",
keywords="qualitative research",
abstract="Background: Self-management of type 1 diabetes (T1D) requires numerous decisions and actions by people with T1D and their caregivers and poses many daily challenges. For those with T1D and a developmental disorder such as autism spectrum disorder (ASD), more complex challenges arise, though these remain largely unstudied. Objective: This study aimed to better understand the barriers and facilitators of raising a child with T1D and ASD. Secondary analysis of web-based content (phase 1) and telephone interviews (phase 2) were conducted to further expand the existing knowledge on the challenges and successes faced by these families. Methods: Phase 1 involved a qualitative analysis of publicly available online forums and blog posts by caregivers of children with both T1D and ASD. Themes from phase 1 were used to create an interview guide for further in-depth exploration via interviews. In phase 2, caregivers of children with both T1D and ASD were recruited from Penn State Health endocrinology clinics and through the web from social media posts to T1D-focused groups and sites. Interested respondents were directed to a secure web-based eligibility assessment. Information related to T1D and ASD diagnosis, contact information, and demographics were collected. On the basis of survey responses, participants were selected for a follow-up telephone interview and were asked to complete the adaptive behavior assessment system, third edition parent form to assess autism severity and upload a copy of their child's most recent hemoglobin A1c (HbA1c) result. Interviews were transcribed, imported into NVivo qualitative data management software, and analyzed to determine common themes related to barriers and facilitators of raising a child with both ASD and T1D. Results: For phase 1, 398 forum posts and blog posts between 2009 and 2016 were analyzed. Common themes related to a lack of understanding by the separate ASD and T1D caregiver communities, advice on coping techniques, rules and routines, and descriptions of the health care experience. For phase 2, 12 eligible respondents were interviewed. For interviewees, the average age of the child at diagnosis with T1D and ASD was 7.92 years and 5.55 years, respectively. Average self-reported and documented HbA1c levels for children with T1D and ASD were 8.6\% (70 mmol/mol) and 8.7\% (72 mmol/mol), respectively. Common themes from the interviews related to increased emotional burden, frustration surrounding the amount of information they are expected to learn, and challenges in the school setting. Conclusions: Caregivers of children with both T1D and ASD face unique challenges, distinct from those faced by caregivers of individuals who have either disorder alone. Understanding these challenges may help health care providers in caring for this unique population. Referral to the diabetes online community may be a potential resource to supplement the care received by the medical community. ",
doi="10.2196/17184",
url="https://www.jmir.org/2020/6/e17184",
url="http://www.ncbi.nlm.nih.gov/pubmed/32217508"
}


@Article{info:doi/10.2196/16772,
author="Chan, SY Windy
and Leung, YM Angela",
title="Facebook as a Novel Tool for Continuous Professional Education on Dementia: Pilot Randomized Controlled Trial",
journal="J Med Internet Res",
year="2020",
month="Jun",
day="2",
volume="22",
number="6",
pages="e16772",
keywords="dementia",
keywords="Facebook",
keywords="social network sites",
keywords="continuous professional education",
abstract="Background: Social network sites (SNSs) are widely exploited in health education and communication by the general public, including patients with various conditions. Nevertheless, there is an absence of evidence evaluating SNSs in connecting health professionals for professional purposes. Objective: This pilot randomized controlled trial was designed to evaluate the feasibility of an intervention aiming to investigate the effects of a continuous professional education program utilizing Facebook to obtain knowledge on dementia and care for patients with dementia. Methods: Eighty health professionals from Hong Kong were recruited for participation in the study and randomized at a 1:1 ratio by a block randomization method to the intervention group (n=40) and control group (n=40). The intervention was an 8-week educational program developed to deliver updated knowledge on dementia care from a multidisciplinary perspective, either by Facebook (intervention group) or by email (control group) from October 2018 to January 2019. The primary outcomes were the effects of the intervention, measured by differences in the means of changes in pre- and postintervention scores of knowledge assessments from the 25-item Dementia Knowledge Assessment Scale (DKAS) and formative evaluation of 20 multiple choice questions. Other outcome measurements included participant compliance, participant engagement in Facebook, satisfaction, and self-perceived uses of Facebook for continuing professional education programs. Results: Significantly more intervention group participants (n=35) completed the study than the control group (n=25) (P<.001). The overall retention rate was 75\% (60/80). The mean of changes in scores in the intervention group were significant in all assessments (P<.001). A significant difference in the mean of changes in scores between the two groups was identified in the DKAS subscale Communication and Behavior (95\% CI 0.4-3.3, P=.02). There was no significant difference in the total DKAS scores, scores of other DKAS subscales, and multiple choice questions. Participant compliance was significantly higher in the intervention group than in the control group (P<.001). The mean numbers of participants accessing the learning materials were 31.5 (SD 3.9) and 17.6 (SD 5.2) in the intervention and control group, respectively. Polls attracted the highest level of participant engagement, followed by videos. Intervention group participants scored significantly higher in favoring the use of Facebook for the continuing education program (P=.03). Overall, participants were satisfied with the interventions (mean score 4 of a total of 5, SD 0.6). Conclusions: The significantly higher retention rate, together with the high levels of participant compliance and engagement, demonstrate that Facebook is a promising tool for professional education. Education delivered through Facebook was significantly more effective at improving participants' knowledge of how people with dementia communicate and behave. Participants demonstrated positive attitudes toward utilizing Facebook for professional learning. These findings provide evidence for the feasibility of using Facebook as an intervention delivery tool in a manner that can be rolled out into practical settings. ",
doi="10.2196/16772",
url="https://www.jmir.org/2020/6/e16772",
url="http://www.ncbi.nlm.nih.gov/pubmed/32484441"
}


@Article{info:doi/10.2196/17224,
author="Rivas, Ryan
and Shahbazi, Moloud
and Garett, Renee
and Hristidis, Vagelis
and Young, Sean",
title="Mental Health--Related Behaviors and Discussions Among Young Adults: Analysis and Classification",
journal="J Med Internet Res",
year="2020",
month="May",
day="29",
volume="22",
number="5",
pages="e17224",
keywords="social media",
keywords="data analysis",
keywords="supervised machine learning",
keywords="universities",
keywords="students",
abstract="Background: There have been recurring reports of web-based harassment and abuse among adolescents and young adults through anonymous social networks. Objective: This study aimed to explore discussions on the popular anonymous social network Yik Yak related to social and mental health messaging behaviors among college students, including cyberbullying, to provide insights into mental health behaviors on college campuses. Methods: From April 6, 2016, to May 7, 2016, we collected anonymous conversations posted on Yik Yak at 19 universities in 4 different states and performed statistical analyses and text classification experiments on a subset of these messages. Results: We found that prosocial messages were 5.23 times more prevalent than bullying messages. The frequency of cyberbullying messages was positively associated with messages seeking emotional help. We found significant geographic variation in the frequency of messages offering supportive vs bullying messages. Across campuses, bullying and political discussions were positively associated. We also achieved a balanced accuracy of over 0.75 for most messaging behaviors and topics with a support vector machine classifier. Conclusions: Our results show that messages containing data about students' mental health--related attitudes and behaviors are prevalent on anonymous social networks, suggesting that these data can be mined for real-time analysis. This information can be used in education and health care services to better engage with students, provide insight into conversations that lead to cyberbullying, and reach out to students who need support. ",
doi="10.2196/17224",
url="http://www.jmir.org/2020/5/e17224/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32469317"
}


@Article{info:doi/10.2196/19273,
author="Chen, Emily
and Lerman, Kristina
and Ferrara, Emilio",
title="Tracking Social Media Discourse About the COVID-19 Pandemic: Development of a Public Coronavirus Twitter Data Set",
journal="JMIR Public Health Surveill",
year="2020",
month="May",
day="29",
volume="6",
number="2",
pages="e19273",
keywords="COVID-19",
keywords="SARS-CoV-2",
keywords="social media",
keywords="network analysis",
keywords="computational social sciences",
abstract="Background: At the time of this writing, the coronavirus disease (COVID-19) pandemic outbreak has already put tremendous strain on many countries' citizens, resources, and economies around the world. Social distancing measures, travel bans, self-quarantines, and business closures are changing the very fabric of societies worldwide. With people forced out of public spaces, much of the conversation about these phenomena now occurs online on social media platforms like Twitter. Objective: In this paper, we describe a multilingual COVID-19 Twitter data set that we are making available to the research community via our COVID-19-TweetIDs GitHub repository. Methods: We started this ongoing data collection on January 28, 2020, leveraging Twitter's streaming application programming interface (API) and Tweepy to follow certain keywords and accounts that were trending at the time data collection began. We used Twitter's search API to query for past tweets, resulting in the earliest tweets in our collection dating back to January 21, 2020. Results: Since the inception of our collection, we have actively maintained and updated our GitHub repository on a weekly basis. We have published over 123 million tweets, with over 60\% of the tweets in English. This paper also presents basic statistics that show that Twitter activity responds and reacts to COVID-19-related events. Conclusions: It is our hope that our contribution will enable the study of online conversation dynamics in the context of a planetary-scale epidemic outbreak of unprecedented proportions and implications. This data set could also help track COVID-19-related misinformation and unverified rumors or enable the understanding of fear and panic---and undoubtedly more. ",
doi="10.2196/19273",
url="http://publichealth.jmir.org/2020/2/e19273/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32427106"
}


@Article{info:doi/10.2196/16540,
author="Kerr, Hanna
and Booth, Richard
and Jackson, Kimberley",
title="Exploring the Characteristics and Behaviors of Nurses Who Have Attained Microcelebrity Status on Instagram: Content Analysis",
journal="J Med Internet Res",
year="2020",
month="May",
day="26",
volume="22",
number="5",
pages="e16540",
keywords="nursing",
keywords="social media",
keywords="professionalism",
keywords="microcelebrity",
keywords="Instagram",
keywords="policy",
keywords="influencer",
abstract="Background: Instagram is a social media platform that enables users to share images and videos worldwide. Some nurses have used Instagram to document their experiences as a nurse and have subsequently gained microcelebrity status---that is, a user who purposefully seeks to amass a substantive Web-based following and has become recognized as a niche area of interest. Objective: This study aimed to identify the characteristics and behaviors of microcelebrity nurses who act as influencers on Instagram and use their nursing profile to gain attention and presence on the Web. Methods: A qualitative, exploratory, nonparticipatory content analysis of media and text generated by a purposeful sample of 10 registered nurses who use Instagram and sustain a definable microcelebrity status was conducted. In this study, manifest and latent data were examined to gain an understanding of the characteristics and behaviors of nurses who have attained microcelebrity status on Instagram. Results: Data analysis revealed 5 themes of Instagram posts: (1) engaging Instagram users, (2) educational opportunities and insights, (3) nursing-related humor, (4) emotions experienced by nurses, and (5) media and narratives including patient details or work context. Messages were primarily positive in nature; however, multiple potential privacy, ethical, and professional issues were noted throughout the posted content. Conclusions: The findings of this study help to expand the current knowledge related to the use of social media platforms such as Instagram, especially in regard to the emergence of nurses who use this form of technology to achieve or maintain a microcelebrity status. This study calls for additional research on nurses' attainment of microcelebrity status on social media as well as further policy development to adequately prepare nurses to navigate social media. ",
doi="10.2196/16540",
url="http://www.jmir.org/2020/5/e16540/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32452809"
}


@Article{info:doi/10.2196/16902,
author="Ure, Cathy
and Cooper-Ryan, Mary Anna
and Condie, Jenna
and Galpin, Adam",
title="Exploring Strategies for Using Social Media to Self-Manage Health Care When Living With and Beyond Breast Cancer: In-Depth Qualitative Study",
journal="J Med Internet Res",
year="2020",
month="May",
day="25",
volume="22",
number="5",
pages="e16902",
keywords="breast cancer",
keywords="social media",
keywords="internet",
keywords="self-management",
keywords="psychosocial health",
keywords="survivorship",
abstract="Background: As breast cancer survival rates improve and structural health resources are increasingly being stretched, health providers require people living with and beyond breast cancer (LwBBC) to self-manage aspects of their care. Objective: This study aimed to explore how women use and experience social media to self-manage their psychosocial needs and support self-management across the breast cancer continuum. Methods: The experiences of 21 women (age range 27-64 years) were explored using an in-depth qualitative approach. The women varied in the duration of their experiences of LwBBC, which facilitated insights into how they evolve and change their self-management strategies over time. Semistructured interviews were analyzed inductively using a thematic analysis, a polytextual analysis, and voice-centered relational methods. Results: The use of multiple social media platforms, such as YouTube, Facebook, WhatsApp, and Twitter, enabled women to self-manage aspects of their care by satisfying needs for timely, relevant, and appropriate support, by navigating identities disrupted by diagnosis and treatment and by allowing them to (re)gain a sense of control. Women described extending their everyday use of multiple platforms to self-manage their care. However, women experienced social media as both empowering and dislocating, as their engagement was impacted by their everyday experiences of LwBBC. Conclusions: Health care professionals (HCPs) need to be more aware, and open to the possibilities, of women using multiple social media resources as self-management tools. It is important for HCPs to initiate value-free discussions and create the space necessary for women to share how social media resources support a tailored and timely self-managed approach to their unique psychosocial needs. ",
doi="10.2196/16902",
url="http://www.jmir.org/2020/5/e16902/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32364510"
}


@Article{info:doi/10.2196/19447,
author="Lwin, Oo May
and Lu, Jiahui
and Sheldenkar, Anita
and Schulz, Johannes Peter
and Shin, Wonsun
and Gupta, Raj
and Yang, Yinping",
title="Global Sentiments Surrounding the COVID-19 Pandemic on Twitter: Analysis of Twitter Trends",
journal="JMIR Public Health Surveill",
year="2020",
month="May",
day="22",
volume="6",
number="2",
pages="e19447",
keywords="COVID-19",
keywords="Twitter",
keywords="pandemic",
keywords="social sentiments",
keywords="emotions",
keywords="infodemic",
abstract="Background: With the World Health Organization's pandemic declaration and government-initiated actions against coronavirus disease (COVID-19), sentiments surrounding COVID-19 have evolved rapidly. Objective: This study aimed to examine worldwide trends of four emotions---fear, anger, sadness, and joy---and the narratives underlying those emotions during the COVID-19 pandemic. Methods: Over 20 million social media twitter posts made during the early phases of the COVID-19 outbreak from January 28 to April 9, 2020, were collected using ``wuhan,'' ``corona,'' ``nCov,'' and ``covid'' as search keywords. Results: Public emotions shifted strongly from fear to anger over the course of the pandemic, while sadness and joy also surfaced. Findings from word clouds suggest that fears around shortages of COVID-19 tests and medical supplies became increasingly widespread discussion points. Anger shifted from xenophobia at the beginning of the pandemic to discourse around the stay-at-home notices. Sadness was highlighted by the topics of losing friends and family members, while topics related to joy included words of gratitude and good health. Conclusions: Overall, global COVID-19 sentiments have shown rapid evolutions within just the span of a few weeks. Findings suggest that emotion-driven collective issues around shared public distress experiences of the COVID-19 pandemic are developing and include large-scale social isolation and the loss of human lives. The steady rise of societal concerns indicated by negative emotions needs to be monitored and controlled by complementing regular crisis communication with strategic public health communication that aims to balance public psychological wellbeing. ",
doi="10.2196/19447",
url="http://publichealth.jmir.org/2020/2/e19447/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32412418"
}


@Article{info:doi/10.2196/19334,
author="Sesagiri Raamkumar, Aravind
and Tan, Guan Soon
and Wee, Lin Hwee",
title="Measuring the Outreach Efforts of Public Health Authorities and the Public Response on Facebook During the COVID-19 Pandemic in Early 2020: Cross-Country Comparison",
journal="J Med Internet Res",
year="2020",
month="May",
day="19",
volume="22",
number="5",
pages="e19334",
keywords="COVID-19",
keywords="sentiment analysis",
keywords="emotion analysis",
keywords="public health authorities",
keywords="infectious disease",
keywords="outbreak",
keywords="public engagement",
keywords="social media",
keywords="public health",
keywords="virus",
abstract="Background: The coronavirus disease (COVID-19) pandemic presents one of the most challenging global crises at the dawn of a new decade. Public health authorities (PHAs) are increasingly adopting the use of social media such as Facebook to rapidly communicate and disseminate pandemic response measures to the public. Understanding of communication strategies across different PHAs and examining the public response on the social media landscapes can help improve practices for disseminating information to the public. Objective: This study aims to examine COVID-19-related outreach efforts of PHAs in Singapore, the United States, and England, and the corresponding public response to these outreach efforts on Facebook. Methods: Posts and comments from the Facebook pages of the Ministry of Health (MOH) in Singapore, the Centers for Disease Control and Prevention (CDC) in the United States, and Public Health England (PHE) in England were extracted from January 1, 2019, to March 18, 2020. Posts published before January 1, 2020, were categorized as pre-COVID-19, while the remaining posts were categorized as peri-COVID-19 posts. COVID-19-related posts were identified and classified into themes. Metrics used for measuring outreach and engagement were frequency, mean posts per day (PPD), mean reactions per post, mean shares per post, and mean comments per post. Responses to the COVID-19 posts were measured using frequency, mean sentiment polarity, positive to negative sentiments ratio (PNSR), and positive to negative emotions ratio (PNER). Toxicity in comments were identified and analyzed using frequency, mean likes per toxic comment, and mean replies per toxic comment. Trend analysis was performed to examine how the metrics varied with key events such as when COVID-19 was declared a pandemic. Results: The MOH published more COVID-19 posts (n=271; mean PPD 5.0) compared to the CDC (n=94; mean PPD 2.2) and PHE (n=45; mean PPD 1.4). The mean number of comments per COVID-19 post was highest for the CDC (mean CPP 255.3) compared to the MOH (mean CPP 15.6) and PHE (mean CPP 12.5). Six major themes were identified, with posts about prevention and safety measures and situation updates being prevalent across the three PHAs. The themes of the MOH's posts were diverse, while the CDC and PHE posts focused on a few themes. Overall, response sentiments for the MOH posts (PNSR 0.94) were more favorable compared to response sentiments for the CDC (PNSR 0.57) and PHE (PNSR 0.55) posts. Toxic comments were rare (0.01\%) across all PHAs. Conclusions: PHAs' extent of Facebook use for outreach purposes during the COVID-19 pandemic varied among the three PHAs, highlighting the strategies and approaches that other PHAs can potentially adopt. Our study showed that social media analysis was capable of providing insights about the communication strategies of PHAs during disease outbreaks. ",
doi="10.2196/19334",
url="http://www.jmir.org/2020/5/e19334/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32401219"
}


@Article{info:doi/10.2196/17741,
author="Linzey, R. Joseph
and Robertson, Faith
and Haider, S. Ali
and Graffeo, Salvatore Christopher
and Wang, Z. Justin
and Shasby, Gillian
and Alotaibi, M. Naif
and Cohen-Gadol, A. Aaron
and Rutka, T. James",
title="Online Impact and Presence of a Specialized Social Media Team for the Journal of Neurosurgery: Descriptive Analysis",
journal="J Med Internet Res",
year="2020",
month="May",
day="19",
volume="22",
number="5",
pages="e17741",
keywords="social media",
keywords="Twitter",
keywords="Facebook",
keywords="research dissemination",
abstract="Background: Social media use continues to gain momentum in academic neurosurgery. To increase journal impact and broaden engagement, many scholarly publications have turned to social media to disseminate research. The Journal of Neurosurgery Publishing Group (JNSPG) established a dedicated, specialized social media team (SMT) in November 2016 to provide targeted improvement in digital outreach. Objective: The goal of this study was to examine the impact of the JNSPG SMT as measured by increased engagement. Methods: We analyzed various metrics, including impressions, engagements, retweets, likes, profile clicks, and URL clicks, from consecutive social media posts from the JNSPG's Twitter and Facebook platforms between February 1, 2015 and February 28, 2019. Standard descriptive statistics were utilized. Results: Between February 2015 and October 2016, when a specialized SMT was created, 170 tweets (8.1 tweets/month) were posted compared to 3220 tweets (115.0 tweets/month) between November 2016 and February 2019. All metrics significantly increased, including the impressions per tweet (mean 1646.3, SD 934.9 vs mean 4605.6, SD 65,546.5; P=.01), engagements per tweet (mean 35.2, SD 40.6 vs mean 198.2, SD 1037.2; P<.001), retweets (mean 2.5, SD 2.8 vs mean 10.5, SD 15.3; P<.001), likes (mean 2.5, SD 4.0 vs mean 18.0, SD 37.9; P<.001), profile clicks (mean 1.5, SD 2.0 vs mean 5.2, SD 43.3; P<.001), and URL clicks (mean 13.1, SD 14.9 vs mean 38.3, SD 67.9; P<.001). Tweets that were posted on the weekend compared to weekdays had significantly more retweets (mean 9.2, SD 9.8 vs mean 13.4, SD 25.6; P<.001), likes (mean 15.3, SD 17.9 vs mean 23.7, SD 70.4; P=.001), and URL clicks (mean 33.4, SD 40.5 vs mean 49.5, SD 117.3; P<.001). Between November 2015 and October 2016, 49 Facebook posts (2.3 posts/month) were sent compared to 2282 posts (81.5 posts/month) sent between November 2016 and February 2019. All Facebook metrics significantly increased, including impressions (mean 5475.9, SD 5483.0 vs mean 8506.1, SD 13,113.9; P<.001), engagements (mean 119.3, SD 194.8 vs mean 283.8, SD 733.8; P<.001), and reach (mean 2266.6, SD 2388.3 vs mean 5344.1, SD 8399.2; P<.001). Weekend Facebook posts had significantly more impressions per post (mean 7967.9, SD 9901.0 vs mean 9737.8, SD 19,013.4; P=.03) and a higher total reach (mean 4975.8, SD 6309.8 vs mean 6108.2, SD 12,219.7; P=.03) than weekday posts. Conclusions: Social media has been established as a crucial tool for the propagation of neurosurgical research and education. Implementation of the JNSPG specialized SMT had a demonstrable impact on increasing the online visibility of social media content. ",
doi="10.2196/17741",
url="http://www.jmir.org/2020/5/e17741/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32163371"
}


@Article{info:doi/10.2196/19556,
author="Ahmad, Ramazan Araz
and Murad, Rasool Hersh",
title="The Impact of Social Media on Panic During the COVID-19 Pandemic in Iraqi Kurdistan: Online Questionnaire Study",
journal="J Med Internet Res",
year="2020",
month="May",
day="19",
volume="22",
number="5",
pages="e19556",
keywords="social media",
keywords="COVID-19",
keywords="infodemic",
keywords="panic",
keywords="mental health",
keywords="fake news",
keywords="misinformation",
keywords="impact",
keywords="Kurdistan region",
keywords="Iraq",
abstract="Background: In the first few months of 2020, information and news reports about the coronavirus disease (COVID-19) were rapidly published and shared on social media and social networking sites. While the field of infodemiology has studied information patterns on the Web and in social media for at least 18 years, the COVID-19 pandemic has been referred to as the first social media infodemic. However, there is limited evidence about whether and how the social media infodemic has spread panic and affected the mental health of social media users. Objective: The aim of this study is to determine how social media affects self-reported mental health and the spread of panic about COVID-19 in the Kurdistan Region of Iraq. Methods: To carry out this study, an online questionnaire was prepared and conducted in Iraqi Kurdistan, and a total of 516 social media users were sampled. This study deployed a content analysis method for data analysis. Correspondingly, data were analyzed using SPSS software. Results: Participants reported that social media has a significant impact on spreading fear and panic related to the COVID-19 outbreak in Iraqi Kurdistan, with a potential negative influence on people's mental health and psychological well-being. Facebook was the most used social media network for spreading panic about the COVID-19 outbreak in Iraq. We found a significant positive statistical correlation between self-reported social media use and the spread of panic related to COVID-19 (R=.8701). Our results showed that the majority of youths aged 18-35 years are facing psychological anxiety. Conclusions: During lockdown, people are using social media platforms to gain information about COVID-19. The nature of the impact of social media panic among people varies depending on an individual's gender, age, and level of education. Social media has played a key role in spreading anxiety about the COVID-19 outbreak in Iraqi Kurdistan. ",
doi="10.2196/19556",
url="http://www.jmir.org/2020/5/e19556/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32369026"
}


@Article{info:doi/10.2196/16688,
author="Bonar, E. Erin
and Schneeberger, M. Diane
and Bourque, Carrie
and Bauermeister, A. Jose
and Young, D. Sean
and Blow, C. Frederic
and Cunningham, M. Rebecca
and Bohnert, SB Amy
and Zimmerman, A. Marc
and Walton, A. Maureen",
title="Social Media Interventions for Risky Drinking Among Adolescents and Emerging Adults: Protocol for a Randomized Controlled Trial",
journal="JMIR Res Protoc",
year="2020",
month="May",
day="13",
volume="9",
number="5",
pages="e16688",
keywords="social media",
keywords="alcohol consumption",
keywords="adolescents",
keywords="emerging adults",
keywords="internet-based intervention",
abstract="Background: Despite intervention efforts to date, the prevalence of risky drinking among adolescents and emerging adults remains high, increasing the risk for health consequences and the development of alcohol use disorders. Peer influences are particularly salient among this age group, including via social media. Thus, the development of efficacious early interventions for youth, delivered with a broad reach via trained peers on social media, could have an important role in addressing risky drinking and concomitant drug use. Objective: This paper describes the protocol of a randomized controlled trial (RCT) testing the efficacy of a social media intervention among adolescents and emerging adults who meet the criteria for risky drinking (using the Alcohol Use Disorders Identification Test-Consumption [AUDIT-C]), delivered with and without financial incentives for participation, compared with an attention placebo control condition (ie, entertaining social media content), on alcohol consumption and consequences. Methods: This RCT involved recruiting 955 youths (aged 16-24 years) via advertisements on Facebook and Instagram to self-administer a brief web-based screening survey. Those screening positive for past 3-month risky drinking (AUDIT-C positive: ages 16-17 years: ?3 females and ?4 males; and ages 18-24 years: ?4 females and ?5 males) were eligible for the RCT. After providing consent (a waiver of parental consent was obtained for minors), participants completed a web-based baseline survey and several verification procedures, including a selfie photo matched to Facebook profile photos. Participants were then randomized to join invitation-only secret Facebook groups, which were not searchable or viewable by parents, friends, or anyone not recruited by the study. The 3 conditions were social media intervention with incentives, social media intervention without incentives (SMI), and attention placebo control. Each condition lasted 8 weeks and consisted of bachelor's-level and master's-level therapist electronic coaches posting relevant content and responding to participants' posts in a manner consistent with Motivational Interviewing. Participants in the control condition and SMI condition did not receive payments but were blind to condition assignment between these 2 conditions. Follow-ups are ongoing and occur at 3, 6, and 12 months poststart of the groups. Results: We enrolled 955 participants over 10 waves of recruitment who screened positive for risky drinking into the RCT. Conclusions: The findings of this study will provide the critical next step in delivering early alcohol interventions to the youth, capitalizing on social media platforms, which could have significant public health impact by altering alcohol use trajectories of adolescents and emerging adults engaged in risky drinking. Trial Registration: ClinicalTrials.gov NCT02809586; https://clinicaltrials.gov/ct2/show/NCT02809586. International Registered Report Identifier (IRRID): DERR1-10.2196/16688 ",
doi="10.2196/16688",
url="https://www.researchprotocols.org/2020/5/e16688",
url="http://www.ncbi.nlm.nih.gov/pubmed/32401225"
}


@Article{info:doi/10.2196/19301,
author="Budhwani, Henna
and Sun, Ruoyan",
title="Creating COVID-19 Stigma by Referencing the Novel Coronavirus as the ``Chinese virus'' on Twitter: Quantitative Analysis of Social Media Data",
journal="J Med Internet Res",
year="2020",
month="May",
day="6",
volume="22",
number="5",
pages="e19301",
keywords="COVID-19",
keywords="coronavirus",
keywords="Twitter",
keywords="stigma",
keywords="social media",
keywords="public health",
abstract="Background: Stigma is the deleterious, structural force that devalues members of groups that hold undesirable characteristics. Since stigma is created and reinforced by society---through in-person and online social interactions---referencing the novel coronavirus as the ``Chinese virus'' or ``China virus'' has the potential to create and perpetuate stigma. Objective: The aim of this study was to assess if there was an increase in the prevalence and frequency of the phrases ``Chinese virus'' and ``China virus'' on Twitter after the March 16, 2020, US presidential reference of this term. Methods: Using the Sysomos software (Sysomos, Inc), we extracted tweets from the United States using a list of keywords that were derivatives of ``Chinese virus.'' We compared tweets at the national and state levels posted between March 9 and March 15 (preperiod) with those posted between March 19 and March 25 (postperiod). We used Stata 16 (StataCorp) for quantitative analysis, and Python (Python Software Foundation) to plot a state-level heat map. Results: A total of 16,535 ``Chinese virus'' or ``China virus'' tweets were identified in the preperiod, and 177,327 tweets were identified in the postperiod, illustrating a nearly ten-fold increase at the national level. All 50 states witnessed an increase in the number of tweets exclusively mentioning ``Chinese virus'' or ``China virus'' instead of coronavirus disease (COVID-19) or coronavirus. On average, 0.38 tweets referencing ``Chinese virus'' or ``China virus'' were posted per 10,000 people at the state level in the preperiod, and 4.08 of these stigmatizing tweets were posted in the postperiod, also indicating a ten-fold increase. The 5 states with the highest number of postperiod ``Chinese virus'' tweets were Pennsylvania (n=5249), New York (n=11,754), Florida (n=13,070), Texas (n=14,861), and California (n=19,442). Adjusting for population size, the 5 states with the highest prevalence of postperiod ``Chinese virus'' tweets were Arizona (5.85), New York (6.04), Florida (6.09), Nevada (7.72), and Wyoming (8.76). The 5 states with the largest increase in pre- to postperiod ``Chinese virus'' tweets were Kansas (n=697/58, 1202\%), South Dakota (n=185/15, 1233\%), Mississippi (n=749/54, 1387\%), New Hampshire (n=582/41, 1420\%), and Idaho (n=670/46, 1457\%). Conclusions: The rise in tweets referencing ``Chinese virus'' or ``China virus,'' along with the content of these tweets, indicate that knowledge translation may be occurring online and COVID-19 stigma is likely being perpetuated on Twitter. ",
doi="10.2196/19301",
url="http://www.jmir.org/2020/5/e19301/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32343669"
}


@Article{info:doi/10.2196/18897,
author="Park, Woo Han
and Park, Sejung
and Chong, Miyoung",
title="Conversations and Medical News Frames on Twitter: Infodemiological Study on COVID-19 in South Korea",
journal="J Med Internet Res",
year="2020",
month="May",
day="5",
volume="22",
number="5",
pages="e18897",
keywords="infodemiology",
keywords="COVID-19",
keywords="SARS-CoV-2",
keywords="coronavirus",
keywords="Twitter",
keywords="South Korea",
keywords="medical news",
keywords="social media",
keywords="pandemic",
keywords="outbreak",
keywords="infectious disease",
keywords="public health",
abstract="Background: SARS-CoV-2 (severe acute respiratory coronavirus 2) was spreading rapidly in South Korea at the end of February 2020 following its initial outbreak in China, making Korea the new center of global attention. The role of social media amid the current coronavirus disease (COVID-19) pandemic has often been criticized, but little systematic research has been conducted on this issue. Social media functions as a convenient source of information in pandemic situations. Objective: Few infodemiology studies have applied network analysis in conjunction with content analysis. This study investigates information transmission networks and news-sharing behaviors regarding COVID-19 on Twitter in Korea. The real time aggregation of social media data can serve as a starting point for designing strategic messages for health campaigns and establishing an effective communication system during this outbreak. Methods: Korean COVID-19-related Twitter data were collected on February 29, 2020. Our final sample comprised of 43,832 users and 78,233 relationships on Twitter. We generated four networks in terms of key issues regarding COVID-19 in Korea. This study comparatively investigates how COVID-19-related issues have circulated on Twitter through network analysis. Next, we classified top news channels shared via tweets. Lastly, we conducted a content analysis of news frames used in the top-shared sources. Results: The network analysis suggests that the spread of information was faster in the Coronavirus network than in the other networks (Corona19, Shincheon, and Daegu). People who used the word ``Coronavirus'' communicated more frequently with each other. The spread of information was faster, and the diameter value was lower than for those who used other terms. Many of the news items highlighted the positive roles being played by individuals and groups, directing readers' attention to the crisis. Ethical issues such as deviant behavior among the population and an entertainment frame highlighting celebrity donations also emerged often. There was a significant difference in the use of nonportal (n=14) and portal news (n=26) sites between the four network types. The news frames used in the top sources were similar across the networks (P=.89, 95\% CI 0.004-0.006). Tweets containing medically framed news articles (mean 7.571, SD 1.988) were found to be more popular than tweets that included news articles adopting nonmedical frames (mean 5.060, SD 2.904; N=40, P=.03, 95\% CI 0.169-4.852). Conclusions: Most of the popular news on Twitter had nonmedical frames. Nevertheless, the spillover effect of the news articles that delivered medical information about COVID-19 was greater than that of news with nonmedical frames. Social media network analytics cannot replace the work of public health officials; however, monitoring public conversations and media news that propagates rapidly can assist public health professionals in their complex and fast-paced decision-making processes. ",
doi="10.2196/18897",
url="http://www.jmir.org/2020/5/e18897/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32325426"
}


@Article{info:doi/10.2196/14940,
author="Liu, Xingyun
and Huang, Jiasheng
and Yu, Xiaonan Nancy
and Li, Qing
and Zhu, Tingshao",
title="Mediation Effect of Suicide-Related Social Media Use Behaviors on the Association Between Suicidal Ideation and Suicide Attempt: Cross-Sectional Questionnaire Study",
journal="J Med Internet Res",
year="2020",
month="Apr",
day="28",
volume="22",
number="4",
pages="e14940",
keywords="suicidal ideation",
keywords="suicide",
keywords="attempted",
keywords="social media",
keywords="suicide-related social media use behaviors",
abstract="Background: A limited number of studies have examined the differences in suicide-related social media use behaviors between suicide ideators and suicide attempters or have sought to elucidate how these social media usage behaviors contributed to the transition from suicidal ideation to suicide attempt. Objective: Suicide attempts can be acquired through suicide-related social media use behaviors. This study aimed to propose 3 suicide-related social media use behaviors (ie, attending to suicide information, commenting on or reposting suicide information, or talking about suicide) based on social cognitive theory, which proposes that successive processes governing behavior transition include attentional, retention, production, and motivational processes. Methods: We aimed to examine the mediating role of suicide-related social media use behaviors in Chinese social media users with suicidal risks. A sample of 569 Chinese social media users with suicidal ideation completed measures on suicidal ideation, suicide attempt, and suicide-related social media use behaviors. Results: The results demonstrated that suicide attempters showed a significantly higher level of suicidal ideation (t563.64=5.04; P<.001; two-tailed) and more suicide-related social media use behaviors, which included attending to suicide information (t567=1.94; P=.05; two-tailed), commenting on or reposting suicide information (t567=2.12; P=.03; two-tailed), or talking about suicide (t542.22=5.12; P<.001; two-tailed). Suicidal ideation also affected suicide attempts through the mediational chains. Conclusions: Our findings thus support the social cognitive theory, and there are implications for population-based suicide prevention that can be achieved by identifying behavioral signals. ",
doi="10.2196/14940",
url="http://www.jmir.org/2020/4/e14940/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32343249"
}


@Article{info:doi/10.2196/14209,
author="Elnaggar, Abdelaziz
and Ta Park, Van
and Lee, J. Sei
and Bender, Melinda
and Siegmund, Anne Lee
and Park, G. Linda",
title="Patients' Use of Social Media for Diabetes Self-Care: Systematic Review",
journal="J Med Internet Res",
year="2020",
month="Apr",
day="24",
volume="22",
number="4",
pages="e14209",
keywords="social media",
keywords="diabetes mellitus",
keywords="peer group",
keywords="self-care",
keywords="systematic review",
abstract="Background: Patient engagement with diabetes self-care is critical to reducing morbidity and mortality. Social media is one form of digital health that is available for diabetes self-care, although its use for peer-to-peer communication has not been systematically described, and its potential to support patient self-care is unclear. Objective: The primary aim of this systematic review was to describe the use of social media among patients (peer-to-peer) to manage diabetes and cardiovascular disease (CVD). The secondary aim was to assess patients' clinical outcomes, behavioral outcomes, quality of life, and self-efficacy resulting from peer-to-peer social media use. Methods: We conducted a literature search in the following databases: PubMed, EMBASE, Web of Science, CINAHL, and PsycINFO (January 2008 through April 2019). The inclusion criteria were quantitative studies that included peer-to-peer use of social media for self-care of diabetes mellitus (with all subtypes) and CVD, including stroke. Results: After an initial yield of 3066 citations, we selected 91 articles for a full-text review and identified 7 papers that met our inclusion criteria. Of these, 4 studies focused on type 1 diabetes, 1 study included both type 1 and 2 diabetes, and 2 studies included multiple chronic conditions (eg, CVD, diabetes, depression, etc). Our search did not yield any individual studies on CVD alone. Among the selected papers, 2 studies used commercial platforms (Facebook and I Seek You), 3 studies used discussion forums developed specifically for each study, and 2 surveyed patients through different platforms or blogs. There was significant heterogeneity in the study designs, methodologies, and outcomes applied, but all studies showed favorable results on either primary or secondary outcomes. The quality of studies was highly variable. Conclusions: The future landscape of social media use for patient self-care is promising. However, current use is nascent. Our extensive search yielded only 7 studies, all of which included diabetes, indicating the most interest and demand for peer-to-peer interaction on diabetes self-care. Future research is needed to establish efficacy and safety in recommending social media use among peers for diabetes self-care and other conditions. ",
doi="10.2196/14209",
url="http://www.jmir.org/2020/4/e14209/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32329745"
}


@Article{info:doi/10.2196/17165,
author="Kerr, Bradley
and D'Angelo, D. Jon
and Diaz-Caballero, Ali
and Moreno, A. Megan",
title="College Student Problematic Internet Use and Digital Communication Medium Used With Parents: Cross-Sectional Study",
journal="JMIR Pediatr Parent",
year="2020",
month="Apr",
day="23",
volume="3",
number="1",
pages="e17165",
keywords="parents",
keywords="young adults",
keywords="social media",
abstract="Background: Problematic internet use (PIU) is associated with mental health concerns such as depression and affects more than 12\% of young adults. Few studies have explored potential influences of parent--college student digital communication on college students' risk of PIU. Objective: This study sought to understand the relationship between parent--college student digital communication frequency via phone calls, text messages, and Facebook contacts and PIU among college students. Methods: Incoming first-year students were randomly selected from registrar lists of a midwestern and northwestern university for a 5-year longitudinal study. Data from interviews conducted in summer 2014 were used. Measures included participants' daily Facebook visits, communication frequency with parents via phone call and text message, and 3 variables related to Facebook connection status and communication: (1) parent--college student Facebook friendship status, (2) college student blocking personal Facebook content from parent, and (3) Facebook communication frequency. PIU risk was assessed using the Problematic and Risky Internet Use Screening Scale. Analysis included participants who reported visiting Facebook at least once per day. Multiple linear regression was used, followed by a post hoc mediation with Hayes process macro to further investigate predictive relationships among significant variables. Results: A total of 151 participants reported daily Facebook use and were included in analyses. Among these participants, 59.6\% (90/151) were female, 62.3\% (94/151) were from the midwestern university, and 78.8\% (119/151) were white. Mean Facebook visits per day was 4.3 (SD 3.34). There was a collective significant effect between participant daily Facebook visits, college student--parent phone calls, texts, and all 3 Facebook connection variables (F6,144=2.60, P=.02, R2=.10). Phone calls, text messages, and Facebook contacts were not associated with PIU risk. However, two individual items were significant predictors for PIU: participant daily Facebook visits were positively associated with increased PIU risk (b=0.04, P=.006) and being friends with a parent on Facebook was negatively associated with PIU risk (b=--0.66, P=.008). Participant daily Facebook visits were not a significant mediator of the relationship between college student--parent Facebook friendship and PIU risk (b=--0.04; 95\% CI --0.11 to 0.04). Conclusions: This study did not find support for a relationship between parent--college student digital communication frequency and PIU among college students. Instead, results suggested Facebook friendship may be a protective factor. Future studies should examine how a parent-child Facebook friendship might protect against PIU among children at varying developmental stages. ",
doi="10.2196/17165",
url="http://pediatrics.jmir.org/2020/1/e17165/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32324140"
}


@Article{info:doi/10.2196/18558,
author="Bjornestad, Jone
and Moltu, Christian
and Veseth, Marius
and Tjora, Tore",
title="Rethinking Social Interaction: Empirical Model Development",
journal="J Med Internet Res",
year="2020",
month="Apr",
day="23",
volume="22",
number="4",
pages="e18558",
keywords="social interaction",
keywords="social functioning",
keywords="social media",
keywords="model",
keywords="empirical",
keywords="adolescence",
keywords="health science",
abstract="Background: Social media is an integral part of human social life. More than 90\% of young people use social media daily. Current theories, models, and measures are primarily based on face-to-face conceptions, leaving research out of sync with current social trends. This may lead to imprecise diagnoses and predictions. Objective: To develop a theoretically based empirical model of current social interfaces to inform relevant measures. Methods: A three-stage, qualitative, data-collection approach included anonymous individual Post-it notes, three full-class discussions, and 10 focus groups to explore 82 adolescents' relational practices. Data analysis followed a meaning-condensation procedure and a field-correspondence technique. Results: We developed an empirical model that categorizes adolescents' social interactions into five experiential positions. Four positions result from trajectories relating to social media and face-to-face social interaction. Positions are described by match or mismatch dynamics between preferred and actual social platforms used. In matched positions, individuals prefer and use both face-to-face and social media platforms (position 1), prefer and use face-to-face platforms (position 2), or prefer and use social media platforms (position 3). In mismatched positions, individuals prefer face-to-face interactions but use social media platforms (position 4) or prefer social media but use face-to-face platforms (position 5). We propose that matched positions indicate good social functioning while mismatched positions indicate serious social challenges. Conclusions: We propose a model that will expand previous unidimensional social interaction constructs, and we hypothesize that the described match and mismatch analyses provide conceptual clarity for research and practical application. We discuss prediction value, implications, and model validation procedures. ",
doi="10.2196/18558",
url="http://www.jmir.org/2020/4/e18558/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32324144"
}


@Article{info:doi/10.2196/18700,
author="Li, Jiawei
and Xu, Qing
and Cuomo, Raphael
and Purushothaman, Vidya
and Mackey, Tim",
title="Data Mining and Content Analysis of the Chinese Social Media Platform Weibo During the Early COVID-19 Outbreak: Retrospective Observational Infoveillance Study",
journal="JMIR Public Health Surveill",
year="2020",
month="Apr",
day="21",
volume="6",
number="2",
pages="e18700",
keywords="COVID-19",
keywords="coronavirus",
keywords="infectious disease",
keywords="social media, surveillance",
keywords="infoveillance",
keywords="infodemiology",
abstract="Background: The coronavirus disease (COVID-19) pandemic, which began in Wuhan, China in December 2019, is rapidly spreading worldwide with over 1.9 million cases as of mid-April 2020. Infoveillance approaches using social media can help characterize disease distribution and public knowledge, attitudes, and behaviors critical to the early stages of an outbreak. Objective: The aim of this study is to conduct a quantitative and qualitative assessment of Chinese social media posts originating in Wuhan City on the Chinese microblogging platform Weibo during the early stages of the COVID-19 outbreak. Methods: Chinese-language messages from Wuhan were collected for 39 days between December 23, 2019, and January 30, 2020, on Weibo. For quantitative analysis, the total daily cases of COVID-19 in Wuhan were obtained from the Chinese National Health Commission, and a linear regression model was used to determine if Weibo COVID-19 posts were predictive of the number of cases reported. Qualitative content analysis and an inductive manual coding approach were used to identify parent classifications of news and user-generated COVID-19 topics. Results: A total of 115,299 Weibo posts were collected during the study time frame consisting of an average of 2956 posts per day (minimum 0, maximum 13,587). Quantitative analysis found a positive correlation between the number of Weibo posts and the number of reported cases from Wuhan, with approximately 10 more COVID-19 cases per 40 social media posts (P<.001). This effect size was also larger than what was observed for the rest of China excluding Hubei Province (where Wuhan is the capital city) and held when comparing the number of Weibo posts to the incidence proportion of cases in Hubei Province. Qualitative analysis of 11,893 posts during the first 21 days of the study period with COVID-19-related posts uncovered four parent classifications including Weibo discussions about the causative agent of the disease, changing epidemiological characteristics of the outbreak, public reaction to outbreak control and response measures, and other topics. Generally, these themes also exhibited public uncertainty and changing knowledge and attitudes about COVID-19, including posts exhibiting both protective and higher-risk behaviors. Conclusions: The results of this study provide initial insight into the origins of the COVID-19 outbreak based on quantitative and qualitative analysis of Chinese social media data at the initial epicenter in Wuhan City. Future studies should continue to explore the utility of social media data to predict COVID-19 disease severity, measure public reaction and behavior, and evaluate effectiveness of outbreak communication. ",
doi="10.2196/18700",
url="http://publichealth.jmir.org/2020/2/e18700/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32293582"
}


@Article{info:doi/10.2196/19145,
author="Basch, E. Charles
and Basch, H. Corey
and Hillyer, C. Grace
and Jaime, Christie",
title="The Role of YouTube and the Entertainment Industry in Saving Lives by Educating and Mobilizing the Public to Adopt Behaviors for Community Mitigation of COVID-19: Successive Sampling Design Study",
journal="JMIR Public Health Surveill",
year="2020",
month="Apr",
day="21",
volume="6",
number="2",
pages="e19145",
keywords="YouTube",
keywords="COVID-19",
keywords="social media",
keywords="pandemic",
keywords="outbreak",
keywords="infectious disease",
keywords="public health",
keywords="prevention",
abstract="Background: Effective community mitigation through voluntary behavior change is currently the best way to reduce mortality caused by coronavirus disease (COVID-19). This study builds on our prior study based on the scientific premise that YouTube is one of the most effective ways to communicate and mobilize the public in community mitigation to reduce exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Objective: Because of the rapidly changing nature of YouTube in the context of the COVID-19 pandemic, we conducted a follow-up study to document how coverage of preventive behaviors for effective community mitigation has changed. Methods: A successive sampling design was used to compare coverage of behaviors to mitigate community transmission of COVID-19 in the 100 most widely viewed YouTube videos in January 2020 and March 2020. Results: Videos in the January and March samples were viewed >125 million times and >355 million times, respectively. Fewer than half of the videos in either sample covered any of the prevention behaviors recommended by the US Centers for Disease Control and Prevention, but many covered key prevention behaviors and were very widely viewed. There were no videos uploaded by entertainment television in the January sample, but this source comprised the majority of videos and garnered the majority of cumulative views in the March sample. Conclusions: This study demonstrates the incredible reach of YouTube and the potential value of partnership with the entertainment industry for communicating and mobilizing the public about community mitigation to reduce mortality from the COVID-19 viral pandemic. ",
doi="10.2196/19145",
url="http://publichealth.jmir.org/2020/2/e19145/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32297593"
}


@Article{info:doi/10.2196/17188,
author="Mazuz, Keren
and Yom-Tov, Elad",
title="Analyzing Trends of Loneliness Through Large-Scale Analysis of Social Media Postings: Observational Study",
journal="JMIR Ment Health",
year="2020",
month="Apr",
day="20",
volume="7",
number="4",
pages="e17188",
keywords="loneliness",
keywords="text postings",
keywords="behavior online",
keywords="social media",
keywords="computer-based analysis",
keywords="online self-disclosure",
abstract="Background: Loneliness has become a public health problem described as an epidemic, and it has been argued that digital behavior such as social media posting affects loneliness. Objective: The aim of this study is to expand knowledge of the determinants of loneliness by investigating online postings in a social media forum devoted to loneliness. Specifically, this study aims to analyze the temporal trends in loneliness and their associations with topics of interest, especially with those related to mental health determinants. Methods: We collected a total of 19,668 postings from 11,054 users in the loneliness forum on Reddit. We asked seven crowdsourced workers to imagine themselves as writing 1 of 236 randomly chosen posts and to answer the short-form UCLA Loneliness Scale. After showing that these postings could provide an assessment of loneliness, we built a predictive model for loneliness scores based on the posts' text and applied it to all collected postings. We then analyzed trends in loneliness postings over time and their correlations with other topics of interest related to mental health determinants. Results: We found that crowdsourced workers can estimate loneliness (interclass correlation=0.19) and that predictive models are correlated with reported loneliness scores (Pearson r=0.38). Our results show that increases in loneliness are strongly associated with postings to a suicidality-related forum (hazard ratio 1.19) and to forums associated with other detrimental behaviors such as depression and illicit drug use. Clustering demonstrates that people who are lonely come from diverse demographics and from a variety of interests. Conclusions: The results demonstrate that it is possible for unrelated individuals to assess people's social media postings for loneliness. Moreover, our findings show the multidimensional nature of online loneliness and its correlated behaviors. Our study shows the advantages of studying a hard-to-reach population through social media and suggests new directions for future studies. ",
doi="10.2196/17188",
url="http://mental.jmir.org/2020/4/e17188/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32310141"
}


@Article{info:doi/10.2196/15565,
author="Yang, Feng-Jung
and Hou, Ying-Hui
and Chang, Ray-E",
title="The Impact of a Social Networking Service--Enhanced Smart Care Model on Stage 5 Chronic Kidney Disease: Quasi-Experimental Study",
journal="J Med Internet Res",
year="2020",
month="Apr",
day="14",
volume="22",
number="4",
pages="e15565",
keywords="chronic kidney disease",
keywords="stage 5 chronic kidney disease",
keywords="chronic care model",
keywords="dialysis initiation",
keywords="social networking services",
keywords="social networking",
keywords="healthcare",
abstract="Background: Stage 5 chronic kidney disease (CKD) presents a high risk for dialysis initiation and for complications such as uremic encephalopathy, uremic symptoms, gastrointestinal bleeding, and infection. One of the most common barriers to health care for patients with stage 5 CKD is poor continuity of care due to unresolved communication gaps. Objective: Our aim was to establish a powerful care model that includes the use of a social networking service (SNS) to improve care quality for patients with CKD and safely delay dialysis initiation. Methods: We used a retrospective cohort of CKD patients aged 20-85 years who received care between 2007 and 2017 to evaluate the efficacy of incorporating an SNS into the health care system. In 2014, author F-JY, a nephrologist at the National Taiwan University Hospital Yunlin Branch, started to use an SNS app to connect with stage 5 CKD patients and their families. In cases of emergency, patients and families could quickly report any condition to F-JY. Using this app, F-JY helped facilitate productive interactions between these patients and the health care system. The intention was to safely delay the initiation of dialysis therapy. We divided patients into four groups: group 1 (G1) included patients at the study hospital during the 2007-2014 period who had contact only with nephrologists other than F-JY; group 2 (G2) included patients who visited F-JY during the 2007-2014 period before he began using the SNS app; group 3 (G3) included patients who visited nephrologists other than F-JY during the 2014-2017 period and had no interactions using the SNS; and group 4 (G4) included patients who visited F-JY during the 2014-2017 period and interacted with him using the SNS app. Results: We recruited 209 patients with stage 5 CKD who had been enrolled in the study hospital's CKD program between 2007 and 2017. Each of the four groups initiated dialysis at different times. Before adjusting for baseline estimated glomerular filtration rate (eGFR), the G4 patients had a longer time to dialysis (mean 761.7 days, SD 616.2 days) than the other groups (G1: mean 403.6 days, SD 409.4 days, P=.011 for G4 vs G1; G2: 394.8 days, SD 318.8 days, P=.04; G3: 369.1 days, SD 330.8 days, P=.049). After adjusting for baseline eGFR, G4 had a longer duration for each eGFR drop (mean 84.8 days, SD 65.1 days) than the other groups (G1: mean 43.5 days, SD 45.4 days, P=.005; G2: mean 42.5 days, SD 26.5 days, P=.03; G3: mean 3.8.7 days, SD 33.5 days, P=.002). Conclusions: The use of an SNS app between patients with stage 5 CKD and their physicians can reduce the communication gap between them and create benefits such as prolonging time-to-dialysis initiation. The role of SNSs and associated care models should be further investigated in a larger population. ",
doi="10.2196/15565",
url="http://www.jmir.org/2020/4/e15565/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32200348"
}


@Article{info:doi/10.2196/15586,
author="Vedel, Isabelle
and Ramaprasad, Jui
and Lapointe, Liette",
title="Social Media Strategies for Health Promotion by Nonprofit Organizations: Multiple Case Study Design",
journal="J Med Internet Res",
year="2020",
month="Apr",
day="6",
volume="22",
number="4",
pages="e15586",
keywords="neoplasm",
keywords="social media",
keywords="information technology",
keywords="organizations, nonprofit",
keywords="cancer",
abstract="Background: Nonprofit organizations have always played an important role in health promotion. Social media is widely used in health promotion efforts. However, there is a lack of evidence on how decisions regarding the use of social media are undertaken by nonprofit organizations that want to increase their impact in terms of health promotion. Objective: The aim of this study was to understand why and how nonprofit health care organizations put forth social media strategies to achieve health promotion goals. Methods: A multiple case study design, using in-depth interviews and a content analysis of each social media strategy, was employed to analyze the use of social media tools by six North American nonprofit organizations dedicated to cancer prevention and management. Results: The resulting process model demonstrates how social media strategies are enacted by nonprofit organizations to achieve health promotion goals. They put forth three types of social media strategies relative to their use of existing information and communication technologies (ICT)---replicate, transform, or innovate---each affecting the content, format, and delivery of the message differently. Organizations make sense of the social media innovation in complementarity with existing ICT. Conclusions: For nonprofit organizations, implementing a social media strategy can help achieve health promotion goals. The process of social media strategy implementation could benefit from understanding the rationale, the opportunities, the challenges, and the potentially complementary role of existing ICT strategies. ",
doi="10.2196/15586",
url="https://www.jmir.org/2020/4/e15586",
url="http://www.ncbi.nlm.nih.gov/pubmed/32250282"
}


@Article{info:doi/10.2196/14952,
author="Rivas, Ryan
and Sadah, A. Shouq
and Guo, Yuhang
and Hristidis, Vagelis",
title="Classification of Health-Related Social Media Posts: Evaluation of Post Content--Classifier Models and Analysis of User Demographics",
journal="JMIR Public Health Surveill",
year="2020",
month="Apr",
day="1",
volume="6",
number="2",
pages="e14952",
keywords="social media",
keywords="demographics",
keywords="classification",
abstract="Background: The increasing volume of health-related social media activity, where users connect, collaborate, and engage, has increased the significance of analyzing how people use health-related social media. Objective: The aim of this study was to classify the content (eg, posts that share experiences and seek support) of users who write health-related social media posts and study the effect of user demographics on post content. Methods: We analyzed two different types of health-related social media: (1) health-related online forums---WebMD and DailyStrength---and (2) general online social networks---Twitter and Google+. We identified several categories of post content and built classifiers to automatically detect these categories. These classifiers were used to study the distribution of categories for various demographic groups. Results: We achieved an accuracy of at least 84\% and a balanced accuracy of at least 0.81 for half of the post content categories in our experiments. In addition, 70.04\% (4741/6769) of posts by male WebMD users asked for advice, and male users' WebMD posts were more likely to ask for medical advice than female users' posts. The majority of posts on DailyStrength shared experiences, regardless of the gender, age group, or location of their authors. Furthermore, health-related posts on Twitter and Google+ were used to share experiences less frequently than posts on WebMD and DailyStrength. Conclusions: We studied and analyzed the content of health-related social media posts. Our results can guide health advocates and researchers to better target patient populations based on the application type. Given a research question or an outreach goal, our results can be used to choose the best online forums to answer the question or disseminate a message. ",
doi="10.2196/14952",
url="https://publichealth.jmir.org/2020/2/e14952",
url="http://www.ncbi.nlm.nih.gov/pubmed/32234706"
}


@Article{info:doi/10.2196/17613,
author="Watanabe-Ito, Masako
and Kishi, Emiko
and Shimizu, Yoko",
title="Promoting Healthy Eating Habits for College Students Through Creating Dietary Diaries via a Smartphone App and Social Media Interaction: Online Survey Study",
journal="JMIR Mhealth Uhealth",
year="2020",
month="Mar",
day="31",
volume="8",
number="3",
pages="e17613",
keywords="health promotion",
keywords="college students",
keywords="eating habits",
keywords="social media",
keywords="smartphone app",
abstract="Background: Youth in developed countries face the contradictory health problems of obesity and an excessive desire for weight loss. Developing a better health attitude for college students is essential as this period of life establishes future lifestyle and habits. Online interaction on social media can help to improve eating habits by creating dietary diaries through a smartphone app; however, the effects of such interactions for college students have not been examined to date. Objective: The aim of this study was to evaluate the potential effectiveness of social media interactions with the use of dietary diaries on a smartphone app to motivate college students in raising self-awareness of their eating habits. Methods: Forty-two college students in the greater Tokyo area of Japan participated in the study by creating dietary diaries online through a smartphone app and then followed/interacted with each other using social media for 7 consecutive days in September to November 2017. Online surveys were administered at baseline, immediately after creating the dietary diaries, and at 1-month follow up. Participants rated their degree of interest and self-evaluation of eating habits using 7-point scales, and answered multiple choice questions related to their thoughts in choosing meals/drinks among 10 topics. Free descriptions about their overall experience throughout the project were also collected in the follow-up survey. Results: Data from 38 participants who completed all processes were analyzed. Over time, the mean score for degree of interest in eating habits increased from 4.6 to 6.2 (P<.001), while the self-evaluation score decreased from 4.5 to 3.6 (P<.001); these significant differences remained after 1 month (5.3, P=.002; 4.1, P=0.04, respectively). A weak negative correlation (P=.009) was observed between scores for degree of interest and self-evaluation. Participants with lower scores for degree of interest at baseline tended to increase their interest level by more than 2 points above the average (P<.001). Participants gradually thought more about their eating habits from various perspectives when choosing a meal/drink, particularly with respect to maintaining well-balanced diets and introducing diverse ingredients. Participants evaluated their experiences as interesting/fun and reported familiarity with using the smartphone app and social media as the preferred method to keep track of their eating. All participants welcomed communication with fellow participants on social media and motivated each other, in addition to monitoring their eating habits through online dietary diaries. Some participants experienced difficulty, especially when they were busy or faced a lack of internet access. Conclusions: Through interactions on social media, college students experienced encouragement and developed an interest and critical thinking with respect to their eating habits. This approach, which embraces peer education and peer support with social media, holds promise for the future of youth health promotion. Further examination will be needed to explore how to sustain this level of heightened awareness. ",
doi="10.2196/17613",
url="http://mhealth.jmir.org/2020/3/e17613/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32229468"
}


@Article{info:doi/10.2196/15678,
author="Kuan, Ya-Ting
and Wang, Tze-Fang
and Guo, Chao-Yu
and Tang, Fu-In
and Hou, I-Ching",
title="Wound Care Knowledge, Attitudes, and Practices and Mobile Health Technology Use in the Home Environment: Cross-Sectional Survey of Social Network Users",
journal="JMIR Mhealth Uhealth",
year="2020",
month="Mar",
day="26",
volume="8",
number="3",
pages="e15678",
keywords="mobile health",
keywords="wound",
keywords="knowledge",
keywords="attitudes",
keywords="practices",
keywords="home environment",
abstract="Background: Injury causing wounds is a frequent event. Inadequate or inappropriate treatment of injuries can threaten individual health. However, little is known about wound care knowledge, attitudes, and practices and mobile health (mHealth) use in the home environment in Taiwan. Objective: This study aimed to evaluate wound care knowledge, attitudes, and practices and mHealth technology use among social network users. Methods: A cross-sectional survey on social media platforms was conducted on adults aged 20 years and older. Data were collected from social network users in the home environment. Results: A total of 361 participants were enrolled. The mHealth technology use of participants was positively correlated with wound care knowledge (r=.132, P=.01), attitudes (r=.239, P<.001), and practices (r=.132, P=.01). Participants did not have adequate knowledge (correct rate 69.1\%) and were unfamiliar with the guidelines of proper wound care (correct rate 74.5\%). Most participants had positive attitudes toward wound care and mHealth technology use. A total of 95.6\% (345/361) of participants perceived that the use of mHealth technology can improve wound care outcomes, and 93.9\% (339/361) perceived that wound care products should be optimized to be used with a mobile device. However, 93.6\% (338/361) of participants had no experience using mHealth technology for wound care. Conclusions: Our study shows the potential of mHealth technology to enhance wound care knowledge among social network users. Thus, government agencies and medical institutions in Taiwan should provide easy-to-use information products that enhance wound care knowledge, promote adequate behavior toward wound care, and prevent unpredictable or undesirable outcomes. ",
doi="10.2196/15678",
url="http://mhealth.jmir.org/2020/3/e15678/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32213478"
}


@Article{info:doi/10.2196/16191,
author="Stevens, C. Robin
and Brawner, M. Bridgette
and Kranzler, Elissa
and Giorgi, Salvatore
and Lazarus, Elizabeth
and Abera, Maramawit
and Huang, Sarah
and Ungar, Lyle",
title="Exploring Substance Use Tweets of Youth in the United States: Mixed Methods Study",
journal="JMIR Public Health Surveill",
year="2020",
month="Mar",
day="26",
volume="6",
number="1",
pages="e16191",
keywords="social media",
keywords="illicit drug",
keywords="youth",
keywords="adolescent",
abstract="Background: Substance use by youth remains a significant public health concern. Social media provides the opportunity to discuss and display substance use--related beliefs and behaviors, suggesting that the act of posting drug-related content, or viewing posted content, may influence substance use in youth. This aligns with empirically supported theories, which posit that behavior is influenced by perceptions of normative behavior. Nevertheless, few studies have explored the content of posts by youth related to substance use. Objective: This study aimed to identify the beliefs and behaviors of youth related to substance use by characterizing the content of youths' drug-related tweets. Using a sequential explanatory mixed methods approach, we sampled drug-relevant tweets and qualitatively examined their content. Methods: We used natural language processing to determine the frequency of drug-related words in public tweets (from 2011 to 2015) among youth Twitter users geolocated to Pennsylvania. We limited our sample by age (13-24 years), yielding approximately 23 million tweets from 20,112 users. We developed a list of drug-related keywords and phrases and selected a random sample of tweets with the most commonly used keywords to identify themes (n=249). Results: We identified two broad classes of emergent themes: functional themes and relational themes. Functional themes included posts that explicated a function of drugs in one's life, with subthemes indicative of pride, longing, coping, and reminiscing as they relate to drug use and effects. Relational themes emphasized a relational nature of substance use, capturing substance use as a part of social relationships, with subthemes indicative of drug-related identity and companionship. We also identified topical areas in tweets related to drug use, including reference to polysubstance use, pop culture, and antidrug content. Across the tweets, the themes of pride (63/249, 25.3\%) and longing (39/249, 15.7\%) were the most popular. Most tweets that expressed pride (46/63, 73\%) were explicitly related to marijuana. Nearly half of the tweets on coping (17/36, 47\%) were related to prescription drugs. Very few of the tweets contained antidrug content (9/249, 3.6\%). Conclusions: Data integration indicates that drugs are typically discussed in a positive manner, with content largely reflective of functional and relational patterns of use. The dissemination of this information, coupled with the relative absence of antidrug content, may influence youth such that they perceive drug use as normative and justified. Strategies to address the underlying causes of drug use (eg, coping with stressors) and engage antidrug messaging on social media may reduce normative perceptions and associated behaviors among youth. The findings of this study warrant research to further examine the effects of this content on beliefs and behaviors and to identify ways to leverage social media to decrease substance use in this population. ",
doi="10.2196/16191",
url="http://publichealth.jmir.org/2020/1/e16191/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32213472"
}


@Article{info:doi/10.2196/14355,
author="Skelton, Kara
and Evans, Retta
and LaChenaye, Jenna",
title="Hidden Communities of Practice in Social Media Groups: Mixed Methods Study",
journal="JMIR Pediatr Parent",
year="2020",
month="Mar",
day="24",
volume="3",
number="1",
pages="e14355",
keywords="online social support",
keywords="breastfeeding",
keywords="social media",
keywords="social support system",
abstract="Background: Although most US mothers initiate breastfeeding, suboptimal breastfeeding rates still exist. Although breastfeeding is a complex process, social support has been linked with increases in positive breastfeeding outcomes. Recent technological advances, including the development of social networking sites, provide mothers with convenient access to a unique array of audiences from which to seek advice about parenting, including breastfeeding. However, little is known about how the use of the sites---specifically groups centered around breastfeeding---influences breastfeeding knowledge, attitudes, or behaviors. Objective: This mixed methods study aimed to explore utilization of an existing probreastfeeding Facebook group and how utilization influences breastfeeding-related knowledge, attitudes, and behaviors. Methods: Participants were recruited online through Facebook wall posts from within the existing group. Mothers aged between 18 and 50 years who were pregnant and intended to breastfeed, were currently breastfeeding, or had recently weaned their infant in the past 3 years were eligible to participate. Participants engaged in online focus group discussions (n=21) and individual interviews (n=12). Inductive content analysis of qualitative data led to the conceptualization and contextualization of a breastfeeding community of practice (COP). Using qualitative results, a quantitative survey was then developed to assess the prevalence of qualities of a COP as well as how COP usage influenced breastfeeding-related attitudes and knowledge. A total of 314 mothers completed the online survey. Results: Qualitative findings showed an overall sense of community, with subthemes of group trust, interaction, and the promotion of breastfeeding. A majority (287/314, 91.5\%) of mothers initiated breastfeeding, with 69.0\% (216/314) of mothers reporting exclusive breastfeeding their infant at 6 months. Approximately 98.5\% (309/314) of mothers reported that the Facebook group captured and stored knowledge; therefore, information could be easily accessed and applied. In addition, 96.2\% (302/317) of mothers reported that the Facebook group motivated them to share breastfeeding-related knowledge. Conclusions: The results suggest that this existing probreastfeeding Facebook group exhibits characteristics of an online COP, which was organically formed. Utilization of the Facebook group, in the context of an online COP, could be beneficial in impacting breastfeeding-related knowledge, attitudes, and behaviors. However, further examination and exploration of breastfeeding COPs, including using this type of model as a method of lactation support or as a telemedicine framework, is a clear need. ",
doi="10.2196/14355",
url="http://pediatrics.jmir.org/2020/1/e14355/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32207693"
}


@Article{info:doi/10.2196/13424,
author="Nguyen, Huu Sau
and Vu, Thu Giang
and Nguyen, Hoang Long
and Nguyen, Tat Cuong
and Le, Thi Thu Hoai
and Tran, Hoang Tung
and Tran, Xuan Bach
and Latkin, A. Carl
and Tam, S. Wilson W.
and Ho, H. Cyrus S.
and Ho, M. Roger C.",
title="Understanding Social Media Use and Engagement Among Dermatology Patients to Inform Dermatological Prevention and Care in Vietnam: Cross-sectional Study",
journal="JMIR Dermatol",
year="2020",
month="Mar",
day="23",
volume="3",
number="1",
pages="e13424",
keywords="dermatology",
keywords="social media",
keywords="engagement",
keywords="prevention",
keywords="Vietnam",
abstract="Background: Social media has emerged as a common source of dermatological information. Monitoring the patterns of social media use and engagement is important to counteract the limitations of social media. However, evidence in Vietnamese dermatology patients is lacking. Objective: This study aimed to explore social media use and engagement by dermatology patients and to identify factors associated with social media use and engagement. Methods: A cross-sectional study was conducted with 519 participants at the Vietnam National Hospital of Dermatology and Venereology during September to November 2018. Data about sociodemographic characteristics, social media use, and social media engagement were collected. Multivariate logistic and tobit regression models were used to identify factors associated with social media use and engagement. Results: Interest in information about ``cosmetic, beauty, and skincare techniques'' was the greatest (184/519, 46.2\%). The mean engagement score was 8.4 points (SD 2.4 points). Female patients were more likely to use social media (odds ratio [OR] 2.23, 95\% CI 1.23-4.06) and be interested dermatological information on social media (OR 3.09, 95\% CI 1.35-7.09). Women also had higher social media engagement scores (coefficient=0.68, 95\% CI 0.17-1.18). Higher social media engagement scores were related with Instagram use (coefficient=0.58, 95\% CI 0.00-1.15) and higher credibility scores for ``family members'' (coefficient=0.15, 95\% CI 0.03-0.26) and ``dermatology companies'' (coefficient=0.22, 95\% CI 0.04-0.39). Conclusions: This study discovered high social media usage among dermatology patients. However, only moderate utilization and credibility levels were reported regarding the use of social media as a source of dermatological information. More efforts should focus on involving dermatologists in the development of individualized information on social media targeting specific groups of dermatology patients. ",
doi="10.2196/13424",
url="http://derma.jmir.org/2020/1/e13424/"
}


@Article{info:doi/10.2196/15330,
author="LeBeau, Kelsea
and Carr, Cary
and Hart, Mark",
title="Examination of Gender Stereotypes and Norms in Health-Related Content Posted to Snapchat Discover Channels: Qualitative Content Analysis",
journal="J Med Internet Res",
year="2020",
month="Mar",
day="20",
volume="22",
number="3",
pages="e15330",
keywords="social media",
keywords="online social networking",
keywords="health behavior",
keywords="sexual health",
keywords="social norms",
keywords="gender",
keywords="gender role",
keywords="mobile applications",
abstract="Background: Snapchat has seen one of the most rapid, and unprecedented, growths in the history of social networking sites and social media with 3 billion Snapchats sent daily. In 2015, Snapchat introduced a new feature, Snapchat Discover, providing a unique way for publishers, such as magazines, to connect their content to Snapchat users. Objective: This study aimed to evaluate qualitatively the health-related content distributed among male-focused and female-focused Discover channels and to determine whether differences exist between the content posted to these channels. Methods: Magazine Discover channels with male and female target audiences were identified based on the magazine's claimed audience and a search of Snapchat Discover's magazine publishers, resulting in the selection of two male-focused and two female-focused channels. Stories were collected daily from each of the selected channels during a 4-week period. Using the constant comparative method, 406 Discover stories were collected and analyzed. Results: Differences in health content coverage existed between male- and female-focused channels. General health stories from male channels comprised 7.5\% (10/134) of total stories compared with 22.8\% (62/272) for female channels. Sexual health stories from male channels comprised 3.0\% (4/134) of total stories compared with 18.8\% (51/272) for female channels. Moreover, female-focused channels' content was more comprehensive. Female audiences were portrayed as being health information seekers, concerned with sexual health and male satisfaction, primarily responsible for contraception and pregnancy prevention, and less informed about sex. Male audiences were portrayed as being less likely to seek health information, obsessed with and driven by sex, and less concerned with sexual health. Conclusions: Understanding the content shared to social media is important, especially when considering the implications content may have for behavior. In terms of content, these findings suggest Discover channels appear to promote gender stereotypes and norms for health and sexual health through the information posted. ",
doi="10.2196/15330",
url="http://www.jmir.org/2020/3/e15330/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32196461"
}


@Article{info:doi/10.2196/15875,
author="Ratanjee-Vanmali, Husmita
and Swanepoel, Wet De
and Laplante-L{\'e}vesque, Ariane",
title="Patient Uptake, Experience, and Satisfaction Using Web-Based and Face-to-Face Hearing Health Services: Process Evaluation Study",
journal="J Med Internet Res",
year="2020",
month="Mar",
day="20",
volume="22",
number="3",
pages="e15875",
keywords="audiology",
keywords="hearing loss",
keywords="internet-based intervention",
keywords="patient outcome assessment",
keywords="patient satisfaction",
keywords="telemedicine",
keywords="text messaging",
keywords="eHealth",
keywords="mHealth",
keywords="social media",
keywords="patient-centered care",
abstract="Background: Globally, access to hearing health care is a growing concern with 900 million people estimated to suffer from disabling hearing loss by 2050. Hearing loss is one of the most common chronic health conditions, yet access to hearing health care is limited. Incorporating Web-based (voice calling, messaging, or emailing) service delivery into current treatment pathways could improve access and allow for better scalability of services. Current electronic health studies in audiology have focused on technical feasibility, sensitivity, and specificity of diagnostic hearing testing and not on patient satisfaction, experiences, and sustainable models along the entire patient journey. Objective: This study aimed to investigate a hybrid (Web-based and face-to-face) hearing health service in terms of uptake, experience, and satisfaction in adult patients with hearing loss. Methods: A nonprofit hearing research clinic using online and face-to-face services was implemented in Durban, South Africa, using online recruitment from the clinic's Facebook page and Google AdWords, which directed persons to an online Web-based hearing screening test. Web-based and face-to-face care pathways included assessment, treatment, and rehabilitation. To evaluate the service, an online survey comprising (1) a validated satisfaction measurement tool (Short Assessment of Patient Satisfaction), (2) a process evaluation of all the 5 steps completed, and (3) personal preferences of communication methods used vs methods preferred was conducted, which was sent to 46 patients who used clinic services. Results: Of the patients invited, 67\% (31/46) completed the survey with mean age 66 years, (SD 16). Almost all patients, 92\% (30/31) reported that the online screening test assisted them in seeking hearing health care. Approximately 60\% (18/31) of the patients accessed the online hearing screening test from an Android device. Patients stayed in contact with the audiologist mostly through WhatsApp instant messaging (27/31, 87\%), and most patients (25/31, 81\%) preferred to use this method of communication. The patients continuing with hearing health care were significantly older and had significantly poorer speech recognition abilities compared with the patients who discontinued seeking hearing health care. A statistically significant positive result (P=.007) was found between age and the number of appointments per patient. Around 61\% (19/31) of patients previously completed diagnostic testing at other practices, with 95\% (18/19) rating the services at the hybrid clinic as better. The net promoter score was 87, indicating that patients were highly likely to recommend the hybrid clinic to friends and family. Conclusions: This study applied Web-based and face-to-face components into a hybrid clinic and measured an overall positive experience with high patient satisfaction through a process evaluation. The findings support the potential of a hybrid clinic with synchronous and asynchronous modes of communication to be a scalable hearing health care model, addressing the needs of adults with hearing loss globally. ",
doi="10.2196/15875",
url="http://www.jmir.org/2020/3/e15875/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32196459"
}


@Article{info:doi/10.2196/15983,
author="Skousen, Tanner
and Safadi, Hani
and Young, Colleen
and Karahanna, Elena
and Safadi, Sami
and Chebib, Fouad",
title="Successful Moderation in Online Patient Communities: Inductive Case Study",
journal="J Med Internet Res",
year="2020",
month="Mar",
day="17",
volume="22",
number="3",
pages="e15983",
keywords="online patient communities",
keywords="online social support",
keywords="online community moderation",
keywords="community management",
abstract="Background: Online patient communities are becoming more prevalent as a resource to help patients take control of their health. However, online patient communities experience challenges that require active moderation. Objective: This study aimed to identify the challenges of sustaining a thriving online patient community and the moderation practices employed to address the challenges and manage the online patient community successfully. Methods: An inductive case study of Mayo Clinic Connect was analyzed using the grounded theory methodology. Insights for the analysis were obtained from semistructured interviews with community managers and community members. Secondary data sources, such as community management documents, observational meeting notes, and community postings, were used to validate and triangulate the findings. Results: We identified four challenges unique to online patient communities. These challenges include passion, nonmedical advice, personal information, and community participation. We identified five categories of practices that community members used to address these challenges and moderate the community successfully. These practices include instructive, semantic, connective, administrative, and policing practices. Conclusions: Successful moderation in online patient communities requires a multitude of practices to manage the challenges that arise in these communities. Some practices are implemented as preventive measures while other practices are more interventive. Additionally, practices can come from both authority figures and exemplary members. ",
doi="10.2196/15983",
url="http://www.jmir.org/2020/3/e15983/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32181743"
}


@Article{info:doi/10.2196/16995,
author="Beier, Michael
and Fr{\"u}h, Sebastian",
title="Technological, Organizational, and Environmental Factors Influencing Social Media Adoption by Hospitals in Switzerland: Cross-Sectional Study",
journal="J Med Internet Res",
year="2020",
month="Mar",
day="9",
volume="22",
number="3",
pages="e16995",
keywords="social media",
keywords="social media adoption",
keywords="hospitals",
keywords="Switzerland",
keywords="organizational technology adoption",
keywords="TOE framework",
abstract="Background: Social media platforms are important tools for hospitals. These platforms offer many potential benefits in various areas of application for hospitals to connect and interact with their stakeholders. However, hospitals differ immensely in their social media adoption. There are studies that provide initial findings on individual factors influencing social media adoption by hospitals, but there is no comprehensive and integrated model. Objective: This study aimed to develop a comprehensive model of social media adoption by hospitals in the context of the Swiss health care system and to test the model with empirical data from Switzerland. Methods: To develop our model, we applied the general technology-organization-environment framework of organizational technology adoption and adapted it to the specific context of social media adoption by hospitals in Switzerland. To test our model, we collected empirical data on all 283 hospitals in Switzerland and identified the accounts they operate on 7 different social media platforms (Facebook, Google+, Twitter, Instagram, LinkedIn, XING, and YouTube). We tested the hypotheses of our model by means of binary logistic regression (dependent variable: platform adoption) and negative binomial regression (dependent variable: number of different platforms adopted). Results: Our general model on social media adoption received broad support. Overall, hospitals in Switzerland are more likely to adopt social media if they have a higher share of patients with voluntary health insurance or have a higher patient volume. In contrast, they are less likely to operate their own social media accounts if they are associated with a hospital network. However, some hypotheses of our model received only partial support for specific social media platforms; for instance, hospitals in Switzerland are more likely to adopt XING if they provide an educational program and are more likely to adopt LinkedIn if they are located in regions with higher competition intensity. Conclusions: Our study provides a comprehensive model of social media adoption by hospitals in Switzerland. This model shows, in detail, the factors that influence hospitals in Switzerland in their social media adoption. In addition, it provides a basic framework that might be helpful in systematically developing and testing comprehensive models of social media adoption by hospitals in other countries. ",
doi="10.2196/16995",
url="https://www.jmir.org/2020/3/e16995",
url="http://www.ncbi.nlm.nih.gov/pubmed/32149718"
}


@Article{info:doi/10.2196/15552,
author="Drehlich, Mark
and Naraine, Michael
and Rowe, Katie
and Lai, K. Samuel
and Salmon, Jo
and Brown, Helen
and Koorts, Harriet
and Macfarlane, Susie
and Ridgers, D. Nicola",
title="Using the Technology Acceptance Model to Explore Adolescents' Perspectives on Combining Technologies for Physical Activity Promotion Within an Intervention: Usability Study",
journal="J Med Internet Res",
year="2020",
month="Mar",
day="6",
volume="22",
number="3",
pages="e15552",
keywords="fitness trackers",
keywords="social media",
keywords="physical activity",
keywords="youth",
abstract="Background: Wearable activity trackers and social media have been identified as having the potential to increase physical activity among adolescents, yet little is known about the perceived ease of use and perceived usefulness of the technology by adolescents. Objective: The aim of this study was to use the technology acceptance model to explore adolescents' acceptance of wearable activity trackers used in combination with social media within a physical activity intervention. Methods: The Raising Awareness of Physical Activity study was a 12-week physical activity intervention that combined a wearable activity tracker (Fitbit Flex) with supporting digital materials that were delivered using social media (Facebook). A total of 124 adolescents aged 13 to 14 years randomized to the intervention group (9 schools) participated in focus groups immediately post intervention. Focus groups explored adolescents' perspectives of the intervention and were analyzed using pen profiles using a coding framework based on the technology acceptance model. Results: Adolescents reported that Fitbit Flex was useful as it motivated them to be active and provided feedback about their physical activity levels. However, adolescents typically reported that Fitbit Flex required effort to use, which negatively impacted on their perceived ease of use. Similarly, Facebook was considered to be a useful platform for delivering intervention content. However, adolescents generally noted preferences for using alternative social media websites, which may have impacted on negative perceptions concerning Facebook's ease of use. Perceptions of technological risks included damage to or loss of the device, integrity of data, and challenges with both Fitbit and Facebook being compatible with daily life. Conclusions: Wearable activity trackers and social media have the potential to impact adolescents' physical activity levels. The findings from this study suggest that although the adolescents recognized the potential usefulness of the wearable activity trackers and the social media platform, the effort required to use these technologies, as well as the issues concerning risks and compatibility, may have influenced overall engagement and technology acceptance. As wearable activity trackers and social media platforms can change rapidly, future research is needed to examine the factors that may influence the acceptance of specific forms of technology by using the technology acceptance model. Trial Registration: Australian and New Zealand Clinical Trials Registry ACTRN12616000899448; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=370716 ",
doi="10.2196/15552",
url="https://www.jmir.org/2020/3/e15552",
url="http://www.ncbi.nlm.nih.gov/pubmed/32141834"
}


@Article{info:doi/10.2196/16427,
author="Liao, Qiuyan
and Fielding, Richard
and Cheung, Derek Yee Tak
and Lian, Jinxiao
and Yuan, Jiehu
and Lam, Tak Wendy Wing",
title="Effectiveness and Parental Acceptability of Social Networking Interventions for Promoting Seasonal Influenza Vaccination Among Young Children: Randomized Controlled Trial",
journal="J Med Internet Res",
year="2020",
month="Feb",
day="28",
volume="22",
number="2",
pages="e16427",
keywords="influenza vaccination",
keywords="social media",
keywords="intervention",
keywords="children",
abstract="Background: Seasonal influenza vaccination (SIV) coverage among young children remains low worldwide. Mobile social networking apps such as WhatsApp Messenger are promising tools for health interventions. Objective: This was a preliminary study to test the effectiveness and parental acceptability of a social networking intervention that sends weekly vaccination reminders and encourages exchange of SIV-related views and experiences among mothers via WhatsApp discussion groups for promoting childhood SIV. The second objective was to examine the effect of introducing time pressure on mothers' decision making for childhood SIV for vaccination decision making. This was done using countdowns of the recommended vaccination timing. Methods: Mothers of child(ren) aged 6 to 72 months were randomly allocated to control or to one of two social networking intervention groups receiving vaccination reminders with (SNI+TP) or without (SNI--TP) a time pressure component via WhatsApp discussion groups at a ratio of 5:2:2. All participants first completed a baseline assessment. Both the SNI--TP and SNI+TP groups subsequently received weekly vaccination reminders from October to December 2017 and participated in WhatsApp discussions about SIV moderated by a health professional. All participants completed a follow-up assessment from April to May 2018. Results: A total of 84.9\% (174/205), 71\% (57/80), and 75\% (60/80) who were allocated to the control, SNI--TP, and SNI+TP groups, respectively, completed the outcome assessment. The social networking intervention significantly promoted mothers' self-efficacy for taking children for SIV (SNI--TP: odds ratio [OR] 2.69 [1.07-6.79]; SNI+TP: OR 2.50 [1.13-5.55]), but did not result in significantly improved children's SIV uptake. Moreover, after adjusting for mothers' working status, introducing additional time pressure reduced the overall SIV uptake in children of working mothers (OR 0.27 [0.10-0.77]) but significantly increased the SIV uptake among children of mothers without a full-time job (OR 6.53 [1.87-22.82]). Most participants' WhatsApp posts were about sharing experience or views (226/434, 52.1\%) of which 44.7\% (101/226) were categorized as negative, such as their concerns over vaccine safety, side effects and effectiveness. Although participants shared predominantly negative experience or views about SIV at the beginning of the discussion, the moderator was able to encourage the discussion of more positive experience or views and more knowledge and information. Most intervention group participants indicated willingness to receive the same interventions (110/117, 94.0\%) and recommend the interventions to other mothers (102/117, 87.2\%) in future Conclusions: Online information support can effectively promote mothers' self-efficacy for taking children for SIV but alone it may not sufficient to address maternal concerns over SIV to achieve a positive vaccination decision. However, the active involvement of health professionals in online discussions can shape positive discussions about vaccination. Time pressure on decision making interacts with maternal work status, facilitating vaccination uptake among mothers who may have more free time, but having the opposite effect among busier working mothers. Trial Registration: Hong Kong University Clinical Trials Registry HKUCTR-2250; https://tinyurl.com/vejv276 ",
doi="10.2196/16427",
url="http://www.jmir.org/2020/2/e16427/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32130136"
}


@Article{info:doi/10.2196/15861,
author="O'Connor, Karen
and Sarker, Abeed
and Perrone, Jeanmarie
and Gonzalez Hernandez, Graciela",
title="Promoting Reproducible Research for Characterizing Nonmedical Use of Medications Through Data Annotation: Description of a Twitter Corpus and Guidelines",
journal="J Med Internet Res",
year="2020",
month="Feb",
day="26",
volume="22",
number="2",
pages="e15861",
keywords="prescription drug misuse",
keywords="social media",
keywords="substance abuse detection",
keywords="natural language processing",
keywords="machine learning",
keywords="infodemiology",
keywords="infoveillance",
abstract="Background: Social media data are being increasingly used for population-level health research because it provides near real-time access to large volumes of consumer-generated data. Recently, a number of studies have explored the possibility of using social media data, such as from Twitter, for monitoring prescription medication abuse. However, there is a paucity of annotated data or guidelines for data characterization that discuss how information related to abuse-prone medications is presented on Twitter. Objective: This study discusses the creation of an annotated corpus suitable for training supervised classification algorithms for the automatic classification of medication abuse--related chatter. The annotation strategies used for improving interannotator agreement (IAA), a detailed annotation guideline, and machine learning experiments that illustrate the utility of the annotated corpus are also described. Methods: We employed an iterative annotation strategy, with interannotator discussions held and updates made to the annotation guidelines at each iteration to improve IAA for the manual annotation task. Using the grounded theory approach, we first characterized tweets into fine-grained categories and then grouped them into 4 broad classes---abuse or misuse, personal consumption, mention, and unrelated. After the completion of manual annotations, we experimented with several machine learning algorithms to illustrate the utility of the corpus and generate baseline performance metrics for automatic classification on these data. Results: Our final annotated set consisted of 16,443 tweets mentioning at least 20 abuse-prone medications including opioids, benzodiazepines, atypical antipsychotics, central nervous system stimulants, and gamma-aminobutyric acid analogs. Our final overall IAA was 0.86 (Cohen kappa), which represents high agreement. The manual annotation process revealed the variety of ways in which prescription medication misuse or abuse is discussed on Twitter, including expressions indicating coingestion, nonmedical use, nonstandard route of intake, and consumption above the prescribed doses. Among machine learning classifiers, support vector machines obtained the highest automatic classification accuracy of 73.00\% (95\% CI 71.4-74.5) over the test set (n=3271). Conclusions: Our manual analysis and annotations of a large number of tweets have revealed types of information posted on Twitter about a set of abuse-prone prescription medications and their distributions. In the interests of reproducible and community-driven research, we have made our detailed annotation guidelines and the training data for the classification experiments publicly available, and the test data will be used in future shared tasks. ",
doi="10.2196/15861",
url="http://www.jmir.org/2020/2/e15861/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32130117"
}


@Article{info:doi/10.2196/16736,
author="Moreno, A. Megan
and Binger, Kole
and Zhao, Qianqian
and Eickhoff, Jens",
title="Measuring Interests Not Minutes: Development and Validation of the Adolescents' Digital Technology Interactions and Importance Scale (ADTI)",
journal="J Med Internet Res",
year="2020",
month="Feb",
day="12",
volume="22",
number="2",
pages="e16736",
keywords="technology",
keywords="adolescents",
keywords="methodology, survey",
keywords="social media",
keywords="screen time",
keywords="instrument development",
abstract="Background: Interactive digital technology use is integral to adolescents' lives and has been associated with both health benefits and risks. Previous studies have largely focused on measuring the quantity of technology use or understanding the use of specific platforms. To better understand adolescents' interactive digital technology use, we need new approaches that consider technology interactions and their importance. Objective: This study aimed to develop an assessment tool to evaluate adolescents' digital technology interactions and their perceived importance. Methods: We used a validated scale development approach comprising 2 initial steps to create an item pool: item pool development and item pool refinement. These steps relied upon empirical literature review and an expert convening. We then evaluated the item pool using a Web-based survey. Data were collected via Qualtrics panel recruitment from a national sample of 12- to 18-year-olds. Participant data were randomly split into a development subsample for exploratory factor analysis (EFA) and a test subsample for confirmatory factor analysis (CFA). We assessed Cronbach alpha as well as model fit characteristics including root mean square error of approximation (RMSEA) and comparative fit index (CFI). Results: Our initial item pool had 71 items and the refined item pool contained 40. A total of 761 adolescents assessed the item pool via Web-based survey. Participants had a mean age of 14.8 (SD 1.7) years and were 52.8\% (402/761) female and 77.5\% (590/761) white. The EFA analysis included 500 participants and an 18-item draft scale was created. The CFA included 261 participants to test the draft scale. Adequate model fit for the scale was indicated by an RMSEA of 0.063 and a CFI of 0.95. The final scale included 18 items in a 3-factor model, with Cronbach alpha for the 3 factors of .87 (factor 1), .90 (factor 2) and .82 (factor 3). The 3 factors were named (1) technology to bridge online and offline experiences, (2) technology to go outside one's identity or offline environment, and (3) technology for social connection. Conclusions: The resulting Adolescents' Digital Technology Interactions and Importance (ADTI) scale is a promising and psychometrically validated tool for identifying the importance of distinct technology interactions. The scale is informed by relevant theory and expert input. The 3 subscales have utility for future studies to understand whether certain subscale score ranges are associated with health or well-being outcomes. ",
doi="10.2196/16736",
url="https://www.jmir.org/2020/2/e16736",
url="http://www.ncbi.nlm.nih.gov/pubmed/32049068"
}


@Article{info:doi/10.2196/13201,
author="Zheng, Zhi-Wei
and Yang, Qing-Ling
and Liu, Zhong-Qi
and Qiu, Jia-Ling
and Gu, Jing
and Hao, Yuan-Tao
and Song, Chao
and Jia, Zhong-Wei
and Hao, Chun",
title="Associations Between Affective States and Sexual and Health Status Among Men Who Have Sex With Men in China: Exploratory Study Using Social Media Data",
journal="J Med Internet Res",
year="2020",
month="Jan",
day="31",
volume="22",
number="1",
pages="e13201",
keywords="affect",
keywords="men who have sex with men",
keywords="sexual behaviors",
keywords="health status",
keywords="social media",
abstract="Background: Affective states, including sentiment and emotion, are critical determinants of health. However, few studies among men who have sex with men (MSM) have examined sentiment and emotion specifically using real-time social media technologies. Moreover, the explorations on their associations with sexual and health status among MSM are limited. Objective: This study aimed to understand and examine the associations of affective states with sexual behaviors and health status among MSM using public data from the Blued (Blued International Inc) app. Methods: A total of 843,745 public postings of 377,610 MSM users located in Guangdong were saved from the Blued app by automatic screen capture. Positive affect, negative affect, sexual behaviors, and health status were measured using the Simplified Chinese Linguistic Inquiry and Word Count. Emotions, including joy, sadness, anger, fear, and disgust, were measured using the Weibo Basic Mood Lexicon. A positive sentiment score and a positive emotion score were also calculated. Univariate and multivariate linear regression models on the basis of a permutation test were used to assess the associations of affective states with sexual behaviors and health status. Results: A total of 5871 active MSM users and their 477,374 postings were finally selected. Both positive affect and positive emotions (eg, joy) peaked between 7 AM and 9 AM. Negative affect and negative emotions (eg, sadness and disgust) peaked between 2 AM and 4 AM. During that time, 25.1\% (97/387) of negative postings were related to health and 13.4\% (52/387) of negative postings were related to seeking social support. A multivariate analysis showed that the MSM who were more likely to post sexual behaviors were more likely to express positive affect (beta=0.3107; P<.001) and positive emotions (joy: beta=0.027; P<.001), as well as negative emotions (sadness: beta=0.0443; P<.001 and disgust: beta=0.0256; P<.001). They also had a higher positive sentiment score (beta=0.2947; P<.001) and a higher positive emotion score (beta=0.1612; P<.001). The MSM who were more likely to post their health status were more likely to express negative affect (beta=0.8088; P<.001) and negative emotions, including sadness (beta=0.0705; P<.001), anger (beta=0.0058; P<.001), fear (beta=0.0052; P<.001), and disgust (beta=0.3065; P<.001), and less likely to express positive affect (beta=?0.0224; P=.02). In addition, they had a lower positive sentiment score (beta=?0.8306; P<.001) and a lower positive emotion score (beta=?0.3743; P<.001). Conclusions: The MSM social media community mainly expressed their positive affect in the early morning and negative affect after midnight. Positive affective states were associated with being sexually active, whereas negative affective states were associated with health problems, mostly about mental health. Our finding suggests the potential to deliver different health-related intervention strategies (eg, psychological counseling and safe sex promotion) on a social media app according to the affective states of MSM in real time. ",
doi="10.2196/13201",
url="http://www.jmir.org/2020/1/e13201/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32012054"
}


@Article{info:doi/10.2196/16382,
author="Goedel, C. William
and Jin, Harry
and Sutten Coats, Cassandra
and Ogunbajo, Adedotun
and Restar, J. Arjee",
title="Predictors of User Engagement With Facebook Posts Generated by a National Sample of Lesbian, Gay, Bisexual, Transgender, and Queer Community Centers in the United States: Content Analysis",
journal="JMIR Public Health Surveill",
year="2020",
month="Jan",
day="28",
volume="6",
number="1",
pages="e16382",
keywords="health communication",
keywords="social media",
keywords="sexual and gender minorities",
keywords="community networks",
abstract="Background: Lesbian, gay, bisexual, transgender, and queer (LGBTQ) community centers remain important venues for reaching and providing crucial health and social services to LGBTQ individuals in the United States. These organizations commonly use Facebook to reach their target audiences, but little is known about factors associated with user engagement with their social media presence. Objective: This study aimed to identify factors associated with engagement with Facebook content generated by LGBTQ community centers in the United States. Methods: Content generated by LGBTQ community centers in 2017 was downloaded using Facebook's application programming interface. Posts were classified by their content and sentiment. Correlates of user engagement were identified using negative binomial regression. Results: A total of 32,014 posts from 175 community centers were collected. Posts with photos (incidence rate ratio, [IRR] 1.07; 95\% CI 1.06-1.09) and videos (IRR 1.54; 95\% CI 1.52-1.56) that contained a direct invitation for engagement (IRR 1.03; 95\% CI 1.02-1.04), that expressed a positive sentiment (IRR 1.11; 95\% CI 1.10-1.12), and that contained content related to stigma (IRR 1.16; 95\% CI 1.14-1.17), mental health (IRR 1.33; 95\% CI 1.31-1.35), and politics (IRR 1.28; 95\% CI 1.27-1.29) received higher levels of engagement. Conclusions: The results of this study provide support for the use of Facebook to extend the reach of LGBTQ community centers and highlight multiple factors that can be leveraged to optimize engagement. ",
doi="10.2196/16382",
url="https://publichealth.jmir.org/2020/1/e16382",
url="http://www.ncbi.nlm.nih.gov/pubmed/32012104"
}


@Article{info:doi/10.2196/15529,
author="Griffioen, Nastasia
and Van Rooij, W. Marieke M. J.
and Lichtwarck-Aschoff, Anna
and Granic, Isabela",
title="A Stimulated Recall Method for the Improved Assessment of Quantity and Quality of Social Media Use",
journal="J Med Internet Res",
year="2020",
month="Jan",
day="28",
volume="22",
number="1",
pages="e15529",
keywords="technology use",
keywords="stimulated recall",
keywords="social media",
keywords="well-being",
keywords="qualitative research",
keywords="interview",
keywords="digital technologies",
abstract="Background: Social media are as popular as ever, and concerns regarding the effects of social media use on adolescent well-being and mental health have sparked many scientific studies into use effects. Social media research is currently at an important crossroads: conflicting results on social media use's effects on well-being are abundant, and recent work in the field suggests that a new approach is required. The field is in need of an approach involving objective data regarding use where necessary and attention to different kinds of detail such as the why and how of social media use. Objective: We present a novel paradigm implementing a principle from educational sciences called stimulated recall and demonstrate how it can be applied to social media use research. Our stimulated recall paradigm implements a number of elements that can fill the gaps currently present in social media and well-being research. Methods: Objective data are collected regarding users' social media behaviors through video footage and in-phone data and used for a structured stimulated recall interview to facilitate detailed and context-sensitive processing of these objective data. In this interview, objective data are reviewed with the participant in an act of co-research, in which details such as the reasons for their use (eg, boredom) and processes surrounding their use (eg, with whom) are discussed and visualized in a stimulated recall chart. Results: Our ongoing study (N=53) implementing this paradigm suggests this method is experienced as pleasant by participants in spite of its personal and intensive nature. Conclusions: The stimulated recall paradigm offers interesting and necessary avenues for approaching social media use research from new angles, addressing aspects of use that have thus far remained underexposed. The answers to questions such as ``Why do adolescents use social media?'' ``In what ways exactly do they use social media?'' and ``How does social media use make them feel in the moment?'' are now within reach, an important step forward in the field of social media use and well-being research. ",
doi="10.2196/15529",
url="https://www.jmir.org/2020/1/e15529",
url="http://www.ncbi.nlm.nih.gov/pubmed/32012075"
}


@Article{info:doi/10.2196/13207,
author="Vasilica, Mihaela Cristina
and Brettle, Alison
and Ormandy, Paula",
title="A Co-Designed Social Media Intervention to Satisfy Information Needs and Improve Outcomes of Patients With Chronic Kidney Disease: Longitudinal Study",
journal="JMIR Form Res",
year="2020",
month="Jan",
day="27",
volume="4",
number="1",
pages="e13207",
keywords="social media",
keywords="patients outcomes",
keywords="long term condition",
keywords="chronic kidney disease",
keywords="self-efficacy",
keywords="patients information needs",
keywords="co-design",
abstract="Background: The number of people living with a long-term condition is increasing worldwide. Social media offers opportunities for patients to exchange information and experiences with others with the same condition, potentially leading to better self-management and improved patient outcomes, at minimal costs to health service providers. Objective: This paper describes how an online network with a range of social media platforms was created, with the help of a group of patients with chronic kidney disease and specialist professionals. The project considered whether information needs and health-related and social outcomes were met. Methods: We performed a longitudinal in-depth evaluation of the creation of the moderated network, observation of the use of the platforms, self-efficacy surveys (at baseline and 6 months), and semistructured interviews (at baseline and 6 months). Results: A total of 15 patients and professionals participated in the co-design of the network (hub), which was initially launched with 50 patients. Several platforms were needed to engage patients at different levels and encourage generation of information, with the support of moderators. In addition, 14 separate patients participated in the evaluation. Satisfaction of information needs through social engagement improved self-efficacy (n=13) with better self-care and management of illness. Social outcomes included seeking employment and an increase in social capital. Conclusions: An online network (hub) with several social media platforms helped patients with chronic kidney disease manage their condition. Careful co-designing with users resulted in a sustainable network with wider applicability across health and social care. ",
doi="10.2196/13207",
url="https://formative.jmir.org/2020/1/e13207",
url="http://www.ncbi.nlm.nih.gov/pubmed/32012040"
}


@Article{info:doi/10.2196/14546,
author="Shieh, Gow-Jen
and Wu, Shi-Liang
and Tsai, Che-Fu
and Chang, Chi-Sen
and Chang, Tsung-Hung
and Lui, Ping-Wing
and Yao, Yuh
and Sheu, Huey-Herng Wayne",
title="A Strategic Imperative for Promoting Hospital Branding: Analysis of Outcome Indicators",
journal="Interact J Med Res",
year="2020",
month="Jan",
day="22",
volume="9",
number="1",
pages="e14546",
keywords="social media",
keywords="branding",
keywords="Facebook",
keywords="Taiwan",
keywords="health services research",
keywords="marketing of health services",
abstract="Background: Optimizing the use of social media to promote hospital branding is important in the present digital era. In Taiwan, only 51.1\% of hospitals have official Facebook fan pages. The numbers of likes for these hospitals are also relatively low. Objective: Our objective was to establish a special branding team for social media operation, led by top administrators of our hospital. Here we present our strategic imperative for promoting hospital branding as well as an analysis of its effectiveness. Methods: Led by top administrators, the branding team was formed by 11 divisions to create branding strategies. From 2016 to 2018, the team implemented action plans. All information unique to the hospital was posted on Facebook, as well as on the hospital's official website. To determine the plans' efficiencies, we obtained reference data from Google Analytics, and we compared Facebook Insights reports for 2016 with those for 2017 and 2018. Results: One of the branding team's main missions was to establish branding strategies and to integrate segmental branding messages. In each quarter we regularly monitored a total of 52 action plan indicators, including those for process and outcome, and discussed the results at team meetings. We selected 4 main performance outcome indicators to reflect the effectiveness of the branding efforts. Compared with 2016, the numbers of likes posted on the Facebook fan page increased by 61.2\% in 2017 and 116.2\% in 2018. Similarly, visits to the hospital website increased by 4.8\% in 2017 and 33.1\% in 2018. Most Facebook fan page and website viewers were in 2 age groups: 25 to 34 years, and 35 to 44 years. Women constituted 60.42\% (14,160/23,436) of Facebook fans and 59.39\% (778,992/1,311,605) of website viewers. According to the Facebook Insights reports, the number of likes and post sharing both increased in 2017 and 2018, relative to 2016. Comment messages also increased from 2016 to 2018 (P=.02 for the trend). The most common theme of posts varied over time, from media reports in 2016, to innovative services in both 2017 and 2018. Likes for innovative services posts increased from 2016 through 2018 (P=.045 for the trend). By the end of 2018, we recorded 23,436 cumulative likes for posts, the highest number among medical centers in Taiwan. Conclusions: We achieved the largest number of Facebook fans among all medical centers in Taiwan. We would like to share our experience with other hospitals that might be interested in engaging in social media for future communications and interactions with their patients. ",
doi="10.2196/14546",
url="https://www.i-jmr.org/2020/1/e14546",
url="http://www.ncbi.nlm.nih.gov/pubmed/32012047"
}


@Article{info:doi/10.2196/14605,
author="Murphy, Douglas Michael
and Pinheiro, Diego
and Iyengar, Rahul
and Lim, Gene
and Menezes, Ronaldo
and Cadeiras, Martin",
title="A Data-Driven Social Network Intervention for Improving Organ Donation Awareness Among Minorities: Analysis and Optimization of a Cross-Sectional Study",
journal="J Med Internet Res",
year="2020",
month="Jan",
day="14",
volume="22",
number="1",
pages="e14605",
keywords="organ donation",
keywords="social media",
keywords="minority health",
keywords="community health education",
abstract="Background: Increasing the number of organ donors may enhance organ transplantation, and past health interventions have shown the potential to generate both large-scale and sustainable changes, particularly among minorities. Objective: This study aimed to propose a conceptual data-driven framework that tracks digital markers of public organ donation awareness using Twitter and delivers an optimized social network intervention (SNI) to targeted audiences using Facebook. Methods: We monitored digital markers of organ donation awareness across the United States over a 1-year period using Twitter and examined their association with organ donation registration. We delivered this SNI on Facebook with and without optimized awareness content (ie, educational content with a weblink to an online donor registration website) to low-income Hispanics in Los Angeles over a 1-month period and measured the daily number of impressions (ie, exposure to information) and clicks (ie, engagement) among the target audience. Results: Digital markers of organ donation awareness on Twitter are associated with donation registration (beta=.0032; P<.001) such that 10 additional organ-related tweets are associated with a 3.20\% (33,933/1,060,403) increase in the number of organ donor registrations at the city level. In addition, our SNI on Facebook effectively reached 1 million users, and the use of optimization significantly increased the rate of clicks per impression (beta=.0213; P<.004). Conclusions: Our framework can provide a real-time characterization of organ donation awareness while effectively delivering tailored interventions to minority communities. It can complement past approaches to create large-scale, sustainable interventions that are capable of raising awareness and effectively mitigate disparities in organ donation. ",
doi="10.2196/14605",
url="https://www.jmir.org/2020/1/e14605",
url="http://www.ncbi.nlm.nih.gov/pubmed/31934867"
}


@Article{info:doi/10.2196/16176,
author="Campbell, Andrew
and Ridout, Brad
and Amon, Krestina
and Navarro, Pablo
and Collyer, Brian
and Dalgleish, John",
title="A Customized Social Network Platform (Kids Helpline Circles) for Delivering Group Counseling to Young People Experiencing Family Discord That Impacts Their Well-Being: Exploratory Study",
journal="J Med Internet Res",
year="2019",
month="Dec",
day="20",
volume="21",
number="12",
pages="e16176",
keywords="social media",
keywords="social networking",
keywords="online counseling",
keywords="family discord",
keywords="well-being",
abstract="Background: It has often been reported that young people are at high risk of mental health concerns, more so than at any other time in development over their life span. The situational factors that young people report as impacting their well-being are not addressed as often: specifically, family discord. Kids Helpline, a national service in Australia that provides free counseling online and by telephone to young people in distress, report that family discord and well-being issues are one of the major concerns reported by clients. In order to meet the preferences that young people seek when accessing counseling support, Kids Helpline has designed and trialed a custom-built social network platform for group counseling of young people experiencing family discord that impacts their well-being. Objective: In this exploratory study, we communicate the findings of Phase 1 of an innovative study in user and online counselor experience. This will lead to an iterative design for a world-first, purpose-built social network that will do the following: (1) increase reach and quality of service by utilizing a digital tool of preference for youth to receive peer-to-peer and counselor-to-peer support in a safe online environment and (2) provide the evidence base to document the best practice for online group counseling in a social network environment. Methods: The study utilized a participatory action research design. Young people aged 13-25 years (N=105) with mild-to-moderate depression or anxiety (not high risk) who contacted Kids Helpline were asked if they would like to trial the social networking site (SNS) for peer-to-peer and counselor-to-peer group support. Subjects were grouped into age cohorts of no more than one year above or below their reported age and assigned to groups of no more than 36 participants, in order to create a community of familiarity around age and problems experienced. Each group entered into an 8-week group counseling support program guided by counselors making regular posts and providing topic-specific content for psychoeducation and discussion. Counselors provided a weekly log of events to researchers; at 2-week intervals, subjects provided qualitative and quantitative feedback through open-ended questions and specific psychometric measures. Results: Qualitative results provided evidence of user support and benefits of the online group counseling environment. Counselors also reported benefits of the modality of therapy delivery. Psychometric scales did not report significance in changes of mood or affect. Counselors and users suggested improvements to the platform to increase user engagement. Conclusions: Phase 1 provided proof of concept for this mode of online counseling delivery. Users and counselors saw value in the model and innovation of the service. Phase 2 will address platform issues with changes to a new social network platform. Phase 2 will focus more broadly on mental health concerns raised by users and permit inclusion of a clinical population of young people experiencing depression and anxiety. Trial Registration: Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12616000518460; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=370381 ",
doi="10.2196/16176",
url="http://www.jmir.org/2019/12/e16176/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31859671"
}


@Article{info:doi/10.2196/16661,
author="Pagoto, Sherry
and Waring, E. Molly
and Xu, Ran",
title="A Call for a Public Health Agenda for Social Media Research",
journal="J Med Internet Res",
year="2019",
month="Dec",
day="19",
volume="21",
number="12",
pages="e16661",
keywords="social media",
keywords="online social networks",
keywords="health information",
keywords="health communication",
doi="10.2196/16661",
url="http://www.jmir.org/2019/12/e16661/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31855185"
}


@Article{info:doi/10.2196/14684,
author="Ukoha, Chukwuma
and Stranieri, Andrew",
title="Criteria to Measure Social Media Value in Health Care Settings: Narrative Literature Review",
journal="J Med Internet Res",
year="2019",
month="Dec",
day="16",
volume="21",
number="12",
pages="e14684",
keywords="social media",
keywords="information systems",
keywords="health care",
keywords="value",
keywords="measurement",
keywords="criteria",
abstract="Background: With the growing use of social media in health care settings, there is a need to measure outcomes resulting from its use to ensure continuous performance improvement. Despite the need for measurement, a unified approach for measuring the value of social media used in health care remains elusive. Objective: This study aimed to elucidate how the value of social media in health care settings can be ascertained and to taxonomically identify steps and techniques in social media measurement from a review of relevant literature. Methods: A total of 65 relevant articles drawn from 341 articles on the subject of measuring social media in health care settings were qualitatively analyzed and synthesized. The articles were selected from the literature from diverse disciplines including business, information systems, medical informatics, and medicine. Results: The review of the literature showed different levels and focus of analysis when measuring the value of social media in health care settings. It equally showed that there are various metrics for measurement, levels of measurement, approaches to measurement, and scales of measurement. Each may be relevant, depending on the use case of social media in health care. Conclusions: A comprehensive yardstick is required to simplify the measurement of outcomes resulting from the use of social media in health care. At the moment, there is neither a consensus on what indicators to measure nor on how to measure them. We hope that this review is used as a starting point to create a comprehensive measurement criterion for social media used in health care. ",
doi="10.2196/14684",
url="https://www.jmir.org/2019/12/e14684",
url="http://www.ncbi.nlm.nih.gov/pubmed/31841114"
}


@Article{info:doi/10.2196/13025,
author="Shen, Lining
and Wang, Shimin
and Chen, Wenqiang
and Fu, Qiang
and Evans, Richard
and Lan, Fuqiang
and Li, Wei
and Xu, Juan
and Zhang, Zhiguo",
title="Understanding the Function Constitution and Influence Factors on Communication for the WeChat Official Account of Top Tertiary Hospitals in China: Cross-Sectional Study",
journal="J Med Internet Res",
year="2019",
month="Dec",
day="9",
volume="21",
number="12",
pages="e13025",
keywords="WeChat official account",
keywords="WeChat service account",
keywords="social media",
keywords="function constitution",
keywords="tertiary hospital",
keywords="tertiary care centers",
keywords="health care",
keywords="WeChat communication index",
keywords="mobile health",
keywords="telemedicine",
abstract="Background: Widespread adoption and continued developments in mobile health care technologies have led to the improved accessibility and quality of medical services. In China, WeChat, an instant messaging and social networking app released by the company Tencent, has developed a specific type of user account called WeChat official account (WOA), which is now widely adopted by hospitals in China. It enables health care providers to connect with local citizens, allowing them to, among other actions, send regular updates through mass circulation. However, with the diversity in function provided by WOA, little is known about its major constitution as well as the influence factors on the WeChat communication index (WCI). The WCI has been widely used in social media impact ranking with various types of WeChat content to fully reflect the dissemination and coverage of tweets as well as the maturity and impact of WOA. Objective: There are two typical WOAs available to users, namely, WeChat subscription account (WSSA) and WeChat service account (WSVA). The biggest difference between them is the frequency of messages transmitted. This study aimed to explore the function constitution of WSVA adopted by top tertiary hospitals in China and the major contributors of the WCI score. Methods: A total of 681 top tertiary hospitals were selected from the Hospital Quality Monitoring System; the WOA of every top tertiary hospital was retrieved in the WeChat app. We divided core functional items of WSVAs using categorical principal component analysis. To elicit the factors that influenced the use of WSVA, quantile regression was employed to analyze the WCI score. Results: From the 668 WOAs identified, adoption of WSVAs (543/668, 81.3\%) was more than that of WSSAs (125/668, 18.7\%). Functional items of WSVAs were categorized into four clusters: (1) hospital introduction, (2) medical services, (3) visiting assistants, and (4) others. With regard to the influence factors on the WCI, the impact of the activity index of WSVA and the total visiting number of outpatients and emergencies on WCI were statistically significant and positive in all quantiles. However, the year of certification, the type of hospital, the year of public hospital reform, and the number of beds merely affected the WCI at some quantiles. Conclusions: Our findings are considered helpful to tertiary hospitals in developing in-depth functional items that improve patient experience. The tertiary hospitals should take full advantage of times of posting and provide high-quality tweets to meet the various needs of patients. ",
doi="10.2196/13025",
url="https://www.jmir.org/2019/12/e13025",
url="http://www.ncbi.nlm.nih.gov/pubmed/31815674"
}


@Article{info:doi/10.2196/13076,
author="Melvin, Sara
and Jamal, Amanda
and Hill, Kaitlyn
and Wang, Wei
and Young, D. Sean",
title="Identifying Sleep-Deprived Authors of Tweets: Prospective Study",
journal="JMIR Ment Health",
year="2019",
month="Dec",
day="6",
volume="6",
number="12",
pages="e13076",
keywords="wearable electronic devices",
keywords="safety",
keywords="natural language processing",
keywords="information storage and retrieval",
keywords="sleep deprivation",
keywords="neural networks (computer)",
keywords="sleep",
keywords="social media",
abstract="Background: Social media data can be explored as a tool to detect sleep deprivation. First-year undergraduate students in their first quarter were invited to wear sleep-tracking devices (Basis; Intel), allow us to follow them on Twitter, and complete weekly surveys regarding their sleep. Objective: This study aimed to determine whether social media data can be used to monitor sleep deprivation. Methods: The sleep data obtained from the device were utilized to create a tiredness model that aided in labeling the tweets as sleep deprived or not at the time of posting. Labeled data were used to train and test a gated recurrent unit (GRU) neural network as to whether or not study participants were sleep deprived at the time of posting. Results: Results from the GRU neural network suggest that it is possible to classify the sleep-deprivation status of a tweet's author with an average area under the curve of 0.68. Conclusions: It is feasible to use social media to identify students' sleep deprivation. The results add to the body of research suggesting that social media data should be further explored as a potential source for monitoring health. ",
doi="10.2196/13076",
url="https://mental.jmir.org/2019/12/e13076",
url="http://www.ncbi.nlm.nih.gov/pubmed/31808747"
}


@Article{info:doi/10.2196/13694,
author="Zhu, Chengyan
and Zeng, Runxi
and Zhang, Wei
and Evans, Richard
and He, Rongrong",
title="Pregnancy-Related Information Seeking and Sharing in the Social Media Era Among Expectant Mothers: Qualitative Study",
journal="J Med Internet Res",
year="2019",
month="Dec",
day="4",
volume="21",
number="12",
pages="e13694",
keywords="pregnant women",
keywords="social media",
keywords="information seeking",
keywords="consumer health information",
keywords="China",
abstract="Background: Social media has become the most popular communication tool used by Chinese citizens, including expectant mothers. An increasing number of women have adopted various forms of social media channels, such as interactive websites, instant messaging, and mobile apps, to solve problems and obtain answers to queries during pregnancy. Although the use of the internet by pregnant women has been studied extensively worldwide, limited research exists that explores the changing social media usage habits in China, where the 1 child policy ended in 2015. Objective: This study aimed to (1) present the status quo of pregnancy-related information seeking and sharing via social media among Chinese expectant mothers, (2) reveal the impact of social media usage, and (3) shed light on pregnancy-related health services delivered via social media channels. Methods: A qualitative approach was employed to examine social media usage and its consequences on pregnant women. A total of 20 women who had conceived and were at various stages of pregnancy were interviewed from July 20 to August 10, 2017. Thematic analysis was conducted on the collected data to identify patterns in usage. Results: Overall, 80\% (16/20) of participants were aged in their 20s (mean 28.5 years [SD 4.3]). All had used social media for pregnancy-related purposes. For the seeking behavior, 18 codes were merged into 4 themes, namely, gravida, fetus, delivery, and the postpartum period; whereas for sharing behaviors, 10 codes were merged into 4 themes, namely, gravida, fetus, delivery, and caretaker. Lurking, small group sharing, bad news avoidance, and cross-checking were identified as the preferred patterns for using social media. Overall, 95\% (19/20) of participants reported a positive mental impact from using social media during their pregnancy. Conclusions: It is indisputable that social media has played an increasingly important role in supporting expectant mothers in China. The specific seeking and sharing patterns identified in this study indicate that the general quality of pregnancy-related information on social media, as well as Chinese culture toward pregnancy, is improving. The new themes that merge in pregnancy-related social media use represent a shift toward safe pregnancy and the promotion of a more enjoyable pregnancy. Future prenatal care should provide further information on services related to being comfortable during pregnancy and reducing the inequality of social media--based services caused by the digital divide. ",
doi="10.2196/13694",
url="https://www.jmir.org/2019/12/e13694",
url="http://www.ncbi.nlm.nih.gov/pubmed/31799939"
}


@Article{info:doi/10.2196/14866,
author="D'Alfonso, Simon
and Phillips, Jessica
and Valentine, Lee
and Gleeson, John
and Alvarez-Jimenez, Mario",
title="Moderated Online Social Therapy: Viewpoint on the Ethics and Design Principles of a Web-Based Therapy System",
journal="JMIR Ment Health",
year="2019",
month="Dec",
day="4",
volume="6",
number="12",
pages="e14866",
keywords="Web-based intervention",
keywords="social network",
keywords="well-being",
keywords="eudaimonia",
keywords="persuasive technology",
keywords="ethical design",
doi="10.2196/14866",
url="https://mental.jmir.org/2019/12/e14866",
url="http://www.ncbi.nlm.nih.gov/pubmed/31799937"
}


@Article{info:doi/10.2196/14886,
author="Russomanno, Jennifer
and Patterson, G. Joanne
and Jabson Tree, M. Jennifer",
title="Social Media Recruitment of Marginalized, Hard-to-Reach Populations: Development of Recruitment and Monitoring Guidelines",
journal="JMIR Public Health Surveill",
year="2019",
month="Dec",
day="2",
volume="5",
number="4",
pages="e14886",
keywords="transgender",
keywords="LGBTQ",
keywords="TGNC",
keywords="marginalized populations",
keywords="cyberbullying",
keywords="engagement",
keywords="compassion fatigue",
keywords="human subjects",
keywords="research protections",
keywords="adverse events",
abstract="Background: Social media can be a useful strategy for recruiting hard-to-reach, stigmatized populations into research studies; however, it may also introduce risks for participant and research team exposure to negative comments. Currently, there is no published formal social media recruitment and monitoring guidelines that specifically address harm reduction for social media recruitment of marginalized populations. Objective: The purpose of this research study was to investigate the utility, successes, challenges, and positive and negative consequences of using targeted Facebook advertisements as a strategy to recruit transgender and gender nonconforming (TGNC) people into a research study. Methods: TGNC adults living in the Southeast Unites States were recruited via targeted Facebook advertisements over two cycles in April and June 2017. During cycle 1, researchers only used inclusion terms to recruit the target population. During cycle 2, the social media recruitment and monitoring protocol and inclusion and exclusion terms were used. Results: The cycle 1 advertisement reached 8518 people and had 188 reactions, comments, and shares but produced cyberbullying, including discriminatory comments from Facebook members. Cycle 2 reached fewer people (6976) and received 166 reactions, comments, and shares but produced mostly positive comments. Conclusions: Researchers must consider potential harms of using targeted Facebook advertisements to recruit hard-to-reach and stigmatized populations. To minimize harm to participants and research staff, researchers must preemptively implement detailed social media recruitment and monitoring guidelines for monitoring and responding to negative feedback on targeted Facebook advertisements. ",
doi="10.2196/14886",
url="http://publichealth.jmir.org/2019/4/e14886/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31789598"
}


@Article{info:doi/10.2196/15869,
author="McCarthy, Edwina
and Mazza, Danielle",
title="Cost and Effectiveness of Using Facebook Advertising to Recruit Young Women for Research: PREFER (Contraceptive Preferences Study) Experience",
journal="J Med Internet Res",
year="2019",
month="Nov",
day="29",
volume="21",
number="11",
pages="e15869",
keywords="social media",
keywords="Facebook",
keywords="recruitment",
keywords="intervention study",
keywords="patient education",
keywords="internet",
abstract="Background: Social media is a popular and convenient method for communicating on the Web. The most commonly used social networking website, Facebook, is increasingly being used as a tool for recruiting research participants because of its large user base and its ability to target advertisements on the basis of Facebook users' information. Objective: We evaluated the cost and effectiveness of using Facebook to recruit young women into a Web-based intervention study (PREFER). The PREFER study aimed to determine whether an educational video could increase preference for and uptake of long-acting reversible contraception (LARC). Methods: We placed an advertisement on Facebook over a 19-day period from December 2017 to January 2018, inviting 16- to 25-year-old women from Australia to participate in a Web-based study about contraception. Those who clicked on the advertisement were directed to project information, and their eligibility was determined by using a screening survey. Results: Our Facebook advertisement delivered 130,129 impressions, resulting in over 2000 clicks at an overall cost of Aus \$918 (Aus \$0.44 per click). Web-based project information was accessed by 493 women. Of these, 462 women completed the screening survey, and 437 (437/463, 95\%) women were eligible. A total of 322 young women participated in Surveys 1 and 2 (74\% response rate), and 284 women participated in Survey 3 (88\% retention rate), with an advertising cost of Aus \$2.85 per consenting participant. Conclusions: Facebook proved to be a quick, effective, and cost-efficient tool for recruiting young Australian women into a study that was investigating contraceptive preferences. However, Web-based recruitment may result in sociodemographic biases. Further research is required to evaluate whether Facebook is suitable for recruiting older study populations. ",
doi="10.2196/15869",
url="http://www.jmir.org/2019/11/e15869/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31782738"
}


@Article{info:doi/10.2196/14729,
author="Li, Yiran
and Guo, Yan
and Hong, Alicia Y.
and Zhu, Mengting
and Zeng, Chengbo
and Qiao, Jiaying
and Xu, Zhimeng
and Zhang, Hanxi
and Zeng, Yu
and Cai, Weiping
and Li, Linghua
and Liu, Cong",
title="Mechanisms and Effects of a WeChat-Based Intervention on Suicide Among People Living With HIV and Depression: Path Model Analysis of a Randomized Controlled Trial",
journal="J Med Internet Res",
year="2019",
month="Nov",
day="27",
volume="21",
number="11",
pages="e14729",
keywords="HIV",
keywords="mHealth",
keywords="depression",
keywords="suicide",
abstract="Background: People living with HIV and depression have high rates of suicide. Studies of mobile health (mHealth) interventions have shown feasibility, acceptability, and efficacy in improving mental health in people living with HIV and depression. However, few studies have examined the mechanisms and effects of mHealth interventions on suicide. Objective: This study was designed to examine the mechanisms and effects of a WeChat-based intervention, Run4Love, on suicide among people living with HIV and depression in China, while considering perceived stress and depressive symptoms as mediators. Methods: A sample of 300 People living with HIV and depression was recruited from the outpatient clinic of a large HIV or AIDS treatment hospital and was randomized to the Run4Love group or a control group. Data were collected at baseline, 3-, 6-, and 9-month follow-ups. Path analysis modeling, with longitudinal data, was used in data analyses. Results: The Run4Love mHealth intervention had a direct effect on reducing suicide rate at the 6-month follow-up (beta=?.18, P=.02) and indirect effect through reducing perceived stress and depressive symptoms at the 3-month follow-up (beta=?.09, P=.001). A partial mediating effect between perceived stress and depressive symptoms accounted for 33\% (--0.09/--0.27) of the total effect. Conclusions: Through path analyses, we understood the mechanisms and effects of an mHealth intervention on suicide prevention. The findings underscored the importance of stress reduction and depression treatment in such a program. We call for more effective suicide prevention, especially mHealth interventions targeting the vulnerable population of people living with HIV and depression. Trial Registration: Chinese Clinical Trial Registry ChiCTR-IPR-17012606; http://www.chictr.org.cn/showprojen.aspx?proj=21019 ",
doi="10.2196/14729",
url="https://www.jmir.org/2019/11/e14729",
url="http://www.ncbi.nlm.nih.gov/pubmed/31774411"
}


@Article{info:doi/10.2196/12536,
author="Lognos, B{\'e}atrice
and Carbonnel, Fran{\c{c}}ois
and Boulze Launay, Isabelle
and Bringay, Sandra
and Guerdoux-Ninot, Estelle
and Mollevi, Caroline
and Senesse, Pierre
and Ninot, Gregory",
title="Complementary and Alternative Medicine in Patients With Breast Cancer: Exploratory Study of Social Network Forum Data",
journal="JMIR Cancer",
year="2019",
month="Nov",
day="27",
volume="5",
number="2",
pages="e12536",
keywords="complementary and alternative medicine (CAM)",
keywords="nonpharmacological interventions",
keywords="cancer",
keywords="social network",
keywords="forum",
keywords="patient",
abstract="Background: Patients and health care professionals are becoming increasingly preoccupied in complementary and alternative medicine (CAM) that can also be called nonpharmacological interventions (NPIs). In just a few years, this supportive care has gone from solutions aimed at improving the quality of life to solutions intended to reduce symptoms, supplement oncological treatments, and prevent recurrences. Digital social networks are a major vector for disseminating these practices that are not always disclosed to doctors by patients. An exploration of the content of exchanges on social networks by patients suffering from breast cancer can help to better identify the extent and diversity of these practices. Objective: This study aimed to explore the interest of patients with breast cancer in CAM from posts published in health forums and French-language social media groups. Methods: The retrospective study was based on a French database of 2 forums and 4 Facebook groups between June 3, 2006, and November 17, 2015. The extracted, anonymized, and compiled data (264,249 posts) were analyzed according to the occurrences associated with the NPI categories and NPI subcategories, their synonyms, and their related terms. Results: The results showed that patients with breast cancer use mainly physical (37.6\%) and nutritional (31.3\%) interventions. Herbal medicine is a subcategory that was cited frequently. However, the patients did not mention digital interventions. Conclusions: This exploratory study of the main French forums and discussion groups indicates a significant interest in CAM during and after treatments for breast cancer, with primarily physical and nutritional interventions complementing approved treatments. This study highlights the importance of accurate information (vs fake medicine), prescription and monitoring of these interventions, and the mediating role that health professionals must play in this regard. ",
doi="10.2196/12536",
url="http://cancer.jmir.org/2019/2/e12536/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31774404"
}


@Article{info:doi/10.2196/15847,
author="Sinclair, Marlene
and McCullough, EM Julie
and Elliott, David
and Latos-Bielenska, Anna
and Braz, Paula
and Cavero-Carbonell, Clara
and Jamry-Dziurla, Anna
and Jo{\~a}o Santos, Ana
and P{\'a}ramo-Rodr{\'i}guez, Luc{\'i}a",
title="Exploring Research Priorities of Parents Who Have Children With Down Syndrome, Cleft Lip With or Without Cleft Palate, Congenital Heart Defects, or Spina Bifida Using ConnectEpeople: A Social Media Coproduction Research Study",
journal="J Med Internet Res",
year="2019",
month="Nov",
day="25",
volume="21",
number="11",
pages="e15847",
keywords="e-forum",
keywords="social media",
keywords="Web-based survey",
keywords="Facebook",
keywords="STAI",
keywords="Down syndrome",
keywords="cleft lip with or without cleft palate",
keywords="congenital heart defects",
keywords="spina bifida",
keywords="parents",
keywords="ocularcentrism",
keywords="coproduction",
abstract="Background: Using social media for research purposes is novel and challenging in terms of recruitment, participant knowledge about the research process, and ethical issues. This paper provides insight into the recruitment of European parents of children with specific congenital anomalies to engage in coproduction research by using social media. Secret Facebook groups, providing optimal security, were set up for newly recruited research-aware parents (RAPs) to communicate privately and confidentially with each other and for the research team to generate questions and to interpret findings. Objective: This study aimed to use social media for the recruitment and engagement of parents in research and to determine the research priorities of parents who have children with Down syndrome, cleft lip with or without cleft palate, congenital heart defects, and spina bifida. Methods: The design was exploratory and descriptive with 3 phases. Phase 1 included the recruitment of RAPs and generation of research questions important to them; phase 2 was a Web-based survey, designed using Qualtrics software, and phase 3 included analysis and ranking of the top 10 research questions using an adapted James Lind Alliance approach. Simple descriptive statistics were used for analysis, and ethical approval was obtained from the Ethics Filter Committee of the Institute of Nursing and Health Research, Ulster University. Results: The recruitment of 32 RAPs was a sensitive process, varying in the time taken to consent (mean 51 days). However, parents valued the screening approach using the State-Trait Anxiety Inventory as a measure to ensure their well-being (mean 32.5). In phase 1, RAPs generated 98 research questions. In phase 2, 251 respondents accessed the Web-based survey, 248 consented, and 80 completed the survey, giving a completeness rate of 32.3\% (80/248). Most parents used social media (74/80, 92\%). Social media, online forums, and meeting in person were ranked the most preferable methods for communication with support groups networks and charities. Most respondents stated that they had a good understanding of research reports (71/80, 89\%) and statistics (68/80, 85\%) and could differentiate among the different types of research methodologies (62/80, 78\%). Phase 3 demonstrated consensus among RAPs and survey respondents, with a need to know the facts about their child's condition, future health, and psychosocial and educational outcomes for children with similar issues. Conclusions: Social media is a valuable facilitator in the coproduction of research between parents and researchers. From a theoretical perspective, ocularcentrism can be an applicable frame of reference for understanding how people favor visual contact. ",
doi="10.2196/15847",
url="http://www.jmir.org/2019/11/e15847/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31763986"
}


@Article{info:doi/10.2196/15441,
author="Laestadius, I. Linnea
and Penndorf, E. Kendall
and Seidl, Melissa
and Cho, I. Young",
title="Assessing the Appeal of Instagram Electronic Cigarette Refill Liquid Promotions and Warnings Among Young Adults: Mixed Methods Focus Group Study",
journal="J Med Internet Res",
year="2019",
month="Nov",
day="25",
volume="21",
number="11",
pages="e15441",
keywords="social media",
keywords="vaping",
keywords="tobacco",
keywords="marketing",
abstract="Background: While marketing for electronic cigarette refill liquids (e-liquids) is widespread on Instagram, little is known about the post elements that create appeal among young adult Instagram users. Further information is needed to help shape regulatory strategies appropriate for social media. Objective: This study examined young adult Instagram user perceptions of actual e-liquid marketing posts and US Food and Drug Administration (FDA)--mandated nicotine addiction warning statements on Instagram. Methods: A series of 12 focus groups (n=69) were held with non--tobacco users, vapers, smokers, and dual users in Wisconsin between September and December 2018. Participants discussed the elements of posts that they found appealing or unappealing, in addition to completing a survey about each post and e-liquid. Focus group transcripts were analyzed by smoking status using a framework analysis approach. Results: Although willingness to try e-liquids was highest among nicotine users, focus group discussions indicated that Instagram posts promoting e-liquids held appeal for individuals across smoking statuses. The primary elements that created appeal were the perceived trustworthiness of the Instagram account, attractive design and flavor visuals, and promotion of flavors and nicotine levels that met personal preferences. Post appeal was reduced by references to vaping subcultures, indicators that the post creator did not take nicotine addiction seriously, and FDA-mandated nicotine warning statements. Non--tobacco users were particularly drawn to posts featuring nicotine-free e-liquids with attractive visual designs and flavors known from foods. Conclusions: Young adults consider a broad range of elements in assessing the appeal of e-liquid marketing on Instagram, with minor but notable distinctions by smoking status. Non--tobacco users are uniquely drawn to nicotine-free e-liquids and are more deterred by the FDA's mandated nicotine addiction warning statements than those from other smoking statuses. This suggests that it may be possible to tailor policy interventions in a manner that helps to reduce novel uptake of vaping without significantly diminishing its potential harm-reduction benefits. ",
doi="10.2196/15441",
url="http://www.jmir.org/2019/11/e15441/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31763987"
}


@Article{info:doi/10.2196/17045,
author="deBronkart, Dave
and Eysenbach, Gunther",
title="Gimme My Damn Data (and Let Patients Help!): The \#GimmeMyDamnData Manifesto",
journal="J Med Internet Res",
year="2019",
month="Nov",
day="22",
volume="21",
number="11",
pages="e17045",
keywords="data",
keywords="participatory medicine",
keywords="ehealth",
doi="10.2196/17045",
url="http://www.jmir.org/2019/11/e17045/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31755873"
}


@Article{info:doi/10.2196/14285,
author="Booth, Alison
and Bell, Timothy
and Halhol, Sonia
and Pan, Shiyu
and Welch, Verna
and Merinopoulou, Evie
and Lambrelli, Dimitra
and Cox, Andrew",
title="Using Social Media to Uncover Treatment Experiences and Decisions in Patients With Acute Myeloid Leukemia or Myelodysplastic Syndrome Who Are Ineligible for Intensive Chemotherapy: Patient-Centric Qualitative Data Analysis",
journal="J Med Internet Res",
year="2019",
month="Nov",
day="22",
volume="21",
number="11",
pages="e14285",
keywords="social media",
keywords="health-related quality of life",
keywords="patient-centric",
keywords="leukemia",
keywords="myeloid",
keywords="acute",
keywords="myelodysplastic syndromes",
keywords="natural language processing",
keywords="patient preference",
keywords="qualitative research",
abstract="Background: Until recently, treatment options were limited for patients with acute myeloid leukemia and myelodysplastic syndrome (AML and MDS) who are ineligible for intensive chemotherapy. Owing to the condition's rapid progression, it is difficult to identify what is most important to patients when making treatment decisions. Patients' needs can be better addressed by gaining a deeper understanding of their perspectives, which is valuable in the decision-making process. The Food and Drug Administration recently encouraged the use of social media as a tool to gain insight on patients' perspectives regarding symptoms experienced and the impacts of their disease. Objective: This study aimed to use disease-specific social media posts by patients with AML or MDS who are ineligible for intensive chemotherapy and their caregivers to capture factors they feel are most important, and to provide current evidence to inform and characterize these perspectives. Methods: Posts by patients with AML or MDS and their caregivers were extracted from publicly available discussions on 3 large AML- or MDS--specific sites. These posts were manually reviewed to only include patients who are ineligible for intensive chemotherapy. A total of 1443 posts from 220 AML patients/caregivers and 2733 posts from 127 MDS patients/caregivers met the study inclusion criteria. A qualitative data analysis (QDA) of a sample of 85 patients'/caregivers' posts was conducted to identify themes, and a targeted QDA of posts from 79 users focused on treatment decision discussions. Posts were manually reviewed, and relevant text segments were coded and grouped into categories and overall themes. Results: Eighty-six percent (73/85) of users in the overall QDA had relevant information about the key objectives. The most commonly discussed treatment experience theme was the humanistic burden of AML or MDS in terms of emotional/physical impact and impact on family (86\%, 63/73 of users), followed by treatment decisions (56\%, 41/73) and unmet needs (50\%, 37/73). In the QDA of treatment decisions, 60 posts from 45 users contained relevant information. Patients commonly reported the desire to reach specific milestones, including birthdays and weddings. They wished for a better quality of life over quantity of life, did not want the risk of suffering from side effects, and expressed a clear preference to be at home rather than in a hospital or care home. Conclusions: This study was a novel application of disease-specific social media. It highlighted experiences in the current treatment of AML and MDS, including information gaps, patient/caregiver uncertainty, and the importance of understanding patients'/caregivers' goals and opinions. A clear finding from this research was the importance of reaching certain personal life goals and being at home with family and friends. The analysis showed that patients/caregivers face additional challenges, including humanistic impacts and a lack of information regarding treatment options. ",
doi="10.2196/14285",
url="http://www.jmir.org/2019/11/e14285/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31755871"
}


@Article{info:doi/10.2196/15155,
author="Sinicrope, S. Pamela
and Koller, R. Kathryn
and Prochaska, J. Judith
and Hughes, A. Christine
and Bock, J. Martha
and Decker, A. Paul
and Flanagan, A. Christie
and Merritt, T. Zoe
and Meade, D. Crystal
and Willetto, L. Abbie
and Resnicow, Ken
and Thomas, K. Timothy
and Patten, A. Christi",
title="Social Media Intervention to Promote Smoking Treatment Utilization and Cessation Among Alaska Native People Who Smoke: Protocol for the Connecting Alaska Native People to Quit Smoking (CAN Quit) Pilot Study",
journal="JMIR Res Protoc",
year="2019",
month="Nov",
day="22",
volume="8",
number="11",
pages="e15155",
keywords="smoking",
keywords="tobacco cessation",
keywords="Alaska",
keywords="Alaska Natives",
keywords="tobacco smoking",
keywords="internet",
keywords="social media",
keywords="clinical trial randomized",
keywords="smoking cessation",
keywords="intervention",
abstract="Background: Despite the high prevalence of tobacco use among Alaska Native (AN) people, tobacco cessation interventions developed specifically for this group are lacking. Social media hold promise as a scalable intervention strategy to promote smoking treatment utilization and cessation, given the barriers to treatment delivery (ie, geographic remoteness, limited funding, climate, and travel costs) in the state of Alaska (AK). Building on a longstanding tobacco control research partnership with the AK Tribal Health System, in this study, we are developing and pilot-testing a culturally relevant, Facebook (FB)-delivered intervention that incorporates a digital storytelling approach adapted from the effective Centers for Disease Control Tips from Former Smokers campaign. Objective: This study aims to promote evidence-based smoking treatment (eg, state quitline and Tribal cessation programs) uptake and cessation among AN people. Methods: This study fulfills the objectives for stage 1 of the National Institute on Drug Abuse behavioral integrative treatment development program. In stage 1a, we will use a mixed method approach to develop the FB intervention. Cultural variance and surface/deep structure frameworks will address the influence of culture in designing health messages. These developmental activities will include qualitative and quantitative assessments, followed by beta testing of proposed intervention content. In stage 1b, we will conduct a randomized pilot trial enrolling 60 AN adults who smoke. We will evaluate the feasibility, uptake, consumer response, and potential efficacy of the FB intervention compared with a control condition (quitline/treatment referral only). Primary outcome measures include feasibility and biochemically verified smoking abstinence at 1-, 3-, and 6-month follow-ups. Secondary outcomes will include self-reported smoking cessation treatment utilization and abstinence from tobacco/nicotine products. We will also explore interdependence (relationship orientation and collaborative efforts in lifestyle change) as a culturally relevant mediator of intervention efficacy. Results: The study enrolled 40 participants for phase 1, with data saturation being achieved at 30 AN people who smoke and 10 stakeholders. For phase 2, we enrolled 40 participants. Qualitative assessment of proposed intervention content was completed with 30 AN smokers and 10 stakeholders. We are currently analyzing data from the quantitative assessment with 40 participants in preparation for the beta testing, followed by the randomized pilot trial. Conclusions: The project is innovative for its use of social media communication tools that are culturally relevant in a behavioral intervention designed to reach AN people statewide to promote smoking treatment utilization and cessation. The study will further advance tobacco cessation research in an underserved disparity group. If the pilot intervention is successful, we will have a blueprint to conduct a large randomized controlled efficacy trial. Our approach could be considered for other remote AN communities to enhance the reach of evidence-based tobacco cessation treatments. International Registered Report Identifier (IRRID): DERR1-10.2196/15155 ",
doi="10.2196/15155",
url="http://www.researchprotocols.org/2019/11/e15155/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31755867"
}


@Article{info:doi/10.2196/13687,
author="Dol, Justine
and Tutelman, R. Perri
and Chambers, T. Christine
and Barwick, Melanie
and Drake, K. Emily
and Parker, A. Jennifer
and Parker, Robin
and Benchimol, I. Eric
and George, B. Ronald
and Witteman, O. Holly",
title="Health Researchers' Use of Social Media: Scoping Review",
journal="J Med Internet Res",
year="2019",
month="Nov",
day="13",
volume="21",
number="11",
pages="e13687",
keywords="health",
keywords="social media",
keywords="review",
abstract="Background: Health researchers are increasingly using social media in a professional capacity, and the applications of social media for health researchers are vast. However, there is currently no published evidence synthesis of the ways in which health researchers use social media professionally, and uncertainty remains as to how best to harness its potential. Objective: This scoping review aimed to explore how social media is used by health researchers professionally, as reported in the literature. Methods: The scoping review methodology guided by Arksey and O'Malley and Levac et al was used. Comprehensive searches based on the concepts of health research and social media were conducted in MEDLINE, EMBASE, CINAHL, PsycINFO, ERIC, and Web of Science databases, with no limitations applied. Articles were screened at the title and abstract level and at full text by two reviewers. One reviewer extracted data that were analyzed descriptively to map the available evidence. Results: A total of 8359 articles were screened at the title and abstract level, of which 719 were also assessed at full text for eligibility. The 414 articles identified for inclusion were published in 278 different journals. Studies originated from 31 different countries, with the most prevalent being the United States (52.7\% [218/414]). The health discipline of the first authors varied, with medicine (33.3\% [138/414]) being the most common. A third of the articles covered health generally, with 61 health-specific topics. Papers used a range of social media platforms (mean 1.33 [SD 0.7]). A quarter of the articles screened reported on social media use for participant recruitment (25.1\% [104/414]), followed by practical ways to use social media (15.5\% [64/414]), and use of social media for content analysis research (13.3\% [55/414]). Articles were categorized as celebratory (ie, opportunities for engagement, 72.2\% [299/414]), contingent (ie, opportunities and possible limitations, 22.7\% [94/414]) and concerned (ie, potentially harmful, 5.1\% [21/414]). Conclusions: Health researchers are increasingly publishing on their use of social media for a range of professional purposes. Although most of the sentiment around the use of social media in health research was celebratory, the uses of social media varied widely. Future research is needed to support health researchers to optimize their social media use. ",
doi="10.2196/13687",
url="https://www.jmir.org/2019/11/e13687",
url="http://www.ncbi.nlm.nih.gov/pubmed/31719028"
}


@Article{info:doi/10.2196/12942,
author="Ford, Elizabeth
and Curlewis, Keegan
and Wongkoblap, Akkapon
and Curcin, Vasa",
title="Public Opinions on Using Social Media Content to Identify Users With Depression and Target Mental Health Care Advertising: Mixed Methods Survey",
journal="JMIR Ment Health",
year="2019",
month="Nov",
day="13",
volume="6",
number="11",
pages="e12942",
keywords="social media",
keywords="depression",
keywords="mental health",
keywords="machine learning",
keywords="public opinion",
keywords="social license",
keywords="survey",
abstract="Background: Depression is a common disorder that still remains underdiagnosed and undertreated in the UK National Health Service. Charities and voluntary organizations offer mental health services, but they are still struggling to promote these services to the individuals who need them. By analyzing social media (SM) content using machine learning techniques, it may be possible to identify which SM users are currently experiencing low mood, thus enabling the targeted advertising of mental health services to the individuals who would benefit from them. Objective: This study aimed to understand SM users' opinions of analysis of SM content for depression and targeted advertising on SM for mental health services. Methods: A Web-based, mixed methods, cross-sectional survey was administered to SM users aged 16 years or older within the United Kingdom. It asked participants about their demographics, their usage of SM, and their history of depression and presented structured and open-ended questions on views of SM content being analyzed for depression and views on receiving targeted advertising for mental health services. Results: A total of 183 participants completed the survey, and 114 (62.3\%) of them had previously experienced depression. Participants indicated that they posted less during low moods, and they believed that their SM content would not reflect their depression. They could see the possible benefits of identifying depression from SM content but did not believe that the risks to privacy outweighed these benefits. A majority of the participants would not provide consent for such analysis to be conducted on their data and considered it to be intrusive and exposing. Conclusions: In a climate of distrust of SM platforms' usage of personal data, participants in this survey did not perceive that the benefits of targeting advertisements for mental health services to individuals analyzed as having depression would outweigh the risks to privacy. Future work in this area should proceed with caution and should engage stakeholders at all stages to maximize the transparency and trustworthiness of such research endeavors. ",
doi="10.2196/12942",
url="http://mental.jmir.org/2019/11/e12942/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31719022"
}


@Article{info:doi/10.2196/14068,
author="Rolls, Denise Kaye
and Hansen, Mary Margaret
and Jackson, Debra
and Elliott, Doug",
title="Why Health Care Professionals Belong to an Intensive Care Virtual Community: Qualitative Study",
journal="J Med Internet Res",
year="2019",
month="Nov",
day="5",
volume="21",
number="11",
pages="e14068",
keywords="social media",
keywords="focus groups",
keywords="physician",
keywords="nurse",
keywords="intensive care",
keywords="innovation diffusion",
keywords="scholarly communication",
abstract="Background: Clinical practice variation that results in poor patient outcomes remains a pressing problem for health care organizations. Some evidence suggests that a key factor may be ineffective internal and professional networks that limit knowledge exchange among health care professionals. Virtual communities have the potential to overcome professional and organizational barriers and facilitate knowledge flow. Objective: This study aimed to explore why health care professionals  belong to an exemplar virtual community, ICUConnect. The specific research objectives were to (1) understand why members join a virtual community and remain a member, (2) identify what purpose the virtual community serves in their professional lives, (3) identify how a member uses the virtual community, and (4) identify how members used the knowledge or resources shared on the virtual community. Methods: A qualitative design, underpinned by pragmatism, was used to collect data from 3 asynchronous online focus groups and 4 key informant interviews, with participants allocated to a group based on their posting behaviors during the previous two years---between September 1, 2012, and August 31, 2014: (1) frequent (>5 times), (2) low (?5 times), and (3) nonposters. A novel approach to focus group moderation, based on the principles of traditional focus groups, and e-moderating was developed. Thematic analysis was undertaken, applying the Diffusion of Innovation theory as the theoretical lens. NCapture (QRS International) was used to extract data from the focus groups, and NVivo was used to manage all data. A research diary and audit trail were maintained. Results: There were 27 participants: 7 frequent posters, 13 low posters, and 7 nonposters. All participants displayed an external orientation, with the majority using other social media; however, listservs were perceived to be superior in terms of professional compatibility and complexity. The main theme was as follows: ``Intensive care professionals are members of ICUConnect because by being a member of a broader community they have access to credible best-practice knowledge.'' The virtual community facilitated access to all professionals caring for the critically ill and was characterized by a positive and collegial online culture. The knowledge found was credible because it was extensive and because the virtual community was moderated and sponsored by a government agency. This enabled members to benchmark and improve their unit practices and keep up to date. Conclusions: This group of health care professionals made a strategic decision to be members of ICUConnect, as they understood that to provide up-to-date clinical practices, they needed to network with colleagues in other facilities. This demonstrated that a closed specialty-specific virtual community can create a broad heterogeneous professional network, overcoming current ineffective networks that may adversely impact knowledge exchange and creation in local practice settings. To address clinical practice variation, health care organizations can leverage low-cost social media technologies to improve interprofessional and interorganizational networks. ",
doi="10.2196/14068",
url="https://www.jmir.org/2019/11/e14068",
url="http://www.ncbi.nlm.nih.gov/pubmed/31687936"
}


@Article{info:doi/10.2196/14007,
author="Shah, Zubair
and Surian, Didi
and Dyda, Amalie
and Coiera, Enrico
and Mandl, D. Kenneth
and Dunn, G. Adam",
title="Automatically Appraising the Credibility of Vaccine-Related Web Pages Shared on Social Media: A Twitter Surveillance Study",
journal="J Med Internet Res",
year="2019",
month="Nov",
day="4",
volume="21",
number="11",
pages="e14007",
keywords="health misinformation",
keywords="credibility appraisal",
keywords="machine learning",
keywords="social media",
abstract="Background: Tools used to appraise the credibility of health information are time-consuming to apply and require context-specific expertise, limiting their use for quickly identifying and mitigating the spread of misinformation as it emerges. Objective: The aim of this study was to estimate the proportion of vaccine-related Twitter posts linked to Web pages of low credibility and measure the potential reach of those posts. Methods: Sampling from 143,003 unique vaccine-related Web pages shared on Twitter between January 2017 and March 2018, we used a 7-point checklist adapted from validated tools and guidelines to manually appraise the credibility of 474 Web pages. These were used to train several classifiers (random forests, support vector machines, and recurrent neural networks) using the text from a Web page to predict whether the information satisfies each of the 7 criteria. Estimating the credibility of all other Web pages, we used the follower network to estimate potential exposures relative to a credibility score defined by the 7-point checklist. Results: The best-performing classifiers were able to distinguish between low, medium, and high credibility with an accuracy of 78\% and labeled low-credibility Web pages with a precision of over 96\%. Across the set of unique Web pages, 11.86\% (16,961 of 143,003) were estimated as low credibility and they generated 9.34\% (1.64 billion of 17.6 billion) of potential exposures. The 100 most popular links to low credibility Web pages were each potentially seen by an estimated 2 million to 80 million Twitter users globally. Conclusions: The results indicate that although a small minority of low-credibility Web pages reach a large audience, low-credibility Web pages tend to reach fewer users than other Web pages overall and are more commonly shared within certain subpopulations. An automatic credibility appraisal tool may be useful for finding communities of users at higher risk of exposure to low-credibility vaccine communications. ",
doi="10.2196/14007",
url="https://www.jmir.org/2019/11/e14007",
url="http://www.ncbi.nlm.nih.gov/pubmed/31682571"
}


@Article{info:doi/10.2196/12880,
author="Mikal, P. Jude
and Grande, W. Stuart
and Beckstrand, J. Michael",
title="Codifying Online Social Support for Breast Cancer Patients: Retrospective Qualitative Assessment",
journal="J Med Internet Res",
year="2019",
month="Oct",
day="24",
volume="21",
number="10",
pages="e12880",
keywords="social support",
keywords="social networking",
keywords="social media",
keywords="health communication",
keywords="breast cancer",
abstract="Background: Social media has emerged as the epicenter for exchanging health-related information, resources, and emotional support. However, despite recognized benefits of social media for advancing health-promoting support exchange, researchers have struggled to differentiate between the different ways social support occurs and is expressed through social media. Objective: The objective of this study was to develop a fuller understanding of social support exchange by examining the ways in which breast cancer patients discuss their health needs and reach out for support on Facebook and to develop a coding schema that can be useful to other social media researchers. Methods: We conducted a retrospective qualitative assessment of text-based social support exchanges through Facebook among 30 breast cancer survivors. Facebook wall data were systematically scraped, organized, coded, and characterized by whether and which types of support were exchanged. Research questions focused on how often participants posted related to cancer, how often cancer patients reached out for support, and the relative frequency of informational, instrumental, or socioemotional support requests broadcast by patients on the site. Results: A novel ground-up coding schema applied to unwieldy Facebook data successfully identified social support exchange in two critical transitions in cancer treatment: diagnosis and transition off cancer therapy. Explanatory coding, design, and analysis processes led to a novel coding schema informed by 100,000 lines of data, an a priori literature review, and observed online social support exchanges. A final coding schema permits a compelling analysis of support exchange as a type of peer community, where members act proactively to buffer stress effects associated with negative health experiences. The coding schema framed operational definitions of what support meant and the forms each type of support could take in social media spaces. Conclusions: Given the importance of social media in social interaction, support exchange, and health promotion, our findings provide insight and clarity for researchers into the different forms informational, resource, and emotional support may take in Web-based social environments. Findings support broader continuity for evaluating computer-mediated support exchange. ",
doi="10.2196/12880",
url="http://www.jmir.org/2019/10/e12880/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31651404"
}


@Article{info:doi/10.2196/13320,
author="Nittas, Vasileios
and Lun, Penny
and Ehrler, Frederic
and Puhan, Alan Milo
and M{\"u}tsch, Margot",
title="Electronic Patient-Generated Health Data to Facilitate Disease Prevention and Health Promotion: Scoping Review",
journal="J Med Internet Res",
year="2019",
month="Oct",
day="14",
volume="21",
number="10",
pages="e13320",
keywords="patient-generated health data",
keywords="personal health information",
keywords="consumer health information",
keywords="primary prevention",
keywords="health promotion",
keywords="telemedicine",
keywords="mobile health",
keywords="medical informatics",
keywords="eHealth",
abstract="Background: Digital innovations continue to shape health and health care. As technology socially integrates into daily living, the lives of health care consumers are transformed into a key source of health information, commonly referred to as patient-generated health data (PGHD). With chronic disease prevalence signaling the need for a refocus on primary prevention, electronic PGHD might be essential in strengthening proactive and person-centered health care. Objective: This study aimed to review and synthesize the existing literature on the utilization and implications of electronic PGHD for primary disease prevention and health promotion purposes. Methods: Guided by a well-accepted methodological framework for scoping studies, we screened MEDLINE, CINAHL, PsycINFO, Scopus, Web of Science, EMBASE, and IEEE Digital Library. We hand-searched 5 electronic journals and 4 gray literature sources, additionally conducted Web searches, reviewed relevant Web pages, manually screened reference lists, and consulted authors. Screening was based on predefined eligibility criteria. Data extraction and synthesis were guided by an adapted PGHD-flow framework. Beyond initial quantitative synthesis, we reported narratively, following an iterative thematic approach. Raw data were coded, thematically clustered, and mapped, allowing for the identification of patterns. Results: Of 183 eligible studies, targeting knowledge and self-awareness, behavior change, healthy environments, and remote monitoring, most literature (125/183, 68.3\%) addressed weight reduction, either through physical activity or nutrition, applying a range of electronic tools from socially integrated to full medical devices. Participants generated their data actively (100/183, 54.6\%), in combination with passive sensor-based trackers (63/183, 34.4\%) or entirely passively (20/183, 10.9\%). The proportions of active and passive data generation varied strongly across prevention areas. Most studies (172/183, 93.9\%) combined electronic PGHD with reflective, process guiding, motivational and educational elements, highlighting the role of PGHD in multicomponent digital prevention approaches. Most of these interventions (110/183, 60.1\%) were fully automatized, underlining broader trends toward low-resource and efficiency-driven care. Only a fraction (47/183, 25.6\%) of studies provided indications on the impact of PGHD on prevention-relevant outcomes, suggesting overall positive trends, especially on vitals (eg, blood pressure) and body composition measures (eg, body mass index). In contrast, the impact of PGHD on health equity remained largely unexplored. Finally, our analysis identified a list of barriers and facilitators clustered around data collection and use, technical and design considerations, ethics, user characteristics, and intervention context and content, aiming to guide future PGHD research. Conclusions: The large, heterogeneous volume of the PGHD literature underlines the topic's emerging nature. Utilizing electronic PGHD to prevent diseases and promote health is a complex matter owing to mostly being integrated within automatized and multicomponent interventions. This underlines trends toward stronger digitalization and weaker provider involvement. A PGHD use that is sensitive to identified barriers, facilitators, consumer roles, and equity considerations is needed to ensure effectiveness. ",
doi="10.2196/13320",
url="http://www.jmir.org/2019/10/e13320/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31613225"
}


@Article{info:doi/10.2196/11205,
author="Nikolaou, Konstantia Charoula
and Tay, Zoey
and Leu, Jodie
and Rebello, Antonette Salome
and Te Morenga, Lisa
and Van Dam, M. Rob
and Lean, John Michael Ernest",
title="Young People's Attitudes and Motivations Toward Social Media and Mobile Apps for Weight Control: Mixed Methods Study",
journal="JMIR Mhealth Uhealth",
year="2019",
month="Oct",
day="10",
volume="7",
number="10",
pages="e11205",
keywords="weight gain",
keywords="young adults",
keywords="obesity",
keywords="public health",
keywords="focus groups",
keywords="mobile apps",
keywords="mHealth",
abstract="Background: Effective prevention at a young enough age is critical to halt the obesity epidemic. Mobile health (mHealth) apps would potentially reach large numbers at low-cost. While there is already a profusion of lifestyle apps, they are mostly non-evidence-based and evidently ineffective against rising obesity prevalence. Objective: The aim of this study was to explore preferences and usage of lifestyle apps among young people in 6 countries. Methods: A mixed methods study was conducted among young people aged 13 to 24 years residing in the United Kingdom, Belgium, Finland, Greece, Singapore, and New Zealand. Participants were recruited from Web advertisements on Facebook, asking for volunteers interested in mobile apps in general, not specific to lifestyle or health, to complete a short survey comprising 18 questions on demographics, weight gain, and mobile app preferences and then to join English-language online focus groups, which were held during 2017, in password-protected Web rooms, moderated by an experienced researcher. Descriptive statistics were carried out for the survey, and thematic analysis was applied to transcripts. Results: A total of 2285 young people (610 adolescents aged 13-17 years and 1675 young adults aged 18-24 years) responded and completed the survey, with 72.0\% (1645) reported being concerned about weight gain for themselves or friends. Later, 807 young people (376 adolescents and 431 young adults) were selected based on age and country to participate in 12 online focus groups, with 719 young people completing. Analysis revealed 4 main themes: (1) feelings toward personal weight; (2) perception of lifestyle apps and desired content for weight gain prevention; (3) social media apps, lifestyle apps, and motivation for downloading and retaining; and (4) data safety and data usage and confidentiality. Young people are interested in evidence-based advice in programs incorporating their preferences. Conclusions: Young people are commonly, and consistently across 6 countries, concerned about weight gain and obesity and would welcome evidence-based mHealth programs, provided the views of young people themselves are incorporated in the program content. ",
doi="10.2196/11205",
url="https://mhealth.jmir.org/2019/10/e11205",
url="http://www.ncbi.nlm.nih.gov/pubmed/31603431"
}


@Article{info:doi/10.2196/14080,
author="Ford, Lynett Kelsey
and Albritton, Tashuna
and Dunn, A. Tara
and Crawford, Kacy
and Neuwirth, Jessica
and Bull, Sheana",
title="Youth Study Recruitment Using Paid Advertising on Instagram, Snapchat, and Facebook: Cross-Sectional Survey Study",
journal="JMIR Public Health Surveill",
year="2019",
month="Oct",
day="9",
volume="5",
number="4",
pages="e14080",
keywords="social media",
keywords="youth",
keywords="surveys and questionnaires",
abstract="Background: The use of paid social media advertising for targeted study recruitment is an effective strategy in health research and evaluation, specifically to reach diverse youth participants. Although the literature adequately describes the utility of Facebook in recruitment, limited information exists for social media platforms that are more popular with youth, specifically Instagram and Snapchat. Objective: This paper outlines a paid advertising approach using Instagram, Snapchat, and Facebook to evaluate a statewide youth marijuana prevention campaign. The objective of this study was to compare recruitment metrics across Instagram, Snapchat, and Facebook for two surveys documenting youth knowledge, attitudes, and behaviors related to retail marijuana in Colorado post legalization. In addition, the study assessed the feasibility of using Instagram and Snapchat as effective additions to Facebook for youth study recruitment. Methods: A social media recruitment strategy was used to conduct two cross-sectional surveys of youth, aged 13 to 20 years, in Colorado. Geographically targeted ads across 3 social media platforms encouraged the completion of a Web-based self-administered survey. Ad Words and Snap Ads were used to deploy and manage advertising campaigns, including ad design, placement, and analysis. Ad costs and recruitment metrics (ie, impressions, link clicks, and conversion rates) were calculated across the three social media platforms. Results: Over two 1-month periods, 763,613 youth were reached (ie, impressions), 6089 of them clicked survey links (ie, clicks), and 828 eligible youth completed surveys about knowledge, attitudes, and behaviors related to retail marijuana. Instagram converted 36.13\% (803/2222) of impressions to clicks (ie, conversion rate) in the first survey and 0.87\% (864/98982) in the second survey. Snapchat generated the most impressions and link clicks, but it did so with the lowest conversion rate for both surveys, with a 1.40\% (1600/114,200) conversion rate in the first survey and a 0.36\% (1818/504700) conversion rate in the second survey. Facebook maintained a consistent conversion rate of roughly 2\% across both surveys, despite reductions in budget for the second survey. The cost-per-click ranged between US \$0.25 and \$0.37 across the three platforms, with Snapchat as both the most cost-effective platform in the first survey and the most expensive platform in the second survey. Conclusions: Recruitment and enrollment outcomes indicate the use of Instagram and Snapchat, in addition to Facebook, may be a modern, useful, and cost-effective approach to reach youth with surveys on sensitive health topics. As the use of Facebook declines among youth, the use of more popular social media platforms can augment study recruitment for health research and evaluation efforts. ",
doi="10.2196/14080",
url="https://publichealth.jmir.org/2019/4/e14080",
url="http://www.ncbi.nlm.nih.gov/pubmed/31599739"
}


@Article{info:doi/10.2196/14731,
author="Albalawi, Yahya
and Nikolov, S. Nikola
and Buckley, Jim",
title="Trustworthy Health-Related Tweets on Social Media in Saudi Arabia: Tweet Metadata Analysis",
journal="J Med Internet Res",
year="2019",
month="Oct",
day="8",
volume="21",
number="10",
pages="e14731",
keywords="social media",
keywords="new media",
keywords="misinformation",
keywords="trustworthiness",
keywords="dissemination",
keywords="health communication",
abstract="Background: Social media platforms play a vital role in the dissemination of health information. However, evidence suggests that a high proportion of Twitter posts (ie, tweets) are not necessarily accurate, and many studies suggest that tweets do not need to be accurate, or at least evidence based, to receive traction. This is a dangerous combination in the sphere of health information. Objective: The first objective of this study is to examine health-related tweets originating from Saudi Arabia in terms of their accuracy. The second objective is to find factors that relate to the accuracy and dissemination of these tweets, thereby enabling the identification of ways to enhance the dissemination of accurate tweets. The initial findings from this study and methodological improvements will then be employed in a larger-scale study that will address these issues in more detail. Methods: A health lexicon was used to extract health-related tweets using the Twitter application programming interface and the results were further filtered manually. A total of 300 tweets were each labeled by two medical doctors; the doctors agreed that 109 tweets were either accurate or inaccurate. Other measures were taken from these tweets' metadata to see if there was any relationship between the measures and either the accuracy or the dissemination of the tweets. The entire range of this metadata was analyzed using Python, version 3.6.5 (Python Software Foundation), to answer the research questions posed. Results: A total of 34 out of 109 tweets (31.2\%) in the dataset used in this study were classified as untrustworthy health information. These came mainly from users with a non-health care background and social media accounts that had no corresponding physical (ie, organization) manifestation. Unsurprisingly, we found that traditionally trusted health sources were more likely to tweet accurate health information than other users. Likewise, these provisional results suggest that tweets posted in the morning are more trustworthy than tweets posted at night, possibly corresponding to official and casual posts, respectively. Our results also suggest that the crowd was quite good at identifying trustworthy information sources, as evidenced by the number of times a tweet's author was tagged as favorited by the community. Conclusions: The results indicate some initially surprising factors that might correlate with the accuracy of tweets and their dissemination. For example, the time a tweet was posted correlated with its accuracy, which may reflect a difference between professional (ie, morning) and hobbyist (ie, evening) tweets. More surprisingly, tweets containing a kashida---a decorative element in Arabic writing used to justify the text within lines---were more likely to be disseminated through retweets. These findings will be further assessed using data analysis techniques on a much larger dataset in future work. ",
doi="10.2196/14731",
url="https://www.jmir.org/2019/10/e14731",
url="http://www.ncbi.nlm.nih.gov/pubmed/31596242"
}


@Article{info:doi/10.2196/12878,
author="Kelley, E. Dannielle
and Brown, Meredith
and Murray, Alice
and Blake, D. Kelly",
title="Prevalence and Characteristics of Twitter Posts About Court-Ordered, Tobacco-Related Corrective Statements: Descriptive Content Analysis",
journal="JMIR Public Health Surveill",
year="2019",
month="Oct",
day="8",
volume="5",
number="4",
pages="e12878",
keywords="social media",
keywords="Twitter",
keywords="tobacco corrective statements",
keywords="tobacco industry/legislation and jurisprudence",
abstract="Background: Three major US tobacco companies were recently ordered to publish corrective statements intended to prevent and restrain further fraud about the health effects of smoking. The court-ordered statements began appearing in newspapers and on television (TV) in late 2017. Objective: The objective of this study was to examine the social media dissemination of the tobacco corrective statements during the first 6 months of the implementation of the statements. Methods: We conducted a descriptive content analysis of Twitter posts using an iterative search strategy through Crimson Hexagon and randomly selected 19.74\% (456/2309) of original posts occurring between November 1, 2017, and March 27, 2018, for coding and analysis. We assessed post volume over time, source or author, valence, linked content, and reference to the industry (eg, big tobacco, tobacco industry, and Philip Morris) and media outlet (TV or newspaper). Retweeted content was coded for source/author and prevalence. Results: Most posts were published in November 2017, surrounding the initial release of the corrective statements. Content was generally neutral (58.7\%, 268/456) or positive (33.3\%, 152/456) in valence, included links to additional information about the statements (94.9\%, 433/456), referred to the industry (87.7\%, 400/456), and did not mention a specific media channel on which the statements were aired or published (15\%). The majority of original posts were created by individual users (55.2\%, 252/456), whereas the majority of retweeted posts were posted by public health organizations (51\%). Differences by source are reported, for example, organization posts are more likely to include a link to additional information compared with individual users (P=.03). Conclusions: Conversations about the court-ordered corrective statements are taking place on Twitter and are generally neutral or positive in nature. Public health organizations may be increasing the prevalence of these conversations through social media engagement. ",
doi="10.2196/12878",
url="https://publichealth.jmir.org/2019/4/e12878",
url="http://www.ncbi.nlm.nih.gov/pubmed/31596243"
}


@Article{info:doi/10.2196/14834,
author="Dogan, Huseyin
and Norman, Helmi
and Alrobai, Amen
and Jiang, Nan
and Nordin, Norazah
and Adnan, Anita",
title="A Web-Based Intervention for Social Media Addiction Disorder Management in Higher Education: Quantitative Survey Study",
journal="J Med Internet Res",
year="2019",
month="Oct",
day="2",
volume="21",
number="10",
pages="e14834",
keywords="Facebook addiction",
keywords="intervention features",
keywords="postgraduate education",
keywords="social media addiction",
keywords="obsessive-compulsive disorder (OCD)",
keywords="PLS-SEM analysis",
abstract="Background: Social media addiction disorder has recently become a major concern and has been reported to have negative impacts on postgraduate studies, particularly addiction to Facebook. Although previous studies have investigated the effects of Facebook addiction disorder in learning settings, there still has been a lack of studies investigating the relationship between online intervention features for Facebook addiction focusing on postgraduate studies. Objective: In an attempt to understand this relationship, this study aimed to carry out an investigation on online intervention features for effective management of Facebook addiction in higher education. Methods: This study was conducted quantitatively using surveys and partial least square-structural equational modeling. The study involved 200 postgraduates in a Facebook support group for postgraduates. The Bergen Facebook Addiction test was used to assess postgraduates' Facebook addiction level, whereas online intervention features were used to assess postgraduates' perceptions of online intervention features for Facebook addiction, which are as follows: (1) self-monitoring features, (2) manual control features, (3) notification features, (4) automatic control features, and (5) reward features. Results: The study discovered six Facebook addiction factors (relapse, conflict, salience, tolerance, withdrawal, and mood modification) and five intervention features (notification, auto-control, reward, manual control, and self-monitoring) that could be used in the management of Facebook addiction in postgraduate education. The study also revealed that relapse is the most important factor and mood modification is the least important factor. Furthermore, findings indicated that notification was the most important intervention feature, whereas self-monitoring was the least important feature. Conclusions: The study's findings (addiction factors and intervention features) could assist future developers and educators in the development of online intervention tools for Facebook addiction management in postgraduate education. ",
doi="10.2196/14834",
url="https://www.jmir.org/2019/10/e14834",
url="http://www.ncbi.nlm.nih.gov/pubmed/31579018"
}


@Article{info:doi/10.2196/13658,
author="Argenyi, Michael
and Kushalnagar, Poorna",
title="Social Media Use and HIV Screening Uptake Among Deaf Adults in the United States: Cross-Sectional Survey Study",
journal="JMIR Public Health Surveill",
year="2019",
month="Oct",
day="2",
volume="5",
number="4",
pages="e13658",
keywords="HIV",
keywords="sexually transmitted disease",
keywords="sexually transmitted infection",
keywords="deaf",
keywords="sign language",
keywords="social media",
keywords="internet",
abstract="Background: About 46\% of US adults obtain recommended HIV screening at least once during their lifetime. There is little knowledge of screening rates among deaf and hard-of-hearing adults who primarily use American Sign Language (ASL), or of social media as a potentially efficacious route for HIV prevention outreach, despite lower HIV/AIDS-specific health literacy and potentially higher HIV seropositivity rates than hearing peers. Objective: We investigated both the likelihood of HIV screening uptake among deaf adults in the past year and over one year ago, and the relationship between social media use and HIV screening uptake among deaf adult ASL users. Methods: The Health Information National Trends Survey in ASL was administered to 1340 deaf US adults between 2015-2018. Modified Poisson with robust standard errors was used to assess the relationship between social media usage as a predictor and HIV screening as an outcome (screened more than one year ago, screened within the past year, and never been screened), after adjusting for sociodemographics and sexually transmitted disease (STD) covariates. Results: The estimated lifetime prevalence of HIV screening uptake among our sample was 54\% (719/1340), with 32\% (429/1340) in the past year. Being of younger age, male gender, black, lesbian, gay, bisexual, or queer, or having some college education or a prior STD were associated with HIV screening uptake. Adjusting for correlates, social media use was significantly associated with HIV screening in the past year, compared to either lifetime or never. Conclusions: Screening falls well short of universal screening targets, with gaps among heterosexual, female, Caucasian, or older deaf adults. HIV screening outreach may not be effective because of technological or linguistic inaccessibility, rendering ASL users an underrecognized minority group. However, social media is still a powerful tool, particularly among younger deaf adults at risk for HIV. ",
doi="10.2196/13658",
url="https://publichealth.jmir.org/2019/4/e13658",
url="http://www.ncbi.nlm.nih.gov/pubmed/31579021"
}


@Article{info:doi/10.2196/14011,
author="Ellway, Daniel
and Reilly, Rachel
and Le Couteur, Amanda
and Ward, James",
title="Exploring How People Affected by Methamphetamine Exchange Social Support Through Online Interactions on Facebook: Content Analysis",
journal="JMIR Ment Health",
year="2019",
month="Oct",
day="1",
volume="6",
number="10",
pages="e14011",
keywords="methamphetamine",
keywords="social media",
keywords="social support",
abstract="Background: Methamphetamine is an illicit and addictive psychostimulant that remains to be a significant cause of economic burden in Australia. Social media is increasingly being used by nongovernment organizations and health services to encourage the growth of social support networks among people with health-related issues. Several studies have investigated the utility of social media in providing social support to groups of people with health-related issues. However, limited research exists that explores how people who have been directly or indirectly affected by methamphetamine use social media for social support. Objective: This study aimed to determine the types of social support being sought and provided by people affected by methamphetamine when interacting with others on a Facebook page. Methods: A total of 14,777 posts were collected from a Facebook page and transferred into an Excel document for content analysis. The posts were manually coded into categories of social support using an adapted version of Cutrona and Suhr's Social Support Behavior Code. Posts could be coded into more than one category. Saturation was reached at 2000 posts, which were used to draw inferences. Results: Emotional support was the most offered support type, with 42.05\% (841/2000) of posts providing this form of support. This is followed by esteem support, which was provided in 40.40\% (808/2000) of posts. Overall, 24.20\% (484/2000) of posts offered informational support. Network support and tangible support were the least offered support types, with 2.25\% (45/2000) and 1.70\% (34/2000) of posts offering these types of support, respectively. Conclusions: This study suggests that online social support groups can be effective in challenging stigma by encouraging people affected by methamphetamine to connect with each other and talk about their struggles. This in turn represents an important step toward successful rehabilitation. ",
doi="10.2196/14011",
url="https://mental.jmir.org/2019/10/e14011",
url="http://www.ncbi.nlm.nih.gov/pubmed/31573926"
}


@Article{info:doi/10.2196/12667,
author="Stetten, E. Nichole
and LeBeau, Kelsea
and Aguirre, A. Maria
and Vogt, B. Alexis
and Quintana, R. Jazmine
and Jennings, R. Alexis
and Hart, Mark",
title="Analyzing the Communication Interchange of Individuals With Disabilities Utilizing Facebook, Discussion Forums, and Chat Rooms: Qualitative Content Analysis of Online Disabilities Support Groups",
journal="JMIR Rehabil Assist Technol",
year="2019",
month="Sep",
day="30",
volume="6",
number="2",
pages="e12667",
keywords="persons with disabilities",
keywords="social media",
keywords="social support",
keywords="online social networking",
keywords="internet",
keywords="psychosocial support systems",
keywords="qualitative research",
abstract="Background: Approximately 1 in 5 adults in the United States are currently living with a form of disability. Although the Americans with Disabilities Act has published guidelines to help make developing technology and social networking sites (SNS) more accessible and user-friendly to people with a range of disabilities, persons with disabilities, on average, have less access to the internet than the general population. The quality, content, and medium vary from site to site and have been greatly understudied. Due to this, it is still unclear how persons with disabilities utilize various platforms of online communication for support. Objective: The objective of this study was to qualitatively explore and compare the interactions and connections among online support groups across Facebook, discussion forums, and chat rooms to better understand how persons with disabilities were utilizing different SNS to facilitate communication interchange, disseminate information, and foster community support. Methods: Facebook groups, discussion forums, and chat rooms were chosen based on predetermined inclusion criteria. Data collected included content posted on Facebook groups, forums, and chat rooms as well as the interactions among group members. Data were analyzed qualitatively using the constant comparative method. Results: A total of 133 Facebook posts, 116 forum posts, and 60 hours of chat room discussions were collected and analyzed. In addition, 4 themes were identified for Facebook posts, 3 for discussion forums, and 3 for chat rooms. Persons with disabilities utilized discussion forums and chat rooms in similar ways, but their interactions on Facebook differed in comparison. They seem to interact on a platform based on the specific functions it offers. Conclusions: Interactions on each of the platforms displayed elements of the 4 types of social support, indicating the ability for social support to be facilitated among SNS; however, the type of social support varied by platform. Findings demonstrate that online support platforms serve specific purposes that may not be interchangeable. Through participation on different platforms, persons with disabilities are able to provide and receive social support in various ways, without the barriers and constraints often experienced by this population. ",
doi="10.2196/12667",
url="http://rehab.jmir.org/2019/2/e12667/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31573937"
}


@Article{info:doi/10.2196/10728,
author="Dave, Arpit
and Yi, Johnny
and Boothe, Andy
and Brashear, Helene
and Byrne, Jeffrey
and Gad, Yash",
title="Listening to the HysterSisters: A Retrospective Keyword Frequency Analysis of Conversations About Hysterectomy Recovery",
journal="JMIR Perioper Med",
year="2019",
month="Sep",
day="26",
volume="2",
number="2",
pages="e10728",
keywords="hysterectomy",
keywords="gynecology",
keywords="social media",
keywords="perceived recovery",
abstract="Background: In the postoperative period, individual patient experiences vary widely and are based on a diverse set of input variables influenced by all stakeholders in and throughout the surgical process. Although clinical research has primarily focused on clinical and administrative datasets to characterize the postoperative recovery experience, there is increasing interest in patient-reported outcome measures (PROMs). The growth of online communities in which patients themselves participate provides a venue to study PROMs directly. One such forum-based community is HysterSisters, dedicated to helping individuals through the experience of hysterectomy, a major surgery which removes the uterus. The surgery can be performed by a variety of methods such as minimally invasive approaches or the traditional abdominal approach using a larger incision. The community offers support for ``medical and emotional issues [...] from diagnosis, to treatment, to recovery.'' Users can specify when and what type of hysterectomy they underwent. They can discuss their shared experience of hysterectomy and provide, among other interactions, feedback, reassurance, sympathy, or advice, thus providing a unique view into conversations surrounding the hysterectomy experience. Objective: We aimed to characterize conversations about hysterectomy recovery as experienced by users of the HysterSisters online community. Methods: A retrospective keyword frequency analysis of the HysterSisters Hysterectomy Recovery forum was performed. Results: Within the Hysterectomy Recovery forum, 33,311 unique users declared their hysterectomy date and type and posted during the first 12 weeks postsurgery. A taxonomy of 8 primary symptom groups was created using a seed list of keywords generated from a term frequency analysis of these threads. Pain and bleeding were the two most mentioned symptom groups and account for almost half of all symptom mentions (19,965/40,127). For symptoms categories such as pain and hormones and emotions, there was no difference in the proportion of users mentioning related keywords, regardless of the type of hysterectomy, whereas bleeding-related or intimacy-related keywords were mentioned more frequently by users undergoing certain minimally invasive approaches when compared with those undergoing abdominal hysterectomy. Temporal patterns in symptom mentions were noted as well. The majority of all posting activity occurred in the first 3 weeks. Across all keyword groups, individuals reporting minimally invasive procedures ceased forum use of these keywords significantly earlier than those reporting abdominal hysterectomy. Peaks in conversation volume surrounding particular symptom categories were also identified at 1, 3, and 6 weeks postoperatively. Conclusions: The HysterSisters Hysterectomy Recovery forum and other such forums centered on users' health care experience can provide novel actionable insights that can improve patient-centered care during the postoperative period. This study adds another dimension to the utility of social media analytics by demonstrating that measurement of post volumes and distribution of symptom mentions over time reveal key opportunities for beneficial symptom-specific patient engagement. ",
doi="10.2196/10728",
url="http://periop.jmir.org/2019/2/e10728/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33393919"
}


@Article{info:doi/10.2196/14589,
author="Harding, Kassandra
and P{\'e}rez-Escamilla, Rafael
and Carroll, Grace
and Aryeetey, Richmond
and Lasisi, Opeyemi",
title="Four Dissemination Pathways for a Social Media--Based Breastfeeding Campaign: Evaluation of the Impact on Key Performance Indicators",
journal="JMIR Nursing",
year="2019",
month="Sep",
day="26",
volume="2",
number="1",
pages="e14589",
keywords="social media",
keywords="health communication",
keywords="breastfeeding",
keywords="dissemination",
keywords="Ghana",
abstract="Background: Social media utilization is on the rise globally, and the potential of social media for health behavior campaigns is widely recognized. However, as the landscape of social media evolves, so do techniques used to optimize campaign dissemination. Objective: The primary aim of this study was to evaluate the impact of 4 material dissemination paths for a breastfeeding social media marketing campaign in Ghana on exposure and engagement with campaign material. Methods: Campaign materials (n=60) were posted to a Facebook and Twitter campaign page over 12 weeks (ie, baseline). The top 40 performing materials were randomized to 1 of 4 redissemination arms (control simply posted on each platform, key influencers, random influencers, and paid advertisements). Key performance indicator data (ie, exposure and engagement) were extracted from both Facebook and Twitter 2 days after the material was posted. A difference-in-difference model was used to examine the impact of the dissemination paths on performance. Results: At baseline, campaign materials received an average (SD) exposure of 1178 (670) on Facebook and 1071 (905) on Twitter (n=60). On Facebook, materials posted with paid advertisements had significantly higher exposure and engagement compared with the control arm (P<.001), and performance of materials shared by either type of influencer did not differ significantly from the control arm. No differences in Twitter performance were detected across arms. Conclusions: Paid advertisements are an effective mechanism to increase exposure and engagement of campaign posts on Facebook, which was achieved at a low cost. ",
doi="10.2196/14589",
url="https://nursing.jmir.org/2019/1/e14589/",
url="http://www.ncbi.nlm.nih.gov/pubmed/34345773"
}


@Article{info:doi/10.2196/13467,
author="Windler, Carolyn
and Clair, Maeve
and Long, Cassandra
and Boyle, Leah
and Radovic, Ana",
title="Role of Moderators on Engagement of Adolescents With Depression or Anxiety in a Social Media Intervention: Content Analysis of Web-Based Interactions",
journal="JMIR Ment Health",
year="2019",
month="Sep",
day="26",
volume="6",
number="9",
pages="e13467",
keywords="moderator",
keywords="social media",
keywords="engagement",
keywords="adolescents",
keywords="mental health",
abstract="Background: The Supporting Our Valued Adolescents (SOVA) intervention aims to use a moderated social media website to encourage peer discussion about negative health beliefs, which may prevent treatment uptake. Web moderators with a background in behavioral health are used to facilitate peer conversation to promote a sense of community, provide social support, and ensure safety. Objective: Although moderation is a core component of this intervention, little is known on best practices for moderators to ensure safety while encouraging engagement. This study sought to describe interactions between moderators and peer users and understand moderator experiences through individual interviews. Methods: Adolescents and young adults aged 14 to 26 years with depression or anxiety history were recruited for a usability study of the SOVA intervention. During this study, 14 moderators were trained to regularly review comments to blog posts for safety, facilitate conversation, and correct misinformation. A total of 110 blog posts and their associated comments were extracted and coded using a codebook based on items from the supportive accountability model and a peer social support analysis. Closing interviews with 12 moderators assessing their experience of moderating were conducted, recorded, and transcribed. Blog post text and comments as well as transcripts of moderator interviews were assessed using a thematic analysis approach, and blog posts were examined for trends in content of moderator comments comparing blog posts with differences in comment contributor order. Results: There were no safety concerns during the study, and moderators only intervened to remove identifiable information. Web moderators exhibited elements of supportive accountability (such as being perceived as experts and using verbal rewards as well as offering informational and emotional support). When the moderators provided the last comment under a blog post, thereby potentially ending contribution by users, they were at times found to be commenting about their own experiences. Moderators interviewed after completing their role expressed challenges in engaging users. A cohort of moderators who received more extensive training on supportive accountability and peer social support felt their ability to engage users improved because of the training. Conclusions: Moderators of a Web-based support site for adolescents with depression or anxiety were able to ensure safety while promoting user engagement. Moderators can elicit user engagement by offering gratitude and encouragement to users, asking users follow-up questions, and limiting their own opinions and experiences when responding to comments. ",
doi="10.2196/13467",
url="http://mental.jmir.org/2019/9/e13467/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31573923"
}


@Article{info:doi/10.2196/15298,
author="Gassman, Ann Ruth
and Dutta, Tapati
and Agley, Jon
and Jayawardene, Wasantha
and Jun, Mikyoung",
title="Social Media Outrage in Response to a School-Based Substance Use Survey: Qualitative Analysis",
journal="J Med Internet Res",
year="2019",
month="Sep",
day="12",
volume="21",
number="9",
pages="e15298",
keywords="social media",
keywords="ATOD",
keywords="survey",
keywords="firestorm",
keywords="digital",
abstract="Background: School-based alcohol, tobacco, and other drug use (ATOD) surveys are a common epidemiological means of understanding youth risk behaviors. They can be used to monitor national trends and provide data, in aggregate, to schools, communities, and states for the purposes of funding allocation, prevention programming, and other supportive infrastructure. However, such surveys sometimes are targeted by public criticism, and even legal action, often in response to a lack of perceived appropriateness. The ubiquity of social media has added the risk of potential online firestorms, or digital outrage events, to the hazards to be considered when administering such a survey. Little research has investigated the influence of online firestorms on public health survey administration, and no research has analyzed the content of such an occurrence. Analyzing this content will facilitate insights as to how practitioners can minimize the risk of generating outrage when conducting such surveys. Objective: This study aimed to identify common themes within social media comments comprising an online firestorm that erupted in response to a school-based ATOD survey in order to inform risk-reduction strategies. Methods: Data were collected by archiving all public comments made in response to a news study about a school-based ATOD survey that was featured on a common social networking platform. Using the general inductive approach and elements of thematic analysis, two researchers followed a multi-step protocol to clean, categorize, and consolidate data, generating codes for all 207 responses. Results: In total, 133 comments were coded as oppositional to the survey and 74 were coded as supportive. Among the former, comments tended to reflect government-related concerns, conspiratorial or irrational thinking, issues of parental autonomy and privacy, fear of child protective services or police, issues with survey mechanisms, and reasoned disagreement. Among the latter, responses showed that posters perceived the ability to prevent abuse and neglect and support holistic health, surmised that opponents were hiding something, expressed reasoned support, or made factual statements about the survey. Consistent with research on moral outrage and digital firestorms, few comments (<10\%) contained factual information about the survey; nearly half of the comments, both supportive and oppositional, were coded in categories that presupposed misinformation. Conclusions: The components of even a small online firestorm targeting a school-based ATOD survey are nuanced and complex. It is likely impossible to be fully insulated against the risk of outrage in response to this type of public health work; however, careful articulation of procedures, anticipating specific concerns, and two-way community-based interaction may reduce risk. ",
doi="10.2196/15298",
url="http://www.jmir.org/2019/9/e15298/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31516129"
}


@Article{info:doi/10.2196/13038,
author="Zhan, Yongcheng
and Zhang, Zhu
and Okamoto, M. Janet
and Zeng, D. Daniel
and Leischow, J. Scott",
title="Underage JUUL Use Patterns: Content Analysis of Reddit Messages",
journal="J Med Internet Res",
year="2019",
month="Sep",
day="09",
volume="21",
number="9",
pages="e13038",
keywords="electronic nicotine delivery systems",
keywords="social media",
keywords="minors",
abstract="Background: The popularity of JUUL (an e-cigarette brand) among youth has recently been reported in news media and academic papers, which has raised great public health concerns. Little research has been conducted on the age distribution, geographic distribution, approaches to buying JUUL, and flavor preferences pertaining to underage JUUL users. Objective: The aim of this study was to analyze social media data related to demographics, methods of access, product characteristics, and use patterns of underage JUUL use. Methods: We collected publicly available JUUL-related data from Reddit. We extracted and summarized the age, location, and flavor preference of subreddit UnderageJuul users. We also compared common and unique users between subreddit UnderageJuul and subreddit JUUL. The methods of purchasing JUULs were analyzed by manually examining the content of the Reddit threads. Results: A total of 716 threads and 2935 comments were collected from the subreddit UnderageJuul before it was shut down. Most threads did not mention a specific age, but ages ranged from 13 years to greater than 21 years in those that did. Mango, mint, and cucumber were the most popular among the 7 flavors listed on JUUL's official website, and 336 subreddit UnderageJuul threads mentioned 7 discreet approaches to circumvent relevant legal regulations to get JUUL products, the most common of which was purchasing JUUL from other Reddit users (n=181). Almost half of the UnderageJuul users (389/844, 46.1\%) also participated in discussions on the main JUUL subreddit and sought information across multiple Reddit forums. Most (64/74, 86\%) posters were from large metropolitan areas. Conclusions: The subreddit UnderageJuul functioned as a forum to explore methods of obtaining JUUL and to discuss and recommend specific flavors before it was shut down. About half of those using UnderageJuul also used the more general JUUL subreddit, so a forum still exists where youths can attempt to share information on how to obtain JUUL and other products. Exploration of such social media data in real time for rapid public health surveillance could provide early warning for significant health risks before they become major public health threats. ",
doi="10.2196/13038",
url="http://www.jmir.org/2019/9/e13038/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31502542"
}


@Article{info:doi/10.2196/13345,
author="Chiang, Lee Austin
and Rabinowitz, Galler Loren
and Kumar, Akhil
and Chan, Wai-Yip Walter",
title="Association Between Institutional Social Media Involvement and Gastroenterology Divisional Rankings: Cohort Study",
journal="J Med Internet Res",
year="2019",
month="Sep",
day="06",
volume="21",
number="9",
pages="e13345",
keywords="social media",
keywords="Twitter",
keywords="hospital ranking",
abstract="Background: Patients often look to social media as an important tool to gather information about institutions and professionals. Since 1990, United States News and World Report (USNWR) has published annual rankings of hospitals and subspecialty divisions. It remains unknown if social media presence is associated with the USNWR gastroenterology and gastrointestinal (GI) surgery divisional rankings, or how changes in online presence over time affects division ranking. Objective: The objective of this study was to determine if social media presence is associated with USNWR gastroenterology and GI surgery divisional rankings and to ascertain how changes in online presence over time affect division rankings. Methods: Social media presence among the top 30 institutions listed in the 2014 USNWR gastroenterology and GI surgery divisional rankings were assessed using Pearson's correlation coefficients and multivariate analysis, controlling for covariates. Linear and logistic regression using data from 2014 and 2016 USNWR rankings were then used to assess the association between institutional ranking or reputation score with any potential changes in numbers of followers over time. Sensitivity analysis was performed by assessing the area under the receiver operating characteristic curve to determine the follower threshold associated with improved or maintained ranking, which was done by dichotomizing changes in followers at values between the 7000 and 12,000 follower mark. Results: Twitter follower count was an independent predictor of divisional ranking ($\beta$=.00004; P<.001) and reputation score ($\beta$=--.00002; P=.03) in 2014. Academic affiliation also independently predicted USNWR division ranking ($\beta$=5.3; P=.04) and reputation score ($\beta$=--7.3; P=.03). Between 2014 and 2016, Twitter followers remained significantly associated with improved or maintained rankings (OR 14.63; 95\% CI 1.08-197.81; P=.04). On sensitivity analysis, an 8000 person increase in Twitter followers significantly predicted improved or maintained rankings compared to other cutoffs. Conclusions: Institutional social media presence is independently associated with USNWR divisional ranking and reputation score. Improvement in social media following was also independently associated with improved or maintained divisional ranking and reputation score, with a threshold of 8000 additional followers as the best predictor of improved or stable ranking. ",
doi="10.2196/13345",
url="http://www.jmir.org/2019/9/e13345/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31493321"
}


@Article{info:doi/10.2196/14329,
author="Rieger, Agnes
and Gaines, Averi
and Barnett, Ian
and Baldassano, Frances Claudia
and Connolly Gibbons, Beth Mary
and Crits-Christoph, Paul",
title="Psychiatry Outpatients' Willingness to Share Social Media Posts and Smartphone Data for Research and Clinical Purposes: Survey Study",
journal="JMIR Form Res",
year="2019",
month="Aug",
day="29",
volume="3",
number="3",
pages="e14329",
keywords="social media",
keywords="smartphone",
keywords="outpatients",
keywords="psychiatry",
keywords="psychotherapy",
keywords="digital health",
keywords="mhealth",
keywords="digital phenotyping",
keywords="privacy",
keywords="user preferences",
abstract="Background: Psychiatry research has begun to leverage data collected from patients' social media and smartphone use. However, information regarding the feasibility of utilizing such data in an outpatient setting and the acceptability of such data in research and practice is limited. Objective: This study aimed at understanding the outpatients' willingness to have information from their social media posts and their smartphones used for clinical or research purposes. Methods: In this survey study, we surveyed patients (N=238) in an outpatient clinic waiting room. Willingness to share social media and passive smartphone data was summarized for the sample as a whole and broken down by sex, age, and race. Results: Most patients who had a social media account and who were receiving talk therapy treatment (74.4\%, 99/133) indicated that they would be willing to share their social media posts with their therapists. The percentage of patients willing to share passive smartphone data with researchers varied from 40.8\% (82/201) to 60.7\% (122/201) depending on the parameter, with sleep duration being the parameter with the highest percentage of patients willing to share. A total of 30.4\% of patients indicated that media stories of social media privacy breaches made them more hesitant about sharing passive smartphone data with researchers. Sex and race were associated with willingness to share smartphone data, with men and whites being the most willing to share. Conclusions: Our results indicate that most patients in a psychiatric outpatient setting would share social media and passive smartphone data and that further research elucidating patterns of willingness to share passive data is needed. ",
doi="10.2196/14329",
url="http://formative.jmir.org/2019/3/e14329/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31493326"
}


@Article{info:doi/10.2196/13837,
author="Modrek, Sepideh
and Chakalov, Bozhidar",
title="The \#MeToo Movement in the United States: Text Analysis of Early Twitter Conversations",
journal="J Med Internet Res",
year="2019",
month="Sep",
day="03",
volume="21",
number="9",
pages="e13837",
keywords="social media",
keywords="sexual abuse",
keywords="sexual assault",
keywords="machine learning",
keywords="infodemiology",
keywords="infoveillance",
abstract="Background: The \#MeToo movement sparked an international debate on the sexual harassment, abuse, and assault and has taken many directions since its inception in October of 2017. Much of the early conversation took place on public social media sites such as Twitter, where the hashtag movement began. Objective: The aim of this study is to document, characterize, and quantify early public discourse and conversation of the \#MeToo movement from Twitter data in the United States. We focus on posts with public first-person revelations of sexual assault/abuse and early life experiences of such events. Methods: We purchased full tweets and associated metadata from the Twitter Premium application programming interface between October 14 and 21, 2017 (ie, the first week of the movement). We examined the content of novel English language tweets with the phrase ``MeToo'' from within the United States (N=11,935). We used machine learning methods, least absolute shrinkage and selection operator regression, and support vector machine models to summarize and classify the content of individual tweets with revelations of sexual assault and abuse and early life experiences of sexual assault and abuse. Results: We found that the most predictive words created a vivid archetype of the revelations of sexual assault and abuse. We then estimated that in the first week of the movement, 11\% of novel English language tweets with the words ``MeToo'' revealed details about the poster's experience of sexual assault or abuse and 5.8\% revealed early life experiences of such events. We examined the demographic composition of posters of sexual assault and abuse and found that white women aged 25-50 years were overrepresented in terms of their representation on Twitter. Furthermore, we found that the mass sharing of personal experiences of sexual assault and abuse had a large reach, where 6 to 34 million Twitter users may have seen such first-person revelations from someone they followed in the first week of the movement. Conclusions: These data illustrate that revelations shared went beyond acknowledgement of having experienced sexual harassment and often included vivid and traumatic descriptions of early life experiences of assault and abuse. These findings and methods underscore the value of content analysis, supported by novel machine learning methods, to improve our understanding of how widespread the revelations were, which likely amplified the spread and saliency of the \#MeToo movement. ",
doi="10.2196/13837",
url="https://www.jmir.org/2019/9/e13837/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31482849"
}


@Article{info:doi/10.2196/14447,
author="Fontaine, Guillaume
and Maheu-Cadotte, Marc-Andr{\'e}
and Lavall{\'e}e, Andr{\'e}ane
and Mailhot, Tanya
and Rouleau, Genevi{\`e}ve
and Bouix-Picasso, Julien
and Bourbonnais, Anne",
title="Communicating Science in the Digital and Social Media Ecosystem: Scoping Review and Typology of Strategies Used by Health Scientists",
journal="JMIR Public Health Surveill",
year="2019",
month="Sep",
day="03",
volume="5",
number="3",
pages="e14447",
keywords="health communication",
keywords="public health",
keywords="social media",
keywords="internet",
keywords="patient participation",
abstract="Background: The public's understanding of science can be influential in a wide range of areas related to public health, including policy making and self-care. Through the digital and social media ecosystem, health scientists play a growing role in public science communication (SC). Objective: This review aimed to (1) synthesize the literature on SC initiated by health scientists targeting the public in the digital and social media ecosystem and (2) describe the SC strategies and communication channels used. Methods: This scoping review was based on the Joanna Briggs Institute Methodological Framework. A systematic search was performed in 6 databases (January 2000 to April 2018). Title and abstract screening, full-text review, data charting, and critical appraisal were performed independently by two review authors. Data regarding included studies and communication channels were synthesized descriptively. A typology of SC strategies was developed using a qualitative and inductive method of data synthesis. Results: Among 960 unique publications identified, 18 met inclusion criteria. A third of publications scored good quality (6/18, 33\%), half scored moderate quality (9/18, 50\%), and less than a fifth scored low quality (3/18, 16\%). Overall, 75 SC strategies used by health scientists were identified. These were grouped into 9 types: content, credibility, engagement, intention, linguistics, planification, presentation, social exchange, and statistics. A total of 5 types of communication channels were identified: social networking platforms (eg, Twitter), content-sharing platforms (eg, YouTube), digital research communities (eg, ResearchGate), personal blogs and websites (eg, WordPress), and social news aggregation and discussion platforms (eg, Reddit). Conclusions: Evidence suggests that multiple types of SC strategies and communication channels are used by health scientists concurrently. Few empirical studies have been conducted on SC by health scientists in the digital and social media ecosystem. Future studies should examine the appropriateness and effectiveness of SC strategies for improving public health--related outcomes and identify the barriers, facilitators, and ethical considerations inherent to the involvement of health scientists in the digital and social media ecosystem. ",
doi="10.2196/14447",
url="http://publichealth.jmir.org/2019/3/e14447/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31482854"
}


@Article{info:doi/10.2196/jmir.7081,
author="Golder, Su
and Scantlebury, Arabella
and Christmas, Helen",
title="Understanding Public Attitudes Toward Researchers Using Social Media for Detecting and Monitoring Adverse Events Data: Multi Methods Study",
journal="J Med Internet Res",
year="2019",
month="Aug",
day="29",
volume="21",
number="8",
pages="e7081",
keywords="adverse effects",
keywords="social media",
keywords="ethics",
keywords="research",
keywords="qualitative research",
keywords="digital health",
keywords="infodemiology",
keywords="infoveillance",
keywords="pharmacovigilance",
keywords="surveillance",
abstract="Background: Adverse events are underreported in research studies, particularly randomized controlled trials and pharmacovigilance studies. A method that researchers could use to identify more complete safety profiles for medications is to use social media analytics. However, patient's perspectives on the ethical issues associated with using patient reports of adverse drug events on social media are unclear. Objective: The objective of this study was to explore the ethics of using social media for detecting and monitoring adverse events for research purposes using a multi methods approach. Methods: A multi methods design comprising qualitative semistructured interviews (n=24), a focus group (n=3), and 3 Web-based discussions (n=20) with members of the public was adopted. Findings from a recent systematic review on the use of social media for monitoring adverse events provided a theoretical framework to interpret the study's findings. Results: Views were ascertained regarding the potential benefits and harms of the research, privacy expectations, informed consent, and social media platform. Although the majority of participants were supportive of social media content being used for research on adverse events, a small number of participants strongly opposed the idea. The potential benefit of the research was cited as the most influential factor to whether participants would give their consent to their data being used for research. There were also some caveats to people's support for the use of their social media data for research purposes: the type of social media platform and consideration of the vulnerability of the social media user. Informed consent was regarded as difficult to obtain and this divided the opinion on whether it should be sought. Conclusions: Social media users were generally positive about their social media data being used for research purposes; particularly for research on adverse events. However, approval was dependent on the potential benefit of the research and that individuals are protected from harm. Further study is required to establish when consent is required for an individual's social media data to be used. ",
doi="10.2196/jmir.7081",
url="http://www.jmir.org/2019/8/e7081/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31469079"
}


@Article{info:doi/10.2196/14077,
author="Garcia-Rudolph, Alejandro
and Laxe, Sara
and Saur{\'i}, Joan
and Bernabeu Guitart, Montserrat",
title="Stroke Survivors on Twitter: Sentiment and Topic Analysis From a Gender Perspective",
journal="J Med Internet Res",
year="2019",
month="Aug",
day="26",
volume="21",
number="8",
pages="e14077",
keywords="stroke",
keywords="emotions",
keywords="Twitter",
keywords="infodemiology",
keywords="infoveillance",
keywords="sentiment analysis",
keywords="topic models",
keywords="gender",
abstract="Background: Stroke is the worldwide leading cause of long-term disabilities. Women experience more activity limitations, worse health-related quality of life, and more poststroke depression than men. Twitter is increasingly used by individuals to broadcast their day-to-day happenings, providing unobtrusive access to samples of spontaneously expressed opinions on all types of topics and emotions. Objective: This study aimed to consider the raw frequencies of words in the collection of tweets posted by a sample of stroke survivors and to compare the posts by gender of the survivor for 8 basic emotions (anger, fear, anticipation, surprise, joy, sadness, trust and disgust); determine the proportion of each emotion in the collection of tweets and statistically compare each of them by gender of the survivor; extract the main topics (represented as sets of words) that occur in the collection of tweets, relative to each gender; and assign happiness scores to tweets and topics (using a well-established tool) and compare them by gender of the survivor. Methods: We performed sentiment analysis based on a state-of-the-art lexicon (National Research Council) with syuzhet R package. The emotion scores for men and women were first subjected to an F-test and then to a Wilcoxon rank sum test. We extended the emotional analysis, assigning happiness scores with the hedonometer (a tool specifically designed considering Twitter inputs). We calculated daily happiness average scores for all tweets. We created a term map for an exploratory clustering analysis using VosViewer software. We performed structural topic modelling with stm R package, allowing us to identify main topics by gender. We assigned happiness scores to all the words defining the main identified topics and compared them by gender. Results: We analyzed 800,424 tweets posted from August 1, 2007 to December 1, 2018, by 479 stroke survivors: Women (n=244) posted 396,898 tweets, and men (n=235) posted 403,526 tweets. The stroke survivor condition and gender as well as membership in at least 3 stroke-specific Twitter lists of active users were manually verified for all 479 participants. Their total number of tweets since 2007 was 5,257,433; therefore, we analyzed the most recent 15.2\% of all their tweets. Positive emotions (anticipation, trust, and joy) were significantly higher (P<.001) in women, while negative emotions (disgust, fear, and sadness) were significantly higher (P<.001) in men in the analysis of raw frequencies and proportion of emotions. Happiness mean scores throughout the considered period show higher levels of happiness in women. We calculated the top 20 topics (with percentages and CIs) more likely addressed by gender and found that women's topics show higher levels of happiness scores. Conclusions: We applied two different approaches---the Plutchik model and hedonometer tool---to a sample of stroke survivors' tweets. We conclude that women express positive emotions and happiness much more than men. ",
doi="10.2196/14077",
url="http://www.jmir.org/2019/8/e14077/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31452514"
}


@Article{info:doi/10.2196/14021,
author="Shaver, Garrett Lance
and Khawer, Ahmed
and Yi, Yanqing
and Aubrey-Bassler, Kris
and Etchegary, Holly
and Roebothan, Barbara
and Asghari, Shabnam
and Wang, Peter Peizhong",
title="Using Facebook Advertising to Recruit Representative Samples: Feasibility Assessment of a Cross-Sectional Survey",
journal="J Med Internet Res",
year="2019",
month="Aug",
day="19",
volume="21",
number="8",
pages="e14021",
keywords="Facebook",
keywords="health surveys",
keywords="Canada",
keywords="research subject recruitment",
keywords="social media",
keywords="internet",
keywords="online recruitment",
abstract="Background: Facebook has shown promise as an economical means of recruiting participants for health research. However, few studies have evaluated this recruitment method in Canada, fewer still targeting older adults, and, to our knowledge, none specifically in Newfoundland and Labrador (NL). Objective: This study aimed to assess Facebook advertising as an economical means of recruiting a representative sample of adults aged 35 to 74 years in NL for a cross-sectional health survey. Methods: Facebook advertising was used to recruit for a Web-based survey on cancer awareness and prevention during April and May 2018; during recruitment, additional advertisements were targeted to increase representation of demographics that we identified as being underrepresented in our sample. Sociodemographic and health characteristics of the study sample were compared with distributions of the underlying population to determine representativeness. Cramer V indicates the magnitude of the difference between the sample and population distributions, interpreted as small (Cramer V=0.10), medium (0.30), and large (0.50). Sample characteristics were considered representative if there was no statistically significant difference in distributions (chi-square P>.01) or if the difference was small (V?0.10), and practically representative if 0.10<V?0.20. The cost per recruit of Facebook advertising was compared with a quote for a random digit dialing (RDD)--recruited postal survey to determine if this method was economical. Results: Facebook advertising is feasible and economical to conduct survey research, reaching 34,012 people, of which 2067 clicked on the ad, for a final sample size of 1048 people at Can \$2.18 per recruit versus the quoted Can \$23,316.05 for 400 recruits (Can \$35.52 per recruit) via RDD. The sample was representative of rural and urban geography (P=.02; V=0.073), practically representative of age (P=.003; V=0.145) and income (P<.001; V=0.188), and over-representative of women (P<.001; V=0.507) and higher levels of education (P<.001; V=0.488). The sample was representative of the proportion of people with a regular health care provider (P=.94; V=0.025), diabetes prevalence (P=.002; V=0.096), and having had a colonoscopy or sigmoidoscopy (P=.27; V=0.034), and it was practically representative of smoking status (P<.001; V=0.14), and body mass index (P<.001; V=0.135). The sample was not representative of arthritis prevalence (P<.001; V=0.573), perceived health (P<.001; V=0.384), or time since last seasonal flu shot (P<.001; V=0.449). Conclusions: Facebook advertising offers an easy, rapid, and economical means to recruit a partially representative (representative or practically representative of 8 of the 13 characteristics studied) sample of middle-aged and older adults for health survey research. As Facebook uses a nonrandom targeting algorithm, caution is warranted in its applications for certain types of research. ",
doi="10.2196/14021",
url="http://www.jmir.org/2019/8/e14021/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31429409"
}


@Article{info:doi/10.2196/12687,
author="Petersen, Maria Jasmine
and Prichard, Ivanka
and Kemps, Eva",
title="A Comparison of Physical Activity Mobile Apps With and Without Existing Web-Based Social Networking Platforms: Systematic Review",
journal="J Med Internet Res",
year="2019",
month="Aug",
day="16",
volume="21",
number="8",
pages="e12687",
keywords="physical activity",
keywords="mobile applications",
keywords="social networking",
abstract="Background: Physical activity mobile apps present a unique medium to disseminate scalable interventions to increase levels of physical activity. However, the effectiveness of mobile apps has previously been limited by low levels of engagement. Existing Web-based social networking platforms (eg, Facebook and Twitter) afford high levels of popularity, reach, and sustain engagement and, thus, may present an innovative strategy to enhance the engagement, and ultimately the effectiveness of mobile apps. Objective: This study aimed to comparatively examine the effectiveness of, and engagement with, interventions that incorporate physical activity mobile apps in conjunction with and without existing Web-based social networking platforms (eg, Facebook and Twitter). Methods: A systematic review was conducted by following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Guidelines. A systematic search of the following databases was conducted: Medline, PsycINFO, Web of Science, Scopus, CINAHL, ProQuest, SPORTDiscus, EMBASE, and Cochrane. According to the comparative objective of this review, 2 independent literature searches were conducted. The first incorporated terms related to apps and physical activity; the second also incorporated terms related to Web-based social networking. The results of the two searches were synthesized and compared narratively. Results: A total of 15 studies were identified, 10 incorporated a physical activity app alone and 5 incorporated an app in conjunction with an existing Web-based social networking platform. Overall, 10 of the 15 interventions were effective in improving one or more physical activity behaviors. Specifically, improvements in physical activity behaviors were reported in 7 of the 10 interventions incorporating physical activity apps alone and in 3 of the 5 interventions incorporating physical activity apps in conjunction with existing Web-based social networking platforms. Interventions incorporating physical activity apps alone demonstrated a decline in app engagement. In contrast, the physical activity apps in conjunction with existing Web-based social networking platforms showed increased and sustained intervention engagement. Conclusions: The interventions incorporating physical activity apps in conjunction with and without existing Web-based social networking platforms demonstrated effectiveness in improving physical activity behaviors. Notably, however, the interventions that incorporated existing Web-based social networking platforms achieved higher levels of engagement than those that did not. This review provides preliminary evidence that existing Web-based social networking platforms may be fundamental to increase engagement with physical activity interventions. ",
doi="10.2196/12687",
url="https://www.jmir.org/2019/8/e12687/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31420956"
}


@Article{info:doi/10.2196/10195,
author="Houman, Justin
and Weinberger, James
and Caron, Ashley
and Hannemann, Alex
and Zaliznyak, Michael
and Patel, Devin
and Moradzadeh, Ariel
and Daskivich, J. Timothy",
title="Association of Social Media Presence with Online Physician Ratings and Surgical Volume Among California Urologists: Observational Study",
journal="J Med Internet Res",
year="2019",
month="Aug",
day="13",
volume="21",
number="8",
pages="e10195",
keywords="social media",
keywords="surgical volume",
keywords="physician ratings",
abstract="Background: Urologists are increasingly using various forms of social media to promote their professional practice and attract patients. Currently, the association of social media on a urologists' practice is unknown. Objectives: We aimed to determine whether social media presence is associated with higher online physician ratings and surgical volume among California urologists. Methods: We sampled 195 California urologists who were rated on the ProPublica Surgeon Scorecard website. We obtained information on professional use of online social media (Facebook, Instagram, Twitter, blog, and YouTube) in 2014 and defined social media presence as a binary variable (yes/no) for use of an individual platform or any platform. We collected data on online physician ratings across websites (Yelp, Healthgrades, Vitals, RateMD, and UCompareHealthcare) and calculated the mean physician ratings across all websites as an average weighted by the number of reviews. We then collected data on surgical volume for radical prostatectomy from the ProPublica Surgeon Scorecard website. We used multivariable linear regression to determine the association of social media presence with physician ratings and surgical volume. Results: Among our sample of 195 urologists, 62 (32\%) were active on some form of social media. Social media presence on any platform was associated with a slightly higher mean physician rating ($\beta$ coefficient: .3; 95\% CI 0.03-0.5; P=.05). However, only YouTube was associated with higher physician ratings ($\beta$ coefficient: .3; 95\% CI 0.2-0.5; P=.04). Social media presence on YouTube was strongly associated with increased radical prostatectomy volume ($\beta$ coefficient: 7.4; 95\% CI 0.3-14.5; P=.04). Social media presence on any platform was associated with increased radical prostatectomy volume ($\beta$ coefficient: 7.1; 95\% CI --0.7 to 14.2; P=.05). Conclusions: Urologists' use of social media, especially YouTube, is associated with a modest increase in physician ratings and prostatectomy volume. Although a majority of urologists are not currently active on social media, patients may be more inclined to endorse and choose subspecialist urologists who post videos of their surgical technique. ",
doi="10.2196/10195",
url="https://www.jmir.org/2019/8/e10195/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31411141"
}


@Article{info:doi/10.2196/13003,
author="Rezaallah, Bita
and Lewis, John David
and Pierce, Carrie
and Zeilhofer, Hans-Florian
and Berg, Britt-Isabelle",
title="Social Media Surveillance of Multiple Sclerosis Medications Used During Pregnancy and Breastfeeding: Content Analysis",
journal="J Med Internet Res",
year="2019",
month="Aug",
day="07",
volume="21",
number="8",
pages="e13003",
keywords="pharmacovigilance",
keywords="machine learning",
keywords="pregnancy outcome",
keywords="postpartum",
keywords="central nervous system agents",
keywords="risk assessment",
keywords="text mining",
abstract="Background: Multiple sclerosis (MS) is a chronic neurological disease occurring mostly in women of childbearing age. Pregnant women with MS are usually excluded from clinical trials; as users of the internet, however, they are actively engaged in threads and forums on social media. Social media provides the potential to explore real-world patient experiences and concerns about the use of medicinal products during pregnancy and breastfeeding. Objective: This study aimed to analyze the content of posts concerning pregnancy and use of medicines in online forums; thus, the study aimed to gain a thorough understanding of patients' experiences with MS medication. Methods: Using the names of medicinal products as search terms, we collected posts from 21 publicly available pregnancy forums, which were accessed between March 2015 and March 2018. After the identification of relevant posts, we analyzed the content of each post using a content analysis technique and categorized the main topics that users discussed most frequently. Results: We identified 6 main topics in 70 social media posts. These topics were as follows: (1) expressing personal experiences with MS medication use during the reproductive period (55/70, 80\%), (2) seeking and sharing advice about the use of medicines (52/70, 74\%), (3) progression of MS during and after pregnancy (35/70, 50\%), (4) discussing concerns about MS medications during the reproductive period (35/70, 50\%), (5) querying the possibility of breastfeeding while taking MS medications (30/70, 42\%), and (6) commenting on communications with physicians (26/70, 37\%). Conclusions: Overall, many pregnant women or women considering pregnancy shared profound uncertainties and specific concerns about taking medicines during the reproductive period. There is a significant need to provide advice and guidance to MS patients concerning the use of medicines in pregnancy and postpartum as well as during breastfeeding. Advice must be tailored to the circumstances of each patient and, of course, to the individual medicine. Information must be provided by a trusted source with relevant expertise and made publicly available. ",
doi="10.2196/13003",
url="https://www.jmir.org/2019/8/e13003/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31392963"
}


@Article{info:doi/10.2196/12914,
author="van Woudenberg, J. Thabo
and Simoski, Bojan
and Fernandes de Mello Ara{\'u}jo, Eric
and Bevelander, E. Kirsten
and Burk, J. William
and Smit, R. Crystal
and Buijs, Laura
and Klein, Michel
and Buijzen, Moniek",
title="Identifying Influence Agents That Promote Physical Activity Through the Simulation of Social Network Interventions: Agent-Based Modeling Study",
journal="J Med Internet Res",
year="2019",
month="Aug",
day="05",
volume="21",
number="8",
pages="e12914",
keywords="physical activity",
keywords="adolescent health",
keywords="peer group",
keywords="computer simulation",
keywords="social network analysis",
abstract="Background: Social network interventions targeted at children and adolescents can have a substantial effect on their health behaviors, including physical activity. However, designing successful social network interventions is a considerable research challenge. In this study, we rely on social network analysis and agent-based simulations to better understand and capitalize on the complex interplay of social networks and health behaviors. More specifically, we investigate criteria for selecting influence agents that can be expected to produce the most successful social network health interventions. Objective: The aim of this study was to test which selection criterion to determine influence agents in a social network intervention resulted in the biggest increase in physical activity in the social network. To test the differences among the selection criteria, a computational model was used to simulate different social network interventions and observe the intervention's effect on the physical activity of primary and secondary school children within their school classes. As a next step, this study relied on the outcomes of the simulated interventions to investigate whether social network interventions are more effective in some classes than others based on network characteristics. Methods: We used a previously validated agent-based model to understand how physical activity spreads in social networks and who was influencing the spread of behavior. From the observed data of 460 participants collected in 26 school classes, we simulated multiple social network interventions with different selection criteria for the influence agents (ie, in-degree centrality, betweenness centrality, closeness centrality, and random influence agents) and a control condition (ie, no intervention). Subsequently, we investigated whether the detected variation of an intervention's success within school classes could be explained by structural characteristics of the social networks (ie, network density and network centralization). Results: The 1-year simulations showed that social network interventions were more effective compared with the control condition (beta=.30; t100=3.23; P=.001). In addition, the social network interventions that used a measure of centrality to select influence agents outperformed the random influence agent intervention (beta=.46; t100=3.86; P<.001). Also, the closeness centrality condition outperformed the betweenness centrality condition (beta=.59; t100=2.02; P=.046). The anticipated interaction effects of the network characteristics were not observed. Conclusions: Social network intervention can be considered as a viable and promising intervention method to promote physical activity. We demonstrated the usefulness of applying social network analysis and agent-based modeling as part of the social network interventions' design process. We emphasize the importance of selecting the most successful influence agents and provide a better understanding of the role of network characteristics on the effectiveness of social network interventions. ",
doi="10.2196/12914",
url="https://www.jmir.org/2019/8/e12914/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31381504"
}


@Article{info:doi/10.2196/12980,
author="Cahill, J. Tiernan
and Wertz, Blake
and Zhong, Qiankun
and Parlato, Andrew
and Donegan, John
and Forman, Rebecca
and Manot, Supriya
and Wu, Tianyi
and Xu, Yazhu
and Cummings, J. James
and Norkunas Cunningham, Tricia
and Wang, Catharine",
title="The Search for Consumers of Web-Based Raw DNA Interpretation Services: Using Social Media to Target Hard-to-Reach Populations",
journal="J Med Internet Res",
year="2019",
month="Jul",
day="30",
volume="21",
number="7",
pages="e12980",
keywords="research subject recruitment",
keywords="social media",
keywords="survey methods",
keywords="data collection methods",
keywords="advertising as topic",
keywords="algorithms",
abstract="Background: In recent years, there has been a proliferation of third-party Web-based services available to consumers to interpret raw DNA from direct-to-consumer genetic testing companies. Little is known about who uses these services and the downstream health implications. Identifying this hard-to-reach population of consumers for research raised questions about the most effective recruitment methods to undertake. Past studies have found that Web-based social media survey distribution can be cost-effective for targeting hard-to-reach populations, yet comparative efficacy information across platforms is limited. Objective: The aim of this study was to identify the most effective Web-based strategies to identify and recruit the target population of direct-to-consumer genetic testing users who also made use of third-party interpretation services to analyze their raw genetic data. Web-based survey recruitment methods varying by social media platform and advertising method were compared in terms of cost-effectiveness and demographics of survey respondents. Methods: A total of 5 Web-based survey distribution conditions were examined: 4 paid advertising services and 1 unpaid service. For the paid services, a 2x2 quasi-experimental design compared social media platforms (Facebook vs Twitter) and advertising tracking metrics (by click vs by conversion). The fifth unpaid comparison method consisted of study postings on the social media platform, Reddit, without any paid advertising. Links to identical Web-based versions of the study questionnaire were posted for 10 to 14 days for each of the distribution conditions, which allowed tracking the number of respondents that entered and completed the questionnaire by distribution condition. Results: In total, 438 individuals were recruited to the study through all conditions. A nearly equivalent number of participants were recruited from paid campaigns on Facebook (n=159) and Twitter (n=167), with a smaller sample recruited on Reddit (n=112). Significantly more participants were recruited through conversion-tracking (n=222) than through click-tracking campaigns (n=104; Z=6.5, P<.001). Response rates were found to be partially driven by organic sharing of recruitment materials among social media users. Conversion tracking was more cost-effective than click tracking across paid social media platforms. Significant differences in terms of gender and age distributions were noted between the platforms and between the tracking metrics. Conclusions: Web-based recruitment methods were effective at recruiting participants from a hard-to-reach population in a short time frame. There were significant differences in the effectiveness of various paid advertising techniques. Recruitment through Web-based communities also appeared to perform adequately, yet it may be limited by the number of users accessible in open community groups. Future research should evaluate the impact of organic sharing of recruitment materials because this appeared to play a substantial role in the observed effectiveness of different methods. ",
doi="10.2196/12980",
url="http://www.jmir.org/2019/7/e12980/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31364607"
}


@Article{info:doi/10.2196/14151,
author="Sapp, C. Jessica L.
and Vogel, L. Robert
and Telfair, Joseph
and Reagan, K. Julie",
title="Evaluating Web-Based Platforms and Traditional Methods for Recruiting Tattoo Artists: Descriptive Survey Research Study",
journal="JMIR Dermatol",
year="2019",
month="Jul",
day="26",
volume="2",
number="1",
pages="e14151",
keywords="tattooing",
keywords="ink",
keywords="social media",
keywords="internet",
keywords="survey and questionnaires",
keywords="United States",
keywords="adult",
keywords="skin diseases",
keywords="advertising as topic",
abstract="Background: Almost one-third of US adults (29\%) have a tattoo, and almost half (47\%) of millennials reported having a tattoo. With more people getting tattoos, there is an increased risk of infectious diseases, skin infections, and allergic reactions. Tattoo artists can influence these health risks with their standards of practice, tattoo inks, and sterilization techniques. Although tattoos are becoming mainstream, it was unclear if tattoo artists would be a hard-to-reach population. Using social media sites represents a promising method for recruiting tattoo artists for Web-based survey studies. Objective: The aim of this study was to evaluate various Web-based platforms and traditional methods for recruiting tattoo artists into a descriptive Web-based survey study. Methods: Recruitment occurred via Facebook ads , Instagram, Twitter, website, Web-based advertisement, emails, and postcards mailed to tattoo shops. Results: Recruitment methods resulted in 2332 respondents, of which 1845 answered question 1, ``Are you a tattoo artist?'' Only 1571 were tattoo artists. Facebook ads recruited the most study participants. Facebook accounted for 1228 (1228/1571, 78.17\%) respondents who were tattoo artists. This number surpassed the next leading category of HTTP Referer unknown, which had 268 (268/1571, 17.06\%). The Tattoo Survey 2015 website recruited 45 (45/1571, 2.86\%) tattoo artists, whereas other Web-based sources contributed to the recruitment of 28 (28/1571, 1.78\%) tattoo artists. Twitter and email had the lowest response rate with only 0.06\% (1/1571) each. Conclusions: Social media sites enhanced survey participation, making it easier to reach tattoo artists nationwide. Of the recruitment methods used, Facebook ads were the most effective option, both for cost and recruitment rates. This study's findings extend those of the previous research studies that demonstrated the timeliness, ease, and effectiveness of using Facebook ads for recruitment. ",
doi="10.2196/14151",
url="http://derma.jmir.org/2019/1/e14151/"
}


@Article{info:doi/10.2196/14398,
author="Allem, Jon-Patrick
and Uppu, Priyanka Sree
and Boley Cruz, Tess
and Unger, B. Jennifer",
title="Characterizing Swisher Little Cigar--Related Posts on Twitter in 2018: Text Analysis",
journal="J Med Internet Res",
year="2019",
month="Jul",
day="19",
volume="21",
number="7",
pages="e14398",
keywords="little cigar",
keywords="cigarillo",
keywords="Swisher",
keywords="social media",
keywords="Twitter",
keywords="tobacco",
abstract="Background: Little cigars are growing in popularity in the United States, and Swisher is the market leader. The contexts and experiences associated with the use of Swisher-related products is understudied, but such information is available via publicly available posts on Twitter. Objective: This study aimed to analyze Twitter posts to characterize Twitter users' recent experiences with Swisher-related products. Methods: Twitter posts containing the term ``swisher'' were analyzed from January 1, 2018, to December 31, 2018. Text classifiers were used to identify topics in posts (n=81,333). Results: The most prevalent topic was Person Tagging (mentioning a Twitter account in a post; 32.77\%), followed by Flavors (eg, Grape and Strawberry; 20.96\%) and Swisher use (eg, smoke swisher; 17.44\%). Additional topics included Cannabis use (eg, blunt, roll, and gut swisher; 6.26\%), Appeal (eg, like Swisher; 5.92\%), Dislike (eg, posts that showed dissatisfaction with Swisher products; 3.53\%), Purchases (eg, buy swisher; 1.90\%), and Cigar comparison (eg, mentions of other cigar products including White-owl and Backwoods; 1.64\%). Conclusions: This paper describes common contexts and experiences associated with the use of Swisher little cigars from the population posting on Twitter in 2018. These online messages may have offline consequences for tobacco-related behaviors, indicating the need for countering from public health officials. Findings should inform us about targets for surveillance, policy, and interventions addressing Swisher little cigars as well as communication planning and tobacco product counter messaging on Twitter. ",
doi="10.2196/14398",
url="http://www.jmir.org/2019/7/e14398/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31325291"
}


@Article{info:doi/10.2196/13218,
author="Hobbs, W. Katherine
and Monette, J. Patrick
and Owoyemi, Praise
and Beard, Courtney
and Rauch, L. Scott
and Ressler, J. Kerry
and Vahia, V. Ipsit",
title="Incorporating Information From Electronic and Social Media Into Psychiatric and Psychotherapeutic Patient Care: Survey Among Clinicians",
journal="J Med Internet Res",
year="2019",
month="Jul",
day="12",
volume="21",
number="7",
pages="e13218",
keywords="technology",
keywords="social media",
keywords="psychotherapy",
keywords="psychiatry",
abstract="Background: Obtaining collateral information from a patient is an essential component of providing effective psychiatric and psychotherapeutic care. Research indicates that patients' social and electronic media contains information relevant to their psychotherapy and clinical care. However, it remains unclear to what degree this content is being actively utilized by clinicians as a part of diagnosis or therapy. Moreover, clinicians' attitudes around this practice have not been well characterized. Objective: This survey aimed to establish the current attitudes and behaviors of outpatient clinicians regarding the incorporation of patients' social and electronic media into psychotherapy. Methods: A Web-based survey was sent to outpatient psychotherapists associated with McLean Hospital in Belmont, Massachusetts. The survey asked clinicians to indicate to what extent and with which patients they reviewed patients' social and electronic media content as part of their clinical practice, as well as their reasons for or against doing so. Results: Of the total 115 respondents, 71 (61.7\%) indicated that they had viewed at least one patient's social or electronic media as part of psychotherapy, and 65 of those 71 (92\%) endorsed being able to provide more effective treatment as a result of this information. The use of either short message service text messages or email was significantly greater than the use of other electronic media platforms ($\chi$21=24.1, n=115, P<.001). Moreover, the analysis of survey responses found patterns of use associated with clinicians' years of experience and patient demographics, including age and primary diagnosis. Conclusions: The incorporation of patients' social and electronic media into therapy is currently common practice among clinicians at a large psychiatric teaching hospital. The results of this survey have informed further questions about whether reviewing patient's media impacts the quality and efficacy of clinical care. ",
doi="10.2196/13218",
url="http://www.jmir.org/2019/7/e13218/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31301127"
}


@Article{info:doi/10.2196/12546,
author="Stawarz, Katarzyna
and Preist, Chris
and Coyle, David",
title="Use of Smartphone Apps, Social Media, and Web-Based Resources to Support Mental Health and Well-Being: Online Survey",
journal="JMIR Ment Health",
year="2019",
month="Jul",
day="12",
volume="6",
number="7",
pages="e12546",
keywords="mental health",
keywords="mobile apps",
keywords="mHealth",
keywords="social media",
keywords="self-instruction programs, computerized",
abstract="Background: Technology can play an important role in supporting mental health. Many studies have explored the effectiveness, acceptability, or context of use of different types of mental health technologies. However, existing research has tended to investigate single types of technology at a time rather than exploring a wider ecosystem that people may use. This narrow focus can limit our understanding of how we could best design mental health technologies. Objective: The aim of this study was to investigate which technologies (smartphone apps, discussion forums and social media, and websites and Web-based programs) people use to support their mental health and why, whether they combine and use more than one technology, what purpose each technology serves, and which features people find the most valuable. Methods: We conducted an online survey to gather responses from members of the public who use technology to support their mental health and well-being. The survey was advertised on social media and via posters at a university. It explored usage patterns, frequently used features, and engagement with technology. To gain deeper insights into users' preferences, we also thematically analyzed open-ended comments about each technology type and suggestions for improvements provided by the respondents. Results: In total, 81 eligible participants completed the survey. Smartphone apps were the most commonly used technology, with 78\% of the participants (63/81) using them, either alone (40\%) or in combination with other technologies (38\%). Each type of technology was used for specific purposes: apps provided guided activities, relaxation, and enabled tracking; social media and discussion forums allowed participants to learn from the experiences of others and use that knowledge to understand their own situation; and Web-based programs and websites helped to find out how to deal on a day-to-day basis with stress and anxiety. The analysis of open-ended responses showed that although many people valued technology and felt it could support targeted activities, it was not seen as a substitute for traditional face-to-face therapy. Participants wanted technology to be more sophisticated and nuanced, supporting personalized and actionable recommendations. There was evidence that participants mistrusted technology, irrespective of the type, and had broader concerns regarding the impact of overuse of technology. Conclusions: People use different types of technology to support their mental health. Each can serve a specific purpose. Although apps are the most widely used technology, mixing and matching different types of technology is also common. Technology should not be seen as a replacement for traditional psychotherapy, rather it offers new opportunities to support mental health as part of an overall ecosystem. People want technology to be more nuanced and personalized to help them plan informed actions. Future interventions should explore the use of multiple technologies and their combined effects on mental health support. ",
doi="10.2196/12546",
url="http://mental.jmir.org/2019/7/e12546/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31301126"
}


@Article{info:doi/10.2196/14289,
author="Moon, Y. Rachel
and Mathews, Anita
and Oden, Rosalind
and Carlin, Rebecca",
title="Mothers' Perceptions of the Internet and Social Media as Sources of Parenting and Health Information: Qualitative Study",
journal="J Med Internet Res",
year="2019",
month="Jul",
day="09",
volume="21",
number="7",
pages="e14289",
keywords="internet",
keywords="parenting",
keywords="social media",
keywords="focus groups",
abstract="Background: Traditionally, guidance and support to new parents have come from family, friends, and health care providers. However, the internet and social media are growing sources of guidance and support for parents. Little is known about how the internet and social media are used by parents of young infants and specifically about parental perceptions of the internet and social media as sources of parenting and infant health information. Objective: The aim of this study was to explore, using qualitative methods, parental perceptions of the advantages and disadvantages of the internet and social media as sources of parenting and health information regarding their infant. Methods: A total of 28 mothers participated in focus groups or individual interviews. Probing questions concerning parenting and health information sources were asked. Themes were developed in an iterative manner from coded data. Results: The central themes were (1) reasons that mothers turn to the internet for parenting and health information, (2) cautionary advice about the internet, and (3) reasons that mothers turn to social media for parenting and health information. Mothers appreciated the ability to gather unlimited information and multiple opinions quickly and anonymously, but recognized the need to use reputable sources of information. Mothers also appreciated the immediacy of affirmation, support, and tailored information available through social media. Conclusions: The internet and social media are rapidly becoming important and trusted sources of parenting and health information that mothers turn to when making infant care decisions. ",
doi="10.2196/14289",
url="https://www.jmir.org/2019/7/e14289/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31290403"
}


@Article{info:doi/10.2196/13957,
author="Bjornestad, Jone
and Hegelstad, Velden Wenche Ten
and Berg, Henrik
and Davidson, Larry
and Joa, Inge
and Johannessen, Olav Jan
and Melle, Ingrid
and Stain, J. Helen
and Pallesen, St{\aa}le",
title="Social Media and Social Functioning in Psychosis: A Systematic Review",
journal="J Med Internet Res",
year="2019",
month="Jun",
day="28",
volume="21",
number="6",
pages="e13957",
keywords="psychosis",
keywords="schizophrenia",
keywords="social media",
keywords="social functioning",
keywords="measures",
keywords="assessment",
keywords="systematic review",
abstract="Background: Individuals with psychosis are heavy consumers of social media. It is unknown to what degree measures of social functioning include measures of online social activity. Objective: To examine the inclusion of social media activity in measures of social functioning in psychosis and ultrahigh risk (UHR) for psychosis. Methods: Two independent authors conducted a search using the following electronic databases: Epistemonikos, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, MEDLINE, Embase, and PsycINFO. The included articles were required to meet all of the following criteria: (1) an empirical study published in the English language in a peer-reviewed journal; (2) the study included a measure of objective or subjective offline (ie, non-Web-mediated contact) and/or online social functioning (ie, Web-mediated contact); (3) the social functioning measure had to be used in samples meeting criteria (ie, Diagnostic and Statistical Manual of Mental Disorders or International Classification of Diseases) for a psychotic disorder or UHR for psychosis; and (4) the study was published between January 2004 and February 2019. Facebook was launched as the first large-scale social media platform in 2004 and, therefore, it is highly improbable that studies conducted prior to 2004 would have included measures of social media activity. Results: The electronic search resulted in 11,844 distinct articles. Full-text evaluation was conducted on 719 articles, of which 597 articles met inclusion criteria. A total of 58 social functioning measures were identified. With some exceptions, reports on reliability and validity were scarce, and only one measure integrated social media social activity. Conclusions: The ecological validity of social functioning measures is challenged by the lack of assessment of social media activity, as it fails to reflect an important aspect of the current social reality of persons with psychosis. Measures should be revised to include social media activity and thus avoid the clinical consequences of inadequate assessment of social functioning. Trial Registration: International Prospective Register of Systematic Reviews (PROSPERO) CRD42017058514; http://www.crd.york.ac.uk/PROSPERO/display\_record.php?ID=CRD42017058514 ",
doi="10.2196/13957",
url="http://www.jmir.org/2019/6/e13957/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31254338"
}


@Article{info:doi/10.2196/14303,
author="Cho, Hyunyi
and Li, Wenbo
and Shen, Lijiang
and Cannon, Julie",
title="Mechanisms of Social Media Effects on Attitudes Toward E-Cigarette Use: Motivations, Mediators, and Moderators in a National Survey of Adolescents",
journal="J Med Internet Res",
year="2019",
month="Jun",
day="27",
volume="21",
number="6",
pages="e14303",
keywords="adolescents",
keywords="e-cigarettes",
keywords="motivation",
keywords="affordances",
keywords="agency",
keywords="realism",
keywords="self-expression",
keywords="social comparison",
keywords="social learning",
keywords="social media",
keywords="filter",
keywords="uses and gratifications",
abstract="Background: Exposure to risk behavior on social media is associated with risk behavior tendencies among adolescents, but research on the mechanisms underlying the effects of social media exposure is sparse. Objective: This study aimed to investigate the motivations of social media use and the mediating and moderating mechanisms of their effects on attitude toward electronic cigarette (e-cigarette) use among adolescents. Methods: Using data from a national sample survey of adolescents (age=14-17 years, N=594), we developed and validated a social media use motivation scale. We examined the roles of motivations in the effect of social media use on risk exposure and risk attitude. Results: Motivations for social media use included agency, self-expression, realism, social learning, social comparison, and filter. These motivations were associated differentially with the frequency of use of Facebook, Instagram, Snapchat, and YouTube. Frequency of social media use was positively associated with exposure to e-cigarette messages across the four platforms (Ps<.001). Exposure to e-cigarette messages on Instagram (P=.005) and Snapchat (P=.03) was positively associated with attitude toward e-cigarette use. Perceived social media realism moderated the effects of e-cigarette message exposure such that when realism was high, the exposure effect was amplified, but when realism was low, the effect was mitigated (P<.001). A three-way interaction effect (P=.02) among exposure, social learning motivation, and social norm on attitude toward e-cigarette use was found. When perceived social norm was high, the moderating effect of social learning motivation on e-cigarette use attitude was amplified, but when social norm was low, the social learning motivation effect was attenuated. Conclusions: Because perceived social media realism moderates the effect of exposure to e-cigarette messages on attitude toward e-cigarette use, future intervention efforts should address the realism perceptions. The three-way interaction among exposure, social learning motivation, and social norm indicates the importance of addressing both the online and offline social environments of adolescents. The social media use motivation scale, reflecting perceived affordances, is broadly applicable. Understanding social media use motivations is important, as they indirectly influence attitude toward e-cigarette use via frequency of social media use and/or frequency of exposure to e-cigarette messages on social media. ",
doi="10.2196/14303",
url="http://www.jmir.org/2019/6/e14303/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31250830"
}


@Article{info:doi/10.2196/14199,
author="Leis, Angela
and Ronzano, Francesco
and Mayer, A. Miguel
and Furlong, I. Laura
and Sanz, Ferran",
title="Detecting Signs of Depression in Tweets in Spanish: Behavioral and Linguistic Analysis",
journal="J Med Internet Res",
year="2019",
month="Jun",
day="27",
volume="21",
number="6",
pages="e14199",
keywords="depression",
keywords="social media",
keywords="mental health",
keywords="text mining",
abstract="Background: Mental disorders have become a major concern in public health, and they are one of the main causes of the overall disease burden worldwide. Social media platforms allow us to observe the activities, thoughts, and feelings of people's daily lives, including those of patients suffering from mental disorders. There are studies that have analyzed the influence of mental disorders, including depression, in the behavior of social media users, but they have been usually focused on messages written in English. Objective: The study aimed to identify the linguistic features of tweets in Spanish and the behavioral patterns of Twitter users who generate them, which could suggest signs of depression. Methods: This study was developed in 2 steps. In the first step, the selection of users and the compilation of tweets were performed. A total of 3 datasets of tweets were created, a depressive users dataset (made up of the timeline of 90 users who explicitly mentioned that they suffer from depression), a depressive tweets dataset (a manual selection of tweets from the previous users, which included expressions indicative of depression), and a control dataset (made up of the timeline of 450 randomly selected users). In the second step, the comparison and analysis of the 3 datasets of tweets were carried out. Results: In comparison with the control dataset, the depressive users are less active in posting tweets, doing it more frequently between 23:00 and 6:00 (P<.001). The percentage of nouns used by the control dataset almost doubles that of the depressive users (P<.001). By contrast, the use of verbs is more common in the depressive users dataset (P<.001). The first-person singular pronoun was by far the most used in the depressive users dataset (80\%), and the first- and the second-person plural pronouns were the least frequent (0.4\% in both cases), this distribution being different from that of the control dataset (P<.001). Emotions related to sadness, anger, and disgust were more common in the depressive users and depressive tweets datasets, with significant differences when comparing these datasets with the control dataset (P<.001). As for negation words, they were detected in 34\% and 46\% of tweets in among depressive users and in depressive tweets, respectively, which are significantly different from the control dataset (P<.001). Negative polarity was more frequent in the depressive users (54\%) and depressive tweets (65\%) datasets than in the control dataset (43.5\%; P<.001). Conclusions: Twitter users who are potentially suffering from depression modify the general characteristics of their language and the way they interact on social media. On the basis of these changes, these users can be monitored and supported, thus introducing new opportunities for studying depression and providing additional health care services to people with this disorder. ",
doi="10.2196/14199",
url="http://www.jmir.org/2019/6/e14199/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31250832"
}


@Article{info:doi/10.2196/10479,
author="Pearson, Carly
and Swindale, Rosanna
and Keighley, Peter
and McKinlay, Ruth Alison
and Ridsdale, Leone",
title="Not Just a Headache: Qualitative Study About Web-Based Self-Presentation and Social Media Use by People With Migraine",
journal="J Med Internet Res",
year="2019",
month="Jun",
day="19",
volume="21",
number="6",
pages="e10479",
keywords="migraine",
keywords="internet",
keywords="social media",
keywords="eHealth",
keywords="social support",
keywords="self-management",
keywords="qualitative research",
abstract="Background: To help with a long-term but invisible medical condition such as migraine, many people seek information and support on social media. The effect of using social media for people with migraine is not fully understood and remains to be investigated. Objective: The aim of this study was to describe how people with migraine use social media and how social media use affects their identity and sense of self. Methods: A total of 20 participants who experienced migraine were recruited via migraine-specific charities. Semistructured interviews were conducted with questions based on a topic guide. Interviews were transcribed verbatim, and transcripts were analyzed using thematic analysis. Results: People with migraine are using social media to obtain information to better understand their condition and treatment options. Social media offers instant access to continuous information and social support. This exchange of social support and information was viewed as mutually beneficial. Participants viewed social media as an outlet to vent frustrations and validate the migraine experience. Several participants pointed out that the invisible and episodic nature of migraine can lead to societal misunderstanding of the impact and or severity of their condition. Some participants masked their online migraine-related behavior using different sites or closed online groups to control who saw their migraine-related content. Participating in closed social media groups sometimes changed Web-based behavior in other areas of the platform. This illustrates the complex relationship between migraine, social media, and identity. Conclusions: How migraine is part of an individual's identity and how this is represented online can vary. Social media can provide people who experience migraine with instant and continuous access to support and information, from a group of empathic others with similar lived experiences. Social media is used to validate the illness experience, as well as provide reassurance and help reduce feelings of isolation. ",
doi="10.2196/10479",
url="http://www.jmir.org/2019/6/e10479/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31219049"
}


@Article{info:doi/10.2196/14290,
author="Shimoga, V. Sandhya
and Erlyana, Erlyana
and Rebello, Vida",
title="Associations of Social Media Use With Physical Activity and Sleep Adequacy Among Adolescents: Cross-Sectional Survey",
journal="J Med Internet Res",
year="2019",
month="Jun",
day="18",
volume="21",
number="6",
pages="e14290",
keywords="adolescent",
keywords="social media",
keywords="exercise",
keywords="sleep",
abstract="Background: Adolescents' use of social media, which has increased considerably in the past decade, has both positive and negative influences on adolescents' health and health behaviors. As social media is the most prominent communication tool of choice for adolescents, it is important to understand the relationship between the frequency of social media use and health behaviors among this population. Objective: The objective of our study was to examine the associations between the frequency of social media use and physical activity and sleep adequacy among middle and high school students. Methods: We used data from the Monitoring the Future survey (2014 and 2015), a nationally representative, annual, cross-sectional survey of American 8th-, 10th-, and 12th-grade students (N=43,994). Health behaviors examined were frequency of vigorous physical activity and frequency of getting 7 hours of sleep (never/seldom, sometimes, and every day/nearly every day). We measured frequency of social media use using a Likert-like scale (never, a few times a year, 1-2 times a month, once a week, or every day). Multivariable generalized ordered logistic regressions examined the association of social media use with different levels of physical activity and sleep. We estimated marginal effects (MEs) for the main independent variable (social media use frequency) by holding all other variables at their observed values. Results: The study population comprised 51.13\% (21,276/42,067) female students, 37.48\% (17,160/43,994) from the South, and 80.07\% (34,953/43,994) from a metropolitan area, with 76.90\% (33,831/43,994) reporting using social media every day. Among physically active students, frequent social media use was associated with a higher likelihood of vigorous daily exercise (ME 50.1\%, 95\% CI 49.2\%-51.0\%). Among sedentary students, frequent social media use was associated with a lower likelihood of vigorous daily exercise (ME 15.8\%, 95\% CI 15.1\%-16.4\%). Moderately active students who used social media once or twice a month had the highest likelihood of reporting vigorous daily exercise (ME 42.0\%, 95\% CI 37.6\%-46.3\%). Among those who normally got adequate sleep, daily social media users were least likely to report adequate sleep (ME 41.3\%, 95\% CI 40.4\%-42.1\%). Among those who were usually sleep deprived, daily social media users were more likely to report adequate sleep (ME 18.3\%, 95\% CI 17.6\%-19.0\%). Conclusions: Regular social media use every day was associated with a reinforcement of health behaviors at both extremes of health behaviors, whereas a medium intensity of social media use was associated with the highest levels of physical activity and lowest sleep adequacy among those with moderate health behaviors. Hence, finding an optimal level of social media use that is beneficial to a variety of health behaviors would be most beneficial to adolescents who are in the middle of the health behavior spectrum. ",
doi="10.2196/14290",
url="http://www.jmir.org/2019/6/e14290/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31215512"
}


@Article{info:doi/10.2196/12709,
author="Kong, Grace
and LaVallee, Heather
and Rams, Alissa
and Ramamurthi, Divya
and Krishnan-Sarin, Suchitra",
title="Promotion of Vape Tricks on YouTube: Content Analysis",
journal="J Med Internet Res",
year="2019",
month="Jun",
day="18",
volume="21",
number="6",
pages="e12709",
keywords="e-cigarettes",
keywords="social media",
keywords="marketing",
abstract="Background: The ability to perform vape tricks (ie, blowing large vapor clouds or shapes like rings) using e-cigarettes appeals to youth. Vape tricks are promoted on social media, but the promotion of vape tricks on social media is not well understood. Objective: The aim of this study was to examine how vape tricks were promoted on YouTube to youth. Methods: Videos on vape tricks that could be accessed by underage youth were identified. The videos were coded for number of views, likes, dislikes, and content (ie, description of vape tricks, e-cigarette devices used for this purpose, video sponsors [private or industry], brand marketing, and contextual characteristics [eg, model characteristics, music, and profanity]). Results: An analysis of 59 sample videos on vape tricks identified 25 distinct vape tricks. These videos had more likes than dislikes (11 to 1 ratio) and a 32,017 median view count. 48\% (28/59) of the videos were posted by industry accounts (27\% [16/59] provaping organizations, 15\% [9/59] online shops, and 3\% [2/59] vape shops) and 53\% by private accounts (55\% [17/31] private users, 26\% [8/31] vape enthusiasts, and 19\% [6/31] YouTube influencers); 53\% (31/59) of the videos promoted a brand of e-cigarette devices, e-liquids, or online/vape shops, and 99\% of the devices used for vape tricks were advanced generation devices. The models in the videos were 80.2\% (160/198) male, 51.5\% white (102/198), and 61.6\% (122/198) aged 18 to 24 years; 85\% (50/59) of the videos had electronic dance music and hip hop, and 32\% (19/59) had profanity. Conclusions: Vape trick videos on YouTube, about half of which were industry sponsored, were accessible to youth. Restrictions of e-cigarette marketing on social media, such as YouTube, are needed. ",
doi="10.2196/12709",
url="http://www.jmir.org/2019/6/e12709/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31215510"
}


@Article{info:doi/10.2196/13475,
author="Yun, Ke
and Xu, Junjie
and Leuba, Sequoia
and Zhu, Yunyu
and Zhang, Jing
and Chu, Zhenxing
and Geng, Wenqing
and Jiang, Yongjun
and Shang, Hong",
title="Development and Validation of a Personalized Social Media Platform--Based HIV Incidence Risk Assessment Tool for Men Who Have Sex With Men in China",
journal="J Med Internet Res",
year="2019",
month="Jun",
day="18",
volume="21",
number="6",
pages="e13475",
keywords="HIV",
keywords="risk prediction",
keywords="social media",
keywords="men who have sex with men",
keywords="China",
abstract="Background: Personalized risk assessments can help medical providers determine targeted populations for counseling and risk reduction interventions. Objective: The objective of this study was to develop a social media platform--based HIV risk prediction tool for men who have sex with men (MSM) in China based on an independent MSM cohort to help medical providers determine target populations for counseling and risk reduction treatments. Methods: A prospective cohort of MSM from Shenyang, China, followed from 2009 to 2016, was used to develop and validate the prediction model. The eligible MSM were randomly assigned to the training and validation dataset, and Cox proportional hazards regression modeling was conducted using predictors for HIV seroconversion selected by the training dataset. Discrimination and calibration were performed, and the related nomogram and social media platform--based HIV risk assessment tool were constructed. Results: The characteristics of the sample between the training dataset and the validation dataset were similar. The risk prediction model identified the following predictors for HIV seroconversion: the main venue used to find male sexual partners, had condomless receptive or insertive anal intercourse, and used rush poppers. The model was well calibrated. The bootstrap C-index was 0.75 (95\% CI 0.65-0.85) in the training dataset, and 0.60 (95\% CI 0.45-0.74) in the validation dataset. The calibration plots showed good agreement between predicted risk and the actual proportion of no HIV infection in both the training and validation datasets. Nomogram and WeChat-based HIV incidence risk assessment tools for MSM were developed. Conclusions: This social media platform--based HIV infection risk prediction tool can be distributed easily, improve awareness of personal HIV infection risk, and stratify the MSM population based on HIV risk, thus informing targeted interventions for MSM at greatest risk for HIV infection. ",
doi="10.2196/13475",
url="https://www.jmir.org/2019/6/e13475/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31215509"
}


@Article{info:doi/10.2196/12554,
author="Cacheda, Fidel
and Fernandez, Diego
and Novoa, J. Francisco
and Carneiro, Victor",
title="Early Detection of Depression: Social Network Analysis and Random Forest Techniques",
journal="J Med Internet Res",
year="2019",
month="Jun",
day="10",
volume="21",
number="6",
pages="e12554",
keywords="depression",
keywords="major depressive disorder",
keywords="social media",
keywords="artificial intelligence",
keywords="machine learning",
abstract="Background: Major depressive disorder (MDD) or depression is among the most prevalent psychiatric disorders, affecting more than 300 million people globally. Early detection is critical for rapid intervention, which can potentially reduce the escalation of the disorder. Objective: This study used data from social media networks to explore various methods of early detection of MDDs based on machine learning. We performed a thorough analysis of the dataset to characterize the subjects' behavior based on different aspects of their writings: textual spreading, time gap, and time span. Methods: We proposed 2 different approaches based on machine learning singleton and dual. The former uses 1 random forest (RF) classifier with 2 threshold functions, whereas the latter uses 2 independent RF classifiers, one to detect depressed subjects and another to identify nondepressed individuals. In both cases, features are defined from textual, semantic, and writing similarities. Results: The evaluation follows a time-aware approach that rewards early detections and penalizes late detections. The results show how a dual model performs significantly better than the singleton model and is able to improve current state-of-the-art detection models by more than 10\%. Conclusions: Given the results, we consider that this study can help in the development of new solutions to deal with the early detection of depression on social networks. ",
doi="10.2196/12554",
url="http://www.jmir.org/2019/6/e12554/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31199323"
}


@Article{info:doi/10.2196/13803,
author="Li, Jiawei
and Xu, Qing
and Shah, Neal
and Mackey, K. Tim",
title="A Machine Learning Approach for the Detection and Characterization of Illicit Drug Dealers on Instagram: Model Evaluation Study",
journal="J Med Internet Res",
year="2019",
month="Jun",
day="15",
volume="21",
number="6",
pages="e13803",
keywords="opioids",
keywords="social media",
keywords="narcotics",
keywords="substance abuse",
keywords="machine learning",
keywords="internet",
keywords="prescription drug abuse",
keywords="artificial intelligence",
abstract="Background: Social media use is now ubiquitous, but the growth in social media communications has also made it a convenient digital platform for drug dealers selling controlled substances, opioids, and other illicit drugs. Previous studies and news investigations have reported the use of popular social media platforms as conduits for opioid sales. This study uses deep learning to detect illicit drug dealing on the image and video sharing platform Instagram. Objective: The aim of this study was to develop and evaluate a machine learning approach to detect Instagram posts related to illegal internet drug dealing. Methods: In this paper, we describe an approach to detect drug dealers by using a deep learning model on Instagram. We collected Instagram posts using a Web scraper between July 2018 and October 2018 and then compared our deep learning model against 3 different machine learning models (eg, random forest, decision tree, and support vector machine) to assess the performance and accuracy of the model. For our deep learning model, we used the long short-term memory unit in the recurrent neural network to learn the pattern of the text of drug dealing posts. We also manually annotated all posts collected to evaluate our model performance and to characterize drug selling conversations. Results: From the 12,857 posts we collected, we detected 1228 drug dealer posts comprising 267 unique users. We used cross-validation to evaluate the 4 models, with our deep learning model reaching 95\% on F1 score and performing better than the other 3 models. We also found that by removing the hashtags in the text, the model had better performance. Detected posts contained hashtags related to several drugs, including the controlled substance Xanax (1078/1228, 87.78\%), oxycodone/OxyContin (321/1228, 26.14\%), and illicit drugs lysergic acid diethylamide (213/1228, 17.34\%) and 3,4-methylenedioxy-methamphetamine (94/1228, 7.65\%). We also observed the use of communication applications for suspected drug trading through user comments. Conclusions: Our approach using a combination of Web scraping and deep learning was able to detect illegal online drug sellers on Instagram, with high accuracy. Despite increased scrutiny by regulators and policymakers, the Instagram platform continues to host posts from drug dealers, in violation of federal law. Further action needs to be taken to ensure the safety of social media communities and help put an end to this illicit digital channel of sourcing. ",
doi="10.2196/13803",
url="http://www.jmir.org/2019/6/e13803/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31199298"
}


@Article{info:doi/10.2196/12876,
author="Foufi, Vasiliki
and Timakum, Tatsawan
and Gaudet-Blavignac, Christophe
and Lovis, Christian
and Song, Min",
title="Mining of Textual Health Information from Reddit: Analysis of Chronic Diseases With Extracted Entities and Their Relations",
journal="J Med Internet Res",
year="2019",
month="Jun",
day="13",
volume="21",
number="6",
pages="e12876",
keywords="social media",
keywords="chronic disease",
keywords="data mining",
abstract="Background: Social media platforms constitute a rich data source for natural language processing tasks such as named entity recognition, relation extraction, and sentiment analysis. In particular, social media platforms about health provide a different insight into patient's experiences with diseases and treatment than those found in the scientific literature. Objective: This paper aimed to report a study of entities related to chronic diseases and their relation in user-generated text posts. The major focus of our research is the study of biomedical entities found in health social media platforms and their relations and the way people suffering from chronic diseases express themselves. Methods: We collected a corpus of 17,624 text posts from disease-specific subreddits of the social news and discussion website Reddit. For entity and relation extraction from this corpus, we employed the PKDE4J tool developed by Song et al (2015). PKDE4J is a text mining system that integrates dictionary-based entity extraction and rule-based relation extraction in a highly flexible and extensible framework. Results: Using PKDE4J, we extracted 2 types of entities and relations: biomedical entities and relations and subject-predicate-object entity relations. In total, 82,138 entities and 30,341 relation pairs were extracted from the Reddit dataset. The most highly mentioned entities were those related to oncological disease (2884 occurrences of cancer) and asthma (2180 occurrences). The relation pair anatomy-disease was the most frequent (5550 occurrences), the highest frequent entities in this pair being cancer and lymph. The manual validation of the extracted entities showed a very good performance of the system at the entity extraction task (3682/5151, 71.48\% extracted entities were correctly labeled). Conclusions: This study showed that people are eager to share their personal experience with chronic diseases on social media platforms despite possible privacy and security issues. The results reported in this paper are promising and demonstrate the need for more in-depth studies on the way patients with chronic diseases express themselves on social media platforms. ",
doi="10.2196/12876",
url="http://www.jmir.org/2019/6/e12876/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31199327"
}


@Article{info:doi/10.2196/13456,
author="On, Jeongah
and Park, Hyeoun-Ae
and Song, Tae-Min",
title="Sentiment Analysis of Social Media on Childhood Vaccination: Development of an Ontology",
journal="J Med Internet Res",
year="2019",
month="Jun",
day="7",
volume="21",
number="6",
pages="e13456",
keywords="social media",
keywords="vaccination",
keywords="health information interoperability",
keywords="semantics",
abstract="Background: Although vaccination rates are above the threshold for herd immunity in South Korea, a growing number of parents have expressed concerns about the safety of vaccines. It is important to understand these concerns so that we can maintain high vaccination rates. Objective: The aim of this study was to develop a childhood vaccination ontology to serve as a framework for collecting and analyzing social data on childhood vaccination and to use this ontology for identifying concerns about and sentiments toward childhood vaccination from social data. Methods: The domain and scope of the ontology were determined by developing competency questions. We checked if existing ontologies and conceptual frameworks related to vaccination can be reused for the childhood vaccination ontology. Terms were collected from clinical practice guidelines, research papers, and posts on social media platforms. Class concepts were extracted from these terms. A class hierarchy was developed using a top-down approach. The ontology was evaluated in terms of description logics, face and content validity, and coverage. In total, 40,359 Korean posts on childhood vaccination were collected from 27 social media channels between January and December 2015. Vaccination issues were identified and classified using the second-level class concepts of the ontology. The sentiments were classified in 3 ways: positive, negative or neutral. Posts were analyzed using frequency, trend, logistic regression, and association rules. Results: Our childhood vaccination ontology comprised 9 superclasses with 137 subclasses and 431 synonyms for class, attribute, and value concepts. Parent's health belief appeared in 53.21\% (15,709/29,521) of posts and positive sentiments appeared in 64.08\% (17,454/27,236) of posts. Trends in sentiments toward vaccination were affected by news about vaccinations. Posts with parents' health belief, vaccination availability, and vaccination policy were associated with positive sentiments, whereas posts with experience of vaccine adverse events were associated with negative sentiments. Conclusions: The childhood vaccination ontology developed in this study was useful for collecting and analyzing social data on childhood vaccination. We expect that practitioners and researchers in the field of childhood vaccination could use our ontology to identify concerns about and sentiments toward childhood vaccination from social data. ",
doi="10.2196/13456",
url="http://www.jmir.org/2019/6/e13456/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31199290"
}


@Article{info:doi/10.2196/12149,
author="Malik, S. Faisal
and Panlasigui, Neil
and Gritton, Jesse
and Gill, Harsimrat
and Yi-Frazier, P. Joyce
and Moreno, A. Megan",
title="Adolescent Perspectives on the Use of Social Media to Support Type 1 Diabetes Management: Focus Group Study",
journal="J Med Internet Res",
year="2019",
month="May",
day="30",
volume="21",
number="6",
pages="e12149",
keywords="type 1 diabetes",
keywords="adolescents",
keywords="social media",
keywords="qualitative research",
abstract="Background: A majority of adolescents report the use of some form of social media, and many prefer to communicate via social networking sites. Social media may offer new opportunities in diabetes management, particularly in terms of how health care teams provide tailored support and treatment to adolescents with diabetes. Objective: The aim of this study was to explore the experiences and perspectives of adolescents with type 1 diabetes on the feasibility of social media use as a tool to collaboratively manage their diabetes with their diabetes care team. Methods: Focus groups of adolescents with type 1 diabetes were conducted in the Seattle metropolitan area in Washington State. Semistructured questions were used to elicit views around the preferred means of communication with the adolescents' diabetes care team, how to best support diabetes self-management, and how social media could be used outside of the clinic setting by the diabetes care team to engage with adolescents with type 1 diabetes. Focus groups were audio recorded and transcribed verbatim. Qualitative content analysis was carried out, and emergent themes were subsequently mapped onto 4 domains of feasibility, which included acceptability, demand, implementation, and practicality. Results: Participants included 45 adolescents with type 1 diabetes (mean age 15.9, SD 1.7 years; 58\% male; diabetes duration mean 6.2, SD 3.6 years; 76\% on insulin pumps; 49\% wore continuous glucose monitors; 93\% reported use of social media; 84\% used smartphones as the primary means for social media access). A total of 7 major topics were identified and mapped onto areas consistent with our focus on feasibility. For acceptability and demand, participants expressed how communication over social media could help facilitate (1) improved communication outside of clinic visits to optimize diabetes management, (2) independence in diabetes self-management, (3) connection to other youth with diabetes for additional diabetes support, and (4) delivery of more timely and personalized care. Addressing implementation and practicality, participants shared the need to (1) ensure patient privacy, (2) maintain professional nature of provider-patient relationship, and (3) recognize that social media is not currently used for medical care by youth with diabetes. Conclusions: Adolescents with type 1 diabetes expressed interest in the use of social media as a tool to support diabetes management and increase engagement with their diabetes care team. Specific implementation measures around privacy and professionalism should be considered when developing a social media intervention to facilitate communication between adolescents and care teams. ",
doi="10.2196/12149",
url="https://www.jmir.org/2019/6/e12149/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31199310"
}


@Article{info:doi/10.2196/12676,
author="Chu, Kar-Hai
and Majmundar, Anuja
and Allem, Jon-Patrick
and Soto, W. Daniel
and Cruz, Boley Tess
and Unger, B. Jennifer",
title="Tobacco Use Behaviors, Attitudes, and Demographic Characteristics of Tobacco Opinion Leaders and Their Followers: Twitter Analysis",
journal="J Med Internet Res",
year="2019",
month="Jun",
day="04",
volume="21",
number="6",
pages="e12676",
keywords="tobacco",
keywords="social media",
keywords="online social networking",
keywords="peer influence",
keywords="social networking",
abstract="Background: Tobacco-related content on social media is generated and propagated by opinion leaders on the Web who disseminate messages to others in their network, including followers, who then continue to spread the information. Opinion leaders can exert powerful influences on their followers' knowledge, attitudes, and behaviors; yet, little is known about the demographic characteristics and tobacco use behavior of tobacco opinion leaders on the Web and their followers, compared with general Twitter users. Objective: In this study, we hypothesized that opinion leaders use more tobacco products and have higher nicotine dependence than the other 2 groups (eg, followers and general Twitter users) and that followers---those who spread messages by opinion leaders---would more likely be in demographic groups that are vulnerable to tobacco marketing influence (eg, young adults and lower educational attainment). Methods: We constructed the social networks of people who tweet about tobacco and categorized them using a combination of social network and Twitter metrics. To understand the characteristics of tobacco opinion leaders and their followers, we conducted a survey of tobacco opinion leaders, their followers, and general Twitter users. The sample included 347 opinion leaders, 567 followers, and 519 general users. The opinion leaders had a median of 1000 followers, whereas followers and general users had fewer than 600 followers. Results: Opinion leaders were more likely than their followers to report past month use of tobacco products; followers, in turn, were more likely to report past month use of these products than general Twitter users. The followers appeared to be an especially vulnerable group; they tended to be younger (mean age 22.4 years) and have lower education compared with the opinion leaders and general users. Conclusions: Followers of Twitter tobacco opinion leaders are a vulnerable group that might benefit from antitobacco education to counter the protobacco communications they see on social media. ",
doi="10.2196/12676",
url="https://www.jmir.org/2019/6/e12676/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31165716"
}


@Article{info:doi/10.2196/13158,
author="Hodgson, Saldivar Nikkie
and Yom-Tov, Elad
and Strong, F. William
and Flores, L. Priscilla
and Ricoy, N. Giselle",
title="Concerns of Female Adolescents About Menarche and First Sexual Intercourse: Mixed Methods Analysis of Social Media Questions",
journal="JMIR Pediatr Parent",
year="2019",
month="Jun",
day="04",
volume="2",
number="1",
pages="e13158",
keywords="menarche",
keywords="sexual intercourse",
keywords="social media",
keywords="infodemiology",
keywords="infoveillance",
abstract="Background: Adolescents use social media for information on medical and social aspects of maturation. Objective: The aim of this study was to investigate the concerns and information needs of adolescents regarding menarche and first sexual intercourse. Methods: Questions about menarche or first sexual intercourse were obtained from Yahoo Answers, a community-based social media question-and-answer website. A total of 1226 questions were analyzed. We focused on 123 question pairs made by users who asked questions on both topics and reported their ages at each. Quantitative and qualitative analyses were performed on these question pairs. Results: Qualitative analysis identified uncertainty as a significant theme for both menarche and first intercourse. Quantitative analysis showed that uncertainty was expressed in 26\% (13/50) of menarche questions and 14\% (7/50) of intercourse questions. Lack of communication was expressed in 4\% (2/50) of menarche questions, compared with 8\% (4/50) of intercourse questions. Ages at menarche and at first sexual intercourse were correlated, with women reporting menarche at the age of 13 years or younger being 2.6 times more likely to experience first sexual intercourse before the age of 16 years (P<.001, chi-square test). Older age at menarche was associated with greater lack of communication with parents (analysis of variance, P=.002). Conclusions: The questions of adolescents on the topics of menarche and first sexual intercourse express anxiety and uncertainty and are associated with a lack of information and deficient communication with parents. The more normative and expected a behavior, the less these factors appear. Therefore, parents and educators should, to the extent possible, improve communication around these topics, especially when they occur at less typical ages. ",
doi="10.2196/13158",
url="http://pediatrics.jmir.org/2019/1/e13158/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31518326"
}


@Article{info:doi/10.2196/12484,
author="Sanders, Ilea
and Short, E. Camille
and Bogomolova, Svetlana
and Stanford, Tyman
and Plotnikoff, Ronald
and Vandelanotte, Corneel
and Olds, Tim
and Edney, Sarah
and Ryan, Jillian
and Curtis, G. Rachel
and Maher, Carol",
title="Characteristics of Adopters of an Online Social Networking Physical Activity Mobile Phone App: Cluster Analysis",
journal="JMIR Mhealth Uhealth",
year="2019",
month="Jun",
day="03",
volume="7",
number="6",
pages="e12484",
keywords="k-medoid cluster analysis",
keywords="social marketing",
keywords="mobile phone app",
keywords="physical activity",
keywords="online social networking",
abstract="Background: To date, many online health behavior programs developed by researchers have not been translated at scale. To inform translational efforts, health researchers must work with marketing experts to design cost-effective marketing campaigns. It is important to understand the characteristics of end users of a given health promotion program and identify key market segments. Objective: This study aimed to describe the characteristics of the adopters of Active Team, a gamified online social networking physical activity app, and identify potential market segments to inform future research translation efforts. Methods: Participants (N=545) were Australian adults aged 18 to 65 years who responded to general advertisements to join a randomized controlled trial (RCT) evaluating the Active Team app. At baseline they provided demographic (age, sex, education, marital status, body mass index, location of residence, and country of birth), behavioral (sleep, assessed by the Pittsburgh Quality Sleep Index) and physical activity (assessed by the Active Australia Survey), psychographic information (health and well-being, assessed by the PERMA [Positive Emotion, Engagement, Relationships, Meaning, Achievement] Profile; depression, anxiety and stress, assessed by the Depression, Anxiety, and Stress Scale [DASS-21]; and quality of life, assessed by the 12-Item Short Form Health Survey [SF-12]). Descriptive analyses and a k-medoids cluster analysis were performed using the software R 3.3.0 (The R Foundation) to identify key characteristics of the sample. Results: Cluster analyses revealed four clusters: (1) younger inactive women with poor well-being (218/545), characterized by a higher score on the DASS-21, low mental component summary score on the SF-12, and relatively young age; (2) older, active women (153/545), characterized by a lower score on DASS-21, a higher overall score on the SF-12, and relatively older age; (3) young, active but stressed men (58/545) with a higher score on DASS-21 and higher activity levels; and (4) older, low active and obese men (30/545), characterized by a high body mass index and lower activity levels. Conclusions: Understanding the characteristics of population segments attracted to a health promotion program will guide the development of cost-effective research translation campaigns. Trial Registration: Australian New Zealand Clinical Trial Registry ACTRN12617000113358;?https://www.anzctr.org .au/Trial/Registration/TrialReview.aspx?id=371463 International Registered Report Identifier (IRRID): RR2-10.1186/s12889-017-4882-7 ",
doi="10.2196/12484",
url="https://mhealth.jmir.org/2019/6/e12484/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31162130"
}


@Article{info:doi/10.2196/12394,
author="Liu, Sam
and Chen, Brian
and Kuo, Alex",
title="Monitoring Physical Activity Levels Using Twitter Data: Infodemiology Study",
journal="J Med Internet Res",
year="2019",
month="Jun",
day="03",
volume="21",
number="6",
pages="e12394",
keywords="physical activity",
keywords="social media",
keywords="internet",
keywords="Twitter messaging",
keywords="population surveillance",
keywords="public health",
abstract="Background: Social media technology such as Twitter allows users to share their thoughts, feelings, and opinions online. The growing body of social media data is becoming a central part of infodemiology research as these data can be combined with other public health datasets (eg, physical activity levels) to provide real-time monitoring of psychological and behavior outcomes that inform health behaviors. Currently, it is unclear whether Twitter data can be used to monitor physical activity levels. Objective: The aim of this study was to establish the feasibility of using Twitter data to monitor physical activity levels by assessing whether the frequency and sentiment of physical activity--related tweets were associated with physical activity levels across the United States. Methods: Tweets were collected from Twitter's application programming interface (API) between January 10, 2017 and January 2, 2018. We used Twitter's garden hose method of collecting tweets, which provided a random sample of approximately 1\% of all tweets with location metadata falling within the United States. Geotagged tweets were filtered. A list of physical activity--related hashtags was collected and used to further classify these geolocated tweets. Twitter data were merged with physical activity data collected as part of the Behavioral Risk Factor Surveillance System. Multiple linear regression models were fit to assess the relationship between physical activity--related tweets and physical activity levels by county while controlling for population and socioeconomic status measures. Results: During the study period, 442,959,789 unique tweets were collected, of which 64,005,336 (14.44\%) were geotagged with latitude and longitude coordinates. Aggregated data were obtained for a total of 3138 counties in the United States. The mean county-level percentage of physically active individuals was 74.05\% (SD 5.2) and 75.30\% (SD 4.96) after adjusting for age. The model showed that the percentage of physical activity--related tweets was significantly associated with physical activity levels (beta=.11; SE 0.2; P<.001) and age-adjusted physical activity (beta=.10; SE 0.20; P<.001) on a county level while adjusting for both Gini index and education level. However, the overall explained variance of the model was low (R2=.11). The sentiment of the physical activity--related tweets was not a significant predictor of physical activity level and age-adjusted physical activity on a county level after including the Gini index and education level in the model (P>.05). Conclusions: Social media data may be a valuable tool for public health organizations to monitor physical activity levels, as it can overcome the time lag in the reporting of physical activity epidemiology data faced by traditional research methods (eg, surveys and observational studies). Consequently, this tool may have the potential to help public health organizations better mobilize and target physical activity interventions. ",
doi="10.2196/12394",
url="https://www.jmir.org/2019/6/e12394/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31162126"
}


@Article{info:doi/10.2196/11264,
author="Nikfarjam, Azadeh
and Ransohoff, D. Julia
and Callahan, Alison
and Jones, Erik
and Loew, Brian
and Kwong, Y. Bernice
and Sarin, Y. Kavita
and Shah, H. Nigam",
title="Early Detection of Adverse Drug Reactions in Social Health Networks: A Natural Language Processing Pipeline for Signal Detection",
journal="JMIR Public Health Surveill",
year="2019",
month="Jun",
day="03",
volume="5",
number="2",
pages="e11264",
keywords="natural language processing",
keywords="signal detection",
keywords="adverse drug reactions",
keywords="social media",
keywords="drug-related side effects",
keywords="medical oncology",
keywords="antineoplastic agents",
keywords="machine learning",
abstract="Background: Adverse drug reactions (ADRs) occur in nearly all patients on chemotherapy, causing morbidity and therapy disruptions. Detection of such ADRs is limited in clinical trials, which are underpowered to detect rare events. Early recognition of ADRs in the postmarketing phase could substantially reduce morbidity and decrease societal costs. Internet community health forums provide a mechanism for individuals to discuss real-time health concerns and can enable computational detection of ADRs. Objective: The goal of this study is to identify cutaneous ADR signals in social health networks and compare the frequency and timing of these ADRs to clinical reports in the literature. Methods: We present a natural language processing-based, ADR signal-generation pipeline based on patient posts on Internet social health networks. We identified user posts from the Inspire health forums related to two chemotherapy classes: erlotinib, an epidermal growth factor receptor inhibitor, and nivolumab and pembrolizumab, immune checkpoint inhibitors. We extracted mentions of ADRs from unstructured content of patient posts. We then performed population-level association analyses and time-to-detection analyses. Results: Our system detected cutaneous ADRs from patient reports with high precision (0.90) and at frequencies comparable to those documented in the literature but an average of 7 months ahead of their literature reporting. Known ADRs were associated with higher proportional reporting ratios compared to negative controls, demonstrating the robustness of our analyses. Our named entity recognition system achieved a 0.738 microaveraged F-measure in detecting ADR entities, not limited to cutaneous ADRs, in health forum posts. Additionally, we discovered the novel ADR of hypohidrosis reported by 23 patients in erlotinib-related posts; this ADR was absent from 15 years of literature on this medication and we recently reported the finding in a clinical oncology journal. Conclusions: Several hundred million patients report health concerns in social health networks, yet this information is markedly underutilized for pharmacosurveillance. We demonstrated the ability of a natural language processing-based signal-generation pipeline to accurately detect patient reports of ADRs months in advance of literature reporting and the robustness of statistical analyses to validate system detections. Our findings suggest the important contributions that social health network data can play in contributing to more comprehensive and timely pharmacovigilance. ",
doi="10.2196/11264",
url="http://publichealth.jmir.org/2019/2/e11264/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31162134"
}


@Article{info:doi/10.2196/14167,
author="Pereira-Sanchez, Victor
and Alvarez-Mon, Angel Miguel
and Asunsolo del Barco, Angel
and Alvarez-Mon, Melchor
and Teo, Alan",
title="Exploring the Extent of the Hikikomori Phenomenon on Twitter: Mixed Methods Study of Western Language Tweets",
journal="J Med Internet Res",
year="2019",
month="May",
day="29",
volume="21",
number="5",
pages="e14167",
keywords="social isolation",
keywords="loneliness",
keywords="hikikomori",
keywords="hidden youth",
keywords="social media",
keywords="Twitter",
keywords="social withdrawal",
abstract="Background: Hikikomori is a severe form of social withdrawal, originally described in Japan but recently reported in other countries. Debate exists as to what extent hikikomori is viewed as a problem outside of the Japanese context. Objective: We aimed to explore perceptions about hikikomori outside Japan by analyzing Western language content from the popular social media platform, Twitter. Methods: We conducted a mixed methods analysis of all publicly available tweets using the hashtag \#hikikomori between February 1 and August 16, 2018, in 5 Western languages (Catalan, English, French, Italian, and Spanish). Tweets were first classified as to whether they described hikikomori as a problem or a nonproblematic phenomenon. Tweets regarding hikikomori as a problem were then subclassified in terms of the type of problem (medical, social, or anecdotal) they referred to, and we marked if they referenced scientific publications or the presence of hikikomori in countries other than Japan. We also examined measures of interest in content related to hikikomori, including retweets, likes, and associated hashtags. Results: A total of 1042 tweets used \#hikikomori, and 656 (62.3\%) were included in the content analysis. Most of the included tweets were written in English (44.20\%) and Italian (34.16\%), and a majority (56.70\%) discussed hikikomori as a problem. Tweets referencing scientific publications (3.96\%) and hikikomori as present in countries other than Japan (13.57\%) were less common. Tweets mentioning hikikomori outside Japan were statistically more likely to be retweeted (P=.01) and liked (P=.01) than those not mentioning it, whereas tweets with explicit scientific references were statistically more retweeted (P=.01) but not liked (P=.10) than those without that reference. Retweet and like figures were not statistically significantly different among other categories and subcategories. The most associated hashtags included references to Japan, mental health, and the youth. Conclusions: Hikikomori is a repeated word in non-Japanese Western languages on Twitter, suggesting the presence of hikikomori in countries outside Japan. Most tweets treat hikikomori as a problem, but the ways they post about it are highly heterogeneous. ",
doi="10.2196/14167",
url="http://www.jmir.org/2019/5/e14167/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31144665"
}


@Article{info:doi/10.2196/14110,
author="Alvarez-Mon, Angel Miguel
and Llavero-Valero, Mar{\'i}a
and S{\'a}nchez-Bayona, Rodrigo
and Pereira-Sanchez, Victor
and Vallejo-Valdivielso, Maria
and Monserrat, Jorge
and Lahera, Guillermo
and Asunsolo del Barco, Angel
and Alvarez-Mon, Melchor",
title="Areas of Interest and Stigmatic Attitudes of the General Public in Five Relevant Medical Conditions: Thematic and Quantitative Analysis Using Twitter",
journal="J Med Internet Res",
year="2019",
month="May",
day="28",
volume="21",
number="5",
pages="e14110",
keywords="social stigma",
keywords="social media",
keywords="psychosis",
keywords="breast cancer",
keywords="HIV",
keywords="dementia",
keywords="public opinion",
keywords="diabetes",
abstract="Background: Twitter is an?indicator of real-world?performance, thus, is an appropriate arena to assess the social consideration and attitudes toward psychosis. Objective: The aim of this study was to perform a mixed-methods study of the content and key metrics of tweets referring to psychosis in comparison with tweets referring to control diseases (breast cancer, diabetes, Alzheimer, and human immunodeficiency virus). Methods: Each tweet's content was rated as nonmedical (NM: testimonies, health care products, solidarity or awareness and misuse) or medical (M: included a reference to the illness's diagnosis, treatment, prognosis, or prevention). NM tweets were classified as positive or pejorative. We assessed the appropriateness of the medical content. The number of retweets generated and the potential reach and impact of the hashtags analyzed was also investigated. Results: We analyzed a total of 15,443 tweets: 8055 classified as NM and 7287 as M. Psychosis-related tweets (PRT) had a significantly higher frequency of misuse 33.3\% (212/636) vs 1.15\% (853/7419; P<.001) and pejorative content 36.2\% (231/636) vs 11.33\% (840/7419; P<.001). The medical content of the PRT showed the highest scientific appropriateness 100\% (391/391) vs 93.66\% (6030/6439; P<.001) and had a higher frequency of content about disease prevention. The potential reach and impact of the tweets related to psychosis were low, but they had a high retweet-to-tweet ratio. Conclusions: We show a reduced number and a different pattern of contents in tweets about psychosis compared with control diseases. PRT showed a predominance of nonmedical content with increased frequencies of misuse and pejorative tone. However, the medical content of PRT showed high scientific appropriateness aimed toward prevention. ",
doi="10.2196/14110",
url="http://www.jmir.org/2019/5/e14110/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31140438"
}


@Article{info:doi/10.2196/12605,
author="Van den Eynde, Jef
and Crauwels, Alexander
and Demaerel, Georg Philip
and Van Eycken, Lisa
and Bullens, Dominique
and Schrijvers, Rik
and Toelen, Jaan",
title="YouTube Videos as a Source of Information About Immunology for Medical Students: Cross-Sectional Study",
journal="JMIR Med Educ",
year="2019",
month="May",
day="28",
volume="5",
number="1",
pages="e12605",
keywords="antigen presentation",
keywords="education",
keywords="immunoglobulins",
keywords="immunology",
keywords="learning",
keywords="students",
abstract="Background: The use of the internet as a source of information has grown exponentially in the last decade. YouTube is currently the second most visited website and a major Web-based educational resource for medical students. Objective: The aim of this study was to evaluate the quality, accuracy, and attractiveness of the information acquired from YouTube videos about 2 central concepts in immunology. Methods: YouTube videos posted before August 27, 2018 were searched using selected keywords related to either antigen presentation or immunoglobulin gene rearrangement. Video characteristics were recorded, and the Video Power Index (VPI) was calculated. Videos were assessed using 5 validated scoring systems: understandability and attractiveness, reliability, content and comprehensiveness, global quality score (GQS), and a subjective score. Videos were categorized by educational usefulness and by source. Results: A total of 82 videos about antigen presentation and 70 about immunoglobulin gene rearrangement were analyzed. Videos had a mean understandability and attractiveness score of 6.57/8 and 5.84/8, content and comprehensiveness score of 9.84/20 and 5.84/20, reliability score of 1.65/4 and 1.53/4, GQS of 3.38/5 and 2.76/5, and subjective score of 2.00/3 and 2.00/3, respectively. The organized channels group tended to have the highest VPI and GQS. Conclusions: YouTube can provide medical students with some useful information about immunology, although content wise it cannot substitute textbooks and academic courses. Students and teachers should be aware of the educational quality of available videos if they intend to use them in the context of blended learning. ",
doi="10.2196/12605",
url="http://mededu.jmir.org/2019/1/e12605/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31140440"
}


@Article{info:doi/10.2196/cancer.7850,
author="Keaver, Laura
and McGough, Aisling
and Du, Mengxi
and Chang, Winnie
and Chomitz, Virginia
and Allen, D. Jennifer
and Attai, J. Deanna
and Gualtieri, Lisa
and Zhang, Fang Fang",
title="Potential of Using Twitter to Recruit Cancer Survivors and Their Willingness to Participate in Nutrition Research and Web-Based Interventions: A Cross-Sectional Study",
journal="JMIR Cancer",
year="2019",
month="May",
day="28",
volume="5",
number="1",
pages="e7850",
keywords="social media",
keywords="nutrition survey",
keywords="cancer survivors",
abstract="Background: Social media is rapidly changing how cancer survivors search for and share health information and can potentially serve as a cost-effective channel to reach cancer survivors and invite them to participate in nutrition intervention programs. Objective: This study aimed to assess the feasibility of using Twitter to recruit cancer survivors for a web-based survey and assess their willingness to complete web-based nutrition surveys, donate biospecimens, and to be contacted about web-based nutrition programs. Methods: We contacted 301 Twitter accounts of cancer organizations, advocates, and survivors to request assistance promoting a web-based survey among cancer survivors. The survey asked respondents whether they would be willing to complete web-based nutrition or lifestyle surveys, donate biospecimens, and be contacted about web-based nutrition programs. Survey promotion rate was assessed by the percentage of Twitter accounts that tweeted the survey link at least once. Survey response was assessed by the number of survey respondents who answered at least 85\% (26/30). We compared the characteristics of cancer survivors who responded to this survey with those who participated in the National Health and Nutrition Examination Survey (NHANES) 1999-2010 and evaluated factors associated with willingness to complete web-based surveys, donate biospecimens, and be contacted to participate in web-based nutrition programs among those who responded to the social media survey. Results: Over 10 weeks, 113 Twitter account owners and 165 of their followers promoted the survey, and 444 cancer survivors provided complete responses. Two-thirds of respondents indicated that they would be willing to complete web-based nutrition or lifestyle surveys (297/444, 67.0\%) and to be contacted to participate in web-based nutrition interventions (294/444, 66.2\%). The percentage of respondents willing to donate biospecimens were 59.3\% (263/444) for oral swab, 52.1\% (231/444) for urine sample, 37.9\% (168/444) for blood sample, and 35.6\% (158/444) for stool sample. Compared with a nationally representative sample of 1550 cancer survivors in NHANES, those who responded to the social media survey were younger (53.1 years vs 60.8 years; P<.001), more likely to be female (93.9\% [417/444] vs 58.7\% [909/1550]; P<.001), non-Hispanic whites (85.4\% [379/444] vs 64.0\% [992/1550]; P<.001), to have completed college or graduate school (30.1 [133/444] vs 19.9\% [308/444]; P<.001), and to be within 5 years of their initial diagnosis (55.2\% [244/444] vs 34.1\% [528/1550]; P<.001). Survivors younger than 45 years, female, and non-Hispanic whites were more willing to complete web-based nutrition surveys than older (65+ years), male, and racial or ethnic minority survivors. Non-Hispanic whites and breast cancer survivors were more willing to donate biospecimens than those with other race, ethnicity or cancer types. Conclusions: Twitter could be a feasible approach to recruit cancer survivors into nutrition research and web-based interventions with potentially high yields. Specific efforts are needed to recruit survivors who are older, male, racial and ethnic minorities, and from socioeconomically disadvantaged groups when Twitter is used as a recruitment method. ",
doi="10.2196/cancer.7850",
url="http://cancer.jmir.org/2019/1/e7850/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31140436"
}


@Article{info:doi/10.2196/13870,
author="Vidal-Alaball, Josep
and Fernandez-Luque, Luis
and Marin-Gomez, X. Francesc
and Ahmed, Wasim",
title="A New Tool for Public Health Opinion to Give Insight Into Telemedicine: Twitter Poll Analysis",
journal="JMIR Form Res",
year="2019",
month="May",
day="28",
volume="3",
number="2",
pages="e13870",
keywords="telemedicine",
keywords="Twitter messaging",
keywords="health care surveys",
abstract="Background: Telemedicine draws on information technologies in order to enable the delivery of clinical health care from a distance. Twitter is a social networking platform that has 316 million monthly active users with 500 million tweets per day; its potential for real-time monitoring of public health has been well documented. There is a lack of empirical research that has critically examined the potential of Twitter polls for providing insight into public health. One of the benefits of utilizing Twitter polls is that it is possible to gain access to a large audience that can provide instant and real-time feedback. Moreover, Twitter polls are completely anonymized. Objective: The overall aim of this study was to develop and disseminate Twitter polls based on existing surveys to gain real-time feedback on public views and opinions toward telemedicine. Methods: Two Twitter polls were developed utilizing questions from previously used questionnaires to explore acceptance of telemedicine among Twitter users. The polls were placed on the Twitter timeline of one of the authors, which had more than 9300 followers, and the account followers were asked to answer the poll and retweet it to reach a larger audience. Results: In a population where telemedicine was expected to enjoy big support, a significant number of Twitter users responding to the poll felt that telemedicine was not as good as traditional care. Conclusions: Our results show the potential of Twitter polls for gaining insight into public health topics on a range of health issues not just limited to telemedicine. Our study also sheds light on how Twitter polls can be used to validate and test survey questions. ",
doi="10.2196/13870",
url="http://formative.jmir.org/2019/2/e13870/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31140442"
}


@Article{info:doi/10.2196/13512,
author="Langford, Aisha
and Loeb, Stacy",
title="Perceived Patient-Provider Communication Quality and Sociodemographic Factors Associated With Watching Health-Related Videos on YouTube: A Cross-Sectional Analysis",
journal="J Med Internet Res",
year="2019",
month="May",
day="17",
volume="21",
number="5",
pages="e13512",
keywords="social media",
keywords="communication",
keywords="health communication",
keywords="ethnic groups",
keywords="physician-patient relations",
keywords="emotions",
keywords="attention",
keywords="cross-sectional studies",
keywords="logistic models",
keywords="HINTS",
abstract="Background: Approximately 73\% of US adults use YouTube, making it the most popular social media platform. Misinformation on social media is a growing concern; recent studies show a high proportion of misinformative health-related videos. Several studies on patient-provider communication and general health information seeking have been conducted. However, few studies to date have examined the potential association between patient-provider communication and health information seeking on specific social media platforms such as YouTube. A better understanding of this relationship may inform future health communication interventions. Objective: The aim was to use nationally representative cross-sectional data to describe the association between perceived patient-provider communication quality and sociodemographic factors on watching YouTube health-related videos. Methods: Data from the 2018 Health Information National Trends Survey were analyzed (N=3504). The primary outcome was whether participants watched a health-related video on YouTube over the past 12 months. A patient-provider communication composite score was created by summing responses about how often providers did the following: (1) gave you the chance to ask all the health-related questions you had, (2) gave attention to your feelings, (3) involved you in health care decisions as much as you wanted, (4) made sure that you understood the things you needed to do to take care of your health, (5) explained things in a way that you could understand, (6) spent enough time with you, and (7) helped you deal with feelings of uncertainty. Sociodemographic factors included age, gender, race/ethnicity, and education. Descriptive statistics and multivariable logistic regression were conducted. Results: Approximately 1067 (35\% weighted prevalence) participants reported watching a health-related video on YouTube. Higher perceived quality of patient-provider communication on the composite score was significantly associated with lower odds of watching health-related videos on YouTube. Regarding sociodemographic factors, increasing age and being a high school graduate (compared with college graduate) were associated with lower odds of watching health-related videos on YouTube; whereas, Hispanic and non-Hispanic Asians were more likely to have watched a health-related video on YouTube. For individual aspects of patient-physician communication, two of seven patient-provider communication variables were significant. Those who reported that providers ``sometimes'' spent enough time with them had higher odds of watching a health-related video on YouTube, compared with those who said providers ``always'' spent enough time with them. Participants reporting that they ``never'' have a chance to ask all their health-related questions also had higher odds of watching health-related videos on YouTube compared with those who reported ``always.'' Conclusions: Higher perceived quality of patient-provider communication is associated with lower odds of watching health-related videos on YouTube. When providers do not spend enough time or give an opportunity to ask questions, patients are more likely to pursue health information on social media. ",
doi="10.2196/13512",
url="http://www.jmir.org/2019/5/e13512/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31102372"
}


@Article{info:doi/10.2196/13090,
author="Daughton, R. Ashlynn
and Paul, J. Michael",
title="Identifying Protective Health Behaviors on Twitter: Observational Study of Travel Advisories and Zika Virus",
journal="J Med Internet Res",
year="2019",
month="May",
day="13",
volume="21",
number="5",
pages="e13090",
keywords="social media",
keywords="travel",
keywords="behavior",
keywords="communicable diseases",
keywords="zika virus",
keywords="public health",
keywords="epidemiology",
keywords="information science",
keywords="travel-related illness",
abstract="Background: An estimated 3.9 billion individuals live in a location endemic for common mosquito-borne diseases. The emergence of Zika virus in South America in 2015 marked the largest known Zika outbreak and caused hundreds of thousands of infections. Internet data have shown promise in identifying human behaviors relevant for tracking and understanding other diseases. Objective: Using Twitter posts regarding the 2015-16 Zika virus outbreak, we sought to identify and describe considerations and self-disclosures of a specific behavior change relevant to the spread of disease---travel cancellation. If this type of behavior is identifiable in Twitter, this approach may provide an additional source of data for disease modeling. Methods: We combined keyword filtering and machine learning classification to identify first-person reactions to Zika in 29,386 English-language tweets in the context of travel, including considerations and reports of travel cancellation. We further explored demographic, network, and linguistic characteristics of users who change their behavior compared with control groups. Results: We found differences in the demographics, social networks, and linguistic patterns of 1567 individuals identified as changing or considering changing travel behavior in response to Zika as compared with a control sample of Twitter users. We found significant differences between geographic areas in the United States, significantly more discussion by women than men, and some evidence of differences in levels of exposure to Zika-related information. Conclusions: Our findings have implications for informing the ways in which public health organizations communicate with the public on social media, and the findings contribute to our understanding of the ways in which the public perceives and acts on risks of emerging infectious diseases. ",
doi="10.2196/13090",
url="https://www.jmir.org/2019/5/e13090/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31094347"
}


@Article{info:doi/10.2196/13324,
author="Nour, Monica
and Chen, Juliana
and Allman-Farinelli, Margaret",
title="Young Adults' Engagement With a Self-Monitoring App for Vegetable Intake and the Impact of Social Media and Gamification: Feasibility Study",
journal="JMIR Form Res",
year="2019",
month="May",
day="10",
volume="3",
number="2",
pages="e13324",
keywords="vegetables",
keywords="young adults",
keywords="mHealth",
keywords="social media",
keywords="experimental game",
abstract="Background: Social media and gamification have been used in digital interventions for improving nutrition behaviors of young adults, but few studies measure engagement. Objective: This feasibility study aimed to explore user engagement with a 4-week smartphone program for improving vegetable intake. Methods: A goal setting and self-monitoring app was developed for feasibility testing. We assessed if additional components of gaming and/or social media support increased engagement. A 2 {\texttimes} 2 factorial study design was used with participants randomly allocated to each group. Engagement with the app (usage) was captured via inbuilt software, which recorded total days of app usage (duration) and the frequency of logging vegetable intake. Uptake of the social media (Facebook) content was measured by tracking views, likes, and comments on posts. Results:  Out of the 110 potential participants who completed the prescreening questionnaire online, 97 were eligible (mean age 24.8 [SD 3.4]). In total, 49\% (47/97) of participants were retained at 4 weeks. Attrition within the first week was the highest among users of the gamified app without social support (Facebook; P<.001). Over the intervention period, 64\% (62/97) of participants logged into their app, with vegetable intake recorded on average for 11 out of 28 days. The frequency of recording decreased each week (mean 4 [SD 2] days in week 1 versus mean 2 [SD 2] days in week 4). No effects of gaming or social support on the frequency of recording vegetables or the duration of app engagement were found. However, regardless of the app type, the duration of app engagement was significantly associated with vegetable intake post intervention (P<.001). In total, 60\% of Facebook posts were viewed by participants but engagement was limited to likes, with no comments or peer-to-peer interaction observed. Conclusions: As duration of usage was associated with vegetable intake, a deeper understanding of factors influencing engagement is needed. Dimensions such as personal attributes and the setting and context require further exploration in addition to content and delivery. ",
doi="10.2196/13324",
url="http://formative.jmir.org/2019/2/e13324/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31094322"
}


@Article{info:doi/10.2196/10942,
author="Wang, Tao
and Mentzakis, Emmanouil
and Brede, Markus
and Ianni, Antonella",
title="Estimating Determinants of Attrition in Eating Disorder Communities on Twitter: An Instrumental Variables Approach",
journal="J Med Internet Res",
year="2019",
month="May",
day="03",
volume="21",
number="5",
pages="e10942",
keywords="medical informatics",
keywords="eating disorders",
keywords="social media",
keywords="attrition",
keywords="emotions",
keywords="social network",
keywords="causality",
keywords="instrumental variables",
abstract="Background: The use of social media as a key health information source has increased steadily among people affected by eating disorders (EDs). Research has examined characteristics of individuals engaging in online communities, whereas little is known about discontinuation of engagement and the phenomenon of participants dropping out of these communities. Objective: This study aimed to investigate the characteristics of dropout behaviors among eating disordered individuals on Twitter and to estimate the causal effects of personal emotions and social networks on dropout behaviors. Methods: Using a snowball sampling method, we collected a set of individuals who self-identified with EDs in their Twitter profile descriptions, as well as their tweets and social networks, leading to 241,243,043 tweets from 208,063 users. Individuals' emotions are measured from their language use in tweets using an automatic sentiment analysis tool, and network centralities are measured from users' following networks. Dropout statuses of users are observed in a follow-up period 1.5 years later (from February 11, 2016 to August 17, 2017). Linear and survival regression instrumental variables models are used to estimate the effects of emotions and network centrality on dropout behaviors. The average levels of attributes among an individual's followees (ie, people who are followed by the individual) are used as instruments for the individual's attributes. Results: Eating disordered users have relatively short periods of activity on Twitter with one half of our sample dropping out at 6 months after account creation. Active users show more negative emotions and higher network centralities than dropped-out users. Active users tend to connect to other active users, whereas dropped-out users tend to cluster together. Estimation results suggest that users' emotions and network centralities have causal effects on their dropout behaviors on Twitter. More specifically, users with positive emotions are more likely to drop out and have shorter lasting periods of activity online than users with negative emotions, whereas central users in a social network have longer lasting participation than peripheral users. Findings on users' tweeting interests further show that users who attempt to recover from EDs are more likely to drop out than those who promote EDs as a lifestyle choice. Conclusions: Presence in online communities is strongly determined by the individual's emotions and social networks, suggesting that studies analyzing and trying to draw condition and population characteristics through online health communities are likely to be biased. Future research needs to examine in more detail the links between individual characteristics and participation patterns if better understanding of the entire population is to be achieved. At the same time, such attrition dynamics need to be acknowledged and controlled when designing online interventions so as to accurately capture their intended populations. ",
doi="10.2196/10942",
url="https://www.jmir.org/2019/5/e10942/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31066718"
}


@Article{info:doi/10.2196/12024,
author="Weijs, Cynthia
and Coe, Jason
and Desmarais, Serge
and Majowicz, Shannon
and Jones-Bitton, Andria",
title="Effects of Mock Facebook Workday Comments on Public Perception of Professional Credibility: A Field Study in Canada",
journal="J Med Internet Res",
year="2019",
month="Apr",
day="18",
volume="21",
number="4",
pages="e12024",
keywords="social media",
keywords="professionalism",
keywords="trust",
keywords="professional-patient relations",
keywords="medical education",
abstract="Background: There is considerable discussion of risks to health professionals' reputations and employment from personal social media use, though its impacts on professional credibility and the health professional-client relationship are unknown. Objective: The aim of this study was to test the extent to which workday comments posted to health professionals' personal Facebook profiles influence their credibility and affect the professional-client relationship. Methods: In a controlled field study, participants (members of the public) reviewed randomly assigned mock Facebook profiles of health professionals. The 2{\texttimes}2{\texttimes}2 factorial design of mock profiles included gender (female/male), health profession (physician/veterinarian), and workday comment type (evident frustration/ambiguous). Participants then rated the profile owner's credibility on a visual analog scale. An analysis of variance test compared ratings. Mediation analyses tested the importance of credibility ratings on participants' willingness to become a client of the mock health professional. Results: Participants (N=357) rated health professionals whose personal Facebook profile showed a comment with evident frustration rather than an ambiguous workday comment as less credible (P<.001; mean difference 11.18 [SE 1.28]; 95\% CI 8.66 to 13.70). Furthermore, participants indicated they were less likely to become clients of the former when they considered credibility (standardized beta=.69; P<.001). Credibility explained 86\% of the variation in the relationship between the type of workday comment and the participant's willingness to become a client of the health professional. Conclusions: This study provides the first evidence of the impact of health professionals' personal online disclosures on credibility and the health relationship. Public perceptions about professionalism and credibility are integral to developing the evidence base for e-professionalism guidelines and encouraging best practices in social media use. ",
doi="10.2196/12024",
url="http://www.jmir.org/2019/4/e12024/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30998223"
}


@Article{info:doi/10.2196/11419,
author="Blomberg, Karin
and Eriksson, Mats
and B{\"o}{\"o}, Rickard
and Gr{\"o}nlund, {\AA}ke",
title="Using a Facebook Forum to Cope With Narcolepsy After Pandemrix Vaccination: Infodemiology Study",
journal="J Med Internet Res",
year="2019",
month="Apr",
day="16",
volume="21",
number="4",
pages="e11419",
keywords="narcolepsy",
keywords="mass vaccination",
keywords="social media",
abstract="Background: In 2010, newly diagnosed narcolepsy cases among children and adolescents were seen in several European countries as a consequence of comprehensive national vaccination campaigns with Pandemrix against H1N1 influenza. Since then, a large number of people have had to live with narcolepsy and its consequences in daily life, such as effects on school life, social relationships, and activities. Initially, the adverse effects were not well understood and there was uncertainty about whether there would be any financial compensation. The situation remained unresolved until 2016, and during these years affected people sought various ways to join forces to handle the many issues involved, including setting up a social media forum. Objective: Our aim was to examine how information was shared, and how opinions and beliefs about narcolepsy as a consequence of Pandemrix vaccination were formed through discussions on social media. Methods: We used quantitative and qualitative methods to investigate a series of messages posted in a social media forum for people affected by narcolepsy after vaccination. Results: Group activity was high throughout the years 2010 to 2016, with peaks corresponding to major narcolepsy-related events, such as the appearance of the first cases in 2010, the first payment of compensation in 2011, and passage of a law on compensation in July 2016. Unusually, most (462/774, 59.7\%) of the group took part in discussions and only 312 of 774 (40.3\%) were lurkers (compared with the usual 90\% rule of thumb for participation in an online community). The conversation in the group was largely factual and had a civil tone, even though there was a long struggle for the link between the vaccine and narcolepsy to be acknowledged and regarding the compensation issue. Radical, nonscientific views, such as those expounded by the antivaccination movement, did not shape the discussions in the group but were being actively expressed elsewhere on the internet. At the outset of the pandemic, there were 18 active Swedish discussion groups on the topic, but most dissolved quickly and only one Facebook group remained active throughout the period. Conclusions: The group studied is a good example of social media use for self-help through a difficult situation among people affected by illness and disease. This shows that social media do not by themselves induce trench warfare but, given a good group composition, can provide a necessary forum for managing an emergency situation where health care and government have failed or are mistrusted, and patients have to organize themselves so as to cope. ",
doi="10.2196/11419",
url="http://www.jmir.org/2019/4/e11419/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30990457"
}


@Article{info:doi/10.2196/11397,
author="DeJonckheere, Melissa
and Nichols, P. Lauren
and Vydiswaran, Vinod V. G.
and Zhao, Xinyan
and Collins-Thompson, Kevyn
and Resnicow, Kenneth
and Chang, Tammy",
title="Using Text Messaging, Social Media, and Interviews to Understand What Pregnant Youth Think About Weight Gain During Pregnancy",
journal="JMIR Form Res",
year="2019",
month="Apr",
day="01",
volume="3",
number="2",
pages="e11397",
keywords="methods",
keywords="adolescents",
keywords="weight gain",
keywords="pregnancy",
keywords="text messaging",
keywords="social media",
keywords="natural language processing",
abstract="Background: The majority of pregnant youth gain more weight than recommended by the National Academy of Medicine guidelines. Excess weight gain during pregnancy increases the risk of dangerous complications during delivery, including operative delivery and stillbirth, and contributes to the risk of long-term obesity in both mother and child. Little is known regarding youth's perceptions of and knowledge about weight gain during pregnancy. Objective: The aim of this study was to describe the feasibility and acceptability of 3 novel data collection and analysis strategies for use with youth (social media posts, text message surveys, and semistructured interviews) to explore their experiences during pregnancy. The mixed-methods analysis included natural language processing and thematic analysis. Methods: To demonstrate the feasibility and acceptability of this novel approach, we used descriptive statistics and thematic qualitative analysis to characterize participation and engagement in the study. Results: Recruitment of 54 pregnant women aged between 16 and 24 years occurred from April 2016 to September 2016. All participants completed at least 1 phase of the study. Semistructured interviews had the highest rate of completion, yet all 3 strategies were feasible and acceptable to pregnant youth. Conclusions: This study has described a novel youth-centered strategy of triangulating 3 sources of mixed-methods data to gain a deeper understanding of a health behavior phenomenon among an at-risk population of youth. ",
doi="10.2196/11397",
url="https://formative.jmir.org/2019/2/e11397/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30932869"
}


@Article{info:doi/10.2196/12181,
author="Tong, Ly Huong
and Coiera, Enrico
and Tong, William
and Wang, Ying
and Quiroz, C. Juan
and Martin, Paige
and Laranjo, Liliana",
title="Efficacy of a Mobile Social Networking Intervention in Promoting Physical Activity: Quasi-Experimental Study",
journal="JMIR Mhealth Uhealth",
year="2019",
month="Mar",
day="28",
volume="7",
number="3",
pages="e12181",
keywords="mobile apps",
keywords="fitness trackers",
keywords="exercise",
keywords="social networking",
abstract="Background: Technological interventions such as mobile apps, Web-based social networks, and wearable trackers have the potential to influence physical activity; yet, only a few studies have examined the efficacy of an intervention bundle combining these different technologies. Objective: This study aimed to pilot test an intervention composed of a social networking mobile app, connected with a wearable tracker, and investigate its efficacy in improving physical activity, as well as explore participant engagement and the usability of the app. Methods: This was a pre-post quasi-experimental study with 1 arm, where participants were subjected to the intervention for a 6-month period. The primary outcome measure was the difference in daily step count between baseline and 6 months. Secondary outcome measures included engagement with the intervention and system usability. Descriptive and inferential statistical tests were conducted; posthoc subgroup analyses were carried out for participants with different levels of steps at baseline, app usage, and social features usage. Results: A total of 55 participants were enrolled in the study; the mean age was 23.6 years and 28 (51\%) were female. There was a nonstatistically significant increase in the average daily step count between baseline and 6 months (mean change=14.5 steps/day, P=.98, 95\% CI --1136.5 to 1107.5). Subgroup analysis comparing the higher and lower physical activity groups at baseline showed that the latter had a statistically significantly higher increase in their daily step count (group difference in mean change from baseline to 6 months=3025 steps per day, P=.008, 95\% CI 837.9-5211.8). At 6 months, the retention rate was 82\% (45/55); app usage decreased over time. The mean system usability score was 60.1 (SD 19.2). Conclusions: This study showed the preliminary efficacy of a mobile social networking intervention, integrated with a wearable tracker to promote physical activity, particularly for less physically active subgroups of the population. Future research should explore how to address challenges faced by physically inactive people to provide tailored advices. In addition, users' perspectives should be explored to shed light on factors that might influence their engagement with the intervention. ",
doi="10.2196/12181",
url="http://mhealth.jmir.org/2019/3/e12181/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30920379"
}


@Article{info:doi/10.2196/11014,
author="Moreno, A. Megan
and D'Angelo, Jonathan",
title="Social Media Intervention Design: Applying an Affordances Framework",
journal="J Med Internet Res",
year="2019",
month="Mar",
day="26",
volume="21",
number="3",
pages="e11014",
keywords="social media",
keywords="health",
keywords="adolescent",
keywords="research",
doi="10.2196/11014",
url="http://www.jmir.org/2019/3/e11014/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30912754"
}


@Article{info:doi/10.2196/12403,
author="Banerjee, Yajnavalka
and Tambi, Richa
and Gholami, Mandana
and Alsheikh-Ali, Alawi
and Bayoumi, Riad
and Lansberg, Peter",
title="Augmenting Flexnerism Via Twitterism: Need for Integrating Social Media Application in Blueprinting Pedagogical Strategies for Undergraduate Medical Education",
journal="JMIR Med Educ",
year="2019",
month="Mar",
day="25",
volume="5",
number="1",
pages="e12403",
keywords="social media",
keywords="medical education",
keywords="twitter messaging",
keywords="Web 2.0",
keywords="curriculum",
abstract="Background: Flexnerism, or ``competency-based medical education,'' advocates that formal analytic reasoning, the kind of rational thinking fundamental to the basic sciences, especially the natural sciences, should be the foundation of physicians' intellectual training. The complexity of 21st century health care requires rethinking of current (medical) educational paradigms. In this ``Millennial Era,'' promulgation of the tenets of Flexnerism in undergraduate medical education requires a design and blueprint of innovative pedagogical strategies, as the targeted learners are millennials (designated as generation-Y medical students). Objective: The aim of this proof-of-concept study was to identify the specific social media app platforms that are selectively preferred by generation-Y medical students in undergraduate medical education. In addition, we aimed to explore if these preferred social media apps can be used to design an effective pedagogical strategy in order to disseminate course learning objectives in the preclinical phase of a spiral curriculum. Methods: A cross-sectional survey was conducted by distributing a 17-item questionnaire among the first- and second-year medical students in the preclinical phase at the Mohammed Bin Rashid University of Medicine and Health Science. Results: The study identified YouTube and WhatsApp as the social media app platforms preferred by generation-Y medical students in undergraduate medical education. This study also identified the differences between female and male generation-Y medical students in terms of the use of social media apps in medical education, which we believe will assist instructors in designing pedagogical strategies to integrate social media apps. In addition, we determined the perceptions of generation-Y medical students on the implementation of social media apps in medical education. The pedagogical strategy designed using social media apps and implemented in the Biochemistry course was well accepted by generation-Y medical students and can be translated to any course in the preclinical phase of the medical curriculum. Moreover, the identified limitations of this study provide an understanding of the gaps in research in the integration of social media apps in a medical curriculum catering to generation-Y medical students. Conclusions: 21st century medical education requires effective use of social media app platforms to augment competency-based medical education: Augmentation of Flexnerism in the current scenario is possible only by the adaptation of Twitterism. ",
doi="10.2196/12403",
url="http://mededu.jmir.org/2019/1/e12403/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30907736"
}


@Article{info:doi/10.2196/12355,
author="Litchman, L. Michelle
and Tran, MJ
and Dearden, E. Susan
and Guo, Jia-Wen
and Simonsen, E. Sara
and Clark, Lauren",
title="What Women With Disabilities Write in Personal Blogs About Pregnancy and Early Motherhood: Qualitative Analysis of Blogs",
journal="JMIR Pediatr Parent",
year="2019",
month="Mar",
day="14",
volume="2",
number="1",
pages="e12355",
keywords="disabled persons",
keywords="pregnancy",
keywords="blog",
keywords="women's health",
keywords="parenting",
keywords="mothers",
keywords="spinal cord injury",
keywords="autism",
keywords="traumatic brain injury",
abstract="Background: More than 1 in 10 women of reproductive age identify as having some type of disability. Most of these women are able to become pregnant and have similar desires for motherhood as women without disability. Women with disability, however, face greater stigma and stereotyping, additional risk factors, and may be less likely to receive adequate reproductive health care compared with their peers without disability. More and more individuals, including those with disability, are utilizing the internet to seek information and peer support. Blogs are one source of peer-to-peer social media engagement that may provide a forum for women with disability to both share and obtain peer-to-peer information and support. Nevertheless, it is not clear what content about reproductive health and pregnancy and/or motherhood is featured in personal blogs authored by women with spinal cord injury (SCI), traumatic brain injury (TBI), spina bifida, and autism. Objective: The objective of this study was twofold: (1) to examine the information being shared in blogs by women with 4 types of disabilities, namely, SCI, TBI, spina bifida, and autism, about reproductive health, disability, health care, pregnancy, and motherhood; and (2) to classify the content of reproductive health experiences addressed by bloggers to better understand what they viewed as important. Methods: Personal blogs were identified by searching Google with keywords related to disabilities, SCI, TBI, spina bifida, and autism, and a variety of keywords related to reproductive health. The first 10 pages of each database search in Google, based on the relevance of the search terms, were reviewed and all blogs in these pages were included. Blog inclusion criteria were as follows: (1) written by a woman or care partner (ie, parent or spouse) of a woman with a self-identified diagnosis of SCI, TBI, spina bifida, or autism; (2) focused on the personal experience of health and health care during the prepregnancy, prenatal, antepartum, intrapartum, and/or postpartum periods; (3) written in English; and (4) published between 2013 and 2017. A descriptive and thematic qualitative analysis of blogs and corresponding comments was facilitated with NVivo software and matrix analysis. Results: Our search strategy identified 125 blogs that met all the inclusion criteria; no blogs written by women with spina bifida were identified. We identified 4 reproductive health themes featured in the blog of women with disabilities: (1) (in)accessible motherhood, (2) (un)supportive others, (3) different, but not different, and (4) society questioning motherhood. Conclusions: This analysis of personal blogs about pregnancy and health care written by women with SCI, TBI, and autism provides a glimpse into their experiences. The challenges faced by these women and the adaptations they made to successfully navigate pregnancy and early motherhood provide insights that can be used to shape future research. ",
doi="10.2196/12355",
url="http://pediatrics.jmir.org/2019/1/e12355/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31518332"
}


@Article{info:doi/10.2196/13058,
author="Jiang, Xiaoya
and Jiang, Wenshi
and Cai, Jiawei
and Su, Qingdong
and Zhou, Zhigang
and He, Lingnan
and Lai, Kaisheng",
title="Characterizing Media Content and Effects of Organ Donation on a Social Media Platform: Content Analysis",
journal="J Med Internet Res",
year="2019",
month="Mar",
day="12",
volume="21",
number="3",
pages="e13058",
keywords="organ donation",
keywords="media",
keywords="media effects",
keywords="social media",
abstract="Background: The lack of organ donors has become a barrier for the development of organ transplantation programs, and many countries are currently facing a severe shortage of deceased organs. Media campaigns on social media have the potential to promote organ donation. However, little is known about what kind of media content is the most appropriate for this purpose. Objective: This study aimed to analyze media posts regarding organ donation on Weibo, a social media platform, and to identify the media themes that are most advantageous in promoting public awareness and attitudes concerning organ donation. Methods: Based on 16 million social media users' posts randomly extracted from January 1 to December 31, 2017, 1507 reposts of 141 distinct media posts relevant to organ donation were found. We analyzed the media posts' themes and examined their effects in promoting public awareness about organ donation by comparing the number of reposts and comments they prompted. The themes' impact on attitude toward organ donation was gauged using the comments indicating support and intentions for organ donation. Results: Overall, 5 major themes were identified from the media posts, among which ``organ donation behaviors'' constituted the highest proportion (58/141, 41.13\%). However, themes of ``statistical descriptions of organ donation'' and ``meaningfulness of donation'' were the most influential in promoting awareness on organ donation: approximately 3 of 10 commenters for the former theme and 2 of 10 commenters for the latter expressed intentions to become organ donors. These two themes, along with ``meaningfulness of organ donation for society,'' a subtheme of ``meaningfulness of donation,'' were the most effective for evoking support and intentions for donation. Conclusions: A discrepancy was revealed between the media themes that were the most salient on the media agenda and those that were the most effective in increasing organ donation awareness and intentions on social media. These findings provide guidance for campaigns on organ donation. The results also suggest the potential of campaigns on social media for promoting prosocial health behaviors and highlight the importance of strategic message design for serving this goal. ",
doi="10.2196/13058",
url="http://www.jmir.org/2019/3/e13058/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30860489"
}


@Article{info:doi/10.2196/12441,
author="Wright, Kevin
and Fisher, Carla
and Rising, Camella
and Burke-Garcia, Amelia
and Afanaseva, Dasha
and Cai, Xiaomei",
title="Partnering With Mommy Bloggers to Disseminate Breast Cancer Risk Information: Social Media Intervention",
journal="J Med Internet Res",
year="2019",
month="Mar",
day="07",
volume="21",
number="3",
pages="e12441",
keywords="breast cancer",
keywords="environment and public health",
keywords="risk reduction behavior",
keywords="blogging",
keywords="social networking",
keywords="social media",
keywords="health communication",
keywords="information dissemination",
abstract="Background: Women are concerned about reducing their breast cancer risk, particularly if they have daughters. Social media platforms, such as blogs written by mothers, are increasingly being recognized as a channel that women use to make personal and family health--related decisions. Government initiatives (eg, Interagency Breast Cancer and Environmental Research Coordinating Committee) and researchers have called for scientists and the community to partner and disseminate scientifically and community-informed environmental risk information. Objective: We developed and evaluated a blog intervention to disseminate breast cancer and environmental risk information to mothers. We teamed with mommy bloggers to disseminate a message that we developed and tailored for mothers and daughters based on scientific evidence from the Breast Cancer and the Environment Research Program (BCERP). We posited that the intervention would influence women's exposure to, acceptance of, and beliefs about environmental risks while promoting their intention to adopt risk-reducing behaviors. Methods: Using a quasi-experimental design, we recruited 75 mommy bloggers to disseminate the breast cancer risk message on their respective blogs and examined the impact of the intervention on (1) readers exposed to the intervention (n=445) and (2) readers not exposed to the intervention (comparison group; n=353). Results: Following the intervention, blog reader scores indicating exposure to the breast cancer risk and prevention information were greater than scores of blog readers who were not exposed (or did not recall seeing the message; mean 3.92, SD 0.85 and mean 3.45, SD 0.92, respectively; P<.001). Readers who recalled the intervention messages also had higher breast cancer risk and prevention information satisfaction scores compared with readers who did not see (or recall) the messages (mean 3.97, SD 0.75 and mean 3.57, SD 0.94, respectively; P<.001). Blog readers who recalled seeing the intervention messages were significantly more likely to share the breast cancer risk and prevention information they read, with their daughters specifically, than readers who did not recall seeing them ($\chi$21=8.1; P=.004). Those who recalled seeing the intervention messages reported significantly higher breast cancer risk and prevention information influence scores, indicative of behavioral intentions, than participants who did not recall seeing them (mean 11.22, SD 2.93 and mean 10.14, SD 3.24, respectively; P=.003). Most women ranked Facebook as their first choice for receiving breast cancer risk information. Conclusions: Results indicated that blog readers who were exposed to (and specifically recalled) the BCERP-adapted intervention messages from mommy bloggers had higher breast cancer risk and prevention information exposure scores and higher breast cancer risk and prevention information satisfaction and influence scores than those who did not see (or recall) them. Mommy bloggers may be important opinion leaders for some women and key to enhancing the messaging, delivery, and impact of environmental breast cancer risk information on mothers. ",
doi="10.2196/12441",
url="https://www.jmir.org/2019/3/e12441/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30843866"
}


@Article{info:doi/10.2196/11206,
author="Bennetts, K. Shannon
and Hokke, Stacey
and Crawford, Sharinne
and Hackworth, J. Naomi
and Leach, S. Liana
and Nguyen, Cattram
and Nicholson, M. Jan
and Cooklin, R. Amanda",
title="Using Paid and Free Facebook Methods to Recruit Australian Parents to an Online Survey: An Evaluation",
journal="J Med Internet Res",
year="2019",
month="Mar",
day="06",
volume="21",
number="3",
pages="e11206",
keywords="parents",
keywords="research subject recruitment",
keywords="retention",
keywords="social media",
keywords="cost effectiveness",
keywords="sampling bias",
keywords="fathers",
keywords="mothers",
keywords="survey",
abstract="Background: The prevalence of social media makes it a potential alternative to traditional offline methods of recruiting and engaging participants in health research. Despite burgeoning use and interest, few studies have rigorously evaluated its effectiveness and feasibility in terms of recruitment rates and costs, sample representativeness, and retention. Objective: This study aimed to determine the feasibility of using Facebook to recruit employed Australian parents to an online survey about managing work and family demands, specifically to examine (1) recruitment rates and costs; (2) sample representativeness, compared with a population-based cohort of parents; and (3) retention, including demographic and health characteristics of parents who returned to complete a follow-up survey 6 weeks later. Methods: Recruitment was conducted using 20 paid Facebook advertising campaigns, supplemented with free advertising approaches such as posts on relevant Facebook pages and requests for professional networks to circulate the survey link via Facebook. Recruitment rates and costs were evaluated using the Checklist for Reporting Results of Internet E-Surveys, including view rate, participation rate, completion rate, cost per consent, and cost per completer. Sample representativeness was evaluated by comparing demographic and outcome variables with a comparable sample from the Longitudinal Study of Australian Children including educational attainment, marital status, country of birth, neighborhood disadvantage, work-family conflict, and psychological distress. Retention was evaluated by comparing the number and demographic characteristics of participants at recruitment and at 6-week follow-up. Results: Recruitment strategies together resulted in 6653 clicks on the survey link, from which 5378 parents consented to participate and 4665 (86.74\%) completed the survey. Of those who completed the survey, 85.94\% (4009/4665) agreed to be recontacted, with 57.79\% (2317/4009) completing the follow-up survey (ie, 43.08\% [2317/5378] of parents who consented to the initial survey). Paid Facebook advertising recruited nearly 75\% of the sample at Aus \$2.32 per completed survey (Aus \$7969 spent, 3440 surveys completed). Compared with a population-based sample, participants at baseline were more likely to be university educated (P<.001), experience greater work-family conflict (P<.001) and psychological distress (P<.001), and were less likely to be born outside Australia (P<.001) or live in a disadvantaged neighborhood (P<.001). Conclusions: Facebook provided a feasible, rapid method to recruit a large national sample of parents for health research. However, some sample biases were observed and should be considered when recruiting participants via Facebook. Retention of participants at 6- to 8-week follow-up was less than half the initial sample; this may reflect limited ongoing participant engagement for those recruited through social media, compared with face-to-face. ",
doi="10.2196/11206",
url="https://www.jmir.org/2019/3/e11206/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30839282"
}


@Article{info:doi/10.2196/10441,
author="Stephenson, Lee Nikki
and Hetherington, Erin
and Dodd, Shawn
and Mathews, Alexander
and Tough, Suzanne",
title="Mitigation of Participant Loss to Follow-Up Using Facebook: All Our Families Longitudinal Pregnancy Cohort",
journal="J Med Internet Res",
year="2019",
month="Feb",
day="15",
volume="21",
number="2",
pages="e10441",
keywords="social media",
keywords="social networking",
keywords="longitudinal studies",
keywords="patient dropouts",
keywords="cohort studies",
keywords="follow-up studies",
keywords="lost to follow-up",
abstract="Background: Facebook, a popular social media site, allows users to communicate and exchange information. Social media sites can also be used as databases to search for individuals, including cohort participants. Retaining and tracking cohort participants are essential for the validity and generalizability of data in longitudinal research. Despite numerous strategies to minimize loss to follow-up, maintaining contact with participants is time-consuming and resource-intensive. Social media may provide alternative methods of contacting participants who consented to follow-up but could not be reached, and thus are potentially ``lost to follow-up.'' Objective: The aim of this study was to determine if Facebook was a feasible method for identifying and contacting participants of a longitudinal pregnancy cohort who were lost to follow-up and re-engaging them without selection bias. Methods: This study used data from the All Our Families cohort. Of the 2827 mother-child dyads within the cohort, 237 participants were lost to follow-up. Participants were considered lost to follow-up if they had agreed to participate in additional research, completed at least one of the perinatal questionnaires, did not complete the 5-year postpartum questionnaire, and could not be contacted after numerous attempts via phone, email, or mail. Participants were considered to be matched to a Facebook profile if 2 or more characteristics matched information previously collected. Participants were sent both a friend request and a personal message through the study's Facebook page and were invited to verify their enrollment in the study. The authors deemed a friend request was necessary because of the reduced functionality of nonfriend direct messaging at the time. If the participant accepted the study's friend request, then a personalized message was sent. Participants were considered reconnected if they accepted the friend request or responded to any messages. Participants were considered re-engaged if they provided up-to-date contact information. Results: Compared with the overall cohort, participants who were lost to follow-up (n=237) were younger (P=.003), nonmarried (P=.02), had lower household income (P<.001), less education (P<.001), and self-identified as being part of an ethnic minority (P=.02). Of the 237 participants considered lost to follow-up, 47.7\% (113/237) participants were identified using Facebook. Among the 113 identified participants, 77.0\% (87/113) were contacted, 32.7\% (37/113) were reconnected, and 17.7\% (20/113) were re-engaged. No significant differences were found between those identified on Facebook (n=113) and those who were not able to be identified (n=124). Conclusions: Facebook identified 47.6\% (113/237) of participants who were considered lost to follow-up, and the social media site may be a practical tool for reconnecting with participants. The results from this study demonstrate that social networking sites, such as Facebook, could be included in the development of retention practices and can be implemented at any point in cohort follow-up. ",
doi="10.2196/10441",
url="https://www.jmir.org/2019/2/e10441/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30767901"
}


@Article{info:doi/10.2196/12264,
author="Hswen, Yulin
and Gopaluni, Anuraag
and Brownstein, S. John
and Hawkins, B. Jared",
title="Using Twitter to Detect Psychological Characteristics of Self-Identified Persons With Autism Spectrum Disorder: A Feasibility Study",
journal="JMIR Mhealth Uhealth",
year="2019",
month="Feb",
day="12",
volume="7",
number="2",
pages="e12264",
keywords="autism",
keywords="digital data",
keywords="emotion",
keywords="mobile phone",
keywords="obsessive-compulsive disorder",
keywords="social media",
keywords="textual analysis",
keywords="tweets",
keywords="Twitter",
keywords="infodemiology",
abstract="Background: More than 3.5 million Americans live with autism spectrum disorder (ASD). Major challenges persist in diagnosing ASD as no medical test exists to diagnose this disorder. Digital phenotyping holds promise to guide in the clinical diagnoses and screening of ASD. Objective: This study aims to explore the feasibility of using the Web-based social media platform Twitter to detect psychological and behavioral characteristics of self-identified persons with ASD. Methods: Data from Twitter were retrieved from 152 self-identified users with ASD and 182 randomly selected control users from March 22, 2012 to July 20, 2017. We conducted a between-group comparative textual analysis of tweets about repetitive and obsessive-compulsive behavioral characteristics typically associated with ASD. In addition, common emotional characteristics of persons with ASD, such as fear, paranoia, and anxiety, were examined between groups through textual analysis. Furthermore, we compared the timing of tweets between users with ASD and control users to identify patterns in communication. Results: Users with ASD posted a significantly higher frequency of tweets related to the specific repetitive behavior of counting compared with control users (P<.001). The textual analysis of obsessive-compulsive behavioral characteristics, such as fixate, excessive, and concern, were significantly higher among users with ASD compared with the control group (P<.001). In addition, emotional terms related to fear, paranoia, and anxiety were tweeted at a significantly higher rate among users with ASD compared with control users (P<.001). Users with ASD posted a smaller proportion of tweets during time intervals of 00:00-05:59 (P<.001), 06:00-11:59 (P<.001), and 18:00-23.59 (P<.001), as well as a greater proportion of tweets from 12:00 to 17:59 (P<.001) compared with control users. Conclusions: Social media may be a valuable resource for observing unique psychological characteristics of self-identified persons with ASD. Collecting and analyzing data from these digital platforms may afford opportunities to identify the characteristics of ASD and assist in the diagnosis or verification of ASD. This study highlights the feasibility of leveraging digital data for gaining new insights into various health conditions. ",
doi="10.2196/12264",
url="http://mhealth.jmir.org/2019/2/e12264/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30747718"
}


@Article{info:doi/10.2196/10146,
author="Della Rosa, Sara
and Sen, Falguni",
title="Health Topics on Facebook Groups: Content Analysis of Posts in Multiple Sclerosis Communities",
journal="Interact J Med Res",
year="2019",
month="Feb",
day="11",
volume="8",
number="1",
pages="e10146",
keywords="social network",
keywords="health information",
keywords="health care internet",
keywords="content analysis",
keywords="Facebook",
abstract="Background: Social network sites (SNSs) are being increasingly used to exchange health information between patients and practitioners, pharmaceutical companies, and research centers. Research contributions have explored the contents of such exchanges discussed online. They have categorized the topics discussed and explored the engagement levels of these discussions. Objective: This research aimed at investigating the potential role of SNSs in health care. Specifically it provides an information-clustering analysis of the health information available on SNSs and develops a research design that allows an investigation of this information in enhancing health care research and delivery. In addition, this research aims at testing whether SNSs are valid tools for sharing drug-related information by patients. Methods: This research is based on a specific chronic disease: multiple sclerosis. We searched Facebook to identify and research the social media groups related to this condition. The analysis was restricted to public groups for privacy concerns. We created a database by downloading posts from two main groups (in the English language). Subsequently, we performed a content analysis and statistical analysis; this allowed us to explore the differences between categories, their engagement levels, and the types of posts shared. The mean level of engagement for each topic was analyzed using a 1-way analysis of variance. Results: From a sample of 7029 posts, initial results showed that there were 8 information categories that resonated (percentage of times the topic appears in our sample) with those who post on Facebook: information and awareness (4923/7029, 70.04\%), event advertising and petitions (365/7029, 5.19\%), fundraising (354/7029, 5.04\%), patient support (217/7029, 3.09\%), drug discussion (144/7029, 2.05\%), clinical trials and research studies (59/7029, 0.84\%), product and drug advertising (48/7029, 0.68\%), and other (919/7029, 13.07\%). Initial analysis showed that comments and likes (as measures of engagement level) are the most frequent indicators and measures of level of engagement. Our results show a high engagement level (in terms of views, likes, comments, etc) for patient support and information and awareness. In addition, although drug discussion had a low resonance, it had an unexpected highly engagement level which we found worthy of further exploration. Conclusions: SNSs have become important tools for patients and health care practitioners to share or seek information. We identified the type of information shared and how the public reacted to it. Our research confirmed that the topics discussed in social media related to specific diseases such as multiple sclerosis are similar to the information categories observed by other researchers. We unexpectedly found other categories such as drug discussion. These and other results of our study enhance our understanding of how content is disseminated and perceived within a specific disease-based community. We concluded that this information has useful implications in the design of prevention campaigns, educational programs, and chronic disease management. ",
doi="10.2196/10146",
url="http://www.i-jmr.org/2019/1/e10146/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30741640"
}


@Article{info:doi/10.2196/11573,
author="Walker, Troy
and Palermo, Claire
and Klassen, Karen",
title="Considering the Impact of Social Media on Contemporary Improvement of Australian Aboriginal Health: Scoping Review",
journal="JMIR Public Health Surveill",
year="2019",
month="Feb",
day="05",
volume="5",
number="1",
pages="e11573",
keywords="aboriginal",
keywords="Indigenous",
keywords="social media",
keywords="health",
keywords="Web-based",
abstract="Background: Social media may have a significant role in influencing the present and future health implications among Australian Aboriginal and Torres Strait Islander people, yet there has been no review of the role of social media in improving health. Objective: This study aims to examine the extent of health initiatives using social media that aimed to improve the health of Australian Aboriginal communities. Methods: A scoping review was conducted by systematically searching databases CINAHL Plus; PubMed; Scopus; Web of Science, and Ovid MEDLINE in June 2017 using the terms and their synonyms ``Aboriginal'' and ``Social media.'' In addition, reference lists of included studies and the Indigenous HealthInfonet gray literature were searched. Key information about the social media intervention and its impacts on health were extracted and data synthesized using narrative summaries. Results: Five papers met inclusion criteria. All included studies were published in the past 5 years and involved urban, rural, and remote Aboriginal or Torres Strait Islander people aged 12-60 years. No studies reported objective impacts on health. Three papers found that social media provided greater space for sharing health messages in a 2-way exchange. The negative portrayal of Aboriginal people and negative health impacts of social media were described in 2 papers. Conclusions: Social media may be a useful strategy to provide health messages and sharing of content among Aboriginal people, but objective impacts on health remain unknown. More research is necessary on social media as a way to connect, communicate, and improve Aboriginal health with particular emphasis on community control, self-empowerment, and decolonization. ",
doi="10.2196/11573",
url="http://publichealth.jmir.org/2019/1/e11573/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30720442"
}


@Article{info:doi/10.2196/11534,
author="Graham, E. Jocelyn
and Moore, L. Jana
and Bell, C. Rhonda
and Miller, Terri",
title="Digital Marketing to Promote Healthy Weight Gain Among Pregnant Women in Alberta: An Implementation Study",
journal="J Med Internet Res",
year="2019",
month="Feb",
day="01",
volume="21",
number="2",
pages="e11534",
keywords="internet",
keywords="maternal health",
keywords="mobile phone",
keywords="pregnant women",
keywords="search engine",
keywords="social media",
abstract="Background: As the use of digital media for health promotion has become increasingly common, descriptive studies exploring current and innovative marketing strategies can enhance the understanding of effective strategies and best practices. Objective: This study aims to describe the implementation of a provincial digital media campaign using complementary advertising platforms to promote healthy pregnancy weight gain messages and direct a Web audience to a credible website. Methods: The digital media campaign occurred in 3 phases, each for 8 weeks, and consisted of search engine marketing using Google AdWords and social media advertising through Facebook. All advertising materials directed users to evidence-based pregnancy-related weight gain content on the Healthy Parents, Healthy Children website. Results: Google Ads received a total of 43,449 impressions, 2522 clicks, and an average click-through rate (CTR) of 5.80\%. Of people who clicked on a Google ad, 78.9\% (1989/2522) completed an action on the website. Across all Facebook advertisements, there were 772,263 impressions, 14,482 clicks, and an average CTR of 1.88\%. The highest-performing advertisement was an image of a group of diverse pregnant women with the headline ``Pregnancy weight is not the same for every woman.'' Conclusions: This study supports the use of digital marketing as an important avenue for delivering health messages and directing Web users to credible sources of information. The opportunity to reach large, yet targeted audiences, along with the ability to monitor and evaluate metrics to optimize activities throughout a campaign is a powerful advantage over traditional marketing tactics. Health organizations can use the results and insights of this study to help inform the design and implementation of similar Web-based activities. ",
doi="10.2196/11534",
url="https://www.jmir.org/2019/2/e11534/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30707100"
}


@Article{info:doi/10.2196/10681,
author="Medich, Melissa
and Swendeman, T. Dallas
and Comulada, Scott W.
and Kao, H. Uyen
and Myers, J. Janet
and Brooks, A. Ronald
and ",
title="Promising Approaches for Engaging Youth and Young Adults Living with HIV in HIV Primary Care Using Social Media and Mobile Technology Interventions: Protocol for the SPNS Social Media Initiative",
journal="JMIR Res Protoc",
year="2019",
month="Jan",
day="31",
volume="8",
number="1",
pages="e10681",
keywords="HIV",
keywords="health outcomes",
keywords="mobile technology",
keywords="social media",
keywords="youth",
keywords="young adult",
keywords="mobile phone",
abstract="Background: In the United States, disparities in the rates of HIV care among youth and young adults result from the intersections of factors that include stigma, substance use, homelessness or marginal housing, institutional neglect, and mental health issues. Novel interventions are needed that are geared to youth and young adults. Objective: In this paper, we aim to describe the interventions used by participating sites for Using Social Media initiative, the process for classifying the intervention components, and the methods for conducting a comprehensive evaluation of the interventions. Methods: In 2015, the Health Resources and Services Administration (HRSA) HIV/AIDS Bureau, Special Projects of National Significance (SPNS) funded the Evaluation and Technical Assistance Center (ETAC) at the University of California, Los Angeles and 10 demonstration projects at sites across the United States that incorporated innovative approaches using a variety of social media and mobile technology strategies designed specifically for youth and young adults living with HIV. The ETAC developed a typology, or a classification system, that systematically summarizes the principal components of the interventions into broader groups and developed a multisite, mixed-methods approach to evaluate them based on the Department of Health and Human Services HIV health outcomes along the HIV care continuum. The mixed-methods approach is key to remove potential biases in assessing the effectiveness of demonstration projects. Results: This SPNS project was funded in September 2015, and enrollment was completed on May 31, 2018. A total of 984 participants have been enrolled in the multisite evaluation. Data collection will continue until August 2019. However, data analysis is currently underway, and the first results are expected to be submitted for publication in 2019. Conclusions: This HRSA-funded initiative seeks to increase engagement in HIV medical care, improve health outcomes for people living with HIV, and reduce HIV-related health disparities and health inequities that affect HIV-positive youth and young adults. International Registered Report Identifier (IRRID): DERR1-10.2196/10681 ",
doi="10.2196/10681",
url="http://www.researchprotocols.org/2019/1/e10681/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30702434"
}


@Article{info:doi/10.2196/11836,
author="Chan, Ling Ko
and Chen, Mengtong",
title="Effects of Social Media and Mobile Health Apps on Pregnancy Care: Meta-Analysis",
journal="JMIR Mhealth Uhealth",
year="2019",
month="Jan",
day="30",
volume="7",
number="1",
pages="e11836",
keywords="mHealth",
keywords="social media",
keywords="pregnancy",
keywords="postpartum",
keywords="maternal health",
abstract="Background: The use of social media and mobile health (mHealth) apps has been increasing in pregnancy care. However, the effectiveness of these interventions is still unclear. Objectives: We conducted a meta-analysis to examine the effectiveness of these interventions with regard to different health outcomes in pregnant and postpartum women and investigate the characteristics and components of interventions that may affect program effectiveness. Method: We performed a comprehensive literature search of major electronic databases and reference sections of related reviews and eligible studies. A random effects model was used to calculate the effect size. Results: Fifteen randomized controlled trial studies published in and before June 2018 that met the inclusion criteria were included in the meta-analysis. The interventions were effective in promoting maternal physical health including weight management, gestational diabetes mellitus control, and asthma control with a moderate to large effect size (d=0.72). Large effect sizes were also found for improving maternal mental health (d=0.84) and knowledge about pregnancy (d=0.80). Weight control interventions using wearable devices were more effective. Conclusion: Social media and mHealth apps have the potential to be widely used in improving maternal well-being. More large-scale clinical trials focusing on different health outcomes are suggested for future studies. ",
doi="10.2196/11836",
url="https://mhealth.jmir.org/2019/1/e11836/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30698533"
}


@Article{info:doi/10.2196/10171,
author="Wu, Dan
and Tang, Weiming
and Lu, Haidong
and Zhang, P. Tiange
and Cao, Bolin
and Ong, J. Jason
and Lee, Amy
and Liu, Chuncheng
and Huang, Wenting
and Fu, Rong
and Li, Katherine
and Pan, W. Stephen
and Zhang, Ye
and Fu, Hongyun
and Wei, Chongyi
and Tucker, D. Joseph",
title="Leading by Example: Web-Based Sexual Health Influencers Among Men Who Have Sex With Men Have Higher HIV and Syphilis Testing Rates in China",
journal="J Med Internet Res",
year="2019",
month="Jan",
day="21",
volume="21",
number="1",
pages="e10171",
keywords="health promotion",
keywords="peer influence",
keywords="internet",
keywords="social networks",
keywords="social media",
keywords="HIV",
keywords="syphilis",
keywords="men who have sex with men",
keywords="China",
abstract="Background: The spread of healthy behaviors through social networks may be accelerated by influential individuals. Previous studies have used lay health influencers to prevent sexually transmitted infections (STIs) among internet-using men who have sex with men (MSM). However, there is a lack of understanding of the characteristics of this key subset of MSM. Objective: This study aimed to examine sociodemographic characteristics, HIV and syphilis testing, and sexual behaviors of Web-based MSM sexual health influencers (SHIs) in China, defined as individuals with relatively stronger influence on spreading HIV and STI information online. Methods: A Web-based survey of MSM was conducted in August 2017 as a final follow-up of a randomized controlled trial promoting HIV testing in 8 Chinese cities. Men were recruited through a gay social networking mobile phone app and were included if they were born biologically male, aged 16 years and above, ever had sex with another man, and HIV negative or with unknown HIV status. Information regarding sociodemographic characteristics, sexual behaviors, and HIV and syphilis testing was obtained. We assessed men's Web-based sexual health influence using a standardized 6-item opinion leadership scale focused on HIV and STI information. Influencers were defined as those whose mean score ranked within the top 13\% (a higher score means greater influence). We used multivariable linear and logistic regression models to measure Web-based sexual health influence's association with HIV and syphilis testing, controlling for intervention trial effects, age, education, income, and marital status. Results: Overall, 1031 men completed the survey. Most men were younger than 30 years (819/1031, 79.43\%) and had at least college education (667/1031, 64.69\%). Influencers were more likely to get tested for HIV (73/132, 55.3\% vs 337/899, 37.5\%; P<.001) and syphilis (35/132, 26.5\% vs 137/899, 15.2\%; P=.001) in the last 3 months compared with noninfluencers. There were no significant differences in condomless sex with male partners (26/132, 19.7\% vs 203/899, 22.6\%; P=.46), mean number of male sex partners (1.32 vs 1.11; P=.16) in the last 3 months, and mainly meeting male sex partners online in the last 12 months (97/132, 73.5\% vs 669/899, 74.4\%; P=.82) between influencers and noninfluencers. Regression analyses showed that influencers had higher odds of HIV testing (adjusted odds ratio, AOR 2.16, 95\% CI 1.48-3.17) and syphilis testing (AOR 1.99, 95\% CI 1.28-3.10) in the last 3 months. Conclusions: We identified Web-based SHIs who might be more likely to help promote healthy HIV and syphilis testing behaviors through MSM populations. Leveraging existing influencers may help improve HIV and syphilis testing among their networks. ",
doi="10.2196/10171",
url="http://www.jmir.org/2019/1/e10171/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30664490"
}


@Article{info:doi/10.2196/11132,
author="Kite, James
and Grunseit, Anne
and Li, Vincy
and Vineburg, John
and Berton, Nathan
and Bauman, Adrian
and Freeman, Becky",
title="Generating Engagement on the Make Healthy Normal Campaign Facebook Page: Analysis of Facebook Analytics",
journal="JMIR Public Health Surveill",
year="2019",
month="Jan",
day="14",
volume="5",
number="1",
pages="e11132",
keywords="social media",
keywords="Facebook",
keywords="overweight and obesity",
keywords="mass media campaign",
keywords="evaluation",
abstract="Background: Facebook is increasingly being used as part of mass media campaigns in public health, including the Make Healthy Normal (MHN) campaign in New South Wales, Australia. Therefore, it is important to understand what role Facebook can play in mass media campaigns and how best to use it to augment or amplify campaign effects. However, few studies have explored this. Objective: This study aimed to investigate usage of and engagement with the MHN Facebook page and to identify influential factors in driving engagement with the page. Methods: We examined both post-level and page-level analytic data from Facebook from the campaign's launch in June 2015 to September 2017. For post-level data, we conducted a series of negative binomial regressions with four different outcome measures (likes, shares, comments, post consumers), including some characteristics of Facebook posts as predictors. We also conducted time series analyses to examine associations between page-level outcomes (new page likes or ``fans'' and number of engaged users) and different measures of exposure to the page (number of unique users reached and total count of impressions) and to television advertising. Results: Of the 392 posts reviewed, 20.7\% (n=81) received a paid boost and 58.9\% (n=231) were photo posts. We found that posts that received a paid boost reached significantly more users and subsequently received significantly more engagement than organic (unpaid) posts (P<.001). After adjusting for reach, we found the effect of being paid was incremental for all outcome measures for photos and links, but not videos. There were also associations between day of the week and time of post and engagement, with Mondays generally receiving less engagement and posts on a Friday and those made between 8 AM and 5 PM receiving more. At the page level, our time series analyses found that organic impressions predicted a higher number of new fans and engaged users, compared to paid impressions, especially for women. We also found no association between television advertising and engagement with the Facebook page. Conclusions: Our study shows that paying for posts is important for increasing their reach, but that page administrators should look to maximize organic reach because it is associated with significantly higher engagement. Once reach is accounted for, video posts do not benefit from being paid, unlike the other post types. This suggests that page administrators should carefully consider how they use videos as part of a Facebook campaign. Additionally, the lack of association between television advertising and engagement suggests that future campaigns consider how best to link different channels to amplify effects. These results highlight the need for ongoing evaluation of Facebook pages if administrators are to maximize engagement. ",
doi="10.2196/11132",
url="https://publichealth.jmir.org/2019/1/e11132/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31344679"
}


@Article{info:doi/10.2196/11571,
author="Tsai, William
and Zavala, Daisy
and Gomez, Sol",
title="Using the Facebook Advertisement Platform to Recruit Chinese, Korean, and Latinx Cancer Survivors for Psychosocial Research: Web-Based Survey Study",
journal="J Med Internet Res",
year="2019",
month="Jan",
day="10",
volume="21",
number="1",
pages="e11571",
keywords="ethnic minority cancer survivor",
keywords="Facebook recruitment",
keywords="Korean cancer survivor",
keywords="Chinese cancer survivor",
keywords="Latinx cancer survivor",
keywords="mobile phone",
abstract="Background: Ethnic minority cancer survivors remain an understudied and underrepresented population in cancer research, in part, due to the challenge of low participant recruitment rates. Therefore, identifying effective recruitment strategies is imperative for reducing cancer health disparities among this population. With the widespread use of social media, health researchers have turned to Facebook as a potential source of recruitment. Objective: We aimed to evaluate the feasibility and effectiveness of purchasing ads on Facebook to recruit Chinese, Korean, and Latinx cancer survivors residing in the United States. We assessed their experience with participating in a Web-based survey and their interest for future research. Methods: We showed 5 purchased ads in English, simplified Chinese, traditional Chinese, Korean, and Spanish on Facebook. Participants who clicked on the Facebook ad were directed to the study website and asked to submit their emails to receive the link to the 30-minute Web-based survey. Inclusion criteria included being of Asian or Latinx heritage, age ?18 years, having a cancer diagnosis, and being within 5 years of cancer treatment. Participants who completed the survey were sent a US \$10 Walmart eGiftcard. Results: The Facebook ads were shown for 48 consecutive days for a total spending of US \$1200.46 (US \$25/day budget). Overall, 11 East Asian and 15 Latinx cancer survivors completed the study, resulting in an average cost per participant of US \$46.17. The East Asian and Latinx cancer survivors did not significantly differ in age, years lived in the United States, education level, generation status, and time since diagnosis. However, Latinx cancer survivors were marginally more likely to have limited English proficiency and lower annual income than East Asian cancer survivors. Both Latinx and East Asian cancer survivors reported that they enjoyed participating in this study and indicated an interest in participating in future psychosocial research studies. Conclusions: The use of Facebook ads successfully resulted in the recruitment of East Asian and Latinx cancer survivors with different cancer diagnoses who reside in various geographic regions of the United States. We found that East Asian and Latinx cancer survivors recruited through Facebook were interested in participating in future psychosocial research, thereby providing support for the feasibility and effectiveness of using Facebook as a source of recruitment for ethnic minority cancer survivors. ",
doi="10.2196/11571",
url="http://www.jmir.org/2019/1/e11571/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30632966"
}


@Article{info:doi/10.2196/11177,
author="Sinnenberg, Lauren
and Mancheno, Christina
and Barg, K. Frances
and Asch, A. David
and Rivard, Lee Christy
and Horst-Martz, Emma
and Buttenheim, Alison
and Ungar, Lyle
and Merchant, Raina",
title="Content Analysis of Metaphors About Hypertension and Diabetes on Twitter: Exploratory Mixed-Methods Study",
journal="JMIR Diabetes",
year="2018",
month="Dec",
day="21",
volume="3",
number="4",
pages="e11177",
keywords="cardiovascular diseases",
keywords="language",
keywords="metaphor",
keywords="social media",
keywords="hypertension",
keywords="diabetes mellitus",
abstract="Background: Widespread metaphors contribute to the public's understanding of health. Prior work has characterized the metaphors used to describe cancer and AIDS. Less is known about the metaphors characterizing cardiovascular disease. Objective: The objective of our study was to characterize the metaphors that Twitter users employ in discussing hypertension and diabetes. Methods: We filtered approximately 10 billion tweets for keywords related to diabetes and hypertension. We coded a random subset of 5000 tweets for the presence of metaphor and the type of metaphor employed. Results: Among the 5000 tweets, we identified 797 (15.9\%) about hypertension or diabetes that employed metaphors. When discussing the development of heart disease, Twitter users described the disease as a journey (n=202), as transmittable (n=116), as an object (n=49), or as being person-like (n=15). In discussing the experience of these diseases, some Twitter users employed war metaphors (n=101). Other users described the challenge to control their disease (n=34), the disease as an agent (n=58), or their bodies as machines (n=205). Conclusions: Metaphors are used frequently by Twitter users in their discussion of hypertension and diabetes. These metaphors can help to guide communication between patients and providers to improve public health. ",
doi="10.2196/11177",
url="http://diabetes.jmir.org/2018/4/e11177/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30578222"
}


@Article{info:doi/10.2196/10349,
author="McKinlay, Ruth Alison
and Ridsdale, Lorna Leone",
title="Views of People With Epilepsy About Web-Based Self-Presentation: A Qualitative Study",
journal="Interact J Med Res",
year="2018",
month="Dec",
day="21",
volume="7",
number="2",
pages="e10349",
keywords="epilepsy",
keywords="internet",
keywords="social stigma",
keywords="social media",
keywords="eHealth",
keywords="social networking",
keywords="social support",
keywords="self-management",
abstract="Background: Web-based media, particularly social networking sites (SNSs), are a source of support for people with long-term conditions, like epilepsy. Living with epilepsy can reduce opportunities for accessing information and social support owing to transportation difficulties and stigma leading to self-isolation. However, some people with epilepsy (PWE) overcome these barriers using SNSs and other Web-based media. At present, little is known about Web-based identity and self-presentation of PWE; this study aims to address this gap. Objective: This study aims to describe how the use of digital technologies, such as SNSs, impacts sense of identity in PWE. Methods: We used qualitative research methods to examine Web-based media use and self-presentation in a group of 14 PWE (age range: 33-73 years; 7 men and 7 women). The median diagnosis duration was 25 years. Semistructured interviews ranged from 40 to 120 minutes, held at participants' homes or in a public place of their choice, in the United Kingdom. QSR Nvivo 11 software was used to perform an inductive thematic analysis. Results: In this study, 9 participants used Web-based media to ``silently'' learn from other PWE by reading user posts on SNSs and epilepsy-related forums. When asked about self-presentation, 7 participants described feeling cautious about disclosing their epilepsy to others online. Six participants presented themselves in the same manner irrespective of the situation and described their identity as being presented in the same way both online and offline. Conclusions: PWE can deploy SNSs and Web-based media to manage aspects of their condition by learning from others and obtaining social support that may otherwise be difficult to access. Some PWE share openly, whereas others silently observe, without posting. Both benefit from the shared experiences of others. Privacy concerns and stigma can act as a barrier to sharing using Web-based media and SNSs. For some, Web-based media offers a chance to experiment with identity and change self-presentation, leading to gradually ``coming out'' and feeling more comfortable discussing epilepsy with others. ",
doi="10.2196/10349",
url="http://www.i-jmr.org/2018/2/e10349/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30578229"
}


@Article{info:doi/10.2196/jmir.9701,
author="Wittmeier, DM Kristy
and Hobbs-Murison, Kendall
and Holland, Cindy
and Crawford, Elizabeth
and Loewen, Hal
and Morris, Melanie
and Lum Min, Suyin
and Abou-Setta, Ahmed
and Keijzer, Richard",
title="Identifying Information Needs for Hirschsprung Disease Through Caregiver Involvement via Social Media: A Prioritization Study and Literature Review",
journal="J Med Internet Res",
year="2018",
month="Dec",
day="21",
volume="20",
number="12",
pages="e297",
keywords="Hirschsprung disease",
keywords="caregivers",
keywords="social media",
keywords="research",
keywords="surgeons",
keywords="surveys and questionnaires",
abstract="Background: Patient and public involvement in health research is important to produce relevant and impactful results. Objective: This paper aimed to prioritize and summarize Hirschsprung disease (HD)--related information needs among caregivers of children with HD and pediatric surgeons through partnership with a parent-initiated social media campaign. Methods: We conducted a Web-based survey with the 2 stakeholder groups to identify information needs. The caregiver survey was conducted through a global Web-based community, and the surgeon survey was distributed to members of the Canadian Association of Paediatric Surgeons (CAPS). We conducted a literature review to identify evidence on the prioritized topics. Results: Our findings showed that 54.9\% (89/162) of the individuals completed the caregiver survey and 23.8\% (52/218 listed members) of the pediatric surgeons completed the survey distributed through CAPS. Only 20\% (18/89) of the caregivers reported being very satisfied or satisfied with the current HD-related resources. A final prioritized list of information needs included bowel management, nutrition and growth, infection, perianal irritation, gastrointestinal pain, surgical diagnostics, and surgical complications. In total, 87 studies were included in the literature review, which included the following: 8 reviews, 2 randomized controlled trials, 74 cohort studies, and 3 practice guidelines. Two priority issues identified by caregivers had only a single study that met the inclusion criteria, whereas 1 topic had none. Conclusions: With caregiver and surgeon input, we identified 7 information priority areas related to HD. A review of the literature on the priorities found little evidence to support the development of high-quality guidelines. More research is necessary to meet the information needs related to HD as identified by stakeholders. ",
doi="10.2196/jmir.9701",
url="http://www.jmir.org/2018/12/e297/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30578208"
}


@Article{info:doi/10.2196/11147,
author="Marin-Gomez, X. Francesc
and Garcia Cuyas, Francesc
and Reig-Bolano, Ramon
and Mendioroz, Jacobo
and Roura-Poch, Pere
and Pico-Nicolau, Margalida
and Vidal-Alaball, Josep",
title="Social Networking App Use Among Primary Health Care Professionals: Web-Based Cross-Sectional Survey",
journal="JMIR Mhealth Uhealth",
year="2018",
month="Dec",
day="21",
volume="6",
number="12",
pages="e11147",
keywords="mHealth",
keywords="social networking",
keywords="smartphone",
keywords="attitude",
keywords="primary health care",
keywords="telemedicine",
keywords="cell phone use",
abstract="Background: Several studies have been conducted to analyze the role social networks play in communication between patients and health professionals. However, there is a shortage of studies in relation to communication among primary health professionals, in a professional context, using the various mobile phone apps available. Objective: The objective of our study was to explore mobile phone social networking app use among primary health care professionals for work-related purposes, by comparing the most widely used apps in the market. Methods: We undertook a cross-sectional study using an anonymous Web survey among a convenience sample of 1635 primary health care professionals during August and September 2017. Results: Of 483 participants in the survey, 474 (98.1\%, 95\% CI 97.1\%-99.4\%) were health professionals who commonly accessed social networking sites and 362 (74.9\%, 95\% CI 71.1\%-78.8\%) accessed the sites in a work-related context. Of those 362 respondents, 219 (96.7\%, 95\% CI 94.8\%-98.5\%) preferred WhatsApp for both personal and professional uses. Of the 362 respondents who used social networking sites in a work-related context, 276 (76.2\%, 95\% CI 71.9\%-80.6\%) rated social networking sites as useful or very useful to solve clinical problems, 261 (72.1\%, 95\% CI 67.5\%-76.7\%) to improve their professional knowledge, and 254 (70.2\%, 95\% CI 65.5\%-74.9\%) to speed up the transmission of clinical information. Most of them (338/362, 94.8\%, 95\% CI 92.5\%-97.0\%) used social networking sites for interprofessional communications, and 204 of 362 (56.4\%, 95\% CI 51.2\%-61.5\%) used them for pharmacological-related consultations. Conclusions: Health professionals frequently accessed social networking sites using their mobile phones and often for work-related issues. This trend suggests that social networking sites may be useful tools in primary care settings, but we need to ensure the security of the data transfer process to make sure that social networking sites are used appropriately. Health institutions need to increase information and training activities to ensure the correct use of these tools. ",
doi="10.2196/11147",
url="https://mhealth.jmir.org/2018/12/e11147/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30578175"
}


@Article{info:doi/10.2196/publichealth.9332,
author="Andrade, Louise Elizabeth
and Evans, Douglas W.
and Barrett, Nicole
and Edberg, Cameron Mark
and Cleary, D. Sean",
title="Strategies to Increase Latino Immigrant Youth Engagement in Health Promotion Using Social Media: Mixed-Methods Study",
journal="JMIR Public Health Surveill",
year="2018",
month="Dec",
day="19",
volume="4",
number="4",
pages="e71",
keywords="social media",
keywords="health promotion",
keywords="Latinos",
keywords="immigrants",
keywords="adolescent",
keywords="Hispanic Americans",
keywords="emigrants and immigrants",
keywords="adolescent health",
abstract="Background: Generating participant engagement in social media applications for health promotion and disease prevention efforts is vital for their effectiveness and increases the likelihood of effecting sustainable behavior change. However, there is limited evidence regarding effective strategies for engaging Latino immigrant youth using social media. As part of the Avance Center for the Advancement of Immigrant/Refugee Health in Washington, DC, USA, we implemented Adelante, a branded primary prevention program, to address risk factors for co-occurring substance use, sexual risk, and interpersonal violence among Latino immigrant adolescents aged 12 to 19 years in a Washington, DC suburb. Objective: The objectives of this study were to (1) characterize Adelante participant Facebook reach and engagement and (2) identify post content and features that resulted in greater user engagement. Methods: We established the Adelante Facebook fan page in October of 2013, and the Adelante social marketing campaign used this platform for campaign activities from September 2015 to September 2016. We used Facebook Insights metrics to examine reach and post engagement of Adelante Facebook page fans (n=743). Data consisted of Facebook fan page posts between October 1, 2013 and September 30, 2016 (n=871). We developed a 2-phased mixed-methods analytical plan and coding scheme, and explored the association between post content categories and features and a composite measure of post engagement using 1-way analysis of variance tests. P<.05 determined statistical significance. Results: Posts on the Adelante Facebook page had a total of 34,318 clicks, 473 comments, 9080 likes or reactions, and 617 shares. Post content categories that were statistically significantly associated with post engagement were Adelante program updates (P<.001); youth achievement showcases (P=.001); news links (P<.001); social marketing campaign posts (P<.001); and prevention topics, including substance abuse (P<.001), safe sex (P=.02), sexually transmitted disease prevention (P<.001), and violence or fighting (P=.047). Post features that were significantly associated with post engagement comprised the inclusion of photos (P<.001); Spanish (P<.001) or bilingual (P=.001) posts; and portrayal of youth of both sexes (P<.001) portrayed in groups (P<.001) that were facilitated by adults (P<.001). Conclusions: Social media outreach is a promising strategy that youth programs can use to complement in-person programming for augmented engagement. The Latino immigrant youth audience in this study had a tendency toward more passive social media consumption, having implications for outreach strategies and engagement measurement in future studies. While study findings confirmed the utility of social marketing campaigns for increasing user engagement, findings also highlighted a high level of engagement among youth with posts that covered casual, day-to-day program activity participation. This finding identifies an underexplored area that should be considered for health messaging, and also supports interventions that use peer-to-peer and user-generated health promotion approaches. ",
doi="10.2196/publichealth.9332",
url="http://publichealth.jmir.org/2018/4/e71/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30567689"
}


@Article{info:doi/10.2196/10984,
author="Basch, H. Corey
and Hillyer, C. Grace
and Romero, Rachelle-Ann
and MacLean, A. Sarah
and Ethan, Danna",
title="College Students' Attitudes and Behaviors Related to Sun Safety and Appearance in Relation to Health Information-Seeking Behavior and Social Media Use: Cross-Sectional Study",
journal="JMIR Dermatol",
year="2018",
month="Dec",
day="19",
volume="1",
number="2",
pages="e10984",
keywords="United States",
keywords="universities",
keywords="students",
keywords="skin neoplasms",
keywords="ultraviolet rays",
abstract="Background: Skin cancer is the most common type of cancer in the United States. Rates of melanoma, a malignant form of skin cancer, are on the rise and are high among people under 30 years of age. Objective: This study aims to explore factors related to sun protection and tanning behavior and examine the influence of social media use and health information-seeking behaviors (HISB) on sun protection actions among a group of college students. Methods: In this cross-sectional study, students (N=258) at a large public university completed a survey that included questions on sun safety and tanning attitudes and behaviors, as well as HISB. A sun protection behavior score was created on the basis of behaviors related to seeking shade, using sunscreen, tanning booth and bed use, and the number of lifetime blistering sunburns. Multivariate logistic regression analyses were performed to assess associations between high and low sun protection behavior and sun safety and tanning attitudes and HISB. Results: The majority of participants were females (164/258, 63.8\%), 31.0\% (80/258) were white, and the mean age was 20.3 (SD 4.1) years. Females (odds ratio [OR] 0.42, 95\% CI 0.22-0.81) and believers that suntan improves appearance (OR 0.25, 95\% CI 0.10-0.66) were less likely to have ``high'' sun protection behaviors. Conclusions: The cultural belief that having a suntan improves appearance, especially among female college students, results in low sun protection behaviors. Interventions can be developed to improve skin cancer-related HISB among college students with the aim of developing better cognizance of skin cancer and sun protection behaviors. ",
doi="10.2196/10984",
url="http://derma.jmir.org/2018/2/e10984/"
}


@Article{info:doi/10.2196/12244,
author="Ridout, Brad
and Campbell, Andrew",
title="The Use of Social Networking Sites in Mental Health Interventions for Young People: Systematic Review",
journal="J Med Internet Res",
year="2018",
month="Dec",
day="18",
volume="20",
number="12",
pages="e12244",
keywords="social media",
keywords="social networking",
keywords="mental health",
keywords="social support",
keywords="support groups",
abstract="Background: The onset of mental health problems peaks between adolescence and young adulthood; however, young people face barriers to treatment and are often reluctant to seek professional help. Many are instead seeking support and information regarding their mental health via the Web, especially via social networking sites (SNSs), and hence, there is a promising opportunity to use SNSs to deliver or integrate with youth-focused online mental health interventions. Previous reviews have evaluated the effectiveness of SNSs for specific disorders in young people; however, none of the reviews have covered the breadth of SNS--based youth mental health interventions available across all mental health issues. Objective: This review aimed to systematically identify available evidence regarding the use of SNS--based interventions to support the mental health of young people aged up to 25 years, to evaluate their effectiveness, suitability, and safety, and identify gaps and opportunities for future research. Methods: The PubMed and PsycINFO databases were searched using Medical Subject Headings terms and exploded keywords and phrases. Retrieved abstracts (n=974) were double screened, yielding 235 articles for screening at the full-text level. Of these, 9 articles met the review inclusion criteria. Given the small number of studies, and the variety of outcome measures used, a quantitative meta-analysis was not possible. Results: The 9 articles (quantitative studies, qualitative studies, and descriptions of the iterative design process) covered 5 separate interventions. Of the 5 interventions, 2 interventions used purpose-built platforms based on the moderated online social therapy (MOST) model, 2 used Facebook, and 1 evaluated a purpose-built mobile app. The 2 MOST interventions targeted specific mental health issues (depression and psychosis), whereas the others focused on improving mental health literacy, social support, and general well-being. Only 3 quantitative studies were identified, and all used a pre-post design (without a control group) to establish proof of concept. Of the outcome variables assessed, there were significant improvements in mental health knowledge and number of depressive symptoms but no improvement in anxiety or psychosis symptoms. Acceptability of and engagement with the SNS platforms were generally high, as were perceptions of usefulness and safety. Moderation by clinical experts was identified as a key component of the more successful interventions. When offered a choice, users showed a preference for mobile apps over Web-based interfaces. Conclusions: The evidence reviewed suggests young people find SNS--based interventions highly usable, engaging, and supportive. However, future studies need to address the current lack of high-quality evidence for their efficacy in reducing mental health symptoms. Given young people are already turning to SNSs to engage in knowledge seeking and peer-to-peer support, SNS--based youth mental health interventions provide an opportunity to address some of the barriers young people face in accessing qualified mental health support and information. ",
doi="10.2196/12244",
url="https://www.jmir.org/2018/12/e12244/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30563811"
}


@Article{info:doi/10.2196/11073,
author="Biancovilli, Priscila
and Jurberg, Claudia",
title="How to Optimize Health Messages About Cancer on Facebook: Mixed-Methods Study",
journal="JMIR Cancer",
year="2018",
month="Dec",
day="18",
volume="4",
number="2",
pages="e11073",
keywords="cancer",
keywords="content analysis",
keywords="Facebook",
keywords="health",
keywords="software",
abstract="Background: Incidence rate of cancer is increasing worldwide, with longer life expectancy being one of the main causes. Yet, between 30\% and 50\% of cancer cases are preventable, and early detection contributes to a better prognosis. This makes health communication strategies essential. Facebook, the world's most used social networking site in 2017 and 2018, can be a useful tool for disseminating powerful messages on health promotion, prevention, and early detection. Objective: We aimed to (1) offer ways of optimizing health messages about cancer on Facebook, focusing on topics, such as risk factors, prevention, treatment, early diagnosis, and cure, and (2) investigate which aspects of these messages generate greater engagement. Methods: To verify what generates greater engagement in topics related to cancer on Facebook, we analyzed 16 Brazilian pages with the main theme of cancer. We performed a manual analysis of texts, content, and engagement rates. Finally, we developed a software program to operationalize the analysis of Facebook posts. The tool we devised aims to automate the analysis of any Facebook page with cancer as the main theme. Results: We analyzed 712 posts over a 1-month period. We divided the posts into the following 8 categories: ``Testimonies or real-life stories,'' ``Solidarity,'' ``Anniversaries,'' ``Science and health,'' ``Events,'' ``Institutional,'' ``Risk factors,'' and ``Beauty.'' The pages were also organized into groups according to the type of profile to which they belonged (ie, hospitals or foundations, informative, nongovernmental organizations, and personal pages).The results showed that the categories generating greater engagement in Brazil were not those with the highest percentage of cancer-related content. For instance, in the ``Informative'' group the ``Testimonies or real-life stories'' category generated an engagement of 79.5\%. However, only 9.5\% (25/261) of the content within the relevant time period dealt with such topics. Another example concerns the category ``Science and health.'' Despite being the one with the highest number of posts (129/261, 49.4\%), it scored 5th in terms of engagement. This investigation served as the basis for the development of a tool designed to automate the analysis of Facebook pages. The list of categories and keywords generated by this analysis was employed to feed the system, which was then able to categorize posts appearing on a Facebook page. We tested the system on 163 posts and only 34 were classified incorrectly, which amounts to a 20.8\% error rate (79.2\% accuracy). Conclusions: The analysis we conducted by categorizing posts and calculating engagement rates shows that the potential of Facebook pages is often underutilized. This occurs because the categories that generate the greatest engagement are often not those most frequently used. The software developed in this research may help administrators of cancer-related pages analyze their posts more easily and increase public interest as a result. ",
doi="10.2196/11073",
url="http://cancer.jmir.org/2018/2/e11073/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30563821"
}


@Article{info:doi/10.2196/publichealth.7496,
author="Aoki, Tomohiro
and Suzuki, Teppei
and Yagahara, Ayako
and Hasegawa, Shin
and Tsuji, Shintaro
and Ogasawara, Katsuhiko",
title="Analysis of the Regionality of the Number of Tweets Related to the 2011 Fukushima Nuclear Power Station Disaster: Content Analysis",
journal="JMIR Public Health Surveill",
year="2018",
month="Dec",
day="18",
volume="4",
number="4",
pages="e70",
keywords="Fukushima nuclear disaster",
keywords="Twitter messaging",
keywords="radiation",
keywords="radioactivity",
keywords="radioactive hazard release",
keywords="geographic location",
keywords="information dissemination",
abstract="Background: The Great East Japan Earthquake on March 11, 2011, triggered a huge tsunami, causing the Fukushima Daiichi nuclear disaster. Radioactive substances were carried in all directions, along with the risks of radioactive contamination. Mass media companies, such as television stations and news websites, extensively reported on radiological information related to the disaster. Upon digesting the available radiological information, many citizens turned to social media, such as Twitter and Facebook, to express their opinions and feelings. Thus, the Fukushima Daiichi nuclear disaster also changed the social media landscape in Japan. However, few studies have explored how the people in Japan who received information on radiation propagated the information. Objective: This study aimed to reveal how the number of tweets by citizens containing radiological information changed regionally on Twitter. Methods: The research used about 19 million tweets that included the terms ``radiation,'' ``radioactivity,'' and ``radioactive substance'' posted for 1 year after the Fukushima Daiichi nuclear disaster. Nearly 45,000 tweets were extracted based on their inclusion of geographic information (latitude and longitude). The number of monthly tweets in 4 districts (Fukushima Prefecture, prefectures around Fukushima Prefecture, within the Tokyo Electric Power Company area, and others) were analyzed. Results: The number of tweets containing the keywords per 100,000 people at the time of the casualty outbreak was 7.05 per month in Fukushima Prefecture, 2.07 per month in prefectures around Fukushima Prefecture, 5.23 per month in the area within Tokyo Electric Power Company, and 1.35 per month in others. The number of tweets per 100,000 people more than doubled in Fukushima Prefecture 2 months after the Fukushima Daiichi nuclear disaster, whereas the number decreased to around 0.7{\textasciitilde}0.8 tweets in other districts. Conclusions: The number of tweets per 100,000 people became half of that on March 2011 3 or 4 months after the Fukushima Daiichi Nuclear Plant disaster in 3 districts except district 1 (Fukushima Prefecture); the number became a half in Fukushima Prefecture half a year later. ",
doi="10.2196/publichealth.7496",
url="http://publichealth.jmir.org/2018/4/e70/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30563815"
}


@Article{info:doi/10.2196/11193,
author="Tougas, E. Michelle
and Chambers, T. Christine
and Corkum, Penny
and Robillard, M. Julie
and Gruzd, Anatoliy
and Howard, Vivian
and Kampen, Andrea
and Boerner, E. Katelynn
and Hundert, S. Amos",
title="Social Media Content About Children's Pain and Sleep: Content and Network Analysis",
journal="JMIR Pediatr Parent",
year="2018",
month="Dec",
day="11",
volume="1",
number="2",
pages="e11193",
keywords="child health",
keywords="knowledge translation",
keywords="pain",
keywords="sleep",
keywords="social media",
abstract="Background: Social media is often used for health communication and can facilitate fast information exchange. Despite its increasing use, little is known about child health information sharing and engagement over social media. Objective: The primary objectives of this study are to systematically describe the content of social media posts about child pain and sleep and identify the level of research evidence in these posts. The secondary objective is to examine user engagement with information shared over social media. Methods: Twitter, Instagram, and Facebook were searched by members of the research team over a 2-week period using a comprehensive search strategy. Codes were used to categorize the content of posts to identify the frequency of content categories shared over social media platforms. Posts were evaluated by content experts to determine the frequency of posts consistent with existing research evidence. User engagement was analyzed using Netlytic, a social network analysis program, to examine visual networks illustrating the level of user engagement. Results: From the 2-week period, nearly 1500 pain-related and 3800 sleep-related posts were identified and analyzed. Twitter was used most often to share knowledge about child pain (639/1133, 56.40\% of posts), and personal experiences for child sleep (2255/3008, 75.00\% of posts). For both topics, Instagram posts shared personal experiences (53/68, 78\% pain; 413/478, 86.4\% sleep), Facebook group posts shared personal experiences (30/49, 61\% pain; 230/345, 66.7\% sleep) and Facebook pages shared knowledge (68/198, 34.3\% pain; 452/1026, 44.05\% sleep). Across platforms, research evidence was shared in 21.96\% (318/1448) of pain- and 9.16\% (445/4857) of sleep-related posts; 5.38\% (61/1133) of all pain posts and 2.82\% (85/3008) of all sleep posts shared information inconsistent with the evidence, while the rest were absent of evidence. User interactions were indirect, with mostly one-way, rather than reciprocal conversations. Conclusions: Social media is commonly used to discuss child health, yet the majority of posts do not contain research evidence, and user engagement is primarily one-way. These findings represent an opportunity to expand engagement through open conversations with credible sources. Research and health care communities can benefit from incorporating specific information about evidence within social media posts to improve communication with the public and empower users to distinguish evidence-based content better. Together, these findings have identified potential gaps in social media communication that may be informative targets to guide future strategies for improving the translation of child health evidence over social media. ",
doi="10.2196/11193",
url="http://pediatrics.jmir.org/2018/2/e11193/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31518292"
}


@Article{info:doi/10.2196/10911,
author="Edney, Sarah
and Bogomolova, Svetlana
and Ryan, Jillian
and Olds, Tim
and Sanders, Ilea
and Maher, Carol",
title="Creating Engaging Health Promotion Campaigns on Social Media: Observations and Lessons From Fitbit and Garmin",
journal="J Med Internet Res",
year="2018",
month="Dec",
day="10",
volume="20",
number="12",
pages="e10911",
keywords="social media",
keywords="engagement",
keywords="physical activity",
abstract="Background: The popularity and reach of social media make it an ideal delivery platform for interventions targeting health behaviors, such as physical inactivity. Research has identified a dose-response relationship whereby greater engagement and exposure are positively associated with intervention effects, hence enhancing engagement will maximize the potential of these interventions. Objective: This study examined the social media activity of successful commercial activity tracker brands to understand which creative elements (message content and design) they use in their communication to their audience, which social media platforms attract the most engagement, and which creative elements prompted the most engagement. Methods: Posts (n=509) made by Fitbit and Garmin on Facebook, Twitter, and Instagram over a 3-month period were coded for the presence of creative elements. User engagement regarding the total number of likes, comments, or shares per post was recorded. Negative binomial regression analyses were used to identify creative elements associated with higher engagement. Results: Engagement on Instagram was 30-200 times higher than on Facebook, or Twitter. Fitbit and Garmin tended to use different creative elements from one another. A higher engagement was achieved by posts featuring an image of the product, highlighting new product features and with themes of self-improvement (P<.01). Conclusions: Findings suggest that Instagram may be a particularly promising platform for delivering engaging health messaging. Health messages which incorporate inspirational imagery and focus on a tangible product appear to achieve the highest engagement. Fitbit and Garmin employed difference creative elements, which is likely to reflect differences in their target markets. This underscores the importance of market segmentation in health messaging campaigns. ",
doi="10.2196/10911",
url="https://www.jmir.org/2018/12/e10911/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30530449"
}


@Article{info:doi/10.2196/10834,
author="Tufts, Christopher
and Polsky, Daniel
and Volpp, G. Kevin
and Groeneveld, W. Peter
and Ungar, Lyle
and Merchant, M. Raina
and Pelullo, P. Arthur",
title="Characterizing Tweet Volume and Content About Common Health Conditions Across Pennsylvania: Retrospective Analysis",
journal="JMIR Public Health Surveill",
year="2018",
month="Dec",
day="06",
volume="4",
number="4",
pages="e10834",
keywords="Twitter messaging",
keywords="disease",
keywords="prevalence",
keywords="public health surveillance",
keywords="social media",
abstract="Background: Tweets can provide broad, real-time perspectives about health and medical diagnoses that can inform disease surveillance in geographic regions. Less is known, however, about how much individuals post about common health conditions or what they post about. Objective: We sought to collect and analyze tweets from 1 state about high prevalence health conditions and characterize the tweet volume and content. Methods: We collected 408,296,620 tweets originating in Pennsylvania from 2012-2015 and compared the prevalence of 14 common diseases to the frequency of disease mentions on Twitter. We identified and corrected bias induced due to variance in disease term specificity and used the machine learning approach of differential language analysis to determine the content (words and themes) most highly correlated with each disease. Results: Common disease terms were included in 226,802 tweets (174,381 tweets after disease term correction). Posts about breast cancer (39,156/174,381 messages, 22.45\%; 306,127/12,702,379 prevalence, 2.41\%) and diabetes (40,217/174,381 messages, 23.06\%; 2,189,890/12,702,379 prevalence, 17.24\%) were overrepresented on Twitter relative to disease prevalence, whereas hypertension (17,245/174,381 messages, 9.89\%; 4,614,776/12,702,379 prevalence, 36.33\%), chronic obstructive pulmonary disease (1648/174,381 messages, 0.95\%; 1,083,627/12,702,379 prevalence, 8.53\%), and heart disease (13,669/174,381 messages, 7.84\%; 2,461,721/12,702,379 prevalence, 19.38\%) were underrepresented. The content of messages also varied by disease. Personal experience messages accounted for 12.88\% (578/4487) of prostate cancer tweets and 24.17\% (4046/16,742) of asthma tweets. Awareness-themed tweets were more often about breast cancer (9139/39,156 messages, 23.34\%) than asthma (1040/16,742 messages, 6.21\%). Tweets about risk factors were more often about heart disease (1375/13,669 messages, 10.06\%) than lymphoma (105/4927 messages, 2.13\%). Conclusions: Twitter provides a window into the Web-based visibility of diseases and how the volume of Web-based content about diseases varies by condition. Further, the potential value in tweets is in the rich content they provide about individuals' perspectives about diseases (eg, personal experiences, awareness, and risk factors) that are not otherwise easily captured through traditional surveys or administrative data. ",
doi="10.2196/10834",
url="http://publichealth.jmir.org/2018/4/e10834/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30522989"
}


@Article{info:doi/10.2196/medinform.9162,
author="Jones, Josette
and Pradhan, Meeta
and Hosseini, Masoud
and Kulanthaivel, Anand
and Hosseini, Mahmood",
title="Novel Approach to Cluster Patient-Generated Data Into Actionable Topics: Case Study of a Web-Based Breast Cancer Forum",
journal="JMIR Med Inform",
year="2018",
month="Nov",
day="29",
volume="6",
number="4",
pages="e45",
keywords="data interpretation",
keywords="natural language processing",
keywords="patient-generated information",
keywords="social media",
keywords="statistical analysis",
keywords="infodemiology",
abstract="Background: The increasing use of social media and mHealth apps has generated new opportunities for health care consumers to share information about their health and well-being. Information shared through social media contains not only medical information but also valuable information about how the survivors manage disease and recovery in the context of daily life. Objective: The objective of this study was to determine the feasibility of acquiring and modeling the topics of a major online breast cancer support forum. Breast cancer patient support forums were selected to discover the hidden, less obvious aspects of disease management and recovery. Methods: First, manual topic categorization was performed using qualitative content analysis (QCA) of each individual forum board. Second, we requested permission from the Breastcancer.org Community for a more in-depth analysis of the postings. Topic modeling was then performed using open source software Machine Learning Language Toolkit, followed by multiple linear regression (MLR) analysis to detect highly correlated topics among the different website forums. Results: QCA of the forums resulted in 20 categories of user discussion. The final topic model organized >4 million postings into 30 manageable topics. Using qualitative analysis of the topic models and statistical analysis, we grouped these 30 topics into 4 distinct clusters with similarity scores of ?0.80; these clusters were labeled Symptoms \& Diagnosis, Treatment, Financial, and Family \& Friends. A clinician review confirmed the clinical significance of the topic clusters, allowing for future detection of actionable items within social media postings. To identify the most significant topics across individual forums, MLR demonstrated that 6 topics---based on the Akaike information criterion values ranging from ?642.75 to ?412.32---were statistically significant. Conclusions: The developed method provides an insight into the areas of interest and concern, including those not ascertainable in the clinic. Such topics included support from lay and professional caregivers and late side effects of therapy that consumers discuss in social media and may be of interest to clinicians. The developed methods and results indicate the potential of social media to inform the clinical workflow with regards to the impact of recovery on daily life. ",
doi="10.2196/medinform.9162",
url="http://medinform.jmir.org/2018/4/e45/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30497991"
}


@Article{info:doi/10.2196/10827,
author="Chen, Shi
and Xu, Qian
and Buchenberger, John
and Bagavathi, Arunkumar
and Fair, Gabriel
and Shaikh, Samira
and Krishnan, Siddharth",
title="Dynamics of Health Agency Response and Public Engagement in Public Health Emergency: A Case Study of CDC Tweeting Patterns During the 2016 Zika Epidemic",
journal="JMIR Public Health Surveill",
year="2018",
month="Nov",
day="22",
volume="4",
number="4",
pages="e10827",
keywords="Centers for Disease Control and Prevention",
keywords="public engagement",
keywords="Twitter",
keywords="time series analysis",
keywords="Zika epidemic",
keywords="social media",
keywords="infodemiology",
keywords="infoveillance",
abstract="Background: Social media have been increasingly adopted by health agencies to disseminate information, interact with the public, and understand public opinion. Among them, the Centers for Disease Control and Prevention (CDC) is one of the first US government health agencies to adopt social media during health emergencies and crisis. It had been active on Twitter during the 2016 Zika epidemic that caused 5168 domestic noncongenital cases in the United States. Objective: The aim of this study was to quantify the temporal variabilities in CDC's tweeting activities throughout the Zika epidemic, public engagement defined as retweeting and replying, and Zika case counts. It then compares the patterns of these 3 datasets to identify possible discrepancy among domestic Zika case counts, CDC's response on Twitter, and public engagement in this topic. Methods: All of the CDC-initiated tweets published in 2016 with corresponding retweets and replies were collected from 67 CDC--associated Twitter accounts. Both univariate and multivariate time series analyses were performed in each quarter of 2016 for domestic Zika case counts, CDC tweeting activities, and public engagement in the CDC-initiated tweets. Results: CDC sent out >84.0\% (5130/6104) of its Zika tweets in the first quarter of 2016 when Zika case counts were low in the 50 US states and territories (only 560/5168, 10.8\% cases and 662/38,885, 1.70\% cases, respectively). While Zika case counts increased dramatically in the second and third quarters, CDC efforts on Twitter substantially decreased. The time series of public engagement in the CDC-initiated tweets generally differed among quarters and from that of original CDC tweets based on autoregressive integrated moving average model results. Both original CDC tweets and public engagement had the highest mutual information with Zika case counts in the second quarter. Furthermore, public engagement in the original CDC tweets was substantially correlated with and preceded actual Zika case counts. Conclusions: Considerable discrepancies existed among CDC's original tweets regarding Zika, public engagement in these tweets, and actual Zika epidemic. The patterns of these discrepancies also varied between different quarters in 2016. CDC was much more active in the early warning of Zika, especially in the first quarter of 2016. Public engagement in CDC's original tweets served as a more prominent predictor of actual Zika epidemic than the number of CDC's original tweets later in the year. ",
doi="10.2196/10827",
url="http://publichealth.jmir.org/2018/4/e10827/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30467106"
}


@Article{info:doi/10.2196/10262,
author="Odlum, Michelle
and Yoon, Sunmoo
and Broadwell, Peter
and Brewer, Russell
and Kuang, Da",
title="How Twitter Can Support the HIV/AIDS Response to Achieve the 2030 Eradication Goal: In-Depth Thematic Analysis of World AIDS Day Tweets",
journal="JMIR Public Health Surveill",
year="2018",
month="Nov",
day="22",
volume="4",
number="4",
pages="e10262",
keywords="community",
keywords="human rights",
keywords="social network",
keywords="infodemiology",
keywords="infoveillence",
keywords="Twitter",
abstract="Background: HIV/AIDS is a tremendous public health crisis, with a call for its eradication by 2030. A human rights response through civil society engagement is critical to support and sustain HIV eradication efforts. However, ongoing civil engagement is a challenge. Objective: This study aimed to demonstrate the use of Twitter data to assess public sentiment in support of civil society engagement. Methods: Tweets were collected during World AIDS Days 2014 and 2015. A total of 39,940 unique tweets (>10 billion users) in 2014 and 78,215 unique tweets (>33 billion users) in 2015 were analyzed. Response frequencies were aggregated using natural language processing. Hierarchical rank-2 nonnegative matrix factorization algorithm generated a hierarchy of tweets into binary trees. Tweet hierarchy clusters were thematically organized by the Joint United Nations Programme on HIV/AIDS core action principles and categorized under HIV/AIDS Prevention, Treatment or Care, or Support. Results: Topics tweeted 35 times or more were visualized. Results show a decrease in 2015 in the frequency of tweets associated with the fight to end HIV/AIDS, the recognition of women, and to achieve an AIDS-free generation. Moreover, an increase in tweets was associated with an integrative approach to the HIV/AIDS response. Hierarchical thematic differences in 2015 included no prevention discussion and the recognition of the pandemic's impact and discrimination. In addition, a decrease was observed in motivation to fast track the pandemic's end and combat HIV/AIDS. Conclusions: The human rights--based response to HIV/AIDS eradication is critical. Findings demonstrate the usefulness of Twitter as a low-cost method to assess public sentiment for enhanced knowledge, increased hope, and revitalized expectations for HIV/AIDS eradication. ",
doi="10.2196/10262",
url="http://publichealth.jmir.org/2018/4/e10262/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30467102"
}


@Article{info:doi/10.2196/10513,
author="Zhang, Youshan
and Allem, Jon-Patrick
and Unger, Beth Jennifer
and Boley Cruz, Tess",
title="Automated Identification of Hookahs (Waterpipes) on Instagram: An Application in Feature Extraction Using Convolutional Neural Network and Support Vector Machine Classification",
journal="J Med Internet Res",
year="2018",
month="Nov",
day="21",
volume="20",
number="11",
pages="e10513",
keywords="convolutional neural network",
keywords="feature extraction",
keywords="image classification",
keywords="Instagram",
keywords="social media",
keywords="support vector machine",
abstract="Background: Instagram, with millions of posts per day, can be used to inform public health surveillance targets and policies. However, current research relying on image-based data often relies on hand coding of images, which is time-consuming and costly, ultimately limiting the scope of the study. Current best practices in automated image classification (eg, support vector machine (SVM), backpropagation neural network, and artificial neural network) are limited in their capacity to accurately distinguish between objects within images. Objective: This study aimed to demonstrate how a convolutional neural network (CNN) can be used to extract unique features within an image and how SVM can then be used to classify the image. Methods: Images of waterpipes or hookah (an emerging tobacco product possessing similar harms to that of cigarettes) were collected from Instagram and used in the analyses (N=840). A CNN was used to extract unique features from images identified to contain waterpipes. An SVM classifier was built to distinguish between images with and without waterpipes. Methods for image classification were then compared to show how a CNN+SVM classifier could improve accuracy. Results: As the number of validated training images increased, the total number of extracted features increased. In addition, as the number of features learned by the SVM classifier increased, the average level of accuracy increased. Overall, 99.5\% (418/420) of images classified were correctly identified as either hookah or nonhookah images. This level of accuracy was an improvement over earlier methods that used SVM, CNN, or bag-of-features alone. Conclusions: A CNN extracts more features of images, allowing an SVM classifier to be better informed, resulting in higher accuracy compared with methods that extract fewer features. Future research can use this method to grow the scope of image-based studies. The methods presented here might help detect increases in the popularity of certain tobacco products over time on social media. By taking images of waterpipes from Instagram, we place our methods in a context that can be utilized to inform health researchers analyzing social media to understand user experience with emerging tobacco products and inform public health surveillance targets and policies. ",
doi="10.2196/10513",
url="http://www.jmir.org/2018/11/e10513/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30452385"
}


@Article{info:doi/10.2196/11669,
author="Allem, Jon-Patrick
and Dharmapuri, Likhit
and Leventhal, M. Adam
and Unger, B. Jennifer
and Boley Cruz, Tess",
title="Hookah-Related Posts to Twitter From 2017 to 2018: Thematic Analysis",
journal="J Med Internet Res",
year="2018",
month="Nov",
day="19",
volume="20",
number="11",
pages="e11669",
keywords="hookah",
keywords="waterpipe",
keywords="Twitter",
keywords="social media",
keywords="nicotine",
keywords="flavors",
keywords="social smoking",
keywords="infodemiology",
abstract="Background: Hookah (or tobacco waterpipe) use has recently become prevalent in the United States. The contexts and experiences associated with hookah use are unclear, yet such information is abundant via publicly available hookah users' social media postings. Objective: In this study, we utilized Twitter data to characterize Twitter users' recent experiences with hookah. Methods: Twitter posts containing the term ``hookah'' were obtained from April 1, 2017 to 29 March, 2018. Text classifiers were used to identify clusters of topics that tended to co-occur in posts (n=176,706). Results: The most prevalent topic cluster was Person Tagging (use of @username to tag another Twitter account in a post) at 21.58\% (38,137/176,706) followed by Promotional or Social Events (eg, mentions of ladies' nights, parties, etc) at 20.20\% (35,701/176,706) and Appeal or Abuse Liability (eg, craving, enjoying hookah) at 18.12\% (32,013/176,706). Additional topics included Hookah Use Behavior (eg, mentions of taking a ``hit'' of hookah) at 11.67\% (20,603/176,706), Polysubstance Use (eg, hookah use along with other substances) at 10.95\% (19,353/176,706), Buying or Selling (eg, buy, order, purchase, sell) at 9.37\% (16,552/176,706), and Flavors (eg, mint, cinnamon, watermelon) at 1.66\% (2927/176,706). The topic Dislike of Hookah (eg, hate, quit, dislike) was rare at 0.59\% (1043/176,706). Conclusions: Social events, appeal or abuse liability, flavors, and polysubstance use were the common contexts and experiences associated with Twitter discussions about hookah in 2017-2018. Considered in concert with traditional data sources about hookah, these results suggest that social events, appeal or abuse liability, flavors, and polysubstance use warrant consideration as targets in future surveillance, policy making, and interventions addressing hookah. ",
doi="10.2196/11669",
url="http://www.jmir.org/2018/11/e11669/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30455162"
}


@Article{info:doi/10.2196/jmir.9713,
author="Triemstra, D. Justin
and Poeppelman, Stork Rachel
and Arora, M. Vineet",
title="Correlations Between Hospitals' Social Media Presence and Reputation Score and Ranking: Cross-Sectional Analysis",
journal="J Med Internet Res",
year="2018",
month="Nov",
day="08",
volume="20",
number="11",
pages="e289",
keywords="social media",
keywords="hospitals",
keywords="benchmarking",
keywords="hospital ranking",
abstract="Background: The US News and World Report reputation score correlates strongly with overall rank in adult and pediatric hospital rankings. Social media affects how information is disseminated to physicians and is used by hospitals as a marketing tool to recruit patients. It is unclear whether the reputation score for adult and children's hospitals relates to social media presence. Objective: The objective of our study was to analyze the association between a hospital's social media metrics and the US News 2017-2018 Best Hospital Rankings for adult and children's hospitals. Methods: We conducted a cross-sectional analysis of the reputation score, total score, and social media metrics (Twitter, Facebook, and Instagram) of hospitals who received at least one subspecialty ranking in the 2017-2018 US News publicly available annual rankings. Regression analysis was employed to analyze the partial correlation coefficients between social media metrics and a hospital's total points (ie, rank) and reputation score for both adult and children's hospitals while controlling for the bed size and time on Twitter. Results: We observed significant correlations for children's hospitals' reputation score and total points with the number of Twitter followers (total points: r=.465, P<.001; reputation: r=.524, P<.001) and Facebook followers (total points: r=.392, P=.002; reputation: r=.518, P<.001). Significant correlations for the adult hospitals reputation score were found with the number of Twitter followers (r=.848, P<.001), number of tweets (r=.535, P<.001), Klout score (r=.242, P=.02), and Facebook followers (r=.743, P<.001). In addition, significant correlations for adult hospitals total points were found with Twitter followers (r=.548, P<.001), number of tweets (r=.358, P<.001), Klout score (r=.203, P=.05), Facebook followers (r=.500, P<.001), and Instagram followers (r=.692, P<.001). Conclusions: A statistically significant correlation exists between multiple social media metrics and both a hospital's reputation score and total points (ie, overall rank). This association may indicate that a hospital's reputation may be influenced by its social media presence or that the reputation or rank of a hospital drives social media followers. ",
doi="10.2196/jmir.9713",
url="http://www.jmir.org/2018/11/e289/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30409768"
}


@Article{info:doi/10.2196/jmir.9372,
author="Akers, Laura
and Gordon, S. Judith",
title="Using Facebook for Large-Scale Online Randomized Clinical Trial Recruitment: Effective Advertising Strategies",
journal="J Med Internet Res",
year="2018",
month="Nov",
day="08",
volume="20",
number="11",
pages="e290",
keywords="research subject recruitment",
keywords="advertisements",
keywords="social media",
doi="10.2196/jmir.9372",
url="http://www.jmir.org/2018/11/e290/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30409765"
}


@Article{info:doi/10.2196/12035,
author="Hazzam, Joe
and Lahrech, Abdelmounaim",
title="Health Care Professionals' Social Media Behavior and the Underlying Factors of Social Media Adoption and Use: Quantitative Study",
journal="J Med Internet Res",
year="2018",
month="Nov",
day="07",
volume="20",
number="11",
pages="e12035",
keywords="social media",
keywords="health care professionals and social media",
keywords="integrated behavioral model",
keywords="technology acceptance theories",
abstract="Background: In the last decade, social media has emerged as a newer platform for knowledge dissemination, information exchange, and interpersonal communication for health care professionals (HCPs). However, the underlying behaviors of HCPs and the ethical use of social media for productivity enhancement and a sustainable health care system remain ambiguous. Objective: This study seeks to understand the factors that relate to the frequency use of social media in the health care discipline. It also aims to explore the underlying online behaviors of HCPs, which include the exchange of medical information with peers, interpersonal communication, and productivity enhancement in their daily practice. Methods: This study adopted the quantitative method in collecting and analyzing data. A survey instrument based on the behavioral and technology acceptance theories was developed for this purpose. The survey was distributed via social media platforms to 973 participants that included physicians, pharmacists, and allied HCPs working in the United Arab Emirates. The responses from 203 completed questionnaires (response rate 20.3\%) were analyzed. Results: Of 203 respondents, 133 HCPs used WhatsApp (65.5\%); therefore, WhatsApp had the highest number of users compared to Facebook and YouTube, with 101 users out of 203 (49.7\%). Overall, 109 of 203 (53.6\%) HCPs used social media platforms for the exchange of peer medical information and 108 of 203 (53.2\%) used social media several times during the day to improve their interpersonal communication with colleagues. However, only 71 of 203 (34.9\%) utilized social media to enhance their productivity in general. The structural model equation showed that behavioral intention (beta=.47; P<.001), habit (beta=.26; P=.001), attitude (beta=.20; P=.002), and perceived usefulness (beta=.12; P=.09) were positively and significantly related to frequency of use. The model explained a rate of 45\% variance in the frequency of use and a rate of 17\% variance in the social media intention of use. Conclusions: The research highlights the significant factors that relate to the adoption of social media platforms in health care practice. Based on the findings of this study, the use of online platforms facilitates the exchange of medical information among peers and enhances the share of experiences that support HCP's learning and development. Moreover, social media platforms foster a higher level of communication among practitioners and might improve daily productivity. Future researchers might explore other variables such as training and external factors. For instance, they may draw on areas related to guidelines and policies. From this standpoint, the health care discipline can benefit from highly interactive platforms and adopt them for development, collaboration, and better health outcomes. ",
doi="10.2196/12035",
url="http://www.jmir.org/2018/11/e12035/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30404773"
}


@Article{info:doi/10.2196/mental.9533,
author="DeJohn, D. Amber
and Schulz, English Emily
and Pearson, L. Amber
and Lachmar, Megan E.
and Wittenborn, K. Andrea",
title="Identifying and Understanding Communities Using Twitter to Connect About Depression: Cross-Sectional Study",
journal="JMIR Ment Health",
year="2018",
month="Nov",
day="05",
volume="5",
number="4",
pages="e61",
keywords="depression",
keywords="Web-based",
keywords="social connection",
keywords="Twitter",
keywords="tweet",
keywords="online communities",
abstract="Background: Depression is the leading cause of diseases globally and is often characterized by a lack of social connection. With the rise of social media, it is seen that Twitter users are seeking Web-based connections for depression. Objective: This study aimed to identify communities where Twitter users tweeted using the hashtag \#MyDepressionLooksLike to connect about depression. Once identified, we wanted to understand which community characteristics correlated to Twitter users turning to a Web-based community to connect about depression. Methods: Tweets were collected using NCapture software from May 25 to June 1, 2016 during the Mental Health Month (n=104) in the northeastern United States and Washington DC. After mapping tweets, we used a Poisson multilevel regression model to predict tweets per community (county) offset by the population and adjusted for percent female, percent population aged 15-44 years, percent white, percent below poverty, and percent single-person households. We then compared predicted versus observed counts and calculated tweeting index values (TIVs) to represent undertweeting and overtweeting. Last, we examined trends in community characteristics by TIV using Pearson correlation. Results: We found significant associations between tweet counts and area-level proportions of females, single-person households, and population aged 15-44 years. TIVs were lower than expected (TIV 1) in eastern, seaboard areas of the study region. There were communities tweeting as expected in the western, inland areas (TIV 2). Counties tweeting more than expected were generally scattered throughout the study region with a small cluster at the base of Maine. When examining community characteristics and overtweeting and undertweeting by county, we observed a clear upward gradient in several types of nonprofits and TIV values. However, we also observed U-shaped relationships for many community factors, suggesting that the same characteristics were correlated with both overtweeting and undertweeting. Conclusions: Our findings suggest that Web-based communities, rather than replacing physical connection, may complement or serve as proxies for offline social communities, as seen through the consistent correlations between higher levels of tweeting and abundant nonprofits. Future research could expand the spatiotemporal scope to confirm these findings. ",
doi="10.2196/mental.9533",
url="http://mental.jmir.org/2018/4/e61/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30401662"
}


@Article{info:doi/10.2196/11344,
author="Skelton, Renee Kara
and Evans, Retta
and LaChenaye, Jenna
and Amsbary, Jonathan
and Wingate, Martha
and Talbott, Laura",
title="Exploring Social Media Group Use Among Breastfeeding Mothers: Qualitative Analysis",
journal="JMIR Pediatr Parent",
year="2018",
month="Nov",
day="05",
volume="1",
number="2",
pages="e11344",
keywords="social media",
keywords="milk",
keywords="human",
keywords="breastfeeding",
abstract="Background: Breastfeeding is well known as the optimal source of nutrition for the first year of life. However, suboptimal exclusively breastfeeding rates in the United States are still prevalent. Given the extent of social media use and the accessibility of this type of peer-to-peer support, the role of social networking sites in enabling and supporting breastfeeding mothers needs to be further explored. Objective: This study aimed to leverage mothers' attitudes and behaviors of social media usage to understand effects on breastfeeding outcomes. Methods: Participants were recruited from 1 probreastfeeding social media group with over 6300 members throughout the United States. Online focus group discussions were conducted with 21 women; interviews were conducted with 12 mothers. Qualitative data were aggregated for thematic analysis. Results: Participants indicated that the social media group formed a community of support for breastfeeding, with normalizing breastfeeding, empowerment for breastfeeding, resource for breastfeeding, and shared experiences in breastfeeding as additional themes. Conclusions: According to participants, social media groups can positively influence breastfeeding-related attitudes, knowledge, and behaviors as well as lead to longer duration of breastfeeding. The results of this study should be taken into account when designing interventions for breastfeeding mothers. ",
doi="10.2196/11344",
url="http://pediatrics.jmir.org/2018/2/e11344/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31518305"
}


@Article{info:doi/10.2196/jmir.9689,
author="Sendall, C. Marguerite
and McCosker, K. Laura
and Crane, Phil
and Rowland, Bevan
and Fleming, Marylou
and Biggs, C. Herbert",
title="Using Facebook for Health Promotion in ``Hard-to-Reach'' Truck Drivers: Qualitative Analysis",
journal="J Med Internet Res",
year="2018",
month="Nov",
day="01",
volume="20",
number="11",
pages="e286",
keywords="communication",
keywords="health promotion interventions",
keywords="mobile phone",
keywords="social media",
keywords="transport industry",
keywords="truck drivers",
keywords="workplace health promotion",
keywords="workplace managers",
abstract="Background: Workers in the road transport industry, and particularly truck drivers, are at increased risk of chronic diseases. Innovative health promotion strategies involving technologies such as social media may engage this ``hard-to-reach'' group. There is a paucity of evidence for the efficacy of social media technologies for health promotion in the Australian transport industry. Objective: This study analyzed qualitative data from interviews and focus group discussions to evaluate a social media health promotion intervention, the Truckin' Healthy Facebook webpage, in selected Australian transport industry workplaces. Methods: We engaged 5 workplace managers and 30 truck drivers from 6 transport industry organizations in developing workplace health promotion strategies, including a social media intervention, within a Participatory Action Research approach. Mixed methods, including a pre- and postintervention manager survey, truck driver survey, key informant semistructured interviews, truck driver focus groups, and focused observation, were used to evaluate the social media intervention. We asked questions about workplace managers' and truck drivers' opinions, engagement, and satisfaction with the intervention. This paper focuses on qualitative data. Results: Of the workplace managers who reported implementing the social media intervention at their workplace, all (3/3, 100\%) reported satisfaction with the intervention and expressed a keen interest in learning more about social media and how it may be used for workplace health promotion and other purposes. Truck drivers were poorly engaged with the intervention because (1) many believed they were the ``wrong age'' and lacked the necessary skills; (2) the cost of smartphone technology was prohibitive; (3) they confined their use of social media to nonwork-related purposes; and (4) many workplaces had ``no Facebook'' policies. Conclusions: The use of social media as a health promotion intervention in transport industry workplaces has potential. Workplace interventions using social media can benefit from a Participatory Action Research approach. Involving managers and workers in the design of social media health promotion interventions and developing strategies to support and deliver the interventions helps to facilitate their success. The workers' profile, including their age and familiarity with social media, and work, workplace, and family context is important to consider in this process. Much more research needs to be undertaken to better understand the effective use of social media to engage ``hard-to-reach'' groups. ",
doi="10.2196/jmir.9689",
url="https://www.jmir.org/2018/11/e286/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30389653"
}


@Article{info:doi/10.2196/11772,
author="Lam, HT Nikki
and Woo, KP Benjamin",
title="Digital Media Recruitment for Fall Prevention Among Older Chinese-American Individuals: Observational, Cross-Sectional Study",
journal="JMIR Aging",
year="2018",
month="Nov",
day="01",
volume="1",
number="2",
pages="e11772",
keywords="ethnic groups",
keywords="falls",
keywords="geriatrics",
keywords="health education",
keywords="social media",
keywords="mobile phone",
abstract="Background: Research in fall prevention programs has increased in recent years in response to the aging demographics of the United States. To date, limited research and outreach programs have focused on ethnic minorities due to increased cost, language barriers, and cultural differences. Digital media platforms may be a cost-effective avenue to initiate fall prevention programs for minority populations. Objective: The objective of this study was to determine whether Facebook advertisements are a practical recruitment method for health education to the Chinese-speaking population. Methods: This was an observational, cross-sectional study. We uploaded a video on fall education on YouTube and initiated an advertisement campaign on Facebook that was linked to the video. The target population was older adults aged >45 years who used Facebook and were presented with the advertisement (N=1039). We recorded metrics such as the number of unique individuals reached, the number of views of the advertisement, the number of clicks, user gender and age, and traffic sources to the advertisement. Data were analyzed with descriptive statistics. Results: Our Facebook advertisement had 1087 views (1039 unique viewers). There were 121 link clicks with a click-through rate of 11.13\% (121/1087). The cost per link click was approximately US \$0.06. Among the viewers, 91.41\% (936/1024) were females and 8.59\% (88/1024) were males. In the 45-54 age group, the ad reached 50 people, with 1 link click (2.00\%). In the 55-64 age group, the ad reached 572 people, with 57 link clicks (9.97\%). In the ?65 age group, the ad reached 417 people, with 63 link clicks (15.11\%). Conclusions: Facebook was able to directly target the advertisement to the desired older ethnic population at a low cost. Engagement was highest among females and among those aged ?65 years. Hence, our results suggest that Facebook can serve as an alternative platform for dissemination of health information to geriatric patients in addition to print-based and face-to-face communication. ",
doi="10.2196/11772",
url="http://aging.jmir.org/2018/2/e11772/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31518249"
}


@Article{info:doi/10.2196/11168,
author="Simacek, F. Kristina
and Ko, J. John
and Moreton, Debbie
and Varga, Stefan
and Johnson, Kristen
and Katic, J. Bozena",
title="The Impact of Disease-Modifying Therapy Access Barriers on People With Multiple Sclerosis: Mixed-Methods Study",
journal="J Med Internet Res",
year="2018",
month="Oct",
day="30",
volume="20",
number="10",
pages="e11168",
keywords="cost sharing",
keywords="insurance",
keywords="mixed methods",
keywords="multiple sclerosis",
keywords="out-of-pocket costs",
keywords="patient adherence",
keywords="pharmaceutical services",
keywords="self-report",
keywords="surveys and questionnaires",
abstract="Background: In the United States, people with relapsing-remitting multiple sclerosis (RRMS) can face difficulty accessing disease-modifying therapies (DMTs) because of insurance, pharmacy, or provider policies. These barriers have been associated with poor adherence and negative health outcomes. Objective: The goals of this study were to describe the overall occurrence of difficulties and delays associated with gaining access to DMTs among people with RRMS, to assess DMT adherence during periods of reduced access, and to contextualize the patients' journey from receipt of a prescription for DMT to obtaining and taking their medication when faced with access barriers. Methods: We recruited US-based adults self-reporting RRMS from a Web-based health data-sharing social network, PatientsLikeMe. Individuals were invited to complete a Web-based survey if they reported a diagnosis of RRMS and were prescribed a DMT for MS. Follow-up phone interviews were conducted with 10 respondents who reported experiencing an MS-related relapse during the time they had experienced challenges accessing DMTs. Results: Among 507 survey completers, nearly half were either currently experiencing an issue related to DMT assess or had difficulty accessing a DMT in the past (233/507, 46.0\%). The most frequently reported reasons for access difficulty were authorization requirements by insurance companies (past issues: 78/182, 42.9\%; current issues: 9/42, 21\%) and high out-of-pocket costs (past issues: 54/182, 29.7\%; current issues: 13/42, 31\%). About half (20/39, 51\%) of participants with current access issues and over a third (68/165, 41.2\%) of those with past issues went without their medication until they could access their prescribed DMT. Relapses were reported during periods of reduced DMT access for almost half (56/118, 47.5\%) of those with past issues and nearly half (22/45, 49\%) of those with current issues. Resolving access issues involved multiple stakeholder agents often coordinated in a patient-led effort. Among those who had resolved issues, about half (57/119, 47.9\%) reported that doctors or office staff were involved, under half (48/119, 40.3\%) were involved themselves, and about a third (39/119, 32.8\%) reported the drug manufacturer was involved in resolving the issue. Follow-up interviews revealed that the financial burden associated with obtaining a prescribed DMT led to nonadherence. Additionally, participants felt that DMT treatment delays and stress associated with obtaining the DMT triggered relapses or worsened their MS. Conclusions: This study expands current research by using a patient-centered, mixed-methods approach to describe barriers to MS treatment, the process to resolve barriers, and the perceived impact of treatment barriers on outcomes. Issues related to DMT access occur frequently, with individuals often serving as their own agents when navigating access difficulties to obtain their medication(s). Support for resolution of DMT access is needed to prevent undue stress and nonadherence. ",
doi="10.2196/11168",
url="http://www.jmir.org/2018/10/e11168/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30377144"
}


@Article{info:doi/10.2196/jmir.9643,
author="TenBarge, M. Andrea
and Riggins, L. Jennifer",
title="Responding to Unsolicited Medical Requests from Health Care Professionals on Pharmaceutical Industry-Owned Social Media Sites: Three Pilot Studies",
journal="J Med Internet Res",
year="2018",
month="Oct",
day="29",
volume="20",
number="10",
pages="e285",
keywords="social media",
keywords="health care professionals",
keywords="medical information",
abstract="Background: The use of social media has risen tremendously over the past decade with usage rates spanning from 5\% American adults in 2005 up to 69\% in 2016. A 2011 survey of 4033 clinicians found that 65\% physicians use social media for professional purposes. To meet the changing needs and preferences of their customers, medical information departments within the pharmaceutical industry must continue to assess new digital channels such as social media and evolve their medical information services. Objective: The objective of the study was to pilot the use of social media as an additional channel to respond to unsolicited medical requests from health care professionals (HCP RUR) directed toward the pharmaceutical industry. Methods: From November 2016 to June 2017, 3 pilots were conducted during 3 professional congresses: the 2016 American College of Rheumatology Annual Meeting, the 2017 American Society of Clinical Oncology Annual Meeting, and the 2017 American Headache Society Annual Scientific Meeting. For each social media account, an identified community manager monitored the incoming account feed for proper triaging of posts. When an unsolicited medical request appeared, the community manager routed the question to the Tier One medical information contact center agents to respond. The following metrics were collected: total number of unsolicited requests directed to medical information contact center agents, total number of unsolicited requests that required escalation to Tier Two medical information associates, total number of unsolicited requests that were confirmed US HCPs, total number of unsolicited requests received after hours, and total number of unsolicited requests that were redirected to a different channel. Results: During the 3 pilots, 9 unsolicited medical requests were received with request numbers ranging from 2 to 4 requests per pilot. Of these, 1 was from a confirmed US HCP that required escalation to the Tier Two medical information associates. A majority of requests (7 out of 9) came in after the scheduled monitoring hours. There were 4 requests redirected to the medical information contact center phone number. The marketing accounts received more unsolicited medical requests than the corporate accounts (7 vs 2, respectively), and the 3 Twitter accounts saw more overall engagement (ie, medical requests and other general engagement) than the LinkedIn account. Conclusions: A limited number of medical questions were asked by confirmed HCPs using social media during the 3 pilots. New innovative medical information contact center channels often take time to build awareness. Continued channel awareness is needed to fully understand the channel's desired use. Because consumers currently make up a majority of social media engagement, companies should look into creating a combined consumer and HCP RUR strategy to provide a better experience for all customers. ",
doi="10.2196/jmir.9643",
url="http://www.jmir.org/2018/10/e285/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30373730"
}


@Article{info:doi/10.2196/10025,
author="Balls-Berry, Joyce
and Sinicrope, Pamela
and Valdez Soto, Miguel
and Brockman, Tabetha
and Bock, Martha
and Patten, Christi",
title="Linking Podcasts With Social Media to Promote Community Health and Medical Research: Feasibility Study",
journal="JMIR Formativ Res",
year="2018",
month="Oct",
day="24",
volume="2",
number="2",
pages="e10025",
keywords="biomedical research",
keywords="community health",
keywords="community and patient engagement in research",
keywords="podcast",
keywords="social media",
abstract="Background: Linking podcasts with social media is a strategy to promote and disseminate health and health research information to the community without constraints of time, weather, and geography. Objective: To describe the process of creating a podcast library and promoting it on social media as a strategy for disseminating health and biomedical research topics to the community. Methods: We used a community and patient engagement in research approach for developing a process to use podcasts for dissemination of health and health research information. We have reported the aspects of audience reach, impressions, and engagement on social media through the number of downloads, shares, and reactions posted on SoundCloud, Twitter, and Facebook, among others. Results: In collaboration with our local community partner, we produced 45 podcasts focused on topics selected from a community health needs assessment with input from health researchers. Episodes lasted about 22 minutes and presented health-related projects, community events, and community resources, with most featured guests from Olmsted County (24/45, 53\%). Health research was the most frequently discussed topic. Between February 2016 and June 2017, episodes were played 1843 times on SoundCloud and reached 1702 users on our Facebook page. Conclusions: This study demonstrated the process and feasibility of creating a content library of podcasts for disseminating health- and research-related information. Further examination is needed to determine the best methods to develop a sustainable social media plan that will further enhance dissemination (audience reach), knowledge acquisition, and communication of health topics. ",
doi="10.2196/10025",
url="http://formative.jmir.org/2018/2/e10025/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30684430"
}


@Article{info:doi/10.2196/11515,
author="Chen, Liang
and Wang, Xiaohui
and Peng, Tai-Quan",
title="Nature and Diffusion of Gynecologic Cancer--Related Misinformation on Social Media: Analysis of Tweets",
journal="J Med Internet Res",
year="2018",
month="Oct",
day="16",
volume="20",
number="10",
pages="e11515",
keywords="social media",
keywords="breast cancer",
keywords="cervical cancer",
keywords="misinformation",
keywords="diffusion",
keywords="China",
abstract="Background: Over the last two decades, the incidence and mortality rates of gynecologic cancers have increased at a constant rate in China. Gynecologic cancers have become one of the most serious threats to women's health in China. With the widespread use of social media, an increasing number of individuals have employed social media to produce, seek, and share cancer-related information. However, health information on social media is not always accurate. Health, and especially cancer-related, misinformation has been widely spread on social media, which can affect individuals' attitudinal and behavioral responses to cancer. Objective: The aim of this study was to examine the nature and diffusion of gynecologic cancer--related misinformation on Weibo, the Chinese equivalent of Twitter. Methods: A total of 2691 tweets related to 2 gynecologic cancers---breast cancer and cervical cancer---posted on Weibo from June 2015 to June 2016 were extracted using the Python Web Crawler. Two medical school graduate students with expertise in gynecologic diseases were recruited to code the tweets to differentiate between true information and misinformation as well as to identify the types of falsehoods. The diffusion characteristics of gynecologic cancer--related misinformation were compared with those of the true information. Results: While most of the gynecologic cancer--related tweets provided medically accurate information, approximately 30\% of them were found to contain misinformation. Furthermore, it was found that tweets about cancer treatment contained a higher percentage of misinformation than prevention-related tweets. Nevertheless, the prevention-related misinformation diffused significantly more broadly and deeply than true information on social media. Conclusions: The findings of this study suggest the need for controlling and reducing the cancer-related misinformation on social media with the efforts from both service providers and medical professionals. More specifically, it is important to correct falsehoods related to the prevention of gynecologic cancers on social media and increase individuals' capacity to assess the veracity of Web-based information to curb the spread and thus minimize the consequences of cancer-related misinformation. ",
doi="10.2196/11515",
url="http://www.jmir.org/2018/10/e11515/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30327289"
}


@Article{info:doi/10.2196/jmir.9646,
author="Zhao, Mengnan
and Yang, C. Christopher",
title="Drug Repositioning to Accelerate Drug Development Using Social Media Data: Computational Study on Parkinson Disease",
journal="J Med Internet Res",
year="2018",
month="Oct",
day="11",
volume="20",
number="10",
pages="e271",
keywords="drug repositioning",
keywords="Parkinson disease",
keywords="heterogeneous network",
keywords="social media",
abstract="Background: Due to the high cost and low success rate in new drug development, systematic drug repositioning methods are exploited to find new indications for existing drugs. Objective: We sought to propose a new computational drug repositioning method to identify repositioning drugs for Parkinson disease (PD). Methods: We developed a novel heterogeneous network mining repositioning method that constructed a 3-layer network of disease, drug, and adverse drug reaction and involved user-generated data from online health communities to identify potential candidate drugs for PD. Results: We identified 44 non-Parkinson drugs by using the proposed approach, with data collected from both pharmaceutical databases and online health communities. Based on the further literature analysis, we found literature evidence for 28 drugs. Conclusions: In summary, the proposed heterogeneous network mining repositioning approach is promising for identifying repositioning candidates for PD. It shows that adverse drug reactions are potential intermediaries to reveal relationships between disease and drug. ",
doi="10.2196/jmir.9646",
url="http://www.jmir.org/2018/10/e271/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30309833"
}


@Article{info:doi/10.2196/mental.9814,
author="Calvo, Fran
and Carbonell, Xavier",
title="Using Facebook for Improving the Psychological Well-Being of Individuals Experiencing Homelessness: Experimental and Longitudinal Study",
journal="JMIR Ment Health",
year="2018",
month="Oct",
day="10",
volume="5",
number="4",
pages="e59",
keywords="homelessness",
keywords="individuals experiencing homelessness",
keywords="health",
keywords="satisfaction with life",
keywords="self-esteem",
keywords="self-efficacy",
keywords="social networking sites",
keywords="social skills",
abstract="Background: Web-based social networks are a powerful communicative element and their use is increasingly widespread. Persons living in extreme social exclusion such as individuals experiencing homelessness can benefit from the positive elements of communication and relationship associated with social networking sites. Objective: This study aimed to suggest the comparison of a Facebook training course and an office software course and their effect on psychological well-being in a group of individuals experiencing homelessness. Methods: An experimental and longitudinal study was designed. Individuals experiencing homelessness were randomly assigned to either the Facebook group or the office software group, and their social skills, self-esteem, self-efficacy, and satisfaction with life were measured on 4 occasions: pretest, at the end of the training course, 1 month later, and 3 months later. A mixed analysis of variance of repeated measures (2{\texttimes}4) was performed. Results: A total of 92 individuals experiencing homelessness participated in the study. The number of cases in which the 4 measurements were completed was 71 (35 in the intervention group and 36 in the control group). The mixed analysis of variance of repeated measures and the multiple regression analysis indicated a significant increase of the 4 analyzed parameters, with greater significance in the areas of social skills and self-esteem. The critical levels associated to the interaction Time{\texttimes}Program were significant in all variables and levels. Therefore, the scores in the 4 analyzed constructs were not equal according to the program carried out throughout the work. The effect size associated to the interaction Time{\texttimes}Program in the social skills scores was large ($\eta$2=0.32); in the self-esteem and self-efficacy scores, it was medium, ($\eta$2=0.13); and in the satisfaction with life scores, it was small ($\eta$2=0.09). The results of the adjustment of the different models of multiple linear regression indicate that the number of hours devoted weekly to the use of Facebook was a predictor of the increase in the scores of social skills (B=3.43, r2=.405) and self-esteem (B=.382). Age (B=.175) and self-efficacy (B=.09) were also variables, which with independence and in equal conditions, predicted self-esteem (r2=.29). Finally, self-esteem (B=.69) was also a predictor variable of the increase of satisfaction with life (r2=.195). Conclusions: These findings suggest that Facebook could be a key element in homeless psychological well-being and socialization. ",
doi="10.2196/mental.9814",
url="http://mental.jmir.org/2018/4/e59/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30305262"
}


@Article{info:doi/10.2196/mhealth.7623,
author="Leung, Ricky
and Guo, Huibin
and Pan, Xuan",
title="Social Media Users' Perception of Telemedicine and mHealth in China: Exploratory Study",
journal="JMIR Mhealth Uhealth",
year="2018",
month="Sep",
day="25",
volume="6",
number="9",
pages="e181",
keywords="mHealth",
keywords="telemedicine",
keywords="China",
keywords="social media",
keywords="text mining",
keywords="keyword analysis",
keywords="mobile phone",
abstract="Background: The use of telemedicine and mHealth has increased rapidly in the People's Republic of China. While telemedicine and mHealth have great potential, wide adoption of this technology depends on how patients, health care providers, and other stakeholders in the Chinese health sector perceive and accept the technology. Objective: To explore this issue, we aimed to examine a social media platform with a dedicated focus on health information technology and informatics in China. Our goal is to utilize the findings to support further research. Methods: In this exploratory study, we selected a social media platform---HC3i.cn---to examine the perception of telemedicine and mHealth in China. We performed keyword analysis and analyzed the prevalence and term frequency--inverse document frequency of keywords in the selected social media platform; furthermore, we performed qualitative analysis. Results: We organized the most prominent 16 keywords from 571 threads into 8 themes: (1) Question versus Answer; (2) Hospital versus Clinic; (3) Market versus Company; (4) Doctor versus Nurse; (5) Family versus Patient; (6) iPad versus Tablet; (7) System versus App; and (8) Security versus Caregiving. Social media participants perceived not only significant opportunities associated with telemedicine and mHealth but also barriers to overcome to realize these opportunities. Conclusions: We identified interesting issues in this paper by studying a social media platform in China. Among other things, participants in the selected platform raised concerns about quality and costs associated with the provision of telemedicine and mHealth, despite the new technology's great potential to address different issues in the Chinese health sector. The methods applied in this paper have some limitations, and the findings may not be generalizable. We have discussed directions for further research. ",
doi="10.2196/mhealth.7623",
url="http://mhealth.jmir.org/2018/9/e181/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30274969"
}


@Article{info:doi/10.2196/resprot.9762,
author="Reuter, Katja
and Angyan, Praveen
and Le, NamQuyen
and MacLennan, Alicia
and Cole, Sarah
and Bluthenthal, N. Ricky
and Lane, J. Christianne
and El-Khoueiry, B. Anthony
and Buchanan, A. Thomas",
title="Monitoring Twitter Conversations for Targeted Recruitment in Cancer Trials in Los Angeles County: Protocol for a Mixed-Methods Pilot Study",
journal="JMIR Res Protoc",
year="2018",
month="Sep",
day="25",
volume="7",
number="9",
pages="e177",
keywords="breast cancer",
keywords="cancer",
keywords="clinical research",
keywords="clinical trial",
keywords="colon cancer",
keywords="kidney cancer",
keywords="listening",
keywords="lung cancer",
keywords="lymphoma",
keywords="monitoring",
keywords="outreach",
keywords="prostate cancer",
keywords="recruitment",
keywords="research participation",
keywords="surveillance",
keywords="Twitter",
keywords="social media",
keywords="social network",
abstract="Background: Insufficient recruitment of participants remains a critical roadblock to successful clinical research, particularly clinical trials. Social media provide new ways for connecting potential participants with research opportunities. Researchers suggest that the social network Twitter may serve as a rich avenue for exploring how patients communicate about their health issues and increasing enrollment in cancer clinical trials. However, there is a lack of evidence that Twitter offers practical utility and impact. Objective: This pilot study aimed to examine the feasibility and impact of using Twitter monitoring data (ie, user activity and their conversations about cancer-related conditions and concerns expressed by Twitter users in Los Angeles County) as a tool for enhancing clinical trial recruitment at a comprehensive cancer center. Methods: We will conduct a mixed-methods interrupted time series study design with a before-and-after social media recruitment intervention. On the basis of a preliminary analysis of eligible trials, we plan to onboard at least 84 clinical trials across 6 disease categories: breast cancer, colon cancer, kidney cancer, lymphoma, non-small cell lung cancer, and prostate cancer that are open to accrual at the University of Southern California (USC) Norris Comprehensive Cancer Center. We will monitor messages about these 6 cancer conditions posted by Twitter users in Los Angeles County. Recruitment for the trials will occur through the Twitter account (@USCTrials). Primary study outcomes---feasibility and acceptance of the social media intervention among targeted Twitter users and the study teams of the onboarded trials---will be assessed using qualitative interviews and the 4-point Likert scale and by calculating the proportion of targeted Twitter users who engaged with outreach messages. Second, impact of the social media intervention will be measured by calculating the proportion of enrollees in trials. The enrollment rate will be compared between the active intervention period and the prior 10 months as historical control for each disease trial group. This study has been funded by the National Center for Advancing Translational Science through a Clinical and Translational Science Award. Study approval was obtained from the clinical investigations committee at USC Norris and the institutional review board at USC. Results: Recruitment on Twitter started in February 2018. Data collection will be completed in November 2018. Conclusions: This pilot project will provide preliminary data and practical insight into the application of publicly available Twitter data to identify and recruit clinical trial participants across 6 cancer disease types. We will shed light on the acceptance of the social media intervention among Twitter users and study team members of the onboarded trials. If successful, the findings will inform a multisite randomized controlled trial to determine the efficacy of the social media intervention across different locations and populations. Trial Registration: ClinicalTrials.gov NCT03408561; https://clinicaltrials.gov/ct2/show/NCT03408561 (Archived by WebCite at http://www.webcitation.org/72LihauzW) Registered Report Identifier: RR1-10.2196/9762 ",
doi="10.2196/resprot.9762",
url="http://www.researchprotocols.org/2018/9/e177/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30274964"
}


@Article{info:doi/10.2196/10897,
author="Victoria Diniz, Marisa
and Sun, Y. Sue
and Barsottini, Claudia
and Viggiano, Mauricio
and Signorini Filho, C. Roney
and Sanches Ozane Pimenta, Bruna
and Elias, M. Kevin
and Horowitz, S. Neil
and Braga, Antonio
and Berkowitz, S. Ross",
title="Experience With the Use of an Online Community on Facebook for Brazilian Patients With Gestational Trophoblastic Disease: Netnography Study",
journal="J Med Internet Res",
year="2018",
month="Sep",
day="24",
volume="20",
number="9",
pages="e10897",
keywords="gestational trophoblastic disease",
keywords="social media",
keywords="Facebook",
keywords="mobile phone",
abstract="Background: The term gestational trophoblastic disease (GTD) includes both complete and partial moles, which are uncommon nonviable pregnancies with the potential to evolve into a malignancy known as gestational trophoblastic neoplasia. While highly curable, the potential for malignancy associated with molar pregnancies worries the patients, leading them to seek information on the internet. A Facebook page headed by Brazilian specialized physicians in GTD was created in 2013 to provide online support for GTD patients. Objective: The objective of our study was to describe the netnography of Brazilian patients with GTD on Facebook (FBGTD) and to evaluate whether their experiences differed depending on whether they received care in a Brazilian gestational trophoblastic disease reference center (BRC) or elsewhere. Methods: This was a cross-sectional study using G Suite Google Platform. The members of FBGTD were invited to participate in a survey from March 6 to October 5, 2017, and a netnographic analysis of interactions among the members was performed. Results: The survey was answered by 356 Brazilian GTD patients: 176 reference center patients (RCP) treated at a BRC and 180 nonreference center patients (NRCP) treated elsewhere. On comparing the groups, we found that RCP felt safer and more confident at the time of diagnosis of GTD (P=.001). RCP were more likely to utilize FBGTD subsequent to a referral by health assistants (P<.001), whereas NRCP more commonly discovered FBGTD through Web searches (P<.001). NRCP had higher educational levels (P=.009) and were more commonly on FBGTD for ? 6 months (P=.03). NRCP were more likely to report that doctors did not adequately explain GTD at diagnosis (P=.007), had more doubts about GTD treatment (P=.01), and were less likely to use hormonal contraception (P<.001). Overall, 89\% (317/356) patients accessed the internet preferentially from home and using mobile phones, and 98\% (349/354) patients declared that they felt safe reading the recommendations posted by FBGTD physicians. Conclusions: This netnographic analysis of GTD patients on FBGTD shows that an Web-based doctor-patient relationship can supplement the care for women with GTD. This resource is particularly valuable for women being cared for outside of established reference centers. ",
doi="10.2196/10897",
url="http://www.jmir.org/2018/9/e10897/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30249575"
}


@Article{info:doi/10.2196/10244,
author="Lama, Yuki
and Chen, Tao
and Dredze, Mark
and Jamison, Amelia
and Quinn, Crouse Sandra
and Broniatowski, A. David",
title="Discordance Between Human Papillomavirus Twitter Images and Disparities in Human Papillomavirus Risk and Disease in the United States: Mixed-Methods Analysis",
journal="J Med Internet Res",
year="2018",
month="Sep",
day="14",
volume="20",
number="9",
pages="e10244",
keywords="disparities",
keywords="health communication",
keywords="HPV vaccines",
keywords="image tweet",
keywords="public health communication",
keywords="social media",
keywords="Twitter",
keywords="visual communication",
abstract="Background: Racial and ethnic minorities are disproportionately affected by human papillomavirus (HPV)-related cancer, many of which could have been prevented with vaccination. Yet, the initiation and completion rates of HPV vaccination remain low among these populations. Given the importance of social media platforms for health communication, we examined US-based HPV images on Twitter. We explored inconsistencies between the demographics represented in HPV images and the populations that experience the greatest burden of HPV-related disease. Objective: The objective of our study was to observe whether HPV images on Twitter reflect the actual burden of disease by select demographics and determine to what extent Twitter accounts utilized images that reflect the burden of disease in their health communication messages. Methods: We identified 456 image tweets about HPV that contained faces posted by US users between November 11, 2014 and August 8, 2016. We identified images containing at least one human face and utilized Face++ software to automatically extract the gender, age, and race of each face. We manually annotated the source accounts of these tweets into 3 types as follows: government (38/298, 12.8\%), organizations (161/298, 54.0\%), and individual (99/298, 33.2\%) and topics (news, health, and other) to examine how images varied by message source. Results: Findings reflected the racial demographics of the US population but not the disease burden (795/1219, 65.22\% white faces; 140/1219, 11.48\% black faces; 71/1219, 5.82\% Asian faces; and 213/1219, 17.47\% racially ambiguous faces). Gender disparities were evident in the image faces; 71.70\% (874/1219) represented female faces, whereas only 27.89\% (340/1219) represented male faces. Among the 11-26 years age group recommended to receive HPV vaccine, HPV images contained more female-only faces (214/616, 34.3\%) than males (37/616, 6.0\%); the remainder of images included both male and female faces (365/616, 59.3\%). Gender and racial disparities were present across different image sources. Faces from government sources were more likely to depict females (n=44) compared with males (n=16). Of male faces, 80\% (12/15) of youth and 100\% (1/1) of adults were white. News organization sources depicted high proportions of white faces (28/38, 97\% of female youth and 12/12, 100\% of adult males). Face++ identified fewer faces compared with manual annotation because of limitations with detecting multiple, small, or blurry faces. Nonetheless, Face++ achieved a high degree of accuracy with respect to gender, race, and age compared with manual annotation. Conclusions: This study reveals critical differences between the demographics reflected in HPV images and the actual burden of disease. Racial minorities are less likely to appear in HPV images despite higher rates of HPV incidence. Health communication efforts need to represent populations at risk better if we seek to reduce disparities in HPV infection. ",
doi="10.2196/10244",
url="http://www.jmir.org/2018/9/e10244/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30217792"
}


@Article{info:doi/10.2196/11652,
author="Khanna, Subhash Aditya
and Goodreau, Michael Steven
and Michaels, Stuart
and Schneider, Alexis John",
title="Using Partially-Observed Facebook Networks to Develop a Peer-Based HIV Prevention Intervention: Case Study",
journal="J Med Internet Res",
year="2018",
month="Sep",
day="14",
volume="20",
number="9",
pages="e11652",
keywords="African Americans",
keywords="computer simulation",
keywords="data mining",
keywords="HIV infections",
keywords="peer group",
keywords="pre-exposure prophylaxis",
keywords="sexual and gender minorities",
keywords="social media",
keywords="social networking",
abstract="Background: This is a case study from an HIV prevention project among young black men who have sex with men. Individual-level prevention interventions have had limited success among young black men who have sex with men, a population that is disproportionately affected by HIV; peer network--based interventions are a promising alternative. Facebook is an attractive digital platform because it enables broad characterization of social networks. There are, however, several challenges in using Facebook data for peer interventions, including the large size of Facebook networks, difficulty in assessing appropriate methods to identify candidate peer change agents, boundary specification issues, and partial observation of social network data. Objective: This study aimed to explore methodological challenges in using social Facebook networks to design peer network--based interventions for HIV prevention and present techniques to overcome these challenges. Methods: Our sample included 298 uConnect study respondents who answered a bio-behavioral survey in person and whose Facebook friend lists were downloaded (2013-2014). The study participants had over 180,000 total Facebook friends who were not involved in the study (nonrespondents). We did not observe friendships between these nonrespondents. Given the large number of nonrespondents whose networks were partially observed, a relational boundary was specified to select nonrespondents who were well connected to the study respondents and who may be more likely to influence the health behaviors of young black men who have sex with men. A stochastic model-based imputation technique, derived from the exponential random graph models, was applied to simulate 100 networks where unobserved friendships between nonrespondents were imputed. To identify peer change agents, the eigenvector centrality and keyplayer positive algorithms were used; both algorithms are suitable for identifying individuals in key network positions for information diffusion. For both algorithms, we assessed the sensitivity of identified peer change agents to the imputation model, the stability of identified peer change agents across the imputed networks, and the effect of the boundary specification on the identification of peer change agents. Results: All respondents and 78.9\% (183/232) of nonrespondents selected as peer change agents by eigenvector on the imputed networks were also selected as peer change agents on the observed networks. For keyplayer, the agreement was much lower; 42.7\% (47/110) and 35.3\% (110/312) of respondent and nonrespondent peer change agents, respectively, selected on the imputed networks were also selected on the observed network. Eigenvector also produced a stable set of peer change agents across the 100 imputed networks and was much less sensitive to the specified relational boundary. Conclusions: Although we do not have a gold standard indicating which algorithm produces the most optimal set of peer change agents, the lower sensitivity of eigenvector centrality to key assumptions leads us to conclude that it may be preferable. The methods we employed to address the challenges in using Facebook networks may prove timely, given the rapidly increasing interest in using online social networks to improve population health. ",
doi="10.2196/11652",
url="http://www.jmir.org/2018/9/e11652/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30217793"
}


@Article{info:doi/10.2196/10781,
author="El Tantawi, Maha
and Al-Ansari, Asim
and AlSubaie, Abdulelah
and Fathy, Amr
and Aly, M. Nourhan
and Mohamed, S. Amira",
title="Reach of Messages in a Dental Twitter Network: Cohort Study Examining User Popularity, Communication Pattern, and Network Structure",
journal="J Med Internet Res",
year="2018",
month="Sep",
day="13",
volume="20",
number="9",
pages="e10781",
keywords="social media",
keywords="health communication",
keywords="dentists",
keywords="students, dental",
keywords="social network analysis",
keywords="twitter",
keywords="social networks",
abstract="Background: Increasing the reach of messages disseminated through Twitter promotes the success of Twitter-based health education campaigns. Objective: This study aimed to identify factors associated with reach in a dental Twitter network (1) initially and (2) sustainably at individual and network levels. Methods: We used instructors' and students' Twitter usernames from a Saudi dental school in 2016-2017 and applied Gephi (a social network analysis tool) and social media analytics to calculate user and network metrics. Content analysis was performed to identify users disseminating oral health information. The study outcomes were reach at baseline and sustainably over 1.5 years. The explanatory variables were indicators of popularity (number of followers, likes, tweets retweeted by others), communication pattern (number of tweets, retweets, replies, tweeting/ retweeting oral health information or not). Multiple logistic regression models were used to investigate associations. Results: Among dental users, 31.8\% had reach at baseline and 62.9\% at the end of the study, reaching a total of 749,923 and dropping to 37,169 users at the end. At an individual level, reach was associated with the number of followers (baseline: odds ratio, OR=1.003, 95\% CI=1.001-1.005 and sustainability: OR=1.002, 95\% CI=1.0001-1.003), likes (baseline: OR=1.001, 95\% CI=1.0001-1.002 and sustainability: OR=1.0031, 95\% CI=1.0003-1.002), and replies (baseline: OR=1.02, 95\% CI=1.005-1.04 and sustainability: OR=1.02, 95\% CI=1.004-1.03). At the network level, users with the least followers, tweets, retweets, and replies had the greatest reach. Conclusions: Reach was reduced by time. Factors increasing reach at the user level had different impact at the network level. More than one strategy is needed to maximize reach. ",
doi="10.2196/10781",
url="http://www.jmir.org/2018/9/e10781/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30213781"
}


@Article{info:doi/10.2196/10435,
author="Pretorius, A. Kelly
and Mackert, Michael
and Wilcox, B. Gary",
title="Sudden Infant Death Syndrome and Safe Sleep on Twitter: Analysis of Influences and Themes to Guide Health Promotion Efforts",
journal="JMIR Pediatr Parent",
year="2018",
month="Sep",
day="07",
volume="1",
number="2",
pages="e10435",
keywords="sudden infant death",
keywords="sudden unexpected infant death",
keywords="accidental suffocation in a sleeping environment",
keywords="infant mortality",
keywords="safe sleep",
keywords="sleep environment",
keywords="social media",
keywords="Twitter",
keywords="health communication",
keywords="public health",
abstract="Background: In the United States, sudden infant death syndrome (SIDS) is the leading cause of death in infants aged 1 month to 1 year. Approximately 3500 infants die from SIDS and sleep-related reasons on a yearly basis. Unintentional sleep-related deaths and bed sharing, a known risk factor for SIDS, are on the rise. Furthermore, ethnic disparities exist among those most affected by SIDS. Despite public health campaigns, infant mortality persists. Given the popularity of social media, understanding social media conversations around SIDS and safe sleep may assist the medical and public health communities with information needed to spread, reinforce, or counteract false information regarding SIDS and safe sleep. Objective: The objective of our study was to investigate the social media conversation around SIDS and safe sleep to understand the possible influences and guide health promotion efforts and public health research as well as enable health professionals to engage in directed communication regarding this topic. Methods: We used textual analytics to identify topics and extract meanings contained in unstructured textual data. Twitter messages were captured during September, October, and November in 2017. Tweets and retweets were collected using NUVI software in conjunction with Twitter's search API using the keywords: ``sids,'' ``infant death syndrome,'' ``sudden infant death syndrome,'' and ``safe sleep.'' This returned a total of 41,358 messages, which were analyzed using text mining and social media monitoring software. Results: Multiple themes were identified, including recommendations for safe sleep to prevent SIDS, safe sleep devices, the potential causes of SIDS, and how breastfeeding reduces SIDS. Compared with September and November, more personal and specific stories of infant loss were demonstrated in October (Pregnancy and Infant Loss Awareness Month). The top influencers were news organizations, universities, and health-related organizations. Conclusions: We identified valuable topics discussed and shared on Twitter regarding SIDS and safe sleep. The study results highlight the contradicting information a subset of the population is exposed to regarding SIDS and the continued controversy over vaccines. In addition, this analysis emphasizes the lack of public health organizations' presence on Twitter compared with the influence of universities and news media organizations. The results also demonstrate the prevalence of safe sleep products that are embedded in safe sleep messaging. These findings can assist providers in speaking about relevant topics when engaging in conversations about the prevention of SIDS and the promotion of safe sleep. Furthermore, public health agencies and advocates should utilize social media and Twitter to better communicate accurate health information as well as continue to combat the spread of false information. ",
doi="10.2196/10435",
url="http://pediatrics.jmir.org/2018/2/e10435/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31518314"
}


@Article{info:doi/10.2196/10501,
author="Cho, Hyunyi
and Silver, Nathan
and Na, Kilhoe
and Adams, Dinah
and Luong, T. Kate
and Song, Chi",
title="Visual Cancer Communication on Social Media: An Examination of Content and Effects of \#Melanomasucks",
journal="J Med Internet Res",
year="2018",
month="Sep",
day="05",
volume="20",
number="9",
pages="e10501",
keywords="cancer",
keywords="comments",
keywords="common sense model",
keywords="emotions",
keywords="illness perception",
keywords="Instagram",
keywords="likes",
keywords="melanoma",
keywords="participative engagement",
keywords="social media",
keywords="social sharing",
keywords="social support",
keywords="visual communication",
abstract="Background: Instagram is increasingly becoming a platform on which visual communication of cancer takes place, but few studies have investigated the content and effects. In particular, a paucity of research has evaluated the effects of visual communication of cancer on participative engagement outcomes. Objective: The objective of our study was to investigate cancer-related beliefs and emotions shared on Instagram and to examine their effects on participative engagement outcomes including likes, comments, and social support. Methods: This study analyzed the content of 441 posts of \#melanomasucks on Instagram and assessed the effects of the content characteristics on outcomes, including the number of likes and comments and types of social support using group least absolute shrinkage and selection operator logistic regression. Results: Posts about controlling melanoma were most frequent (271/441, 61.5\%), followed by 240 (54.4\%) posts about outcomes of having melanoma. Ninety posts (20.4\%) were about the causes of melanoma. A greater number of posts expressed positive (159/441, 36.1\%) than negative emotions (100/441, 22.7\%). Eighty posts (18.1\%) expressed hope, making it the most frequently expressed emotion; 49 posts expressed fear (11.1\%), 46 were humorous (10.4\%), and 46 showed sadness (10.4\%). Posts about self behavior as a cause of melanoma decreased likes (P<.001) and social support comments (P=.048). Posts about physical consequences of melanoma decreased likes (P=.02) but increased comments (P<.001) and emotional social support (P<.001); posts about melanoma treatment experience increased comments (P=.03) and emotional social support (P<.001). None of the expressions of positive emotions increased likes, comments, or social support. Expression of anger increased the number of likes (P<.001) but those about fear (P<.001) and joy (P=.006) decreased the number of likes. Posts about fear (P=.003) and sadness (P=.003) increased emotional social support. Posts showing images of melanoma or its treatment on the face or body parts made up 21.8\% (96/441) of total posts. Inclusion of images increased the number of comments (P=.001). Conclusions: To our knowledge, this is the first investigation of the content and effects of user-generated visual cancer communication on social media. The findings show where the self-expressive and social engagement functions of \#melanomasucks converge and diverge, providing implications for extending research on the commonsense model of illness and for developing conceptual frameworks explaining participative engagement on social media. ",
doi="10.2196/10501",
url="http://www.jmir.org/2018/9/e10501/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30185403"
}


@Article{info:doi/10.2196/11375,
author="Patel, V. Viraj
and Ginsburg, Zo{\"e}
and Golub, A. Sarit
and Horvath, J. Keith
and Rios, Nataly
and Mayer, H. Kenneth
and Kim, S. Ryung
and Arnsten, H. Julia",
title="Empowering With PrEP (E-PrEP), a Peer-Led Social Media--Based Intervention to Facilitate HIV Preexposure Prophylaxis Adoption Among Young Black and Latinx Gay and Bisexual Men: Protocol for a Cluster Randomized Controlled Trial",
journal="JMIR Res Protoc",
year="2018",
month="Aug",
day="28",
volume="7",
number="8",
pages="e11375",
keywords="pre-exposure prophylaxis",
keywords="HIV",
keywords="social media interventions",
keywords="HIV prevention",
keywords="social network intervention",
keywords="social media",
keywords="social networking",
keywords="telemedicine",
abstract="Background: Young black and Latinx, gay, bisexual, and other men who have sex with men (YBLGBM, aged 18-29 years) have among the highest rates of new HIV infections in the United States and are not consistently reached by existing prevention interventions. Preexposure prophylaxis (PrEP), an oral antiretroviral regimen taken daily by HIV-uninfected individuals to prevent HIV acquisition, is highly efficacious in reducing HIV acquisition and could help stop the HIV epidemic in YBLGBM. Use of social media (eg, Facebook, Twitter, online dating sites) is ubiquitous among young people, providing an efficient avenue to engage YBLGBM to facilitate PrEP adoption. Objective: Our overall goal was to develop and pilot test a theoretically grounded, social media--based, peer-led intervention to increase PrEP uptake in YBLGBM. We used diffusion of innovation and information-motivation-behavioral skills frameworks to (1) identify potential factors associated with interest in and adoption of PrEP among YBLGBM; (2) develop Empowering with PrEP (E-PrEP), a social media--based, peer-led intervention to increase PrEP uptake in YBLGBM; and (3) pilot test the feasibility and acceptability of E-PrEP, and determine its preliminary efficacy for increasing adoption of PrEP by YBLGBM. We describe the development and protocol for E-PrEP. Methods: Using a participatory research approach, we partnered with YBLGBM intervention development partners to develop a social media--based behavioral intervention to facilitate PrEP uptake, which involved an online messaging campaign disseminated by YBLGBM peer leaders to their existing online networks. We designed the 6-week campaign to provide education about PrEP, increase motivation to use PrEP, and facilitate access to PrEP. We then conducted a cluster-randomized trial of E-PrEP compared with an attention-matched general health control condition (E-Health) among YBLGBM aged 18 to 29 years to assess E-PrEP's feasibility, acceptability, preliminary efficacy for increasing self-reported intention to use PrEP, PrEP uptake, and impact on knowledge and attitudes about PrEP at 12-week follow-up (6 weeks after the end of the online campaign). Results: From October 2016 to March 2017, we developed, pretested, and refined E-PrEP with 6 YBLGBM intervention development partners. From May to June 2017, we recruited, enrolled, and randomly assigned 10 peer leaders (n=5 for each condition). The 10 peer leaders then recruited and enrolled 152 participants from their existing online networks (range 3-33 per peer leader), during June and July 2017. Intervention follow-up was completed after 12 weeks, in November 2017, with analyses underway. Conclusions: We hypothesize that, compared with E-Health, participants randomly assigned to E-PrEP will be more likely to express intention to use PrEP and greater PrEP uptake, and will also show changes in potential mediators of PrEP uptake (knowledge, attitudes, stigma, and access). A Web-based biobehavioral intervention model such as E-PrEP could be rapidly scaled even with limited resources and have significant population-level impact. Trial Registration: ClinicalTrials.gov NCT03213366; https://clinicaltrials.gov/ct2/show/NCT03213366 (Archived by WebCite at http://www.webcitation.org/71onSdcXY) Registered Report Identifier: RR1-10.2196/11375 ",
doi="10.2196/11375",
url="http://www.researchprotocols.org/2018/8/e11375/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30154071"
}


@Article{info:doi/10.2196/jmir.9373,
author="Li, Qiudan
and Wang, Can
and Liu, Ruoran
and Wang, Lei
and Zeng, Dajun Daniel
and Leischow, James Scott",
title="Understanding Users' Vaping Experiences from Social Media: Initial Study Using Sentiment Opinion Summarization Techniques",
journal="J Med Internet Res",
year="2018",
month="Aug",
day="15",
volume="20",
number="8",
pages="e252",
keywords="electronic nicotine delivery systems",
keywords="e-cigarette",
keywords="e-liquid",
keywords="JuiceDB",
keywords="sentiment opinion summarization",
keywords="social media",
keywords="vaping",
keywords="infodemiology",
abstract="Background: E-liquid is one of the main components in electronic nicotine delivery systems (ENDS). ENDS review comments could serve as an early warning on use patterns and even function to serve as an indicator of problems or adverse events pertaining to the use of specific e-liquids---much like types of responses tracked by the Food and Drug Administration (FDA) regarding medications. Objective: This study aimed to understand users' ``vaping'' experience using sentiment opinion summarization techniques, which can help characterize how consumers think about specific e-liquids and their characteristics (eg, flavor, throat hit, and vapor production). Methods: We collected e-liquid reviews on JuiceDB from June 27, 2013 to December 31, 2017 using its public application programming interface. The dataset contains 27,070 reviews for 8058 e-liquid products. Each review is accompanied by an overall rating and a set of 4 aspect ratings of an e-liquid, each on a scale of 1-5: flavor accuracy, throat hit, value, and cloud production. An iterative dichotomiser 3 (ID3)-based influential aspect analysis model was adopted to learn the key elements that impact e-liquid use. Then, fine-grained sentiment analysis was employed to mine opinions on various aspects of vaping experience related to e-liquids. Results: We found that flavor accuracy and value were the two most important aspects that affected users' sentiments toward e-liquids. Of reviews in JuiceDB, 67.83\% (18,362/27,070) were positive, while 12.67\% (3430/27,070) were negative. This indicates that users generally hold positive attitudes toward e-liquids. Among the 9 flavors, fruity and sweet were the two most popular. Great and sweet tastes, reasonable value, and strong throat hit made users satisfied with fruity and sweet flavors, whereas ``strange'' tastes made users dislike those flavors. Meanwhile, users complained about some e-liquids' steep or expensive prices, bad quality, and harsh throat hit. There were 2342 fruity e-liquids and 2049 sweet e-liquids. There were 55.81\% (1307/2342) and 59.83\% (1226/2049) positive sentiments and 13.62\% (319/2342) and 12.88\% (264/2049) negative sentiments toward fruity e-liquids and sweet e-liquids, respectively. Great flavors and good vapors contributed to positive reviews of fruity and sweet products. However, bad tastes such as ``sour'' or ``bitter'' resulted in negative reviews. These findings can help businesses and policy makers to further improve product quality and formulate effective policy. Conclusions: This study provides an effective mechanism for analyzing users' ENDS vaping experience based on sentiment opinion summarization techniques. Sentiment opinions on aspect and products can be found using our method, which is of great importance to monitor e-liquid products and improve work efficiency. ",
doi="10.2196/jmir.9373",
url="http://www.jmir.org/2018/8/e252/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30111530"
}


@Article{info:doi/10.2196/10303,
author="Gabarron, Elia
and {\AA}rsand, Eirik
and Wynn, Rolf",
title="Social Media Use in Interventions for Diabetes: Rapid Evidence-Based Review",
journal="J Med Internet Res",
year="2018",
month="Aug",
day="10",
volume="20",
number="8",
pages="e10303",
keywords="social media",
keywords="social networking",
keywords="health promotion",
keywords="intervention studies",
keywords="diabetes",
abstract="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. ",
doi="10.2196/10303",
url="http://www.jmir.org/2018/8/e10303/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30097421"
}


@Article{info:doi/10.2196/jmir.9607,
author="Zhang, Wei
and Deng, Zhaohua
and Evans, Richard
and Xiang, Fei
and Ye, Qing
and Zeng, Runxi",
title="Social Media Landscape of the Tertiary Referral Hospitals in China: Observational Descriptive Study",
journal="J Med Internet Res",
year="2018",
month="Aug",
day="09",
volume="20",
number="8",
pages="e249",
keywords="social media usage",
keywords="best tertiary hospitals",
keywords="China",
keywords="Sina Weibo",
keywords="WeChat",
abstract="Background: Social media has penetrated all walks of life. Chinese health care institutions are increasingly utilizing social media to connect with their patients for better health service delivery. Current research has focused heavily on the use of social media in developed countries, with few studies exploring its usage in the context of developing countries, such as China. Tertiary hospitals in China are usually located in city centers, and they serve as medical hubs for multiple regions, with comprehensive and specialized medical care being provided. These hospitals are assumed to be the pioneers in creating official social media accounts to connect with their patients due to the fact that they appear to have more resources to support this innovative approach to communication and health care education.  Objective: The objective of our study was to examine China's best tertiary hospitals, as recognized by The National Health Commission of the People's Republic of China (NHCPRC), and to map out the landscape of current social media usage by hospitals when engaging with patients. Methods: We examined the best 705 tertiary hospitals in China by collecting and analyzing data regarding their usage of popular Chinese social media apps Sina Weibo and WeChat. The specific data included (1) hospital characteristics (ie, time since established, number of beds, hospital type, and regions or localities) and (2) status of social media usage regarding two of the most popular local social media platforms in China (ie, time of initiation, number of followers, and number of tweets or posts). We further used a logistic regression model to test the association between hospital characteristics and social media adoption. Results: Of all, 76.2\% (537/705) tertiary referral hospitals have created official accounts on either Sina Weibo or WeChat, with the latter being more popular among the two. In addition, our study suggests that larger and newer hospitals with greater resources are more likely to adopt social media, while hospital type and affiliation with universities are not significant predictors of social media adoption among hospitals. Conclusions: Our study demonstrated that hospitals are more inclined to use WeChat. The move by hospitals from Sina Weibo to WeChat indicates that patients are not satisfied by mere communication and that they now place more value on health service delivery. Meanwhile, utilizing social media requires comprehensive thinking from the hospital side. Once adopted, hospitals are encouraged to implement specific rules regarding social media usage. In the future, a long journey still lies ahead for hospitals in terms of operating their official social media accounts. ",
doi="10.2196/jmir.9607",
url="http://www.jmir.org/2018/8/e249/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30093370"
}


@Article{info:doi/10.2196/mental.9903,
author="Hammond, S. Alexis
and Paul, J. Michael
and Hobelmann, Joseph
and Koratana, R. Animesh
and Dredze, Mark
and Chisolm, S. Margaret",
title="Perceived Attitudes About Substance Use in Anonymous Social Media Posts Near College Campuses: Observational Study",
journal="JMIR Ment Health",
year="2018",
month="Aug",
day="02",
volume="5",
number="3",
pages="e52",
keywords="Yik Yak",
keywords="college",
keywords="social media",
keywords="substance",
keywords="drugs",
keywords="alcohol",
abstract="Background: Substance use is a major issue for adolescents and young adults, particularly college students. With the importance of peer influence and the ubiquitous use of social media among these age groups, it is important to assess what is discussed on various social media sites regarding substance use. One particular mobile app (Yik Yak) allowed users to post any message anonymously to nearby persons, often in areas with close proximity to major colleges and universities. Objective: This study describes the content, including attitude toward substances, of social media discussions that occurred near college campuses and involved substances. Methods: A total of 493 posts about drugs and alcohol on Yik Yak were reviewed and coded for their content, as well as the poster's attitude toward the substance(s) mentioned. Results: Alcohol (226/493, 45.8\%), marijuana (206/493, 41.8\%), and tobacco (67/493, 13\%) were the most frequently mentioned substances. Posts about use (442/493) were generally positive toward the substance mentioned (262/442, 59.3\%), unless the post was about abstinence from the substance. Additionally, posts that commented on the substance use of others tended to be less positive (18/92, 19.6\% positive) compared to posts about one's own use (132/202, 65.3\% positive). Conclusions: This study provides a description of anonymous discussions on or near college campuses about drugs and alcohol, which serves as an example of data that can be examined from social media sites for further research and prevention campaigns. ",
doi="10.2196/mental.9903",
url="http://mental.jmir.org/2018/3/e52/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30072359"
}


@Article{info:doi/10.2196/10496,
author="Escobar-Viera, G. C{\'e}sar
and Whitfield, L. Darren
and Wessel, B. Charles
and Shensa, Ariel
and Sidani, E. Jaime
and Brown, L. Andre
and Chandler, J. Cristian
and Hoffman, L. Beth
and Marshal, P. Michael
and Primack, A. Brian",
title="For Better or for Worse? A Systematic Review of the Evidence on Social Media Use and Depression Among Lesbian, Gay, and Bisexual Minorities",
journal="JMIR Ment Health",
year="2018",
month="Jul",
day="23",
volume="5",
number="3",
pages="e10496",
keywords="social media",
keywords="social networking sites",
keywords="sexual minorities",
keywords="lesbian",
keywords="gay",
keywords="bisexual",
keywords="depression",
keywords="systematic review",
abstract="Background: Over 90\% of adults in the United States have at least one social media account, and lesbian, gay, and bisexual (LGB) persons are more socially active on social media than heterosexuals. Rates of depression among LGB persons are between 1.5- and 2-fold higher than those among their heterosexual counterparts. Social media allows users to connect, interact, and express ideas, emotions, feelings, and thoughts. Thus, social media use might represent both a protective and a risk factor for depression among LGB persons. Studying the nature of the relationship between social media use and depression among LGB individuals is a necessary step to inform public health interventions for this population. Objective: The objective of this systematic review was to synthesize and critique the evidence on social media use and depression among LGB populations. Methods: We conducted a literature search for quantitative and qualitative studies published between January 2003 and June 2017 using 3 electronic databases. Articles were included if they were peer-reviewed, were in English, assessed social media use either quantitatively or qualitatively, measured depression, and focused on LGB populations. A minimum of two authors independently extracted data from each study using an a priori developed abstraction form. We assessed appropriate reporting of studies using the Strengthening the Reporting of Observational Studies in Epidemiology and the Consolidated Criteria for Reporting Qualitative Research for quantitative and qualitative studies, respectively. Results: We included 11 articles in the review; 9 studies were quantitative and cross-sectional and 2 were qualitative. Appropriate reporting of results varied greatly. Across quantitative studies, we found heterogeneity in how social media use was defined and measured. Cyberbullying was the most studied social media experience and was associated with depression and suicidality. Qualitative studies found that while social media provides a space to disclose minority experiences and share ways to cope and get support, constant surveillance of one's social media profile can become a stressor, potentially leading to depression. In most studies, sexual minority participants were identified inconsistently. Conclusions: This review supports the need for research on the role of social media use on depression outcomes among LBG persons. Using social media may be both a protective and a risk factor for depression among LGB individuals. Support gained via social media may buffer the impact of geographic isolation and loneliness. Negative experiences such as cyberbullying and other patterns of use may be associated with depression. Future research would benefit from more consistent definitions of both social media use and study populations. Moreover, use of larger samples and accounting for patterns of use and individuals' experiences on social media may help better understand the factors that impact LGB mental health disparities. ",
doi="10.2196/10496",
url="http://mental.jmir.org/2018/3/e10496/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30037786"
}


@Article{info:doi/10.2196/11140,
author="Lewis, D. Jaime
and Fane, E. Kathleen
and Ingraham, M. Angela
and Khan, Ayesha
and Mills, M. Anne
and Pitt, C. Susan
and Ramo, Danielle
and Wu, I. Roseann
and Pollart, M. Susan",
title="Expanding Opportunities for Professional Development: Utilization of Twitter by Early Career Women in Academic Medicine and Science",
journal="JMIR Med Educ",
year="2018",
month="Jul",
day="23",
volume="4",
number="2",
pages="e11140",
keywords="female",
keywords="leadership",
keywords="social media",
keywords="academic success",
keywords="professional development",
doi="10.2196/11140",
url="http://mededu.jmir.org/2018/2/e11140/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30037788"
}


@Article{info:doi/10.2196/10069,
author="Hartnup, Becky
and Dong, Lin
and Eisingerich, Benedikt Andreas",
title="How an Environment of Stress and Social Risk Shapes Student Engagement With Social Media as Potential Digital Learning Platforms: Qualitative Study",
journal="JMIR Med Educ",
year="2018",
month="Jul",
day="13",
volume="4",
number="2",
pages="e10069",
keywords="social media",
keywords="online learning",
keywords="digital engagement",
keywords="stress",
keywords="social risk",
keywords="digital platforms",
keywords="education",
keywords="university adjustment",
abstract="Background: Social media has been increasingly used as a learning tool in medical education. Specifically, when joining university, students often go through a phase of adjustment, and they need to cope with various challenges such as leaving their families and friends and trying to fit into a new environment. Research has shown that social media helps students to connect with old friends and to establish new relationships. However, managing friendships on social media might intertwine with the new learning environment that shapes students' online behaviors. Especially, when students perceive high levels of social risks when using social media, they may struggle to take advantage of the benefits that social media can provide for learning. Objective: This study aimed to develop a model that explores the drivers and inhibitors of student engagement with social media during their university adjustment phase. Methods: We used a qualitative method by interviewing 78 undergraduate students studying medical courses at UK research-focused universities. In addition, we interviewed 6 digital technology experts to provide additional insights into students' learning behaviors on social media. Results: Students' changing relationships and new academic environment in the university adjustment phase led to various factors that affected their social media engagement. The main drivers of social media engagement were maintaining existing relationships, building new relationships, and seeking academic support. Simultaneously, critical factors that inhibited the use of social media for learning emerged, namely, collapsed online identity, uncertain group norms, the desire to present an ideal self, and academic competition. These inhibitors led to student stress when managing their social media accounts, discouraged them from actively engaging on social media, and prevented the full exploitation of social media as an effective learning tool. Conclusions: This study identified important drivers and inhibitors for students to engage with social media platforms as learning tools. Although social media supported students to manage their relationships and support their learning, the interaction of critical factors, such as collapsed online identity, uncertain group norms, the desire to present an ideal self, and academic competition, caused psychological stress and impeded student engagement. Future research should explore how these inhibitors can be removed to reduce students' stress and to increase the use of social media for learning. More specifically, such insights will allow students to take full advantage of being connected, thus facilitating a richer learning experience during their university life. ",
doi="10.2196/10069",
url="http://mededu.jmir.org/2018/2/e10069/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30006324"
}


@Article{info:doi/10.2196/jmir.9413,
author="Du, Jingcheng
and Tang, Lu
and Xiang, Yang
and Zhi, Degui
and Xu, Jun
and Song, Hsing-Yi
and Tao, Cui",
title="Public Perception Analysis of Tweets During the 2015 Measles Outbreak: Comparative Study Using Convolutional Neural Network Models",
journal="J Med Internet Res",
year="2018",
month="Jul",
day="09",
volume="20",
number="7",
pages="e236",
keywords="convolutional neural networks",
keywords="social media",
keywords="measles",
keywords="public perception",
abstract="Background: Timely understanding of public perceptions allows public health agencies to provide up-to-date responses to health crises such as infectious diseases outbreaks. Social media such as Twitter provide an unprecedented way for the prompt assessment of the large-scale public response. Objective: The aims of this study were to develop a scheme for a comprehensive public perception analysis of a measles outbreak based on Twitter data and demonstrate the superiority of the convolutional neural network (CNN) models (compared with conventional machine learning methods) on measles outbreak-related tweets classification tasks with a relatively small and highly unbalanced gold standard training set. Methods: We first designed a comprehensive scheme for the analysis of public perception of measles based on tweets, including 3 dimensions: discussion themes, emotions expressed, and attitude toward vaccination. All 1,154,156 tweets containing the word ``measles'' posted between December 1, 2014, and April 30, 2015, were purchased and downloaded from DiscoverText.com. Two expert annotators curated a gold standard of 1151 tweets (approximately 0.1\% of all tweets) based on the 3-dimensional scheme. Next, a tweet classification system based on the CNN framework was developed. We compared the performance of the CNN models to those of 4 conventional machine learning models and another neural network model. We also compared the impact of different word embeddings configurations for the CNN models: (1) Stanford GloVe embedding trained on billions of tweets in the general domain, (2) measles-specific embedding trained on our 1 million measles related tweets, and (3) a combination of the 2 embeddings. Results: Cohen kappa intercoder reliability values for the annotation were: 0.78, 0.72, and 0.80 on the 3 dimensions, respectively. Class distributions within the gold standard were highly unbalanced for all dimensions. The CNN models performed better on all classification tasks than k-nearest neighbors, na{\"i}ve Bayes, support vector machines, or random forest. Detailed comparison between support vector machines and the CNN models showed that the major contributor to the overall superiority of the CNN models is the improvement on recall, especially for classes with low occurrence. The CNN model with the 2 embedding combination led to better performance on discussion themes and emotions expressed (microaveraging F1 scores of 0.7811 and 0.8592, respectively), while the CNN model with Stanford embedding achieved best performance on attitude toward vaccination (microaveraging F1 score of 0.8642). Conclusions: The proposed scheme can successfully classify the public's opinions and emotions in multiple dimensions, which would facilitate the timely understanding of public perceptions during the outbreak of an infectious disease. Compared with conventional machine learning methods, our CNN models showed superiority on measles-related tweet classification tasks with a relatively small and highly unbalanced gold standard. With the success of these tasks, our proposed scheme and CNN-based tweets classification system is expected to be useful for the analysis of tweets about other infectious diseases such as influenza and Ebola. ",
doi="10.2196/jmir.9413",
url="http://www.jmir.org/2018/7/e236/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29986843"
}


@Article{info:doi/10.2196/10109,
author="Parmar, Nilesh
and Dong, Lin
and Eisingerich, Benedikt Andreas",
title="Connecting With Your Dentist on Facebook: Patients' and Dentists' Attitudes Towards Social Media Usage in Dentistry",
journal="J Med Internet Res",
year="2018",
month="Jun",
day="29",
volume="20",
number="6",
pages="e10109",
keywords="social media, medical communication, dental practices, dental anxiety, Facebook, Twitter",
abstract="Background: Social media has begun to proliferate across medical areas and transformed how medical professionals serve and interact with their patients. It offers a new communication avenue that has the potential to engage patients and, hence, may be used to create value for both medical professionals and patients. In dentistry, even though patients and dentists frequently use social media in their personal lives, little is known about their attitudes and expectations toward using social media for professional interactions. Objective: In this paper, we focus on the role of social media in dentistry. Specifically, we explore patients' and dentists' attitudes toward social media usage and their current online behaviors in this context. Furthermore, we examine potential challenges and opportunities regarding dentists' adoption of social media practices. Methods: This research employed a large-scale online survey of 588 patients and 532 dental professionals. We assessed the attitudes, expectations, and social media behaviors from both patients' and dentists' perspectives. Results: We found that more than 55\% (290/532) of dentists in our sample have accounts for their dental practice on various social media platforms. Interestingly, while 73\% (374/511) of patients did not expect their dental practice to have a social media presence, and 44\% (207/468) thought that establishing a friendship with their dentists is not appropriate, the findings show that 36\% (164/460) of patients had searched for their dentists, and 44\% (207/470) of them were happy to establish contacts with dentists on social media. Furthermore, the findings highlight that patients were interested in exploring additional information such as online reviews and the qualifications of their dentists on Facebook pages. For dentists, more than half (375/432, 83\%) of them in our sample thought that social media marketing is more efficient compared to traditional marketing. Conclusions: Our findings revealed some key challenges and opportunities to utilize social media in dentistry. For both patients and dentists, the role of social media in dental services remains vague, and both parties still share concerns about connecting with each other on social media platforms. However, there also exists a sizeable number of patients who are already comfortable to connect with their dentists on social media sites such as Facebook. The current findings show that there is an opportunity for dental practices to trade upon a more active social media presence for enhanced patient interaction and engagement. ",
doi="10.2196/10109",
url="http://www.jmir.org/2018/6/e10109/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29959108"
}


@Article{info:doi/10.2196/10150,
author="Muralidhara, Sachin
and Paul, J. Michael",
title="\#Healthy Selfies: Exploration of Health Topics on Instagram",
journal="JMIR Public Health Surveill",
year="2018",
month="Jun",
day="29",
volume="4",
number="2",
pages="e10150",
keywords="social media",
keywords="Instagram",
keywords="image sharing",
keywords="topic modeling",
keywords="computer vision",
keywords="public health",
abstract="Background: Social media provides a complementary source of information for public health surveillance. The dominate data source for this type of monitoring is the microblogging platform Twitter, which is convenient due to the free availability of public data. Less is known about the utility of other social media platforms, despite their popularity. Objective: This work aims to characterize the health topics that are prominently discussed in the image-sharing platform Instagram, as a step toward understanding how this data might be used for public health research. Methods: The study uses a topic modeling approach to discover topics in a dataset of 96,426 Instagram posts containing hashtags related to health. We use a polylingual topic model, initially developed for datasets in different natural languages, to model different modalities of data: hashtags, caption words, and image tags automatically extracted using a computer vision tool. Results: We identified 47 health-related topics in the data (kappa=.77), covering ten broad categories: acute illness, alternative medicine, chronic illness and pain, diet, exercise, health care \& medicine, mental health, musculoskeletal health and dermatology, sleep, and substance use. The most prevalent topics were related to diet (8,293/96,426; 8.6\% of posts) and exercise (7,328/96,426; 7.6\% of posts). Conclusions: A large and diverse set of health topics are discussed in Instagram. The extracted image tags were generally too coarse and noisy to be used for identifying posts but were in some cases accurate for identifying images relevant to studying diet and substance use. Instagram shows potential as a source of public health information, though limitations in data collection and metadata availability may limit its use in comparison to platforms like Twitter. ",
doi="10.2196/10150",
url="http://publichealth.jmir.org/2018/2/e10150/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29959106"
}


@Article{info:doi/10.2196/10332,
author="Bernard, Florian
and Lem{\'e}e, Jean-Michel
and Aubin, Ghislaine
and Ter Minassian, Aram
and Menei, Philippe",
title="Using a Virtual Reality Social Network During Awake Craniotomy to Map Social Cognition: Prospective Trial",
journal="J Med Internet Res",
year="2018",
month="Jun",
day="26",
volume="20",
number="6",
pages="e10332",
keywords="virtual reality",
keywords="neurosurgery",
keywords="social cognition",
keywords="awake surgery",
abstract="Background: In awake craniotomy, it is possible to temporarily inactivate regions of the brain using direct electrical stimulation, while the patient performs neuropsychological tasks. If the patient shows decreased performance in a given task, the neurosurgeon will not remove these regions, so as to maintain all brain functions. Objective: The objective of our study was to describe our experience of using a virtual reality (VR) social network during awake craniotomy and discuss its future applications for perioperative mapping of nonverbal language, empathy, and theory of mind. Methods: This was a single-center, prospective, unblinded trial. During wound closure, different VR experiences with a VR headset were proposed to the patient. This project sought to explore interactions with the neuropsychologist's avatar in virtual locations using a VR social network as an available experience. Results: Three patients experienced VR. Despite some limitations due to patient positioning during the operation and the limitation of nonverbal cues inherent to the app, the neuropsychologist, as an avatar, could communicate with the patient and explore gesture communication while wearing a VR headset. Conclusions: With some improvements, VR social networks can be used in the near future to map social cognition during awake craniotomy. Trial Registration: ClinicalTrials.gov NCT03010943; https://clinicaltrials.gov/ct2/show/NCT03010943 (Archived at WebCite at http://www.webcitation.org/70CYDil0P) ",
doi="10.2196/10332",
url="http://www.jmir.org/2018/6/e10332/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29945859"
}


@Article{info:doi/10.2196/jmir.9355,
author="Hendriks, Hanneke
and Van den Putte, Bas
and Gebhardt, A. Winifred
and Moreno, A. Megan",
title="Social Drinking on Social Media: Content Analysis of the Social Aspects of Alcohol-Related Posts on Facebook and Instagram",
journal="J Med Internet Res",
year="2018",
month="Jun",
day="22",
volume="20",
number="6",
pages="e226",
keywords="social media",
keywords="alcohol drinking",
keywords="social interaction",
abstract="Background: Alcohol is often consumed in social contexts. An emerging social context in which alcohol is becoming increasingly apparent is social media. More and more young people display alcohol-related posts on social networking sites such as Facebook and Instagram. Objective: Considering the importance of the social aspects of alcohol consumption and social media use, this study investigated the social content of alcohol posts (ie, the evaluative social context and presence of people) and social processes (ie, the posting of and reactions to posts) involved with alcohol posts on social networking sites. Methods: Participants (N=192; mean age 20.64, SD 4.68 years, 132 women and 54 men) gave researchers access to their Facebook and/or Instagram profiles, and an extensive content analysis of these profiles was conducted. Coders were trained and then coded all screenshotted timelines in terms of evaluative social context, presence of people, and reactions to post. Results: Alcohol posts of youth frequently depict alcohol in a positive social context (425/438, 97.0\%) and display people holding drinks (277/412, 67.2\%). In addition, alcohol posts were more often placed on participants' timelines by others (tagging; 238/439, 54.2\%) than posted by participants themselves (201/439, 45.8\%). Furthermore, it was revealed that such social posts received more likes (mean 35.50, SD 26.39) and comments than nonsocial posts (no people visible; mean 10.34, SD 13.19, P<.001). Conclusions: In terms of content and processes, alcohol posts on social media are social in nature and a part of young people's everyday social lives. Interventions aiming to decrease alcohol posts should therefore focus on the broad social context of individuals in which posting about alcohol takes place. Potential intervention strategies could involve making young people aware that when they post about social gatherings in which alcohol is visible and tag others, it may have unintended negative consequences and should be avoided. ",
doi="10.2196/jmir.9355",
url="http://www.jmir.org/2018/6/e226/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29934290"
}


@Article{info:doi/10.2196/10176,
author="Litchman, L. Michelle
and Snider, Christopher
and Edelman, S. Linda
and Wawrzynski, E. Sarah
and Gee, M. Perry",
title="Diabetes Online Community User Perceptions of Successful Aging With Diabetes: Analysis of a \#DSMA Tweet Chat",
journal="JMIR Aging",
year="2018",
month="Jun",
day="22",
volume="1",
number="1",
pages="e10176",
keywords="diabetes",
keywords="aging",
keywords="social media",
keywords="Twitter",
abstract="Background: According to the American Diabetes Association, there are approximately 30.3 million Americans with diabetes, and the incidence is growing by nearly 1.5 million cases per year. These individuals are at particularly high risk of developing secondary comorbid conditions related to diabetes and aging. Nearly 45\% of individuals aged 65 to 75 years use social media, and this number is steadily growing. The use of social media provides the opportunity to assess the perceptions and needs of this population. Objective: The purpose of this study was to examine stakeholder perceptions of successful aging with diabetes. Methods: This study presents a retrospective analysis of a tweet chat focused on aging with diabetes. Tweets were collected using Symplur Signals data analytics software (Symplur LLC) and analyzed for content analysis, sentiment, and participant demographics. Two authors reviewed discussion posts for accuracy of analysis. Results: A total of 59 individuals participated in this tweet chat generating 494 tweets and nearly 2 million impressions. Most (36/59, 63\%) tweet chat participants were people living with diabetes; 25\% (14/59) were caregivers and advocates. Seven countries were represented in the conversation. A majority (352/494, 71.3\%) of the tweets indicated positive sentiment related to aging with diabetes. Five major themes emerged from the qualitative analysis: (1) personal decline now and in the future, (2) limited access to treatment, (3) inability to provide self-care, (4) health care provider capacity to support aging with diabetes, and (5) life-long online peer health support to facilitate diabetes management. Conclusions: Individuals with diabetes are living longer and want to be supported with specialized care and access to technology that will allow them to successfully age. Aging- and diabetes-related changes may complicate diabetes management into old age. People with diabetes desire options including aging in place; therefore, special training for care partners and health care providers who care for older adults is needed. ",
doi="10.2196/10176",
url="http://aging.jmir.org/2018/1/e10176/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31518231"
}


@Article{info:doi/10.2196/jmir.9461,
author="Guillory, Jamie
and Wiant, F. Kristine
and Farrelly, Matthew
and Fiacco, Leah
and Alam, Ishrat
and Hoffman, Leah
and Crankshaw, Erik
and Delahanty, Janine
and Alexander, N. Tesfa",
title="Recruiting Hard-to-Reach Populations for Survey Research: Using Facebook and Instagram Advertisements and In-Person Intercept in LGBT Bars and Nightclubs to Recruit LGBT Young Adults",
journal="J Med Internet Res",
year="2018",
month="Jun",
day="18",
volume="20",
number="6",
pages="e197",
keywords="sexual minorities",
keywords="social media",
keywords="public health",
keywords="tobacco",
keywords="survey methods",
keywords="transgender persons",
abstract="Background: Tobacco public education campaigns focus increasingly on hard-to-reach populations at higher risk for smoking, prompting campaign creators and evaluators to develop strategies to reach hard-to-reach populations in virtual and physical spaces where they spend time. Objective: The aim of this study was to describe two novel recruitment strategies (in-person intercept interviews in lesbian, gay, bisexual, and transgender [LGBT] social venues and targeted social media ads) and compares characteristics of participants recruited via these strategies for the US Food and Drug Administration's This Free Life campaign evaluation targeting LGBT young adults who smoke cigarettes occasionally. Methods: We recruited LGBT adults aged 18-24 years in the United States via Facebook and Instagram ads (N=1709, mean age 20.94, SD 1.94) or intercept in LGBT social venues (N=2348, mean age 21.98, SD 1.69) for the baseline evaluation survey. Covariates related to recruitment strategy were age; race or ethnicity; LGBT identity; education; pride event attendance; and alcohol, cigarette, and social media use. Results: Lesbian or gay women (adjusted odds ratio, AOR 1.88, 95\% CI 1.54-2.29, P<.001), bisexual men and women (AOR 1.46, 95\% CI 1.17-1.82, P=.001), gender minorities (AOR 1.68, 95\% CI 1.26-2.25, P<.001), and other sexual minorities (AOR 2.48, 95\% CI 1.62-3.80, P<.001) were more likely than gay men to be recruited via social media (than intercept). Hispanic (AOR 0.73, 95\% CI 0.61-0.89, P=.001) and other or multiracial, non-Hispanic participants (AOR 0.70, 95\% CI 0.54-0.90, P=.006) were less likely than white, non-Hispanic participants to be recruited via social media. As age increased, odds of recruitment via social media decreased (AOR 0.76, 95\% CI 0.72-0.80, P<.001). Participants with some college education (AOR 1.27, 95\% CI 1.03-1.56, P=.03) were more likely than those with a college degree to be recruited via social media. Participants reporting past 30-day alcohol use were less likely to be recruited via social media (AOR 0.33, 95\% CI 0.24-0.44, P<.001). Participants who reported past-year pride event attendance were more likely to be recruited via social media (AOR 1.31, 95\% CI 1.06-1.64, P=.02), as well as those who used Facebook at least once daily (AOR 1.43, 95\% CI 1.14-1.80, P=.002). Participants who reported using Instagram at least once daily were less likely to be recruited via social media (AOR 0.73, 95\% CI 0.62-0.86, P<.001). Social media recruitment was faster (incidence rate ratio, IRR=3.31, 95\% CI 3.11-3.52, P<.001) and less expensive (2.2\% of combined social media and intercept recruitment cost) but had greater data quality issues---a larger percentage of social media respondents were lost because of duplicate and low-quality responses (374/4446, 8.41\%) compared with intercept respondents lost to interviewer misrepresentation (15/4446, 0.34\%; P<.001). Conclusions: Social media combined with intercept provided access to important LGBT subpopulations (eg, gender and other sexual minorities) and a more diverse sample. Social media methods have more data quality issues but are faster and less expensive than intercept. Recruiting hard-to-reach populations via audience-tailored strategies enabled recruitment of one of the largest LGBT young adult samples, suggesting these methods' promise for accessing hard-to-reach populations. ",
doi="10.2196/jmir.9461",
url="http://www.jmir.org/2018/6/e197/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29914861"
}


@Article{info:doi/10.2196/jmir.9156,
author="Easton, Stephanie
and Morton, Katherine
and Tappy, Zara
and Francis, Daniella
and Dennison, Laura",
title="Young People's Experiences of Viewing the Fitspiration Social Media Trend: Qualitative Study",
journal="J Med Internet Res",
year="2018",
month="Jun",
day="18",
volume="20",
number="6",
pages="e219",
keywords="Social media",
keywords="Fitspiration",
keywords="behaviour",
keywords="health",
keywords="body image",
keywords="self-esteem",
keywords="eating disorders",
keywords="qualitative research",
keywords="focus groups",
keywords="interviews",
abstract="Background: Social media use has become ubiquitous in the lives of many people, especially young adults. A popular recent trend emerging on social media is that of posting and following `Fitspirational' content - material that purports to motivate and showcase healthy lifestyle habits, particularly relating to exercise and diet. There is very limited existing literature on how engaging with this type of content influences people's psychological and physical heath. Initial studies have focused on concerns over potential negative effects on psychological wellbeing including body image, self-esteem and eating disorders. Objective: We aimed to address a gap in the literature for exploratory research on this topic from the perspective of users. We used a qualitative approach to explore how people experience viewing Fitspiration on social media including why and how they engage with this material and how they perceive that it affects their thoughts, emotions, behaviour and health. Methods: We recruited 20 young adults (14 females, 6 males, aged 18-25) who self-declared themselves to be Fitspiration followers to participate in either focus groups or individual interviews. We asked detailed, open-ended questions about their motivations for following Fitspiration, experiences of viewing this content and its perceived impact. We used inductive thematic analysis to derive themes that represented common and salient features of the data set. Results: Four main themes were developed: 1) A tool with the potential to support healthy living, 2) Unrealistic, untrustworthy content, 3) Negative effects on emotional wellbeing, and 4) Vulnerability and protective factors. Following Fitspirational posts on social media can provide young people with knowledge and motivation that may support healthy lifestyle behaviours. However, a range of harms also appeared to arise from Fitspiration viewing ranging from minor annoyances and frustrations to more meaningful negative effects on psychological \& physical health. These negative effects seemed to persist despite individuals acknowledging that the material can be unrealistic, and believing that they are personally equipped to minimise harms to themselves. Conclusions: This study suggests that Fitspiration on social media can be attractive and compelling for young people but appears to bring about negative as well as positive effects. Future research should aim to confirm the scale and intensity of positive and negative effects and investigate ways of harnessing desirable outcomes and minimising undesirable outcomes. ",
doi="10.2196/jmir.9156",
url="http://www.jmir.org/2018/6/e219/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29914859"
}


@Article{info:doi/10.2196/10227,
author="Klassen, Michelle Karen
and Borleis, S. Emily
and Brennan, Linda
and Reid, Mike
and McCaffrey, A. Tracy
and Lim, SC Megan",
title="What People ``Like'': Analysis of Social Media Strategies Used by Food Industry Brands, Lifestyle Brands, and Health Promotion Organizations on Facebook and Instagram",
journal="J Med Internet Res",
year="2018",
month="Jun",
day="14",
volume="20",
number="6",
pages="e10227",
keywords="nutrition",
keywords="social media",
keywords="Facebook",
keywords="Instagram",
keywords="health promotion",
abstract="Background: Health campaigns have struggled to gain traction with young adults using social media, even though more than 80\% of young adults are using social media at least once per day. Many food industry and lifestyle brands have been successful in achieving high levels of user engagement and promoting their messages; therefore, there may be lessons to be learned by examining the successful strategies commercial brands employ. Objective: This study aims to identify and quantify social media strategies used by the food industry and lifestyle brands, and health promotion organizations across the social networking sites Facebook and Instagram. Methods: The six most engaging posts from the 10 most popular food industry and lifestyle brands and six health promotion organizations were included in this study. A coding framework was developed to categorize social media strategies, and engagement metrics were collected. Exploratory linear regression models were used to examine associations between strategies used and interactions on Facebook and Instagram. Results: Posts from Facebook (143/227, 63.0\%) and Instagram (84/227, 37.0\%) were included. Photos (64\%) and videos (34\%) were used to enhance most posts. Different strategies were most effective for Facebook and Instagram. Strategies associated with higher Facebook interactions included links to purchasable items (beta=0.81, 95\% CI 0.50 to 1.13, P<.001) featuring body image messages compared with food content (beta=1.96, 95\% CI 1.29 to 2.64, P<.001), and where the content induced positive emotions (beta=0.31, 95\% CI 0.04 to 0.57, P=.02). Facebook interactions were negatively associated with using pop culture (beta=--0.67, 95\% CI --0.99 to --0.34, P<.001), storytelling (beta=--0.86, 95\% CI --1.29 to --0.43, P<.001) or visually appealing graphics (beta=--0.53, 95\% CI --0.78 to --0.28, P<.001) in their posts compared with other strategies. Posting relatable content was negatively associated with interactions on Facebook (beta=--0.29, 95\% CI --0.53 to --0.06, P=.01), but positively associated on Instagram (beta=0.50, 95\% CI 0.05 to 0.95, P=.03). Instagram interactions were negatively associated with weight loss (beta=--1.45, 95\% CI --2.69 to --0.21, P=.02) and other content (beta=--0.81, 95\% CI --1.57 to --.06, P=.04) compared with food content. Conclusions: Health promotion professionals and organizations can improve engagement using positive messaging and tailoring posts appropriate for different social media channels. ",
doi="10.2196/10227",
url="http://www.jmir.org/2018/6/e10227/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29903694"
}


@Article{info:doi/10.2196/ijmr.9554,
author="Bosak, Kelly
and Park, Hye Shin",
title="Characteristics of Adults' Use of Facebook and the Potential Impact on Health Behavior: Secondary Data Analysis",
journal="Interact J Med Res",
year="2018",
month="Jun",
day="14",
volume="7",
number="1",
pages="e11",
keywords="social media",
keywords="health promotion",
keywords="health behavior",
keywords="adults",
abstract="Background: Social influences are a primary factor in the adoption of health behaviors. Social media platforms, such as Facebook, disseminate information, raise awareness, and provide motivation and support for positive health behaviors. Facebook has evolved rapidly and is now a part of many individuals' daily routine. The high degree of individual engagement and low attrition rate of this platform necessitate consideration for a potentially positive impact on health behavior. Objective: The aim of this paper is to investigate the use of Facebook by adults. Knowledge is limited to the unique characteristics of Facebook users, including time spent on Facebook by adults of various age groups. Characteristics of Facebook users are important to understand to direct efforts to engage adults in future health behavior interventions. Methods: Institutional Review Board approval was obtained for this secondary analysis of existing de-identified survey data collected for the Pew Research Center. The sample included adults age 18-65 years and above. Binomial logistic regression was performed for the model of age group and Facebook use, controlling for other demographics. A multinomial logistic regression model was used for the variable of time spent on Facebook. Based on the regression models, we computed and reported the marginal effects on Facebook use and time spent of adults age groups, including age groups 18-29, 30-49, 50-64, and 65 and over. We discuss these findings in the context of the implications for promoting positive health behaviors. Results: The demographics of the final sample (N=730) included adults age 18-65 years and above (mean 48.2 yrs, SD 18.3 yrs). The majority of the participants were female (372/730, 50.9\%), white (591/730, 80.9\%) and non-Hispanic (671/730, 91.9\%). Bivariate analysis indicated that Facebook users and nonusers differed significantly by age group ($\chi$2=76.71, P<.001) and sex ($\chi$2=9.04, P=.003). Among subjects aged 50 and above, the predicted probability was 66\% for spending the same amount of time, 10\% with increased time, and 24\% with decreased time. Conclusions: The key findings of this study were Facebook use among midlife and older adults was more likely to stay the same over time, compared to the other age groups. Interestingly, the young adult age group 18-29 years was more likely to decrease their time on Facebook over time. Specifically, younger females were most likely to decrease time spent on Facebook. In general, male participants were most likely to spend the same amount of time on Facebook. These findings have implications for future health intervention research, and ultimately, for translation to the clinic setting to improve health outcomes. ",
doi="10.2196/ijmr.9554",
url="http://www.i-jmr.org/2018/1/e11/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29903698"
}


@Article{info:doi/10.2196/jmir.9870,
author="Keller, Sophie Michelle
and Mosadeghi, Sasan
and Cohen, R. Erica
and Kwan, James
and Spiegel, Ross Brennan Mason",
title="Reproductive Health and Medication Concerns for Patients With Inflammatory Bowel Disease: Thematic and Quantitative Analysis Using Social Listening",
journal="J Med Internet Res",
year="2018",
month="Jun",
day="11",
volume="20",
number="6",
pages="e206",
keywords="pregnancy",
keywords="breastfeeding",
keywords="reproductive health",
keywords="social media",
keywords="medication adherence",
keywords="infodemiology",
keywords="pharmacovigilance",
abstract="Background: Inflammatory bowel disease (IBD) affects many individuals of reproductive age. Most IBD medications are safe to use during pregnancy and breastfeeding; however, observational studies find that women with IBD have higher rates of voluntary childlessness due to fears about medication use during pregnancy. Understanding why and how individuals with IBD make decisions about medication adherence during important reproductive periods can help clinicians address patient fears about medication use. Objective: The objective of this study was to gain a more thorough understanding of how individuals taking IBD medications during key reproductive periods make decisions about their medication use. Methods: We collected posts from 3000 social media sites posted over a 3-year period and analyzed the posts using qualitative descriptive content analysis. The first level of analysis, open coding, identified individual concepts present in the social media posts. We subsequently created a codebook from significant or frequently occurring codes in the data. After creating the codebook, we reviewed the data and coded using our focused codes. We organized the focused codes into larger thematic categories. Results: We identified 7 main themes in 1818 social media posts. Individuals used social media to (1) seek advice about medication use related to reproductive health (13.92\%, 252/1818); (2) express beliefs about the safety of IBD therapies (7.43\%, 135/1818); (3) discuss personal experiences with medication use (16.72\%, 304/1818); (4) articulate fears and anxieties about the safety of IBD therapies (11.55\%, 210/1818); (5) discuss physician-patient relationships (3.14\%, 57/1818); (6) address concerns around conception, infertility, and IBD medications (17.38\%, 316/1818); and (7) talk about IBD symptoms during and after pregnancy and breastfeeding periods (11.33\%, 206/1818). Conclusions: Beliefs around medication safety play an important role in whether individuals with IBD decide to take medications during pregnancy and breastfeeding. Having a better understanding about why patients stop or refuse to take certain medications during key reproductive periods may allow clinicians to address specific beliefs and attitudes during office visits. ",
doi="10.2196/jmir.9870",
url="http://www.jmir.org/2018/6/e206/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29891471"
}


@Article{info:doi/10.2196/cancer.7952,
author="Kalf, RJ Rachel
and Makady, Amr
and ten Ham, MT Renske
and Meijboom, Kim
and Goettsch, G. Wim
and ",
title="Use of Social Media in the Assessment of Relative Effectiveness: Explorative Review With Examples From Oncology",
journal="JMIR Cancer",
year="2018",
month="Jun",
day="08",
volume="4",
number="1",
pages="e11",
keywords="social media",
keywords="relative effectiveness",
keywords="real-world data",
keywords="patient reported outcomes",
abstract="Background: An element of health technology assessment constitutes assessing the clinical effectiveness of drugs, generally called relative effectiveness assessment. Little real-world evidence is available directly after market access, therefore randomized controlled trials are used to obtain information for relative effectiveness assessment. However, there is growing interest in using real-world data for relative effectiveness assessment. Social media may provide a source of real-world data. Objective: We assessed the extent to which social media-generated health data has provided insights for relative effectiveness assessment. Methods: An explorative literature review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to identify examples in oncology where health data were collected using social media. Scientific and grey literature published between January 2010 and June 2016 was identified by four reviewers, who independently screened studies for eligibility and extracted data. A descriptive qualitative analysis was performed. Results: Of 1032 articles identified, eight were included: four articles identified adverse events in response to cancer treatment, three articles disseminated quality of life surveys, and one study assessed the occurrence of disease-specific symptoms. Several strengths of social media-generated health data were highlighted in the articles, such as efficient collection of patient experiences and recruiting patients with rare diseases. Conversely, limitations included validation of authenticity and presence of information and selection bias. Conclusions: Social media may provide a potential source of real-world data for relative effectiveness assessment, particularly on aspects such as adverse events, symptom occurrence, quality of life, and adherence behavior. This potential has not yet been fully realized and the degree of usefulness for relative effectiveness assessment should be further explored. ",
doi="10.2196/cancer.7952",
url="http://cancer.jmir.org/2018/1/e11/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29884607"
}


@Article{info:doi/10.2196/jmir.8882,
author="Sarkar, Urmimala
and Le, M. Gem
and Lyles, R. Courtney
and Ramo, Danielle
and Linos, Eleni
and Bibbins-Domingo, Kirsten",
title="Using Social Media to Target Cancer Prevention in Young Adults: Viewpoint",
journal="J Med Internet Res",
year="2018",
month="Jun",
day="05",
volume="20",
number="6",
pages="e203",
keywords="cancer",
keywords="prevention \& control",
keywords="young adult",
keywords="behavior",
keywords="social media",
doi="10.2196/jmir.8882",
url="http://www.jmir.org/2018/6/e203/"
}


@Article{info:doi/10.2196/publichealth.9594,
author="Vassallo, Jo Amy
and Kelly, Bridget
and Zhang, Lelin
and Wang, Zhiyong
and Young, Sarah
and Freeman, Becky",
title="Junk Food Marketing on Instagram: Content Analysis",
journal="JMIR Public Health Surveill",
year="2018",
month="Jun",
day="05",
volume="4",
number="2",
pages="e54",
keywords="food and beverage",
keywords="advertisements",
keywords="social media",
abstract="Background: Omnipresent marketing of processed foods is a key driver of dietary choices and brand loyalty. Market data indicate a shift in food marketing expenditures to digital media, including social media. These platforms have greater potential to influence young people, given their unique peer-to-peer transmission and youths' susceptibility to social pressures. Objective: The aim of this study was to investigate the frequency of images and videos posted by the most popular, energy-dense, nutrient-poor food and beverage brands on Instagram and the marketing strategies used in these images, including any healthy choice claims. Methods: A content analysis of 15 accounts was conducted, using 12 months of Instagram posts from March 15, 2015, to March 15, 2016. A pre-established hierarchical coding guide was used to identify the primary marketing strategy of each post. Results: Each brand used 6 to 11 different marketing strategies in their Instagram accounts; however, they often adhered to an overall theme such as athleticism or relatable consumers. There was a high level of branding, although not necessarily product information on all accounts, and there were very few health claims. Conclusions: Brands are using social media platforms such as Instagram to market their products to a growing number of consumers, using a high frequency of targeted and curated posts that manipulate consumer emotions rather than present information about their products. Policy action is needed that better reflects the current media environment. Public health bodies also need to engage with emerging media platforms and develop compelling social counter-marketing campaigns. ",
doi="10.2196/publichealth.9594",
url="http://publichealth.jmir.org/2018/2/e54/"
}


@Article{info:doi/10.2196/mhealth.7657,
author="Saez, Laura
and Langlois, Johanne
and Legrand, Karine
and Quinet, Marie-H{\'e}l{\`e}ne
and Lecomte, Edith
and Omorou, Y. Abdou
and Brian{\c{c}}on, Serge
and ",
title="Reach and Acceptability of a Mobile Reminder Strategy and Facebook Group Intervention for Weight Management in Less Advantaged Adolescents: Insights From the PRALIMAP-IN{\`E}S Trial",
journal="JMIR Mhealth Uhealth",
year="2018",
month="May",
day="18",
volume="6",
number="5",
pages="e110",
keywords="adolescent",
keywords="social media",
keywords="text messaging",
keywords="overweight",
keywords="socioeconomic factors",
keywords="weight loss",
abstract="Background: Although information and communication technology interventions appear to be a promising means of reducing the health inequality gap in overweight and obesity prevention, research on information and communication technology interventions is lacking outside the Anglo-Saxon world. Objective: The aim of this study was to assess the reach and acceptability of 2 information and communication technology interventions delivered as part of a French nutritional program: an SMS text messaging (short message service, SMS) attendance-reminder for collective sessions strategy and a Facebook challenge group. Methods: This study sample comprised 262 socially less advantaged overweight adolescents aged between 13 and 18 years. The information and communication technology interventions were carried out during the 2013-2014 academic year in 33 French state-run schools. For the SMS attendance-reminder for collective sessions strategy, at the start of the academic year, adolescents were asked to give their mobile number. SMS attendance-reminders were sent shortly before each of the 5 collective sessions. For the Facebook challenge group, adolescents were invited to join a closed Facebook group in which challenges on physical activity and on diet were posted weekly. Process data and 2 sets of face-to-face interviews were also used to interpret participation rates and access to Facebook. Appreciation for both interventions was evaluated by a questionnaire at the end of the academic year. Results: Of the recruited adolescents, 79.0\% (207/262) gave their mobile number, reflecting high access to a mobile phone. Giving a number was significantly more likely for girls (odds ratio [OR] 2.1, 95\% CI 1.1-3.9; P=.02) and adolescents in a vocational or general high school as opposed to middle school (OR 1.0, 95\% CI 0.4-2.7; OR 0.2, 95\% CI 0.1-0.5; P<.001). Indicating a mobile number at the start of the year was not significantly associated with participation in collective sessions. Of the adolescents seen at the start-of-year face-to-face interviews, 78.1\% (153/196) declared an interest in the Facebook challenge group, which implies having a Facebook account or being able to have access to one. However, only 21 adolescents went through the process of joining the group. Although there was satisfaction with the Facebook group among the participants, the low participation rate in the Facebook group does not allow conclusions to be drawn with confidence. Conclusions: The results are in line with the claim that using information and communication technologies in health programs is unlikely to widen health inequalities. However, in this population of French adolescents, mobile phone strategies seem more adapted to a high school context, and caution should be exercised with a younger audience. Although there is positive appreciation of the SMS attendance-reminders and a Facebook intervention is initially highly appealing to less advantaged adolescents, no evidence of impact could be demonstrated. These results highlight the difficulty in assessing the impact of specific interventions in complex health programs. Trial Registration: Clinicaltrials.gov NCT01688453; https://clinicaltrials.gov/ct2/show/NCT01688453 (Archived by WebCite at http://www.webcitation.org/6yy6EQ0SM) ",
doi="10.2196/mhealth.7657",
url="http://mhealth.jmir.org/2018/5/e110/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29776897"
}


@Article{info:doi/10.2196/jmir.9549,
author="Kordzadeh, Nima
and Young, K. Diana",
title="Exploring Hospitals' Use of Facebook: Thematic Analysis",
journal="J Med Internet Res",
year="2018",
month="May",
day="16",
volume="20",
number="5",
pages="e190",
keywords="social media",
keywords="qualitative research",
keywords="social networking",
keywords="health care providers",
abstract="Background: Although health care organizations such as hospitals and clinics have widely embraced social media as a means to educate the community on health topics and increase patient loyalty and satisfaction, little is known about the content these organizations actually share when using social media channels. Objective: This study aimed to explore the types of content US hospitals post on their Facebook pages and how hospitals' Facebook activities differ with regard to content types. Methods: We collected and thematically analyzed more than 1700 Facebook posts made over a 3-month period by 17 US hospitals. During the first phase, the 2 researchers coded a set of 159 posts and created an initial thematic web of content. During the second phase, the researchers coded the remaining posts and then revised, refined, and validated the initial web of content accordingly. Coding consensus was achieved on 1184 of the 1548 analyzable sampled posts (76.49\%). Results: We identified a list of 13 unique health social media post themes and classified those themes into 3 thematic groups that included announcing, sharing, and recognizing activities. The most frequently used theme was sharing health information, which appeared in 35.81\% (424/1184) of the posts analyzed. Such posts sought to provide health tips and advice to community members. Recognizing special days and recognizing employees were the second and third most frequently used themes, respectively, with 14.95\% (177/1184) and 11.82\% (140/1184) of the posts containing those themes. The frequency of these themes was surprising as the content was geared more toward stakeholders internal to the organization, although most previous literature has focused on social media as a tool to connect with external stakeholders. In addition, we found many of the posts involved more than one theme, and selected sets of themes co-occurred frequently. For example, 25.4\% (45/177) of the posts recognizing special days also included content to share health information, and approximately 38\% (32/85) of the posts announcing research activities also included content to share health information. Finally, we found similarities and differences between the sampled hospitals in terms of the types of content they posted more frequently on their Facebook pages. Conclusions: Hospitals use Facebook as an inexpensive way to educate people on health and wellness topics and to communicate different types of information and news to the public audience. Hospitals and clinics that are expanding their social media activities or are starting to embark on social media strategies can use the results of this study to better formulate their activities on Facebook. ",
doi="10.2196/jmir.9549",
url="http://www.jmir.org/2018/5/e190/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29769173"
}


@Article{info:doi/10.2196/derma.8482,
author="Maganty, Nishita
and Ilyas, Muneeb
and Ginsberg, Zachary
and Sharma, Amit",
title="Social Media as a Platform for Information and Support for Melanoma Patients: Analysis of Melanoma Facebook Groups and Pages",
journal="JMIR Dermatol",
year="2018",
month="May",
day="16",
volume="1",
number="1",
pages="e2",
keywords="Facebook",
keywords="melanoma",
keywords="online health information",
keywords="patient education",
keywords="support",
keywords="health promotion",
abstract="Background: Social media is increasingly used as a source of health information and is useful for information exchange and patient support. Objective: The aim of this study is to describe the Facebook groups and pages that are available for melanoma patients. Methods: A systematic search of Facebook groups and pages was performed using the word ``melanoma.'' The first 50 pages found in the search, sorted by most relevant, were analyzed for several characteristics, namely page name, category, verification status, number of likes, number of followers, visitor posts per week, page posts per week, ability to donate, date of inception, and for-profit or nonprofit. The first 50 groups found in the search, sorted by most relevant, were analyzed for name, category, number of members, and privacy setting. Results: There were 669 pages and 568 groups related to melanoma found on Facebook. The first 50 pages had a combined total of 266,709 likes and 257,183 followers and, of these, 30\% (15/50) were verified by Facebook. Within the analyzed Facebook pages, the average number of visitor posts per week was 0.48, the average number of posts by the page per week was 5.6, and the most common page categories were community and nonprofit. Of the 50 groups analyzed, 18 were public and 32 were private (closed). The total number of combined group members in all 50 groups was found to be 23,047 and 52\% (26/50) of the groups were categorized as support. Conclusions: Melanoma pages and groups on Facebook reach a large portion of the population. To provide resources for the population of patients diagnosed with malignant melanoma and ensure that proper information is distributed, physicians and health care organizations may consider using Facebook as a platform to support and educate patients with melanoma. ",
doi="10.2196/derma.8482",
url="https://derma.jmir.org/2018/1/e2/"
}


@Article{info:doi/10.2196/mental.8509,
author="Liu, Lin Lucia
and Li, MH Tim
and Teo, R. Alan
and Kato, A. Takahiro
and Wong, WC Paul",
title="Harnessing Social Media to Explore Youth Social Withdrawal in Three Major Cities in China: Cross-Sectional Web Survey",
journal="JMIR Ment Health",
year="2018",
month="May",
day="10",
volume="5",
number="2",
pages="e34",
keywords="adolescent",
keywords="social withdrawal",
keywords="hikikomori",
keywords="youth social issues",
keywords="Web survey",
keywords="China",
abstract="Background: Socially withdrawn youth belong to an emerging subgroup of youth who are not in employment, education, or training and who have limited social interaction intention and opportunities. The use of the internet and social media is expected to be an alternative and feasible way to reach this group of young people because of their reclusive nature. Objective: The aim of this study was to explore the possibility of using various social media platforms to investigate the existence of the phenomenon of youth social withdrawal in 3 major cities in China. Methods: A cross-sectional open Web survey was conducted from October 2015 to May 2016 to identify and reach socially withdrawn youth in 3 metropolitan cities in China: Beijing, Shanghai, and Shenzhen. To advertise the survey, 3 social media platforms were used: Weibo, WeChat, and Wandianba, a social networking gaming website. Results: In total, 137 participants completed the survey, among whom 13 (9.5\%) were identified as belonging to the withdrawal group, 7 (5.1\%) to the asocial group, and 9 (6.6\%) to the hikikomori group (both withdrawn and asocial for more than 3 months). The cost of recruitment via Weibo was US \$7.27 per participant. Conclusions: Several social media platforms in China are viable and inexpensive tools to reach socially withdrawn youth, and internet platforms that specialize in a certain culture or type of entertainment appeared to be more effective in reaching socially withdrawn youth. ",
doi="10.2196/mental.8509",
url="http://mental.jmir.org/2018/2/e34/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29748164"
}


@Article{info:doi/10.2196/publichealth.8214,
author="Bollegala, Danushka
and Maskell, Simon
and Sloane, Richard
and Hajne, Joanna
and Pirmohamed, Munir",
title="Causality Patterns for Detecting Adverse Drug Reactions From Social Media: Text Mining Approach",
journal="JMIR Public Health Surveill",
year="2018",
month="May",
day="09",
volume="4",
number="2",
pages="e51",
keywords="machine learning",
keywords="ADR detection",
keywords="causality",
keywords="lexical patterns",
keywords="causality detection",
keywords="support vector machines",
abstract="Background: Detecting adverse drug reactions (ADRs) is an important task that has direct implications for the use of that drug. If we can detect previously unknown ADRs as quickly as possible, then this information can be provided to the regulators, pharmaceutical companies, and health care organizations, thereby potentially reducing drug-related morbidity and saving lives of many patients. A promising approach for detecting ADRs is to use social media platforms such as Twitter and Facebook. A high level of correlation between a drug name and an event may be an indication of a potential adverse reaction associated with that drug. Although numerous association measures have been proposed by the signal detection community for identifying ADRs, these measures are limited in that they detect correlations but often ignore causality. Objective: This study aimed to propose a causality measure that can detect an adverse reaction that is caused by a drug rather than merely being a correlated signal. Methods: To the best of our knowledge, this was the first causality-sensitive approach for detecting ADRs from social media. Specifically, the relationship between a drug and an event was represented using a set of automatically extracted lexical patterns. We then learned the weights for the extracted lexical patterns that indicate their reliability for expressing an adverse reaction of a given drug. Results: Our proposed method obtains an ADR detection accuracy of 74\% on a large-scale manually annotated dataset of tweets, covering a standard set of drugs and adverse reactions. Conclusions: By using lexical patterns, we can accurately detect the causality between drugs and adverse reaction--related events. ",
doi="10.2196/publichealth.8214",
url="http://publichealth.jmir.org/2018/2/e51/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29743155"
}


@Article{info:doi/10.2196/jmir.9267,
author="Seabrook, M. Elizabeth
and Kern, L. Margaret
and Fulcher, D. Ben
and Rickard, S. Nikki",
title="Predicting Depression From Language-Based Emotion Dynamics: Longitudinal Analysis of Facebook and Twitter Status Updates",
journal="J Med Internet Res",
year="2018",
month="May",
day="08",
volume="20",
number="5",
pages="e168",
keywords="automated text analysis",
keywords="depression",
keywords="Facebook",
keywords="Twitter",
keywords="emotions",
keywords="variability",
keywords="instability",
abstract="Background: Frequent expression of negative emotion words on social media has been linked to depression. However, metrics have relied on average values, not dynamic measures of emotional volatility. Objective: The aim of this study was to report on the associations between depression severity and the variability (time-unstructured) and instability (time-structured) in emotion word expression on Facebook and Twitter across status updates. Methods: Status updates and depression severity ratings of 29 Facebook users and 49 Twitter users were collected through the app MoodPrism. The average proportion of positive and negative emotion words used, within-person variability, and instability were computed. Results: Negative emotion word instability was a significant predictor of greater depression severity on Facebook (rs(29)=.44, P=.02, 95\% CI 0.09-0.69), even after controlling for the average proportion of negative emotion words used (partial rs(26)=.51, P=.006) and within-person variability (partial rs(26)=.49, P=.009). A different pattern emerged on Twitter where greater negative emotion word variability indicated lower depression severity (rs(49)=?.34, P=.01, 95\% CI ?0.58 to 0.09). Differences between Facebook and Twitter users in their emotion word patterns and psychological characteristics were also explored. Conclusions: The findings suggest that negative emotion word instability may be a simple yet sensitive measure of time-structured variability, useful when screening for depression through social media, though its usefulness may depend on the social media platform. ",
doi="10.2196/jmir.9267",
url="http://www.jmir.org/2018/5/e168/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29739736"
}


@Article{info:doi/10.2196/mental.8971,
author="Young, D. Sean
and Garett, Renee",
title="Ethical Issues in Addressing Social Media Posts About Suicidal Intentions During an Online Study Among Youth: Case Study",
journal="JMIR Ment Health",
year="2018",
month="May",
day="03",
volume="5",
number="2",
pages="e33",
keywords="suicide",
keywords="social media",
keywords="undergraduates",
doi="10.2196/mental.8971",
url="http://mental.jmir.org/2018/2/e33/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29724707"
}


@Article{info:doi/10.2196/jmir.8563,
author="Young, D. Sean",
title="Social Media as a New Vital Sign: Commentary",
journal="J Med Internet Res",
year="2018",
month="Apr",
day="30",
volume="20",
number="4",
pages="e161",
keywords="social media",
keywords="big data",
keywords="personal health records",
doi="10.2196/jmir.8563",
url="http://www.jmir.org/2018/4/e161/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29712631"
}


@Article{info:doi/10.2196/10029,
author="Mackey, Tim
and Kalyanam, Janani
and Klugman, Josh
and Kuzmenko, Ella
and Gupta, Rashmi",
title="Solution to Detect, Classify, and Report Illicit Online Marketing and Sales of Controlled Substances via Twitter: Using Machine Learning and Web Forensics to Combat Digital Opioid Access",
journal="J Med Internet Res",
year="2018",
month="Apr",
day="27",
volume="20",
number="4",
pages="e10029",
keywords="online pharmacies",
keywords="drug abuse",
keywords="opioid abuse",
keywords="machine learning",
keywords="unsupervised machine learning",
keywords="prescription drug misuse",
abstract="Background: On December 6 and 7, 2017, the US Department of Health and Human Services (HHS) hosted its first Code-a-Thon event aimed at leveraging technology and data-driven solutions to help combat the opioid epidemic. The authors---an interdisciplinary team from academia, the private sector, and the US Centers for Disease Control and Prevention---participated in the Code-a-Thon as part of the prevention track. Objective: The aim of this study was to develop and deploy a methodology using machine learning to accurately detect the marketing and sale of opioids by illicit online sellers via Twitter as part of participation at the HHS Opioid Code-a-Thon event. Methods: Tweets were collected from the Twitter public application programming interface stream filtered for common prescription opioid keywords in conjunction with participation in the Code-a-Thon from November 15, 2017 to December 5, 2017. An unsupervised machine learning--based approach was developed and used during the Code-a-Thon competition (24 hours) to obtain a summary of the content of the tweets to isolate those clusters associated with illegal online marketing and sale using a biterm topic model (BTM). After isolating relevant tweets, hyperlinks associated with these tweets were reviewed to assess the characteristics of illegal online sellers. Results: We collected and analyzed 213,041 tweets over the course of the Code-a-Thon containing keywords codeine, percocet, vicodin, oxycontin, oxycodone, fentanyl, and hydrocodone. Using BTM, 0.32\% (692/213,041) tweets were identified as being associated with illegal online marketing and sale of prescription opioids. After removing duplicates and dead links, we identified 34 unique ``live'' tweets, with 44\% (15/34) directing consumers to illicit online pharmacies, 32\% (11/34) linked to individual drug sellers, and 21\% (7/34) used by marketing affiliates. In addition to offering the ``no prescription'' sale of opioids, many of these vendors also sold other controlled substances and illicit drugs. Conclusions: The results of this study are in line with prior studies that have identified social media platforms, including Twitter, as a potential conduit for supply and sale of illicit opioids. To translate these results into action, authors also developed a prototype wireframe for the purposes of detecting, classifying, and reporting illicit online pharmacy tweets selling controlled substances illegally to the US Food and Drug Administration and the US Drug Enforcement Agency. Further development of solutions based on these methods has the potential to proactively alert regulators and law enforcement agencies of illegal opioid sales, while also making the online environment safer for the public. ",
doi="10.2196/10029",
url="http://www.jmir.org/2018/4/e10029/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29613851"
}


@Article{info:doi/10.2196/publichealth.8972,
author="Frye, Victoria
and Duffy, Louisa
and France, L. Janis
and Kessler, A. Debra
and Rebosa, Mark
and Shaz, H. Beth
and Carlson, W. Bruce
and France, R. Christopher",
title="The Development of a Social Networking--Based Relatedness Intervention Among Young, First-Time Blood Donors: Pilot Study",
journal="JMIR Public Health Surveill",
year="2018",
month="Apr",
day="26",
volume="4",
number="2",
pages="e44",
keywords="blood donation",
keywords="social media intervention",
keywords="donor identity",
keywords="internal motivation",
abstract="Background: Increasing repeat blood donation behavior is a critical public health goal. According to self-determination theory, the process of developing internal motivation to give blood and an associated self-identity as a blood donor may be promoted by feelings of ``relatedness'' or a connection to other donors, which may be enhanced through social relations and interactions. Objective: The purpose of this report it to describe the development and pilot testing of a social networking-based (Facebook) intervention condition designed to increase feelings of relatedness via virtual social interaction and support. Methods: To develop the intervention condition content, images, text, polls, and video content were assembled. Ohio University college students (N=127) rated the content (82 images/text) presented by computer in random order using a scale of one to five on various dimensions of relatedness. Mean ratings were calculated and analyses of variance were conducted to assess associations among the dimensions. Based on these results, the relatedness intervention was adapted and evaluated for feasibility, acceptability, and preliminary efficacy among 24 first-time donors, aged 18 to 24 years, in a 30-day pilot trial. Paired t-tests were conducted to examine change over time in relatedness and connectedness. Results: The intervention condition that was developed was acceptable and feasible. Results of the uncontrolled, preintervention, and postintervention evaluation revealed that feelings of individual-level relatedness increased significantly after the intervention. Conclusions: By promoting first-time blood donor relatedness, our goal is to enhance internal motivation for donating and the integration of the blood donor identity, thus increasing the likelihood of future repeat donation. Trial Registration: ClinicalTrials.gov NCT02717338; https://clinicaltrials.gov/ct2/show/NCT02717338 (Archived by WebCite at http://www.webcitation.org/6ymHRBCwu) ",
doi="10.2196/publichealth.8972",
url="http://publichealth.jmir.org/2018/2/e44/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29699961"
}


@Article{info:doi/10.2196/publichealth.7686,
author="Clyne, Wendy
and Pezaro, Sally
and Deeny, Karen
and Kneafsey, Rosie",
title="Using Social Media to Generate and Collect Primary Data: The \#ShowsWorkplaceCompassion Twitter Research Campaign",
journal="JMIR Public Health Surveill",
year="2018",
month="Apr",
day="23",
volume="4",
number="2",
pages="e41",
keywords="work engagement",
keywords="health personnel",
keywords="empathy",
keywords="attitude of health personnel",
abstract="Background: Compassion is a core value embedded in the concept of quality in healthcare. The need for compassion toward healthcare staff in the workplace, for their own health and well-being and also to enable staff to deliver compassionate care for patients, is increasingly understood. However, we do not currently know how healthcare staff understand and characterize compassion toward themselves as opposed to patients. Objective: The aim of this study was to use social media for the generation and collection of primary data to gain understanding of the concept of workplace compassion. Methods: Tweets that contained the hashtag \#ShowsWorkplaceCompassion were collected from Twitter and analyzed. The study took place between April 21 and May 21, 2016. Participants were self-selecting users of the social media service Twitter. The study was promoted by a number of routes: the National Health Service (NHS) England website, the personal Twitter accounts of the research team, internal NHS England communications, and via social media sharing. Participants were asked to contribute their views about what activities, actions, policies, philosophies or approaches demonstrate workplace compassion in healthcare using the hashtag \#ShowsWorkplaceCompassion. All tweets including the research hashtag \#ShowsWorkplaceCompassion were extracted from Twitter and studied using content analysis. Data concerning the frequency, nature, origin, and location of Web-based engagement with the research campaign were collected using Bitly (Bitly, Inc, USA) and Symplur (Symplur LLC, USA) software. Results: A total of 260 tweets were analyzed. Of the 251 statements within the tweets that were coded, 37.8\% (95/251) of the statements concerned Leadership and Management aspects of workplace compassion, 29.5\% (74/251) were grouped under the theme related to Values and Culture, 17.5\% (44/251) of the statements related to Personalized Policies and Procedures that support workplace compassion, and 15.2\% (38/251) of the statements concerned Activities and Actions that show workplace compassion. Content analysis showed that small acts of kindness, an embedded organizational culture of caring for one another, and recognition of the emotional and physical impact of healthcare work were the most frequently mentioned characteristics of workplace compassion in healthcare. Conclusions: This study presents a new and innovative research approach using Twitter. Although previous research has analyzed the nature and pattern of tweets retrospectively, this study used Twitter to both recruit participants and collect primary data. ",
doi="10.2196/publichealth.7686",
url="http://publichealth.jmir.org/2018/2/e41/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29685866"
}


@Article{info:doi/10.2196/jmir.9127,
author="Wu, Bing",
title="Patient Continued Use of Online Health Care Communities: Web Mining of Patient-Doctor Communication",
journal="J Med Internet Res",
year="2018",
month="Apr",
day="16",
volume="20",
number="4",
pages="e126",
keywords="health information management",
keywords="health communication",
keywords="information literacy",
keywords="social networking",
abstract="Background: In practice, online health communities have passed the adoption stage and reached the diffusion phase of development. In this phase, patients equipped with knowledge regarding the issues involved in health care are capable of switching between different communities to maximize their online health community activities. Online health communities employ doctors to answer patient questions, and high quality online health communities are more likely to be acknowledged by patients. Therefore, the factors that motivate patients to maintain ongoing relationships with online health communities must be addressed. However, this has received limited scholarly attention. Objective: The purpose of this study was to identify the factors that drive patients to continue their use of online health communities where doctor-patient communication occurs. This was achieved by integrating the information system success model with online health community features. Methods: A Web spider was used to download and extract data from one of the most authoritative Chinese online health communities in which communication occurs between doctors and patients. The time span analyzed in this study was from January 2017 to March 2017. A sample of 469 valid anonymous patients with 9667 posts was obtained (the equivalent of 469 respondents in survey research). A combination of Web mining and structural equation modeling was then conducted to test the research hypotheses. Results: The results show that the research framework for integrating the information system success model and online health community features contributes to our understanding of the factors that drive patients' relationships with online health communities. The primary findings are as follows: (1) perceived usefulness is found to be significantly determined by three exogenous variables (ie, social support, information quality, and service quality; R2=0.88). These variables explain 87.6\% of the variance in perceived usefulness of online health communities; (2) similarly, patient satisfaction was found to be significantly determined by the three variables listed above (R2=0.69). These variables explain 69.3\% of the variance seen in patient satisfaction; (3) continuance use (dependent variable) is significantly influenced by perceived usefulness and patient satisfaction (R2=0.93). That is, the combined effects of perceived usefulness and patient satisfaction explain 93.4\% of the variance seen in continuance use; and (4) unexpectedly, individual literacy had no influence on perceived usefulness and satisfaction of patients using online health communities. Conclusions: First, this study contributes to the existing literature on the continuance use of online health communities using an empirical approach. Second, an appropriate metric was developed to assess constructs related to the proposed research model. Additionally, a Web spider enabled us to acquire objective data relatively easily and frequently, thereby overcoming a major limitation of survey techniques. ",
doi="10.2196/jmir.9127",
url="http://www.jmir.org/2018/4/e126/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29661747"
}


@Article{info:doi/10.2196/publichealth.8145,
author="Card, George Kiffer
and Lachowsky, Nathan
and Hawkins, W. Blake
and Jollimore, Jody
and Baharuddin, Fahmy
and Hogg, S. Robert",
title="Predictors of Facebook User Engagement With Health-Related Content for Gay, Bisexual, and Other Men Who Have Sex With Men: Content Analysis",
journal="JMIR Public Health Surveill",
year="2018",
month="Apr",
day="06",
volume="4",
number="2",
pages="e38",
keywords="social media",
keywords="health promotion",
keywords="gay and bisexual men",
keywords="user engagement",
abstract="Background: Social media is used by community-based organizations (CBOs) to promote the well-being of gay and bisexual men (GBM). However, few studies have quantified which factors facilitate the diffusion of health content tailored for sexual minorities. Objective: The aim of this study was to identify post characteristics that can be leveraged to optimize the health promotion efforts of CBOs on Facebook. Methods: The Facebook application programming interface was used to collect 5 years' of posts shared across 10 Facebook pages administered by Vancouver-based CBOs promoting GBM health. Network analysis assessed basic indicators of network structure. Content analyses were conducted using informatics-based approaches. Hierarchical negative binomial regression of post engagement data was used to identify meaningful covariates of engagement. Results: In total, 14,071 posts were shared and 21,537 users engaged with these posts. Most users (n=13,315) engaged only once. There was moderate correlation between the number of posts and the number of CBOs users engaged with (r=.53, P<.001). Higher user engagement was positively associated with positive sentiment, sharing multimedia, and posting about pre-exposure prophylaxis, stigma, and mental health. Engagement was negatively associated with asking questions, posting about dating, and sharing posts during or after work (versus before). Conclusions: Results highlight the existence of a core group of Facebook users who facilitate diffusion. Factors associated with greater user engagement present CBOs with a number of strategies for improving the diffusion of health content. ",
doi="10.2196/publichealth.8145",
url="http://publichealth.jmir.org/2018/2/e38/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29625953"
}


@Article{info:doi/10.2196/mental.8808,
author="Booth, G. Richard
and Allen, N. Britney
and Bray Jenkyn, M. Krista
and Li, Lihua
and Shariff, Z. Salimah",
title="Youth Mental Health Services Utilization Rates After a Large-Scale Social Media Campaign: Population-Based Interrupted Time-Series Analysis",
journal="JMIR Ment Health",
year="2018",
month="Apr",
day="06",
volume="5",
number="2",
pages="e27",
keywords="mental health",
keywords="youth",
keywords="adolescent",
keywords="social media",
keywords="population health",
keywords="mass media",
abstract="Background: Despite the uptake of mass media campaigns, their overall impact remains unclear. Since 2011, a Canadian telecommunications company has operated an annual, large-scale mental health advocacy campaign (Bell Let's Talk) focused on mental health awareness and stigma reduction. In February 2012, the campaign began to explicitly leverage the social media platform Twitter and incented participation from the public by promising donations of Can \$0.05 for each interaction with a campaign-specific username (@Bell\_LetsTalk). Objective: The intent of the study was to examine the impact of this 2012 campaign on youth outpatient mental health services in the province of Ontario, Canada. Methods: Monthly outpatient mental health visits (primary health care and psychiatric services) were obtained for the Ontario youth aged 10 to 24 years (approximately 5.66 million visits) from January 1, 2006 to December 31, 2015. Interrupted time series, autoregressive integrated moving average modeling was implemented to evaluate the impact of the campaign on rates of monthly outpatient mental health visits. A lagged intervention date of April 1, 2012 was selected to account for the delay required for a patient to schedule and attend a mental health--related physician visit. Results: The inclusion of Twitter into the 2012 Bell Let's Talk campaign was temporally associated with an increase in outpatient mental health utilization for both males and females. Within primary health care environments, female adolescents aged 10 to 17 years experienced a monthly increase in the mental health visit rate from 10.2/1000 in April 2006 to 14.1/1000 in April 2015 (slope change of 0.094 following campaign, P<.001), whereas males of the same age cohort experienced a monthly increase from 9.7/1000 to 9.8/1000 (slope change of 0.052 following campaign, P<.001). Outpatient psychiatric services visit rates also increased for both male and female adolescents aged 10 to 17 years post campaign (slope change of 0.005, P=.02; slope change of 0.003, P=.005, respectively). For young adults aged 18 to 24 years, females who used primary health care experienced the most significant increases in mental health visit rates from 26.5/1000 in April 2006 to 29.2/1000 in April 2015 (slope change of 0.17 following campaign, P<.001). Conclusions: The 2012 Bell Let's Talk campaign was temporally associated with an increase in the rate of mental health visits among Ontarian youth. Furthermore, there appears to be an upward trend of youth mental health utilization in the province of Ontario, especially noticeable in females who accessed primary health care services. ",
doi="10.2196/mental.8808",
url="http://mental.jmir.org/2018/2/e27/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29625954"
}


@Article{info:doi/10.2196/medinform.8895,
author="Daniel, Fady
and Jabak, Suha
and Sasso, Roula
and Chamoun, Yara
and Tamim, Hani",
title="Patient-Physician Communication in the Era of Mobile Phones and Social Media Apps: Cross-Sectional Observational Study on Lebanese Physicians' Perceptions and Attitudes",
journal="JMIR Med Inform",
year="2018",
month="Apr",
day="06",
volume="6",
number="2",
pages="e18",
keywords="social media",
keywords="communication",
keywords="patient-physician communication",
keywords="technology use",
abstract="Background: The increased prevalence of virtual communication technology, particularly social media, has shifted the physician-patient relationship away from the well-established face-to-face interaction. The views and habits of physicians in Lebanon toward the use of online apps and social media as forms of patient communication have not been previously described. Objective: The aim of this study is to describe the views of Lebanese physicians toward the use of social media and other online apps as means of patient communication. Methods: This was a cross-sectional observational study using an online survey that addressed physicians' perceptions on the use of virtual communication in their clinical practice. The study took place between April and June 2016, and was directed toward physicians at the American University of Beirut Medical Center. Results: A total of 834 doctors received the online survey, with 238 physicians completing the survey. Most of the participants were from medical specialties. Most responders were attending physicians. Less than half of the respondents believed that Web-based apps and social media could be a useful tool for communicating with patients. Email was the most common form of professional online app, followed by WhatsApp (an instant messaging service). The majority of participants felt that this mode of communication can result in medicolegal issues and that it was a breach of privacy. Participants strictly against the use of virtual forms of communication made up 47.5\% (113/238) of the study sample. Conclusions: The majority of physicians at the American University of Beirut Medical Center are reluctant to use virtual communication technology as a form of patient communication. Appropriate policy making and strategies can allow both physicians and patients to communicate virtually in a more secure setting without fear of breaching privacy and confidentiality. ",
doi="10.2196/medinform.8895",
url="http://medinform.jmir.org/2018/2/e18/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29625955"
}


@Article{info:doi/10.2196/jmir.8221,
author="Chen, Tao
and Dredze, Mark",
title="Vaccine Images on Twitter: Analysis of What Images are Shared",
journal="J Med Internet Res",
year="2018",
month="Apr",
day="03",
volume="20",
number="4",
pages="e130",
keywords="vaccine",
keywords="visual communication",
keywords="image tweet",
keywords="Twitter",
keywords="retweet prediction",
keywords="social media",
abstract="Background: Visual imagery plays a key role in health communication; however, there is little understanding of what aspects of vaccine-related images make them effective communication aids. Twitter, a popular venue for discussions related to vaccination, provides numerous images that are shared with tweets. Objective: The objectives of this study were to understand how images are used in vaccine-related tweets and provide guidance with respect to the characteristics of vaccine-related images that correlate with the higher likelihood of being retweeted. Methods: We collected more than one million vaccine image messages from Twitter and characterized various properties of these images using automated image analytics. We fit a logistic regression model to predict whether or not a vaccine image tweet was retweeted, thus identifying characteristics that correlate with a higher likelihood of being shared. For comparison, we built similar models for the sharing of vaccine news on Facebook and for general image tweets. Results: Most vaccine-related images are duplicates (125,916/237,478; 53.02\%) or taken from other sources, not necessarily created by the author of the tweet. Almost half of the images contain embedded text, and many include images of people and syringes. The visual content is highly correlated with a tweet's textual topics. Vaccine image tweets are twice as likely to be shared as nonimage tweets. The sentiment of an image and the objects shown in the image were the predictive factors in determining whether an image was retweeted. Conclusions: We are the first to study vaccine images on Twitter. Our findings suggest future directions for the study and use of vaccine imagery and may inform communication strategies around vaccination. Furthermore, our study demonstrates an effective study methodology for image analysis. ",
doi="10.2196/jmir.8221",
url="http://www.jmir.org/2018/4/e130/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29615386"
}


@Article{info:doi/10.2196/publichealth.8737,
author="Fung, Chun-Hai Isaac
and Jackson, M. Ashley
and Mullican, A. Lindsay
and Blankenship, B. Elizabeth
and Goff, Elizabeth Mary
and Guinn, J. Amy
and Saroha, Nitin
and Tse, Ho Zion Tsz",
title="Contents, Followers, and Retweets of the Centers for Disease Control and Prevention's Office of Advanced Molecular Detection (@CDC\_AMD) Twitter Profile: Cross-Sectional Study",
journal="JMIR Public Health Surveill",
year="2018",
month="Apr",
day="02",
volume="4",
number="2",
pages="e33",
keywords="communications media",
keywords="health communication",
keywords="social media",
abstract="Background: The Office of Advanced Molecular Detection (OAMD), Centers for Disease Control and Prevention (CDC), manages a Twitter profile (@CDC\_AMD). To our knowledge, no prior study has analyzed a CDC Twitter handle's entire contents and all followers. Objective: This study aimed to describe the contents and followers of the Twitter profile @CDC\_AMD and to assess if attaching photos or videos to tweets posted by @CDC\_AMD would increase retweet frequency. Methods: Data of @CDC\_AMD were retrieved on November 21, 2016. All followers (N=809) were manually categorized. All tweets (N=768) were manually coded for contents and whether photos or videos were attached. Retweet count for each tweet was recorded. Negative binomial regression models were applied to both the original and the retweet corpora. Results: Among the 809 followers, 26.0\% (210/809) were individual health professionals, 11.6\% (94/809) nongovernmental organizations, 3.3\% (27/809) government agencies' accounts, 3.3\% (27/809) accounts of media organizations and journalists, and 0.9\% (7/809) academic journals, with 54.9\% (444/809) categorized as miscellaneous. A total of 46.9\% (360/768) of @CDC\_AMD's tweets referred to the Office's website and their current research; 17.6\% (135/768) referred to their scientists' publications. Moreover, 80\% (69/86) of tweets retweeted by @CDC\_AMD fell into the miscellaneous category. In addition, 43.4\% (333/768) of the tweets contained photos or videos, whereas the remaining 56.6\% (435/768) did not. Attaching photos or videos to original @CDC\_AMD tweets increases the number of retweets by 37\% (probability ratio=1.37, 95\% CI 1.13-1.67, P=.002). Content topics did not explain or modify this association. Conclusions: This study confirms CDC health communicators' experience that original tweets created by @CDC\_AMD Twitter profile sharing images or videos (or their links) received more retweets. The current policy of attaching images to tweets should be encouraged. ",
doi="10.2196/publichealth.8737",
url="http://publichealth.jmir.org/2018/2/e33/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29610112"
}


@Article{info:doi/10.2196/jmir.8382,
author="Chan, SY Windy
and Leung, YM Angela",
title="Use of Social Network Sites for Communication Among Health Professionals: Systematic Review",
journal="J Med Internet Res",
year="2018",
month="Mar",
day="28",
volume="20",
number="3",
pages="e117",
keywords="social networking",
keywords="social media",
keywords="health communication",
keywords="Facebook",
keywords="WhatsApp",
keywords="professional network",
keywords="health professionals",
abstract="Background: Although much research has been done investigating the roles of social network sites (SNSs) in linking patients and health professionals, there is a lack of information about their uses, benefits, and limitations in connecting health professions only for professional communication. Objective: This review aimed to examine the utilization of SNSs for communication among health professionals in (1) frontline clinical practice, (2) professional networks, and (3) education and training to identify areas for future health communication research. Methods: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. A systematic search of the literature published in the last 10 years (January 1, 2007, to March 1, 2017) was performed in March 2017, using the following electronic databases: MEDLINE via OvidSP, EMBASE, CINAHL Complete, and InfoSci-Journals. The searches were conducted using the following defined search terms: ``social media'' OR ``social network'' OR ``social network site'' OR ``Facebook'' OR ``Twitter'' OR ``Linkedin'' OR ``Instagram'' OR ``Weibo'' OR ``Whatsapp'' OR ``Telegram'' OR ``WeChat'' AND ``health'' OR ``health profession.'' Results: Of the 6977 papers retrieved, a total of 33 studies were included in this review. They were exploratory in nature, and the majority used surveys (n=25) and interviews (n=6). All retrieved studies stated that SNSs enhanced effective communication and information sharing. SNSs were used for supporting delivering of clinical services, making referrals, and sharing information. They were beneficial to network building and professional collaboration. SNSs were novel tools to enhance educational interactions among peers, students, instructors, and preceptors. The application of SNSs came with restraints in technical knowledge, concerns on data protection, privacy and liability, issues in professionalism, and data protection. Conclusions: SNSs provide platforms facilitating efficient communication, interactions, and connections among health professionals in frontline clinical practice, professional networks, education, and training with limitations identified as technical knowledge, professionalism, and risks of data protection. The evolving use of SNSs necessitates robust research to explore the full potential and the relative effectiveness of SNSs in professional communication. ",
doi="10.2196/jmir.8382",
url="http://www.jmir.org/2018/3/e117/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29592845"
}


@Article{info:doi/10.2196/publichealth.7217,
author="Mejova, Yelena
and Weber, Ingmar
and Fernandez-Luque, Luis",
title="Online Health Monitoring using Facebook Advertisement Audience Estimates in the United States: Evaluation Study",
journal="JMIR Public Health Surveill",
year="2018",
month="Mar",
day="28",
volume="4",
number="1",
pages="e30",
keywords="social media",
keywords="public health",
keywords="Internet",
keywords="infodemiology",
abstract="Background: Facebook, the most popular social network with over one billion daily users, provides rich opportunities for its use in the health domain. Though much of Facebook's data are not available to outsiders, the company provides a tool for estimating the audience of Facebook advertisements, which includes aggregated information on the demographics and interests, such as weight loss or dieting, of Facebook users. This paper explores the potential uses of Facebook ad audience estimates for eHealth by studying the following: (1) for what type of health conditions prevalence estimates can be obtained via social media and (2) what type of marker interests are useful in obtaining such estimates, which can then be used for recruitment within online health interventions. Objective: The objective of this study was to understand the limitations and capabilities of using Facebook ad audience estimates for public health monitoring and as a recruitment tool for eHealth interventions. Methods: We use the Facebook Marketing application programming interface to correlate estimated sizes of audiences having health-related interests with public health data. Using several study cases, we identify both potential benefits and challenges in using this tool. Results: We find several limitations in using Facebook ad audience estimates, for example, using placebo interest estimates to control for background level of user activity on the platform. Some Facebook interests such as plus-size clothing show encouraging levels of correlation (r=.74) across the 50 US states; however, we also sometimes find substantial correlations with the placebo interests such as r=.68 between interest in Technology and Obesity prevalence. Furthermore, we find demographic-specific peculiarities in the interests on health-related topics. Conclusions: Facebook's advertising platform provides aggregate data for more than 190 million US adults. We show how disease-specific marker interests can be used to model prevalence rates in a simple and intuitive manner. However, we also illustrate that building effective marker interests involves some trial-and-error, as many details about Facebook's black box remain opaque. ",
doi="10.2196/publichealth.7217",
url="http://publichealth.jmir.org/2018/1/e30/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29592849"
}


@Article{info:doi/10.2196/publichealth.7998,
author="Zhou, Jiaqi
and Zhang, Qingpeng
and Zeng, Dajun Daniel
and Tsui, Leung Kwok",
title="Influence of Flavors on the Propagation of E-Cigarette--Related Information: Social Media Study",
journal="JMIR Public Health Surveill",
year="2018",
month="Mar",
day="23",
volume="4",
number="1",
pages="e27",
keywords="e-cigarettes",
keywords="flavors",
keywords="social media",
keywords="information propagation",
keywords="social networks",
keywords="electronic nicotine delivery systems",
keywords="flavoring agents",
keywords="information dissemination",
keywords="social networking",
abstract="Background: Modeling the influence of e-cigarette flavors on information propagation could provide quantitative policy decision support concerning smoking initiation and contagion, as well as e-cigarette regulations. Objective: The objective of this study was to characterize the influence of flavors on e-cigarette--related information propagation on social media. Methods: We collected a comprehensive dataset of e-cigarette--related discussions from public Pages on Facebook. We identified 11 categories of flavors based on commonly used categorizations. Each post's frequency of being shared served as a proxy measure of information propagation. We evaluated a set of regression models and chose the hurdle negative binomial model to characterize the influence of different flavors and nonflavor control variables on e-cigarette--related information propagation. Results: We found that 5 flavors (sweet, dessert \& bakery, fruits, herbs \& spices, and tobacco) had significantly negative influences on e-cigarette--related information propagation, indicating the users' tendency not to share posts related to these flavors. We did not find a positive significance of any flavors, which is contradictory to previous research. In addition, we found that a set of nonflavor--related factors were associated with information propagation. Conclusions: Mentions of flavors in posts did not enhance the popularity of e-cigarette--related information. Certain flavors could even have reduced the popularity of information, indicating users' lack of interest in flavors. Promoting e-cigarette--related information with mention of flavors is not an effective marketing approach. This study implies the potential concern of users about flavorings and suggests a need to regulate the use of flavorings in e-cigarettes. ",
doi="10.2196/publichealth.7998",
url="http://publichealth.jmir.org/2018/1/e27/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29572202"
}


@Article{info:doi/10.2196/jmir.8871,
author="Sanz-Lorente, Mar{\'i}a
and Wanden-Berghe, Carmina
and Castej{\'o}n-Bolea, Ram{\'o}n
and Sanz-Valero, Javier",
title="Web 2.0 Tools in the Prevention of Curable Sexually Transmitted Diseases: Scoping Review",
journal="J Med Internet Res",
year="2018",
month="Mar",
day="22",
volume="20",
number="3",
pages="e113",
keywords="sexually transmitted diseases, bacterial",
keywords="internet",
keywords="webcasts",
keywords="social media",
abstract="Background: The internet is now the primary source of information that young people use to get information on issues related to sex, contraception, and sexually transmitted infections. Objective: The goal of the research was to review the scientific literature related to the use of Web 2.0 tools as opposed to other strategies in the prevention of curable sexually transmitted diseases (STDs). Methods: A scoping review was performed on the documentation indexed in the bibliographic databases MEDLINE, Cochrane Library, Scopus, Cumulative Index to Nursing and Allied Health Literature, Web of Science, Literatura Latinoamericana y del Caribe en Ciencias de la Salud, PsycINFO, Educational Resources Information Center, the databases of Centro Superior de Investigaciones Cient{\'i}ficas in Spain, and the {\'I}ndice Bibliogr{\'a}fico Espa{\~n}ol de Ciencias de la Salud from the first available date according to the characteristics of each database until April 2017. The equation search was realized by means of the using of descriptors together with the consultation of the fields of title register and summary with free terms. Bibliographies of the selected papers were searched for additional articles. Results: A total of 627 references were retrieved, of which 6 papers were selected after applying the inclusion and exclusion criteria. The STDs studied were chlamydia, gonorrhea, and syphilis. The Web 2.0 tools used were Facebook, Twitter, Instagram, and YouTube. The 6 papers used Web 2.0 in the promotion of STD detection. Conclusions: Web 2.0 tools have demonstrated a positive effect on the promotion of prevention strategies for STDs and can help attract and link youth to campaigns related to sexual health. These tools can be combined with other interventions. In any case, Web 2.0 and especially Facebook have all the potential to become essential instruments for public health. ",
doi="10.2196/jmir.8871",
url="http://www.jmir.org/2018/3/e113/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29567633"
}


@Article{info:doi/10.2196/jmir.7753,
author="Harpel, Tammy",
title="Pregnant Women Sharing Pregnancy-Related Information on Facebook: Web-Based Survey Study",
journal="J Med Internet Res",
year="2018",
month="Mar",
day="22",
volume="20",
number="3",
pages="e115",
keywords="pregnancy",
keywords="social media",
keywords="Facebook",
abstract="Background: Research indicates expectant and new mothers use the Internet, specifically social media, to gain information and support during the transition to parenthood. Although parents regularly share information about and photos of their child or children on Facebook, researchers have neither explored the use of Facebook to share pregnancy-related information nor investigated factors that influence such sharing. Objective: The aim of this study was to address a gap in the literature by exploring the use of Facebook by pregnant women. Specifically, the study examined the use of Facebook to share pregnancy-related information, as well as any association between prenatal attachment and the aforementioned aspects of sharing pregnancy-related information on Facebook. Methods: Pregnant women who were at least 18 years of age were recruited for participation in the study through posts and paid advertisements on Facebook and posts to professional organization listservs. Individuals interested in participating were directed to a secure Web-based survey system where they completed the consent form and the survey that focused on their current pregnancy. Participants completed the Maternal Antenatal Attachment Scale and answered questions that assessed how often they shared pregnancy-related information on Facebook, who they shared it with, why they shared it, and what they shared. Results: A total of 117 pregnant women completed the survey. Descriptive statistics indicated that the pregnancy announcement was most commonly shared (75/108, 69.4\%), with most women sharing pregnancy-related information on Facebook less than monthly (52/117, 44.4\%) with only family and friends (90/116, 77.6\% and 91/116, 78.4\%, respectively) and for the purpose of involving others or sharing the experience (62/107, 57.9\%). Correlation and regression analyses showed that prenatal attachment, in general, was positively and significantly related to all aspects of sharing pregnancy-related information at the P<.05 level, with the exception of sharing because of expectations. Quality of attachment, which involves the positive feelings the woman has about her unborn child, was significantly associated with sharing to involve others or share the pregnancy (t8,93=2.654 , P=.009). In contrast, after controlling for other variables, the strength or preoccupation component of prenatal attachment was significantly associated with frequency of sharing (t8,100=2.554 , P=.01), number to types of information shared (t8,97=2.605 , P=.01), number of groups with whom shared (t8,99=3.467, P=.001), and sharing to get advice ($\chi$28=5.339 , P=.02). Conclusions: Pregnant women in this study used Facebook for a variety of reasons, demonstrating the use of the social media platform during pregnancy for supportive and informational purposes. Overall, the results of this study are likely to be useful to professionals who are seeking alternative methods for providing intervention, information, and support to pregnant women via social media in our technology-driven society. ",
doi="10.2196/jmir.7753",
url="http://www.jmir.org/2018/3/e115/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29567636"
}


@Article{info:doi/10.2196/ijmr.9182,
author="Jeon, Andrew Yongwoog
and Hale, Brent
and Knackmuhs, Eric
and Mackert, Michael",
title="Weight Stigma Goes Viral on the Internet: Systematic Assessment of YouTube Comments Attacking Overweight Men and Women",
journal="Interact J Med Res",
year="2018",
month="Mar",
day="20",
volume="7",
number="1",
pages="e6",
keywords="stigma",
keywords="cyberbullying",
keywords="gender",
keywords="sex differences",
keywords="verbal behavior",
abstract="Background: Anonymous verbal attacks against overweight individuals on social media are common and widespread. These comments often use negative, misogynist, or derogatory words, which stigmatize the targeted individuals with obesity. These verbal attacks may cause depression in overweight individuals, which could subsequently promote unhealthy eating behavior (ie, binge eating) and further weight gain. To develop an intervention policy and strategies that tackle the anonymous, Web-based verbal attacks, a thorough understanding of the comments is necessary. Objective: This study aimed to examine how anonymous users verbally attack or defend overweight individuals in terms of 3 themes: (1) topic of verbal attack (ie, what aspects of overweight individuals are verbally attacked), (2) gender of commenters and targeted overweight individuals, and (3) intensity of derogation depending on the targeted gender (ie, the number of swear words used within comments). Methods: This study analyzed the content of YouTube comments that discuss overweight individuals or groups from 2 viral videos, titled ``Fat Girl Tinder Date'' and ``Fat Guy Tinder Date.'' The twin videos provide an avenue through which to analyze discussions of obesity as they organically occurred in a contemporary setting. We randomly sampled and analyzed 320 comments based on a coding instrument developed for this study. Results: First, there were twice as many comments verbally attacking overweight individuals (n=174) than comments defending them (n=89). Second, overweight women are attacked for their capacities (eg, laziness, maturity; 14/51, 28\%), whereas overweight men are attacked for their heterosocial skills (eg, rudeness, annoyance; 24/29, 83\%). Third, the majority of commenters who attacked overweight women are male (42/52, 81\%). Fourth, attacking comments generated toward overweight women included more swear words (mean 0.44, SD 0.77) than those targeting men (mean 0.23, SD 0.48). Conclusions: Our data elucidate a worrying situation of frequent disinhibited aggressive messages against overweight individuals online. Importantly, the patterns of verbal aggression differ depending on the gender of the targeted overweight individuals. Thus, gender-tailored intervention strategies that specifically tackle Internet users' verbal aggression against overweight individuals need to be developed. ",
doi="10.2196/ijmr.9182",
url="http://www.i-jmr.org/2018/1/e6/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29559426"
}


@Article{info:doi/10.2196/resprot.8229,
author="Prout Parks, Elizabeth
and Moore, H. Rene{\'e}
and Li, Ziyi
and Bishop-Gilyard, T. Chanelle
and Garrett, R. Andrew
and Hill, L. Douglas
and Bruton, P. Yasmeen
and Sarwer, B. David",
title="Assessing the Feasibility of a Social Media to Promote Weight Management Engagement in Adolescents with Severe Obesity: Pilot Study",
journal="JMIR Res Protoc",
year="2018",
month="Mar",
day="19",
volume="7",
number="3",
pages="e52",
keywords="e-medicine",
keywords="adolescents",
keywords="social media",
keywords="obesity",
keywords="intervention",
keywords="nutrition",
keywords="internet",
abstract="Background: Severe obesity in adolescents has deleterious physical and psychological complications necessitating frequent multi-disciplinary clinic visits. Greater treatment engagement has been equated with weight-loss. However, traditional medical weight-loss programs for adolescents have high attrition rates. Social media is widely used by adolescents and may enhance medical weight management engagement and success. Objective: The first objective was to examine the acceptability and feasibility of using a private social media group as an adjunct to medical weight management in youth ages 14 to 20 years with severe obesity [body mass index (BMI) ? 35 kg/m2]. The second objective was to pilot test the use of social media to improve treatment engagement and decrease attrition rates. Methods: In this single arm, 12 week pre-post study, participants attended individual clinic visits and participated in a moderated private social media group that received nutrition, exercise, and behavior change social media communications or ``posts'' 3 to 4 times/week. Youth commented and/or liked posts from the moderator and each other. Social media engagement was measured with the number of likes and comments on social media. Clinic attrition was compared, measuring clinic visit attendance 12 weeks prior, during, and after the intervention with mixed linear regression models. Correlations of social media engagement with changes from baseline for BMI, BMI-z score, and psychosocial measures were fit. Results: All 13 enrolled youth completed the study and reported that the group was enjoyable, helpful, reinforced their weight management program, and would recommend using social media to support other youth. The pilot trial was acceptable and feasible. Youth mean weekly engagement (likes + comments) in social media was greater than once a day (8.6 {\textpm}3.6). Compared to 12 weeks prior to the intervention, there was no significant decrease in clinic visit attendance at the end of the intervention (M=.231, P=.69) or 12 weeks at the conclusion of the intervention (M=.589, P=.28). Increased social media comments correlated with weight change (r=--.633, P=.04). Conclusions: This pilot trial demonstrated that the use of social media as an adjunct to medical weight management was feasible and acceptable to adolescents with severe obesity. Based upon these preliminary findings, social media may be an effective way to mitigate attrition from obesity treatment programs, and improve health outcomes in this high-risk population. ",
doi="10.2196/resprot.8229",
url="http://www.researchprotocols.org/2018/3/e52/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29555623"
}


@Article{info:doi/10.2196/jmir.8056,
author="Maben-Feaster, E. Rosalyn
and Stansfield, Brent R.
and Opipari, AnneMarie
and Hammoud, M. Maya",
title="Evaluating Patient Perspectives of Provider Professionalism on Twitter in an Academic Obstetrics and Gynecology Clinic: Patient Survey",
journal="J Med Internet Res",
year="2018",
month="Mar",
day="12",
volume="20",
number="3",
pages="e78",
keywords="patients",
keywords="social networking sites",
keywords="professionalism",
keywords="surveys and questionnaires",
keywords="perception",
keywords="Twitter",
abstract="Background: One-third of Americans use social media websites as a source of health care information. Twitter, a microblogging site that allows users to place 280-character posts---or tweets---on the Web, is emerging as an important social media platform for health care. However, most guidelines on medical professionalism on social media are based on expert opinion. Objective: This study sought to examine if provider Twitter profiles with educational tweets were viewed as more professional than profiles with personal tweets or a mixture of the two, and to determine the impact of provider gender on perceptions of professionalism in an academic obstetrics and gynecology clinic. Methods: This study randomized obstetrics and gynecology patients at the University of Michigan Von Voigtlander Clinic to view one of six medical provider Twitter profiles, which differed in provider gender and the nature of tweets. Each participant answered 10 questions about their perception of the provider's professionalism based on the Twitter profile content. Results: The provider profiles with educational tweets alone received higher mean professionalism scores than profiles with personal tweets. Specifically, the female and male provider profiles with exclusively educational tweets had the highest and second highest overall mean professionalism ratings at 4.24 and 3.85, respectively. In addition, the female provider profiles received higher mean professionalism ratings than male provider profiles with the same content. The female profile with mixed content received a mean professionalism rating of 3.38 compared to 3.24 for the male mixed-content profile, and the female profile with only personal content received a mean professionalism rating of 3.68 compared to 2.68 for the exclusively personal male provider profile. Conclusions: This study showed that in our obstetrics and gynecology clinic, patients perceived providers with educational profiles as more professional than those with a mixture of educational and personal tweets or only personal tweets. It also showed that our patient population perceived the female provider with educational tweets to be the most professional. This study will help inform the development of evidence-based guidelines for social media use in medicine as it adds to the growing body of literature examining professionalism and social media. ",
doi="10.2196/jmir.8056",
url="http://www.jmir.org/2018/3/e78/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29530838"
}


@Article{info:doi/10.2196/jmir.9172,
author="Ashford, D. Robert
and Lynch, Kevin
and Curtis, Brenda",
title="Technology and Social Media Use Among Patients Enrolled in Outpatient Addiction Treatment Programs: Cross-Sectional Survey Study",
journal="J Med Internet Res",
year="2018",
month="Mar",
day="06",
volume="20",
number="3",
pages="e84",
keywords="digital divide",
keywords="behavioral health",
keywords="social media",
keywords="addiction",
keywords="recovery",
keywords="relapse",
abstract="Background: Substance use disorder research and practice have not yet taken advantage of emerging changes in communication patterns. While internet and social media use is widespread in the general population, little is known about how these mediums are used in substance use disorder treatment. Objective: The aims of this paper were to provide data on patients' with substance use disorders mobile phone ownership rates, usage patterns on multiple digital platforms (social media, internet, computer, and mobile apps), and their interest in the use of these platforms to monitor personal recovery. Methods: We conducted a cross-sectional survey of patients in 4 intensive outpatient substance use disorder treatment facilities in Philadelphia, PA, USA. Logistic regressions were used to examine associations among variables. Results: Survey participants (N=259) were mostly male (72.9\%, 188/259), African American (62.9\%, 163/259), with annual incomes less than US \$10,000 (62.5\%, 161/259), and averaged 39 (SD 12.24) years of age. The vast majority of participants (93.8\%, 243/259) owned a mobile phone and about 64.1\% (166/259) owned a mobile phone with app capabilities, of which 85.1\% (207/243) accessed the internet mainly through their mobile phone. There were no significant differences in age, gender, ethnicity, or socio-economic status by computer usage, internet usage, number of times participants changed their phone, type of mobile phone contract, or whether participants had unlimited calling plans. The sample was grouped into 3 age groups (Millennials, Generation Xers, and Baby Boomers). The rates of having a social media account differed across these 3 age groups with significant differences between Baby Boomers and both Generation Xers and Millennials (P<.001 in each case). Among participants with a social media account (73.6\%, 190/259), most (76.1\%, 144/190) reported using it daily and nearly all (98.2\%, 186/190) used Facebook. Nearly half of participants (47.4\%, 90/190) reported viewing content on social media that triggered substance cravings and an equal percentage reported being exposed to recovery information on social media. There was a significant difference in rates of reporting viewing recovery information on social media across the 3 age groups with Baby Boomers reporting higher rates than Millennials (P<.001). The majority of respondents (70.1\%, 181/259) said they would prefer to use a relapse prevention app on their phone or receive SMS (short message service) relapse prevention text messages (72.3\%, 186/259), and nearly half (49.1\%, 127/259) expressed an interest in receiving support by allowing social media accounts to be monitored as a relapse prevention technique. Conclusions: To our knowledge, this is the first and largest study examining the online behavior and preferences regarding technology-based substance use disorder treatment interventions in a population of patients enrolled in community outpatient treatment programs. Patients were generally receptive to using relapse prevention apps and text messaging interventions and a substantial proportion supported social media surveillance tools. However, the design of technology-based interventions remains as many participants have monthly telephone plans which may limit continuity. ",
doi="10.2196/jmir.9172",
url="http://www.jmir.org/2018/3/e84/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29510968"
}


@Article{info:doi/10.2196/jmir.9003,
author="Wu, Tailai
and Deng, Zhaohua
and Feng, Zhanchun
and Gaskin, J. Darrell
and Zhang, Donglan
and Wang, Ruoxi",
title="The Effect of Doctor-Consumer Interaction on Social Media on Consumers' Health Behaviors: Cross-Sectional Study",
journal="J Med Internet Res",
year="2018",
month="Feb",
day="28",
volume="20",
number="2",
pages="e73",
keywords="physician patient relationships",
keywords="health behavior",
keywords="social media",
keywords="social theory",
keywords="psychological theory",
keywords="medical informatics",
abstract="Background: Both doctors and consumers have engaged in using social media for health purposes. Social media has changed traditional one-to-one communication between doctors and patients to many-to-many communication between doctors and consumers. However, little is known about the effect of doctor-consumer interaction on consumers' health behaviors. Objective: The aim of this study was to investigate how doctor-consumer interaction in social media affects consumers' health behaviors. Methods: On the basis of professional-client interaction theory and social cognitive theory, we propose that doctor-consumer interaction can be divided into instrumental interaction and affective interaction. These two types of interactions influence consumers' health behaviors through declarative knowledge (DK), self-efficacy (SE), and outcome expectancy (OE). To validate our proposed research model, we employed the survey method and developed corresponding measurement instruments for constructs in our research model. A total of 352 valid answers were collected, and partial least square was performed to analyze the data. Results: Instrumental doctor-consumer interaction was found to influence consumers' DK (t294=5.763, P<.001), SE (t294=4.891, P<.001), and OE (t294=7.554, P<.001) significantly, whereas affective doctor-consumer interaction also impacted consumers' DK (t294=4.025, P<.001), SE (t294=4.775, P<.001), and OE (t294=4.855, P<.001). Meanwhile, consumers' DK (t294=3.838, P<.001), SE (t294=3.824, P<.001), and OE (t294=2.985, P<.01) all significantly affected consumers' health behaviors. Our mediation analysis showed that consumers' DK, SE, and OE partially mediated the effect of instrumental interaction on health behaviors, whereas the three mediators fully mediated the effect of affective interaction on health behaviors. Conclusions: Compared with many intentional intervention programs, doctor-consumer interaction can be treated as a natural cost-effective intervention to promote consumers' health behaviors. Meanwhile, both instrumental and affective interaction should be highlighted for the best interaction results. DK, SE, and OE are working mechanisms of doctor-consumer interaction. ",
doi="10.2196/jmir.9003",
url="http://www.jmir.org/2018/2/e73/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29490892"
}


@Article{info:doi/10.2196/jmir.7862,
author="Looyestyn, Jemma
and Kernot, Jocelyn
and Boshoff, Kobie
and Maher, Carol",
title="A Web-Based, Social Networking Beginners' Running Intervention for Adults Aged 18 to 50 Years Delivered via a Facebook Group: Randomized Controlled Trial",
journal="J Med Internet Res",
year="2018",
month="Feb",
day="26",
volume="20",
number="2",
pages="e67",
keywords="social network",
keywords="health behavior",
keywords="program evaluation",
keywords="Internet",
keywords="physical activity",
abstract="Background: Online social networks continue to grow in popularity, with 1.7 billion users worldwide accessing Facebook each month. The use of social networking sites such as Facebook for the delivery of health behavior programs is relatively new. Objective: The primary aim of this study was to determine the effectiveness of a Web-based beginners' running program for adults aged 18 to 50 years, delivered via a Facebook group, in increasing physical activity (PA) and cardiorespiratory fitness. Methods: A total of 89 adults with a mean age of 35.2 years (SD 10.9) were recruited online and via print media. Participants were randomly allocated to receive the UniSA Run Free program, an 8-week Web-based beginners' running intervention, delivered via a closed Facebook group (n=41) that included daily interactive posts (information with links, motivational quotes, opinion polls, or questions) and details of the running sessions; or to the control group who received a hard copy of the running program (n=48). Assessments were completed online at baseline, 2 months, and 5 months. The primary outcome measures were self-reported weekly moderate to vigorous physical activity (MVPA) and objectively measured cardiorespiratory fitness. Secondary outcomes were social support, exercise attitudes, and self-efficacy. Analyses were undertaken using random effects mixed modeling. Compliance with the running program and engagement with the Facebook group were analyzed descriptively. Results: Both groups significantly increased MVPA across the study period (P=.004); however, this was significantly higher in the Facebook group (P=.04). The Facebook group increased their MVPA from baseline by 140 min/week versus 91 min for the control at 2 months. MVPA remained elevated for the Facebook group (from baseline) by 129 min/week versus a 50 min/week decrease for the control at 5 months. Both groups had significant increases in social support scores at 2 months (P=.02); however, there were no group by time differences (P=.16). There were no significant changes in the other outcomes. A process evaluation revealed relatively high levels of engagement with the Facebook group during the 8-week intervention (eg, mean number of interactions 35 [SD 41]). Conclusions: An 8-week beginners' running program delivered through Facebook produced sizable and sustained changes in weekly MVPA and received strong engagement and positive feedback from participants. Future research investigating this intervention approach is warranted in other populations and health behaviors. Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12616001500448; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=371607\&isReview=true (Archived by WebCite at http://www.webcitation.org/6xSAuz4NW) ",
doi="10.2196/jmir.7862",
url="http://www.jmir.org/2018/2/e67/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29483065"
}


@Article{info:doi/10.2196/jmir.8342,
author="Elaheebocus, Ally Sheik Mohammad Roushdat
and Weal, Mark
and Morrison, Leanne
and Yardley, Lucy",
title="Peer-Based Social Media Features in Behavior Change Interventions: Systematic Review",
journal="J Med Internet Res",
year="2018",
month="Feb",
day="22",
volume="20",
number="2",
pages="e20",
keywords="systematic review",
keywords="social media",
keywords="behavior control",
keywords="health behavior",
keywords="behavioral medicine",
keywords="eHealth",
abstract="Background: Incorporating social media features into digital behavior change interventions (DBCIs) has the potential to contribute positively to their success. However, the lack of clear design principles to describe and guide the use of these features in behavioral interventions limits cross-study comparisons of their uses and effects. Objective: The aim of this study was to provide a systematic review of DBCIs targeting modifiable behavioral risk factors that have included social media features as part of their intervention infrastructure. A taxonomy of social media features is presented to inform the development, description, and evaluation of behavioral interventions. Methods: Search terms were used in 8 databases to identify DBCIs that incorporated social media features and targeted tobacco smoking, diet and nutrition, physical activities, or alcohol consumption. The screening and review process was performed by 2 independent researchers. Results: A total of 5264 articles were screened, and 143 articles describing a total of 134 studies were retained for full review. The majority of studies (70\%) reported positive outcomes, followed by 28\% finding no effects with regard to their respective objectives and hypothesis, and 2\% of the studies found that their interventions had negative outcomes. Few studies reported on the association between the inclusion of social media features and intervention effect. A taxonomy of social media features used in behavioral interventions has been presented with 36 social media features organized under 7 high-level categories. The taxonomy has been used to guide the analysis of this review. Conclusions: Although social media features are commonly included in DBCIs, there is an acute lack of information with respect to their effect on outcomes and a lack of clear guidance to inform the selection process based on the features' suitability for the different behaviors. The proposed taxonomy along with the set of recommendations included in this review will support future research aimed at isolating and reporting the effects of social media features on DBCIs, cross-study comparisons, and evaluations. ",
doi="10.2196/jmir.8342",
url="http://www.jmir.org/2018/2/e20/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29472174"
}


@Article{info:doi/10.2196/jmir.9230,
author="Dumas, Audr{\'e}e-Anne
and Lapointe, Annie
and Desroches, Sophie",
title="Users, Uses, and Effects of Social Media in Dietetic Practice: Scoping Review of the Quantitative and Qualitative Evidence",
journal="J Med Internet Res",
year="2018",
month="Feb",
day="20",
volume="20",
number="2",
pages="e55",
keywords="social media",
keywords="diet",
keywords="review",
abstract="Background: Social media platforms are increasingly used by registered dietitians (RDs) to improve knowledge translation and exchange in nutrition. However, a thorough understanding of social media in dietetic practice is lacking. Objective: The objective of this study was to map and summarize the evidence about the users, uses, and effects of social media in dietetic practice to identify gaps in the literature and inform future research by using a scoping review methodology. Methods: Stages for conducting the scoping review included the following: (1) identifying the research question; (2) identifying relevant studies through a comprehensive multidatabase and gray literature search strategy; (3) selecting eligible studies; (4) charting the data; and (5) collating, summarizing, and reporting results for dissemination. Finally, knowledge users (RDs working for dietetic professional associations and public health organizations) were involved in each review stage to generate practical findings. Results: Of the 47 included studies, 34 were intervention studies, 4 were descriptive studies, 2 were content analysis studies, and 7 were expert opinion papers in dietetic practice. Discussion forums were the most frequent social media platform evaluated (n=19), followed by blogs (n=13) and social networking sites (n=10). Most studies targeted overweight and obese or healthy users, with adult populations being most studied. Social media platforms were used to deliver content as part of larger multiple component interventions for weight management. Among intervention studies using a control group with no exposition to social media, we identified positive, neutral, and mixed effects of social media for outcomes related to users' health behaviors and status (eg, dietary intakes and body weight), participation rates, and professional knowledge. Factors associated with the characteristics of the specific social media, such as ease of use, a design for quick access to desired information, and concurrent reminders of use, were perceived as the main facilitators to the use of social media in dietetic practice, followed to a lesser extent by interactions with an RD and social support from fellow users. Barriers to social media use were mostly related to complicated access to the site and time issues. Conclusions: Research on social media in dietetic practice is at its infancy, but it is growing fast. So far, this field of research has targeted few social media platforms, most of which were assessed in multiple-component interventions for weight management among overweight or obese adults. Trials isolating the effects and mechanisms of action of specific social media platforms are needed to draw conclusions regarding the effectiveness of those tools to support dietetic practice. Future studies should address barriers and facilitators related to the use of social media written by RDs and should explore how to make these tools useful for RDs to reach health consumers to improve health through diet. ",
doi="10.2196/jmir.9230",
url="http://www.jmir.org/2018/2/e55/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29463487"
}


@Article{info:doi/10.2196/jmir.8932,
author="Jessup, L. Dana
and Glover IV, McKinley
and Daye, Dania
and Banzi, Lynda
and Jones, Philip
and Choy, Garry
and Shepard, O. Jo-Anne
and Flores, J. Efr{\'e}n",
title="Implementation of Digital Awareness Strategies to Engage Patients and Providers in a Lung Cancer Screening Program: Retrospective Study",
journal="J Med Internet Res",
year="2018",
month="Feb",
day="15",
volume="20",
number="2",
pages="e52",
keywords="lung neoplasms",
keywords="diagnostic imaging",
keywords="social media",
keywords="patient participation",
keywords="search engine",
abstract="Background: Lung cancer is the leading cause of cancer-related deaths in the United States. Despite mandated insurance coverage for eligible patients, lung cancer screening rates remain low. Digital platforms, including social media, provide a potentially valuable tool to enhance health promotion and patient engagement related to lung cancer screening (LCS). Objective: The aim was to assess the effectiveness of LCS digital awareness campaigns on utilization of low-dose computed tomography (LDCT) and visits to institutional online educational content. Methods: A pay-per-click campaign utilizing Google and Facebook targeted adults aged 55 years and older and caregivers aged 18 years and older (eg, spouses, adult children) with LCS content during a 20-week intervention period from May to September 2016. A concurrent pay-per-click campaign using LinkedIn and Twitter targeted health care providers with LCS content. Geographic target radius was within 60 miles of an academic medical center. Social media data included aggregate demographics and click-through rates (CTRs). Primary outcome measures were visits to institutional Web pages and scheduled LDCT exams. Study period was 20 weeks before, during, and after the digital awareness campaigns. Results: Weekly visits to the institutional LCS Web pages were significantly higher during the digital awareness campaigns compared to the 20-week period prior to implementation (mean 823.9, SD 905.8 vs mean 51, SD 22.3, P=.001). The patient digital awareness campaign surpassed industry standard CTRs on Google (5.85\%, 1108/18,955 vs 1.8\%) and Facebook (2.59\%, 47,750/1,846,070 vs 0.8\%). The provider digital awareness campaign surpassed industry standard CTR on LinkedIn (1.1\%, 630/57,079 vs 0.3\%) but not Twitter (0.19\%, 1139/587,133 vs 0.25\%). Mean scheduled LDCT exam volumes per week before, during, and after the digital awareness campaigns were 17.4 (SD 7.5), 20.4 (SD 5.4), and 26.2 (SD 6.4), respectively, with the difference between the mean number of scheduled exams after the digital awareness campaigns and the number of exams scheduled before and after the digital awareness campaigns being statistically significant (P<.001). Conclusions: Implementation of the LCS digital awareness campaigns was associated with increased visits to institutional educational Web pages and scheduled LDCT exams. Digital platforms are an important tool to enhance health promotion activities and engagement with patients and providers. ",
doi="10.2196/jmir.8932",
url="http://www.jmir.org/2018/2/e52/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29449199"
}


@Article{info:doi/10.2196/mental.9120,
author="Schlichthorst, Marisa
and King, Kylie
and Turnure, Jackie
and Sukunesan, Suku
and Phelps, Andrea
and Pirkis, Jane",
title="Influencing the Conversation About Masculinity and Suicide: Evaluation of the Man Up Multimedia Campaign Using Twitter Data",
journal="JMIR Ment Health",
year="2018",
month="Feb",
day="15",
volume="5",
number="1",
pages="e14",
keywords="mental health",
keywords="suicide",
keywords="masculinity",
keywords="men's health",
abstract="Background: It has been suggested that some dominant aspects of traditional masculinity are contributing to the high suicide rates among Australian men. We developed a three-episode documentary called Man Up, which explores the complex relationship between masculinity and suicide and encourages men to question socially imposed rules about what it means to be a man and asks them to open up, express difficult emotions, and seek help if and when needed. We ran a three-phase social media campaign alongside the documentary using 5 channels (Twitter, Facebook, Instagram, YouTube, and Tumblr). Objective: This study aimed to examine the extent to which the Man Up Twitter campaign influenced the social media conversation about masculinity and suicide. Methods: We used Twitter insights data to assess the reach of and engagement with the campaign (using metrics on followers, likes, retweets, and impressions) and to determine the highest and lowest performing tweets in the campaign (using an aggregated performance measure of reactions). We used original content tweets to determine whether the campaign increased the volume of relevant Twitter conversations (aggregating the number of tweets for selected campaign hashtags over time), and we used a subset of these data to gain insight into the main content themes with respect to audience engagement. Results: The campaign generated a strong following that was engaged with the content of the campaign; over its whole duration, the campaign earned approximately 5000 likes and 2500 retweets and gained around 1,022,000 impressions. The highest performing tweets posted by the host included video footage and occurred during the most active period of the campaign (around the screening of the documentary). The volume of conversations in relation to commonly used hashtags (\#MANUP, \#ABCMANUP, \#LISTENUP, and \#SPEAKUP) grew in direct relation to the campaign activities, achieving strongest growth during the 3 weeks when the documentary was aired. Strongest engagement was found with content related to help-seeking, masculinity, and expressing emotions. A number of followers tweeted personal stories that revealed overwhelmingly positive perceptions of the content of the documentary and strongly endorsed its messages. Conclusions: The Man Up Twitter campaign triggered conversations about masculinity and suicide that otherwise may not have happened. For some, this may have been game-changing in terms of shifting attitudes toward expressing emotions and reaching out to others for help. The campaign was particularly effective in disseminating information and promoting conversations in real time, an advantage that it had over more traditional health promotion campaigns. This sort of approach could well be adapted to other areas of mental (and physical) health promotion campaigns to increase their reach and effectiveness. ",
doi="10.2196/mental.9120",
url="http://mental.jmir.org/2018/1/e14/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29449203"
}


@Article{info:doi/10.2196/jmir.9190,
author="Alanzi, Turki",
title="Role of Social Media in Diabetes Management in the Middle East Region: Systematic Review",
journal="J Med Internet Res",
year="2018",
month="Feb",
day="13",
volume="20",
number="2",
pages="e58",
keywords="social media",
keywords="Saudi Arabia",
keywords="eHealth",
keywords="telemedicine",
keywords="mobile phone",
keywords="cell phone",
keywords="outcome of care",
keywords="Middle East",
abstract="Background: Diabetes is a major health care burden in the Middle East region. Social networking tools can contribute to the management of diabetes with improved educational and care outcomes using these popular tools in the region. Objective: The objective of this review was to evaluate the impact of social networking interventions on the improvement of diabetes management and health outcomes in patients with diabetes in the Middle East. Methods: Peer-reviewed articles from PubMed (1990-2017) and Google Scholar (1990-2017) were identified using various combinations of predefined terms and search criteria. The main inclusion criterion consisted of the use of social networking apps on mobile phones as the primary intervention. Outcomes were grouped according to study design, type of diabetes, category of technological intervention, location, and sample size. Results: This review included 5 articles evaluating the use of social media tools in the management of diabetes in the Middle East. In most studies, the acceptance rate for the use of social networking to optimize the management of diabetes was relatively high. Diabetes-specific management tools such as the Saudi Arabia Networking for Aiding Diabetes and  Diabetes Intelligent Management System for Iraq systems helped collect patient information and lower hemoglobin A1c (HbA1c) levels, respectively. Conclusions: The reviewed studies demonstrated the potential of social networking tools being adopted in regions in the Middle East to improve the management of diabetes. Future studies consisting of larger sample sizes spanning multiple regions would provide further insight into the use of social media for improving patient outcomes. ",
doi="10.2196/jmir.9190",
url="http://www.jmir.org/2018/2/e58/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29439941"
}


@Article{info:doi/10.2196/humanfactors.7856,
author="Daneshvar, Hadi
and Anderson, Stuart
and Williams, Robin
and Mozaffar, Hajar",
title="How Can Social Media Lead to Co-Production (Co-Delivery) of New Services for the Elderly Population? A Qualitative Study",
journal="JMIR Hum Factors",
year="2018",
month="Feb",
day="12",
volume="5",
number="1",
pages="e5",
keywords="social media",
keywords="eHealth",
keywords="mHealth",
keywords="social networking",
keywords="Web 2.0",
keywords="health informatics",
abstract="Background: The future of health care services in the European Union faces the triple challenges of aging, fiscal restriction, and inclusion. Co-production offers ways to manage informal care resources to help them cater for the growing needs of elderly people. Social media (SM) is seen as a critical enabler for co-production. Objective: The objective of this study was to investigate how SM---private Facebook groups, forums, Twitter, and blogging---acts as an enabler of co-production in health and care by facilitating its four underlying principles: equality, diversity, accessibility, and reciprocity. Methods: We used normalization process theory as our theoretical framework to design this study. We conducted a qualitative study and collected data through 20 semistructured interviews and observation of the activities of 10 online groups and individuals. We then used thematic analysis and drew on principles of co-production (equality, diversity, accessibility, and reciprocity) as a deductive coding framework to analyze our findings. Results: Our findings point to distinct patterns of feature use by different people involved in care of elderly people. This diversity makes possible the principles of co-production by offering equality among users, enabling diversity of use, making experiences accessible, and encouraging reciprocity in the sharing of knowledge and mutual support. We also identified that explication of common resources may lead to new forms of competition and conflicts. These conflicts require better management to enhance the coordination of the common pool of resources. Conclusions: SM uses afford new forms of organizing and collective engagement between patients, carers, and professionals, which leads to change in health and care communication and coordination. ",
doi="10.2196/humanfactors.7856",
url="http://humanfactors.jmir.org/2018/1/e5/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29434014"
}


@Article{info:doi/10.2196/publichealth.6260,
author="Brown-Johnson, G. Cati
and Boeckman, M. Lindsay
and White, H. Ashley
and Burbank, D. Andrea
and Paulson, Sjonna
and Beebe, A. Laura",
title="Trust in Health Information Sources: Survey Analysis of Variation by Sociodemographic and Tobacco Use Status in Oklahoma",
journal="JMIR Public Health Surveill",
year="2018",
month="Feb",
day="12",
volume="4",
number="1",
pages="e8",
keywords="tobacco use cessation",
keywords="health communication",
keywords="trust",
keywords="social media",
keywords="health care providers",
keywords="electronic cigarettes",
keywords="mass media",
keywords="radio",
keywords="television",
keywords="Oklahoma",
abstract="Background: Modern technology (ie, websites and social media) has significantly changed social mores in health information access and delivery. Although mass media campaigns for health intervention have proven effective and cost-effective in changing health behavior at a population scale, this is best studied in traditional media sources (ie, radio and television). Digital health interventions are options that use short message service/text messaging, social media, and internet technology. Although exposure to these products is becoming ubiquitous, electronic health information is novel, incompletely disseminated, and frequently inaccurate, which decreases public trust. Previous research has shown that audience trust in health care providers significantly moderates health outcomes, demographics significantly influence audience trust in electronic media, and preexisting health behaviors such as smoking status significantly moderate audience receptivity to traditional mass media. Therefore, modern health educators must assess audience trust in all sources, both media (traditional and digital) and interpersonal, to balance pros and cons before structuring multicomponent community health interventions. Objective: We aimed to explore current trust and moderators of trust in health information sources given recent changes in digital health information access and delivery to inform design of future health interventions in Oklahoma. Methods: We conducted phone surveys of a cross-sectional sample of 1001 Oklahoma adults (age 18-65 years) in spring 2015 to assess trust in seven media sources: traditional (television and radio), electronic (online and social media), and interpersonal (providers, insurers, and family/friends). We also gathered information on known moderators of trust (sociodemographics and tobacco use status). We modeled log odds of a participant rating a source as ``trustworthy'' (SAS PROC SURVEYLOGISTIC), with subanalysis for confounders (sociodemographics and tobacco use). Results: Oklahomans showed the highest trust in interpersonal sources: 81\% (808/994) reported providers were trustworthy, 55\% (550/999) for friends and family, and 48\% (485/998) for health insurers. For media sources, 24\% of participants (232/989) rated the internet as trustworthy, followed by 21\% of participants for television (225/998), 18\% for radio (199/988), and only 11\% for social media (110/991). Despite this low self-reported trust in social media, 40\% (406/991) of participants reported using social media for tobacco-related health information. Trust in health providers did not vary by subpopulation, but sociodemographic variables (gender, income, and education) and tobacco use status significantly moderated trust in other sources. Women were on the whole more trusting than men, trust in media decreased with income, and trust in friends and family decreased with education. Conclusions: Health education interventions should incorporate digital media, particularly when targeting low-income populations. Utilizing health care providers in social media settings could leverage high-trust and low-cost features of providers and social media, respectively. ",
doi="10.2196/publichealth.6260",
url="http://publichealth.jmir.org/2018/1/e8/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29434015"
}


@Article{info:doi/10.2196/publichealth.9321,
author="Baral, Stefan
and Turner, M. Rachael
and Lyons, E. Carrie
and Howell, Sean
and Honermann, Brian
and Garner, Alex
and Hess III, Robert
and Diouf, Daouda
and Ayala, George
and Sullivan, S. Patrick
and Millett, Greg",
title="Population Size Estimation of Gay and Bisexual Men and Other Men Who Have Sex With Men Using Social Media-Based Platforms",
journal="JMIR Public Health Surveill",
year="2018",
month="Feb",
day="08",
volume="4",
number="1",
pages="e15",
keywords="AIDS",
keywords="estimates",
keywords="HIV",
keywords="key populations",
keywords="men who have sex with men",
keywords="social media",
abstract="Background: Gay, bisexual, and other cisgender men who have sex with men (GBMSM) are disproportionately affected by the HIV pandemic. Traditionally, GBMSM have been deemed less relevant in HIV epidemics in low- and middle-income settings where HIV epidemics are more generalized. This is due (in part) to how important population size estimates regarding the number of individuals who identify as GBMSM are to informing the development and monitoring of HIV prevention, treatment, and care programs and coverage. However, pervasive stigma and criminalization of same-sex practices and relationships provide a challenging environment for population enumeration, and these factors have been associated with implausibly low or absent size estimates of GBMSM, thereby limiting knowledge about the dynamics of HIV transmission and the implementation of programs addressing GBMSM. Objective: This study leverages estimates of the number of members of a social app geared towards gay men (Hornet) and members of Facebook using self-reported relationship interests in men, men and women, and those with at least one reported same-sex interest. Results were categorized by country of residence to validate official size estimates of GBMSM in 13 countries across five continents. Methods: Data were collected through the Hornet Gay Social Network and by using an a priori determined framework to estimate the numbers of Facebook members with interests associated with GBMSM in South Africa, Ghana, Nigeria, Senegal, C{\^o}te d'Ivoire, Mauritania, The Gambia, Lebanon, Thailand, Malaysia, Brazil, Ukraine, and the United States. These estimates were compared with the most recent Joint United Nations Programme on HIV/AIDS (UNAIDS) and national estimates across 143 countries. Results: The estimates that leveraged social media apps for the number of GBMSM across countries are consistently far higher than official UNAIDS estimates. Using Facebook, it is also feasible to assess the numbers of GBMSM aged 13-17 years, which demonstrate similar proportions to those of older men. There is greater consistency in Facebook estimates of GBMSM compared to UNAIDS-reported estimates across countries. Conclusions: The ability to use social media for epidemiologic and HIV prevention, treatment, and care needs continues to improve. Here, a method leveraging different categories of same-sex interests on Facebook, combined with a specific gay-oriented app (Hornet), demonstrated significantly higher estimates than those officially reported. While there are biases in this approach, these data reinforce the need for multiple methods to be used to count the number of GBMSM (especially in more stigmatizing settings) to better inform mathematical models and the scale of HIV program coverage. Moreover, these estimates can inform programs for those aged 13-17 years; a group for which HIV incidence is the highest and HIV prevention program coverage, including the availability of pre-exposure prophylaxis (PrEP), is lowest. Taken together, these results highlight the potential for social media to provide comparable estimates of the number of GBMSM across a large range of countries, including some with no reported estimates. ",
doi="10.2196/publichealth.9321",
url="http://publichealth.jmir.org/2018/1/e15/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29422452"
}


@Article{info:doi/10.2196/jmir.8249,
author="Pan, Chih-Long
and Lin, Chih-Hao
and Lin, Yan-Ren
and Wen, Hsin-Yu
and Wen, Jet-Chau",
title="The Significance of Witness Sensors for Mass Casualty Incidents and Epidemic Outbreaks",
journal="J Med Internet Res",
year="2018",
month="Feb",
day="02",
volume="20",
number="2",
pages="e39",
keywords="social media",
keywords="mass casualty incident",
keywords="internet",
keywords="sensor",
doi="10.2196/jmir.8249",
url="https://www.jmir.org/2018/2/e39/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29396388"
}


@Article{info:doi/10.2196/ijmr.6573,
author="Barbieri, Stefania
and Feltracco, Paolo
and Lucchetta, Vittorio
and Gaudio, Maria Rosa
and Tredese, Alberto
and Bergamini, Mauro
and Vettore, Gianna
and Pietrantonio, Vincenzo
and Avato, Maria Francesco
and Donato, Daniele
and Boemo, Gianni Deris
and Nesoti, Vittoria Maria
and Snenghi, Rossella",
title="A Social Media-Based Acute Alcohol Consumption Behavior (NekNomination): Case Series in Italian Emergency Departments",
journal="Interact J Med Res",
year="2018",
month="Jan",
day="31",
volume="7",
number="1",
pages="e2",
keywords="alcohol drinking",
keywords="drinking behavior",
keywords="underage drinking",
keywords="binge drinking",
keywords="alcoholic intoxication",
keywords="adolescent",
keywords="neknomination",
keywords="alcoholic games",
keywords="social network",
abstract="Background: NekNomination, also known as NekNominate, Neck and Nominate, or Neck Nomination, is a social network--based drinking game which is thought to have originated in Australia and spread all over the world between 2013 and 2014. Individuals record videos of themselves while rapidly drinking excessive quantities of alcoholic drinks (necking) and then nominate friends to outdo them within 24 hours; the videos are then posted on social media such as Facebook or YouTube. The consequences of this drinking game have been very dangerous; at least 5 people under age 30 years have died after drinking deadly cocktails, and many others have suffered from alcohol intoxication. Objective: The goal of the research is to evaluate data about clinically important acute alcohol intoxication among teenagers and young adults and inform and educate the general public, especially parents, teachers, and health workers, about the spreading craze of dangerous Internet-related behavior among today's teenagers and young people up to the age of 23 years. Methods: Patients aged 15 to 23 years with acute alcohol intoxication who came to the emergency department (ED) of 2 major hospitals in Italy from January 1, 2011, to June 30, 2014, were included in this study. Data were retrieved from prehospital and intrahospital medical records and included personal information, methods of intoxication, triage color code, date and time of access to the ED, any relevant signs and symptoms, blood alcohol concentration, and diagnosis at discharge. Results: A total of 450 young patients (male 277/450, 61.5\%, female 173/450, 38.5\%; age 15 to 16 years 15/450, 3.3\%, age 17 to 18 years 184/450, 40.9\%, age 19 to 23 years 251/450, 55.8\%) were recruited. The causes of intoxication were happy hour, binge drinking, NekNominate, eyeballing, other alcoholic games, or a mix of them. Happy hour was found to be more common among the older patients, whereas NekNominate accounted for almost half of the youngest group of hospitalizations. Eyeballing occurred in 1.6\% (7/450) of cases; binge drinking and other alcoholic games caused 23.3\% (105/450) and 23.8\% (107/450) of hospitalizations, respectively. On admission, 44.2\% (199/450) of patients were assigned a red or yellow color code requiring immediate medical attention; about 14\% of them required additional medical assistance (after being in the ED) or hospitalization, some in semi-intensive care units. Conclusions: Our study shows that the increased numbers of hospitalizations due to alcohol intoxication in the adolescent age group, as a consequence of NekNominate or other drinking games, is alarming and represents a serious public health issue. The potential markers of improper use of social networks must be clearly identified, including categories at risk of alcohol abuse, in order to develop intervention and prevention strategies in terms of education and awareness, which may help in averting potentially fatal episodes. ",
doi="10.2196/ijmr.6573",
url="http://www.i-jmr.org/2018/1/e2/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29386170"
}


@Article{info:doi/10.2196/jmir.7683,
author="Comerford, Megan
and Fogel, Rachel
and Bailey, Robert James
and Chilukuri, Prianka
and Chalasani, Naga
and Lammert, Steven Craig",
title="Leveraging Social Networking Sites for an Autoimmune Hepatitis Genetic Repository: Pilot Study to Evaluate Feasibility",
journal="J Med Internet Res",
year="2018",
month="Jan",
day="18",
volume="20",
number="1",
pages="e14",
keywords="autoimmune hepatitis",
keywords="social media",
keywords="rare disease",
abstract="Background: Conventional approaches to participant recruitment are often inadequate in rare disease investigation. Social networking sites such as Facebook may provide a vehicle to circumvent common research limitations and pitfalls. We report our preliminary experience with Facebook-based methodology for participant recruitment and participation into an ongoing study of autoimmune hepatitis (AIH). Objective: The goal of our research was to conduct a pilot study to assess whether a Facebook-based methodology is capable of recruiting geographically widespread participants into AIH patient-oriented research and obtaining quality phenotypic data. Methods: We established a Facebook community, the Autoimmune Hepatitis Research Network (AHRN), in 2014 to provide a secure and reputable distillation of current literature and AIH research opportunities. Quarterly advertisements for our ongoing observational AIH study were posted on the AHRN over 2 years. Interested and self-reported AIH participants were subsequently enrolled after review of study materials and completion of an informed consent by our study coordinator. Participants returned completed study materials, including epidemiologic questionnaires and genetic material, to our facility via mail. Outside medical records were obtained and reviewed by a study physician. Results: We successfully obtained all study materials from 29 participants with self-reported AIH within 2 years from 20 different states. Liver biopsy results were available for 90\% (26/29) of participants, of which 81\% (21/29) had findings consistent with AIH, 15\% (4/29) were suggestive of AIH with features of primary biliary cholangitis (PBC), and 4\% (1/29) had PBC alone. A total of 83\% (24/29) had at least 2 of 3 proposed criteria: positive autoimmune markers, consistent histologic findings of AIH on liver biopsy, and reported treatment with immunosuppressant medications. Self-reported and physician records were discrepant for immunosuppressant medications or for AIH/PBC diagnoses in 4 patients. Conclusions: Facebook can be an effective ancillary tool for facilitating patient-oriented research in rare diseases. A social media-based approach transcends established limitations in rare disease research and can further develop research communities. ",
doi="10.2196/jmir.7683",
url="http://www.jmir.org/2018/1/e14/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29348111"
}


@Article{info:doi/10.2196/jmir.7558,
author="Partridge, R. Stephanie
and Gallagher, Patrick
and Freeman, Becky
and Gallagher, Robyn",
title="Facebook Groups for the Management of Chronic Diseases",
journal="J Med Internet Res",
year="2018",
month="Jan",
day="17",
volume="20",
number="1",
pages="e21",
keywords="social media, prevention, intervention, Facebook",
doi="10.2196/jmir.7558",
url="http://www.jmir.org/2018/1/e21/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29343460"
}


@Article{info:doi/10.2196/jmir.7643,
author="Shi, Jingyuan
and Salmon, T. Charles",
title="Identifying Opinion Leaders to Promote Organ Donation on Social Media: Network Study",
journal="J Med Internet Res",
year="2018",
month="Jan",
day="09",
volume="20",
number="1",
pages="e7",
keywords="social media",
keywords="health promotion",
keywords="organ donation",
keywords="opinion leaders",
keywords="social network analysis",
abstract="Background: In the recent years, social networking sites (SNSs, also called social media) have been adopted in organ donation campaigns, and recruiting opinion leaders for such campaigns has been found effective in promoting behavioral changes. Objective: The aim of this paper was to focus on the dissemination of organ donation tweets on Weibo, the Chinese equivalent of Twitter, and to examine the opinion leadership in the retweet network of popular organ donation messages using social network analysis. It also aimed to investigate how personal and social attributes contribute to a user's opinion leadership on the topic of organ donation. Methods: All messages about organ donation posted on Weibo from January 1, 2015 to December 31, 2015 were extracted using Python Web crawler. A retweet network with 505,047 nodes and 545,312 edges of the popular messages (n=206) was constructed and analyzed. The local and global opinion leaderships were measured using network metrics, and the roles of personal attributes, professional knowledge, and social positions in obtaining the opinion leadership were examined using general linear model. Results: The findings revealed that personal attributes, professional knowledge, and social positions predicted individual's local opinion leadership in the retweet network of popular organ donation messages. Alternatively, personal attributes and social positions, but not professional knowledge, were significantly associated with global opinion leadership. Conclusions: The findings of this study indicate that health campaign designers may recruit peer leaders in SNS organ donation promotions to facilitate information sharing among the target audience. Users who are unverified, active, well connected, and experienced with information and communications technology (ICT) will accelerate the sharing of organ donation messages in the global environment. Medical professionals such as organ transplant surgeons who can wield a great amount of influence on their direct connections could also effectively participate in promoting organ donation on social media. ",
doi="10.2196/jmir.7643",
url="http://www.jmir.org/2018/1/e7/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29317384"
}


@Article{info:doi/10.2196/resprot.8065,
author="Pase, Claudiana
and Mathias, Dias Andr{\'e}ia
and Garcia, Druck Clotilde
and Garcia Rodrigues, Clarissa",
title="Using Social Media for the Promotion of Education and Consultation in Adolescents Who Have Undergone Kidney Transplant: Protocol for a Randomized Control Trial",
journal="JMIR Res Protoc",
year="2018",
month="Jan",
day="09",
volume="7",
number="1",
pages="e3",
keywords="transplantation",
keywords="education",
keywords="social network",
keywords="adolescents",
abstract="Background: Falling ill represents a traumatic experience especially in adolescence, since in addition to the moments of ambiguity and contradictions that this period brings, there is coping with the disease. Renal transplantation provides a better quality of life but the dependence on dialysis is replaced by the greater responsibility of self-care. With advances in technology, contemporary communication methods are a strategic mechanism for the approximation of the adolescent and the multiprofessional team. In this perspective, our research may provide possible changes and propose alternatives, using social networks for the integration of the multiprofessional team, promoting education within a virtual environment for adolescents who have undergone kidney transplants. Objective: The goal of our research is to compare the knowledge, satisfaction, and self-esteem of adolescent renal transplant patients in 2 groups: patients undergoing conventional treatment versus patients undergoing conventional treatment plus the full-time use of social networks to aid in education and consultation. Methods: Nonblind randomized clinical trial with 128 adolescents (aged 13 to 21 years) divided in 2 groups: the first group will receive conventional care and the second group will be invited to participate in a secret group on the social network Facebook. This group will be used as a new education platform to involve young renal transplant patients to participate in the guidelines provided to them by the multiprofessional team. Results: An environment for learning and exchanging life experiences will be created by using a well-known technology among adolescents. As a low-cost intervention, it will allow a better interaction between the patient and the transplant team. It is expected that the adolescents will improve their knowledge about the disease also increasing their self-esteem and the treatment adhesion. Conclusions: Health professionals need to seek alternatives when educating patients, focusing on easily understandable ways for effective guidance. In the adolescent population, it is understood that the use of technology as support in education is a fundamental tool for this age group. The proposed project will directly benefit adolescent renal transplant patients as it uses language aimed directly at the target demographic. It attempts to overcome the traditional model by being more in contact with the current generation. This approach makes the content easier to assimilate and, consequently, increases understanding. Trial Registration: ClinicalTrials.gov: NCT03214965; https://clinicaltrials.gov/ct2/show/NCT02239354 (Archived by Webcite at http://www.webcitation.org/6wKnYrFGx) ",
doi="10.2196/resprot.8065",
url="http://www.researchprotocols.org/2018/1/e3/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29317381"
}


@Article{info:doi/10.2196/publichealth.7726,
author="Simpson, S. Sean
and Adams, Nikki
and Brugman, M. Claudia
and Conners, J. Thomas",
title="Detecting Novel and Emerging Drug Terms Using Natural Language Processing: A Social Media Corpus Study",
journal="JMIR Public Health Surveill",
year="2018",
month="Jan",
day="08",
volume="4",
number="1",
pages="e2",
keywords="natural language processing",
keywords="street drugs",
keywords="social media",
keywords="vocabulary",
abstract="Background: With the rapid development of new psychoactive substances (NPS) and changes in the use of more traditional drugs, it is increasingly difficult for researchers and public health practitioners to keep up with emerging drugs and drug terms. Substance use surveys and diagnostic tools need to be able to ask about substances using the terms that drug users themselves are likely to be using. Analyses of social media may offer new ways for researchers to uncover and track changes in drug terms in near real time. This study describes the initial results from an innovative collaboration between substance use epidemiologists and linguistic scientists employing techniques from the field of natural language processing to examine drug-related terms in a sample of tweets from the United States. Objective: The objective of this study was to assess the feasibility of using distributed word-vector embeddings trained on social media data to uncover previously unknown (to researchers) drug terms. Methods: In this pilot study, we trained a continuous bag of words (CBOW) model of distributed word-vector embeddings on a Twitter dataset collected during July 2016 (roughly 884.2 million tokens). We queried the trained word embeddings for terms with high cosine similarity (a proxy for semantic relatedness) to well-known slang terms for marijuana to produce a list of candidate terms likely to function as slang terms for this substance. This candidate list was then compared with an expert-generated list of marijuana terms to assess the accuracy and efficacy of using word-vector embeddings to search for novel drug terminology. Results: The method described here produced a list of 200 candidate terms for the target substance (marijuana). Of these 200 candidates, 115 were determined to in fact relate to marijuana (65 terms for the substance itself, 50 terms related to paraphernalia). This included 30 terms which were used to refer to the target substance in the corpus yet did not appear on the expert-generated list and were therefore considered to be successful cases of uncovering novel drug terminology. Several of these novel terms appear to have been introduced as recently as 1 or 2 months before the corpus time slice used to train the word embeddings. Conclusions: Though the precision of the method described here is low enough as to still necessitate human review of any candidate term lists generated in such a manner, the fact that this process was able to detect 30 novel terms for the target substance based only on one month's worth of Twitter data is highly promising. We see this pilot study as an important proof of concept and a first step toward producing a fully automated drug term discovery system capable of tracking emerging NPS terms in real time. ",
doi="10.2196/publichealth.7726",
url="http://publichealth.jmir.org/2018/1/e2/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29311050"
}


@Article{info:doi/10.2196/publichealth.7823,
author="Sinha, S. Michael
and Freifeld, C. Clark
and Brownstein, S. John
and Donneyong, M. Macarius
and Rausch, Paula
and Lappin, M. Brian
and Zhou, H. Esther
and Dal Pan, J. Gerald
and Pawar, M. Ajinkya
and Hwang, J. Thomas
and Avorn, Jerry
and Kesselheim, S. Aaron",
title="Social Media Impact of the Food and Drug Administration's Drug Safety Communication Messaging About Zolpidem: Mixed-Methods Analysis",
journal="JMIR Public Health Surveill",
year="2018",
month="Jan",
day="05",
volume="4",
number="1",
pages="e1",
keywords="Food and Drug Administration",
keywords="drug safety communications",
keywords="surveillance",
keywords="epidemiology",
keywords="social media",
keywords="Twitter",
keywords="Facebook",
keywords="Google Trends",
abstract="Background: The Food and Drug Administration (FDA) issues drug safety communications (DSCs) to health care professionals, patients, and the public when safety issues emerge related to FDA-approved drug products. These safety messages are disseminated through social media to ensure broad uptake. Objective: The objective of this study was to assess the social media dissemination of 2 DSCs released in 2013 for the sleep aid zolpidem. Methods: We used the MedWatcher Social program and the DataSift historic query tool to aggregate Twitter and Facebook posts from October 1, 2012 through August 31, 2013, a period beginning approximately 3 months before the first DSC and ending 3 months after the second. Posts were categorized as (1) junk, (2) mention, and (3) adverse event (AE) based on a score between --0.2 (completely unrelated) to 1 (perfectly related). We also looked at Google Trends data and Wikipedia edits for the same time period. Google Trends search volume is scaled on a range of 0 to 100 and includes ``Related queries'' during the relevant time periods. An interrupted time series (ITS) analysis assessed the impact of DSCs on the counts of posts with specific mention of zolpidem-containing products. Chow tests for known structural breaks were conducted on data from Twitter, Facebook, and Google Trends. Finally, Wikipedia edits were pulled from the website's editorial history, which lists all revisions to a given page and the editor's identity. Results: In total, 174,286 Twitter posts and 59,641 Facebook posts met entry criteria. Of those, 16.63\% (28,989/174,286) of Twitter posts and 25.91\% (15,453/59,641) of Facebook posts were labeled as junk and excluded. AEs and mentions represented 9.21\% (16,051/174,286) and 74.16\% (129,246/174,286) of Twitter posts and 5.11\% (3,050/59,641) and 68.98\% (41,138/59,641) of Facebook posts, respectively. Total daily counts of posts about zolpidem-containing products increased on Twitter and Facebook on the day of the first DSC; Google searches increased on the week of the first DSC. ITS analyses demonstrated variability but pointed to an increase in interest around the first DSC. Chow tests were significant (P<.0001) for both DSCs on Facebook and Twitter, but only the first DSC on Google Trends. Wikipedia edits occurred soon after each DSC release, citing news articles rather than the DSC itself and presenting content that needed subsequent revisions for accuracy. Conclusions: Social media offers challenges and opportunities for dissemination of the DSC messages. The FDA could consider strategies for more actively disseminating DSC safety information through social media platforms, particularly when announcements require updating. The FDA may also benefit from directly contributing content to websites like Wikipedia that are frequently accessed for drug-related information. ",
doi="10.2196/publichealth.7823",
url="http://publichealth.jmir.org/2018/1/e1/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29305342"
}


@Article{info:doi/10.2196/jmir.8959,
author="Nelson, M. Kimberly
and Ramirez, J. Jaime
and Carey, P. Michael",
title="Developing Online Recruitment and Retention Methods for HIV Prevention Research Among Adolescent Males Who Are Interested in Sex with Males: Interviews with Adolescent Males",
journal="J Med Internet Res",
year="2017",
month="Dec",
day="21",
volume="19",
number="12",
pages="e428",
keywords="HIV",
keywords="adolescent males",
keywords="sexual minority",
keywords="recruitment",
keywords="retention",
keywords="online research",
keywords="MSM",
abstract="Background: Adolescent males interested in sex with males (AMSM) are an important audience for HIV prevention interventions, but they are difficult to reach due to their age and social stigma. Objective: We aim to identify efficient methods to recruit and retain AMSM in online research. Methods: Interviews with 14-to-18-year-old AMSM (N=16) were conducted at 2017 Pride events in Boston, MA and Providence, RI. Results: Participants reported that (1) social media platforms are viable recruitment venues; (2) recruitment advertisements should describe the study using colorful/bright pictures, familiar words, and information about compensation; (3) surveys should be <20 minutes in length; (4) modest compensation (eg, email gift card, US \$10 to \$20) was preferred; and (5) communications that remind participants about the length and content of surveys, and compensation, should be sent between study activities to increase retention. Conclusions: Soliciting input from AMSM provides critical guidance regarding recruitment and retention procedures to increase the efficiency of HIV prevention research for this at-risk group. ",
doi="10.2196/jmir.8959",
url="http://www.jmir.org/2017/12/e428/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29269343"
}


@Article{info:doi/10.2196/jmir.8184,
author="Wagner, Moritz
and Lampos, Vasileios
and Yom-Tov, Elad
and Pebody, Richard
and Cox, J. Ingemar",
title="Estimating the Population Impact of a New Pediatric Influenza Vaccination Program in England Using Social Media Content",
journal="J Med Internet Res",
year="2017",
month="Dec",
day="21",
volume="19",
number="12",
pages="e416",
keywords="health intervention",
keywords="influenza",
keywords="vaccination",
keywords="social media",
keywords="Twitter",
abstract="Background: The rollout of a new childhood live attenuated influenza vaccine program was launched in England in 2013, which consisted of a national campaign for all 2 and 3 year olds and several pilot locations offering the vaccine to primary school-age children (4-11 years of age) during the influenza season. The 2014/2015 influenza season saw the national program extended to include additional pilot regions, some of which offered the vaccine to secondary school children (11-13 years of age) as well. Objective: We utilized social media content to obtain a complementary assessment of the population impact of the programs that were launched in England during the 2013/2014 and 2014/2015 flu seasons. The overall community-wide impact on transmission in pilot areas was estimated for the different age groups that were targeted for vaccination. Methods: A previously developed statistical framework was applied, which consisted of a nonlinear regression model that was trained to infer influenza-like illness (ILI) rates from Twitter posts originating in pilot (school-age vaccinated) and control (unvaccinated) areas. The control areas were then used to estimate ILI rates in pilot areas, had the intervention not taken place. These predictions were compared with their corresponding Twitter-based ILI estimates. Results: Results suggest a reduction in ILI rates of 14\% (1-25\%) and 17\% (2-30\%) across all ages in only the primary school-age vaccine pilot areas during the 2013/2014 and 2014/2015 influenza seasons, respectively. No significant impact was observed in areas where two age cohorts of secondary school children were vaccinated. Conclusions: These findings corroborate independent assessments from traditional surveillance data, thereby supporting the ongoing rollout of the program to primary school-age children and providing evidence of the value of social media content as an additional syndromic surveillance tool. ",
doi="10.2196/jmir.8184",
url="http://www.jmir.org/2017/12/e416/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29269339"
}


@Article{info:doi/10.2196/publichealth.8641,
author="Allem, Jon-Patrick
and Ferrara, Emilio
and Uppu, Priyanka Sree
and Cruz, Boley Tess
and Unger, B. Jennifer",
title="E-Cigarette Surveillance With Social Media Data: Social Bots, Emerging Topics, and Trends",
journal="JMIR Public Health Surveill",
year="2017",
month="Dec",
day="20",
volume="3",
number="4",
pages="e98",
keywords="electronic cigarettes",
keywords="vaping",
keywords="Twitter",
keywords="social media",
keywords="social bots",
keywords="electronic nicotine delivery system",
keywords="infoveillance",
abstract="Background: As e-cigarette use rapidly increases in popularity, data from online social systems (Twitter, Instagram, Google Web Search) can be used to capture and describe the social and environmental context in which individuals use, perceive, and are marketed this tobacco product. Social media data may serve as a massive focus group where people organically discuss e-cigarettes unprimed by a researcher, without instrument bias, captured in near real time and at low costs. Objective: This study documents e-cigarette--related discussions on Twitter, describing themes of conversations and locations where Twitter users often discuss e-cigarettes, to identify priority areas for e-cigarette education campaigns. Additionally, this study demonstrates the importance of distinguishing between social bots and human users when attempting to understand public health--related behaviors and attitudes. Methods: E-cigarette--related posts on Twitter (N=6,185,153) were collected from December 24, 2016, to April 21, 2017. Techniques drawn from network science were used to determine discussions of e-cigarettes by describing which hashtags co-occur (concept clusters) in a Twitter network. Posts and metadata were used to describe where geographically e-cigarette--related discussions in the United States occurred. Machine learning models were used to distinguish between Twitter posts reflecting attitudes and behaviors of genuine human users from those of social bots. Odds ratios were computed from 2x2 contingency tables to detect if hashtags varied by source (social bot vs human user) using the Fisher exact test to determine statistical significance. Results: Clusters found in the corpus of hashtags from human users included behaviors (eg, \#vaping), vaping identity (eg, \#vapelife), and vaping community (eg, \#vapenation). Additional clusters included products (eg, \#eliquids), dual tobacco use (eg, \#hookah), and polysubstance use (eg, \#marijuana). Clusters found in the corpus of hashtags from social bots included health (eg, \#health), smoking cessation (eg, \#quitsmoking), and new products (eg, \#ismog). Social bots were significantly more likely to post hashtags that referenced smoking cessation and new products compared to human users. The volume of tweets was highest in the Mid-Atlantic (eg, Pennsylvania, New Jersey, Maryland, and New York), followed by the West Coast and Southwest (eg, California, Arizona and Nevada). Conclusions: Social media data may be used to complement and extend the surveillance of health behaviors including tobacco product use. Public health researchers could harness these data and methods to identify new products or devices. Furthermore, findings from this study demonstrate the importance of distinguishing between Twitter posts from social bots and humans when attempting to understand attitudes and behaviors. Social bots may be used to perpetuate the idea that e-cigarettes are helpful in cessation and to promote new products as they enter the marketplace. ",
doi="10.2196/publichealth.8641",
url="http://publichealth.jmir.org/2017/4/e98/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29263018"
}


@Article{info:doi/10.2196/jmir.8330,
author="Sanguansak, Thuss
and Morley, E. Katharine
and Morley, G. Michael
and Thinkhamrop, Kavin
and Thuanman, Jaruwan
and Agarwal, Isha",
title="Two-Way Social Media Messaging in Postoperative Cataract Surgical Patients: Prospective Interventional Study",
journal="J Med Internet Res",
year="2017",
month="Dec",
day="19",
volume="19",
number="12",
pages="e413",
keywords="cataract",
keywords="social media",
keywords="postoperative care",
keywords="medication adherence",
abstract="Background: Social media offers a new way to provide education, reminders, and support for patients with a variety of health conditions. Most of these interventions use one-way, provider-patient communication. Incorporating social media tools to improve postoperative (postop) education and follow-up care has only been used in limited situations. Objective: The aim of this study was to determine the feasibility and efficacy of two-way social media messaging to deliver reminders and educational information about postop care to cataract patients. Methods: A total of 98 patients undergoing their first eye cataract surgery were divided into two groups: a no message group receiving usual pre- and postop care and a message group receiving usual care plus messages in a mobile social media format with standardized content and timing. Each patient in the message group received nine messages about hand and face hygiene, medication and postop visit adherence, and links to patient education videos about postop care. Patients could respond to messages as desired. Main outcome measures included medication adherence, postop visit adherence, clinical outcomes, and patients' subjective assessments of two-way messaging. The number, types, content, and timing of responses by patients to messages were recorded. Results: Medication adherence was better in the message group at postop day 7, with high adherence in 47 patients (96\%, 47/49) versus 36 patients (73\%, 36/49) in the no message group (P=.004), but no statistically significant differences in medication adherence between the groups were noted at preop and postop day 30. Visit adherence was higher at postop day 30 in the message group (100\%, 49/49) versus the no message group (88\%, 43/49; P=.03) but was 100\% (49/49) in both groups at postop day 1 and 7. Final visual outcomes were similar between groups. A total of 441 standardized messages were sent to the message group. Out of 270 responses generated, 188 (70\%) were simple acknowledgments or ``thank you,'' and 82 (30\%) responses were questions that were divided into three general categories: administrative, postop care, and clinical issues. Out of the 82 question responses, 31 (11\%) were about administrative issues, 28 (10\%) about postop care, and 23 (9\%) about clinical symptoms. All the messages about symptoms were triaged by nurses or ophthalmologists and only required reassurance or information. Patients expressed satisfaction with messaging. Conclusions: Two-way social media messaging to deliver postop information to cataract patients is feasible and improves early medication compliance. Further design improvements can streamline work flow to optimize efficiency and patient satisfaction. ",
doi="10.2196/jmir.8330",
url="http://www.jmir.org/2017/12/e413/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29258973"
}


@Article{info:doi/10.2196/jmir.7467,
author="Keller, Sophie Michelle
and Park, J. Hannah
and Cunningham, Elena Maria
and Fouladian, Eleazar Joshua
and Chen, Michelle
and Spiegel, Ross Brennan Mason",
title="Public Perceptions Regarding Use of Virtual Reality in Health Care: A Social Media Content Analysis Using Facebook",
journal="J Med Internet Res",
year="2017",
month="Dec",
day="19",
volume="19",
number="12",
pages="e419",
keywords="social media",
keywords="virtual reality",
keywords="qualitative research",
abstract="Background: Virtual reality (VR) technology provides an immersive environment that enables users to have modified experiences of reality. VR is increasingly used to manage patients with pain, disability, obesity, neurologic dysfunction, anxiety, and depression. However, public opinion regarding the use of VR in health care has not been explored. Understanding public opinion of VR is critical to ensuring effective implementation of this emerging technology. Objective: This study aimed to examine public opinion about health care VR using social listening, a method that allows for the exploration of unfiltered views of topics discussed on social media and online forums. Methods: In March 2016, NBC News produced a video depicting the use of VR for patient care. The video was repackaged by NowThis, a social media news website, and distributed on Facebook by Upworthy, a news aggregator, yielding 4.3 million views and 2401 comments. We used Microsoft Excel Power Query and ATLAS.ti software (version 7.5, Scientific Software Development) to analyze the comments using content analysis and categorized the comments around first-, second-, and third-order concepts. We determined self-identified gender from the user's Facebook page and performed sentiment analysis of the language to analyze whether the perception of VR differed by gender using a Pearson's chi-square test. Results: Out of the 1614 analyzable comments, 1021 (63.26\%) were attributed to female Facebook users, 572 (35.44\%) to male users, and 21 (1.30\%) to users of unknown gender. There were 1197 comments coded as expressing a positive perception about VR (74.16\%), 251 coded as expressing a negative perception and/or concern (15.56\%), and 560 coded as neutral (34.70\%). Informants identified 20 use cases for VR in health care, including the use of VR for pain and stress reduction; bed-bound individuals; women during labor; and patients undergoing chemotherapy, dialysis, radiation, or imaging procedures. Negative comments expressed concerns about radiation, infection risk, motion sickness, and the ubiquity of and overall dependence on technology. There was a statistically significant association between the language valence of the Facebook post and the gender of the Facebook user; men were more likely to post negative perceptions about the use of VR for health care, whereas women were more likely to post positive perceptions (P<.001). Conclusions: Most informants expressed positive perceptions about the use of VR in a wide range of health care settings. However, many expressed concerns that should be acknowledged and addressed as health care VR continues to evolve. Our results provide guidance in determining where further research on the use of VR in patient care is needed, and offer a formal opportunity for public opinion to shape the VR research agenda. ",
doi="10.2196/jmir.7467",
url="http://www.jmir.org/2017/12/e419/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29258975"
}


@Article{info:doi/10.2196/jmir.9266,
author="Bian, Jiang
and Zhao, Yunpeng
and Salloum, G. Ramzi
and Guo, Yi
and Wang, Mo
and Prosperi, Mattia
and Zhang, Hansi
and Du, Xinsong
and Ramirez-Diaz, J. Laura
and He, Zhe
and Sun, Yuan",
title="Using Social Media Data to Understand the Impact of Promotional Information on Laypeople's Discussions: A Case Study of Lynch Syndrome",
journal="J Med Internet Res",
year="2017",
month="Dec",
day="13",
volume="19",
number="12",
pages="e414",
keywords="social media",
keywords="Lynch syndrome",
keywords="public health surveillance",
keywords="sentiment analysis",
abstract="Background: Social media is being used by various stakeholders among pharmaceutical companies, government agencies, health care organizations, professionals, and news media as a way of engaging audiences to raise disease awareness and ultimately to improve public health. Nevertheless, it is unclear what effects this health information has on laypeople. Objective: This study aimed to provide a detailed examination of how promotional health information related to Lynch syndrome impacts laypeople's discussions on a social media platform (Twitter) in terms of topic awareness and attitudes. Methods: We used topic modeling and sentiment analysis techniques on Lynch syndrome--related tweets to answer the following research questions (RQs): (1) what are the most discussed topics in Lynch syndrome--related tweets?; (2) how promotional Lynch syndrome--related information on Twitter affects laypeople's discussions?; and (3) what impact do the Lynch syndrome awareness activities in the Colon Cancer Awareness Month and Lynch Syndrome Awareness Day have on laypeople's discussions and their attitudes? In particular, we used a set of keywords to collect Lynch syndrome--related tweets from October 26, 2016 to August 11, 2017 (289 days) through the Twitter public search application programming interface (API). We experimented with two different classification methods to categorize tweets into the following three classes: (1) irrelevant, (2) promotional health information, and (3) laypeople's discussions. We applied a topic modeling method to discover the themes in these Lynch syndrome--related tweets and conducted sentiment analysis on each layperson's tweet to gauge the writer's attitude (ie, positive, negative, and neutral) toward Lynch syndrome. The topic modeling and sentiment analysis results were elaborated to answer the three RQs. Results: Of all tweets (N=16,667), 87.38\% (14,564/16,667) were related to Lynch syndrome. Of the Lynch syndrome--related tweets, 81.43\% (11,860/14,564) were classified as promotional and 18.57\% (2704/14,564) were classified as laypeople's discussions. The most discussed themes were treatment (n=4080) and genetic testing (n=3073). We found that the topic distributions in laypeople's discussions were similar to the distributions in promotional Lynch syndrome--related information. Furthermore, most people had a positive attitude when discussing Lynch syndrome. The proportion of negative tweets was 3.51\%. Within each topic, treatment (16.67\%) and genetic testing (5.60\%) had more negative tweets compared with other topics. When comparing monthly trends, laypeople's discussions had a strong correlation with promotional Lynch syndrome--related information on awareness (r=.98, P<.001), while there were moderate correlations on screening (r=.602, P=.05), genetic testing (r=.624, P=.04), treatment (r=.69, P=.02), and risk (r=.66, P=.03). We also discovered that the Colon Cancer Awareness Month (March 2017) and the Lynch Syndrome Awareness Day (March 22, 2017) had significant positive impacts on laypeople's discussions and their attitudes. Conclusions: There is evidence that participative social media platforms, namely Twitter, offer unique opportunities to inform cancer communication surveillance and to explore the mechanisms by which these new communication media affect individual health behavior and population health. ",
doi="10.2196/jmir.9266",
url="http://www.jmir.org/2017/12/e414/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29237586"
}


@Article{info:doi/10.2196/jmir.8729,
author="Tan, Ziying
and Liu, Xingyun
and Liu, Xiaoqian
and Cheng, Qijin
and Zhu, Tingshao",
title="Designing Microblog Direct Messages to Engage Social Media Users With Suicide Ideation: Interview and Survey Study on Weibo",
journal="J Med Internet Res",
year="2017",
month="Dec",
day="12",
volume="19",
number="12",
pages="e381",
keywords="microblog direct message",
keywords="social media",
keywords="suicide prevention",
abstract="Background: While Web-based interventions can be efficacious, engaging a target population's attention remains challenging. We argue that strategies to draw such a population's attention should be tailored to meet its needs. Increasing user engagement in online suicide intervention development requires feedback from this group to prevent people who have suicide ideation from seeking treatment. Objective: The goal of this study was to solicit feedback on the acceptability of the content of messaging from social media users with suicide ideation. To overcome the common concern of lack of engagement in online interventions and to ensure effective learning from the message, this research employs a customized design of both content and length of the message. Methods: In study 1, 17 participants suffering from suicide ideation were recruited. The first (n=8) group conversed with a professional suicide intervention doctor about its attitudes and suggestions for a direct message intervention. To ensure the reliability and consistency of the result, an identical interview was conducted for the second group (n=9). Based on the collected data, questionnaires about this intervention were formed. Study 2 recruited 4222 microblog users with suicide ideation via the Internet. Results: The results of the group interviews in study 1 yielded little difference regarding the interview results; this difference may relate to the 2 groups' varied perceptions of direct message design. However, most participants reported that they would be most drawn to an intervention where they knew that the account was reliable. Out of 4222 microblog users, we received responses from 725 with completed questionnaires; 78.62\% (570/725) participants were not opposed to online suicide intervention and they valued the link for extra suicide intervention information as long as the account appeared to be trustworthy. Their attitudes toward the intervention and the account were similar to those from study 1, and 3 important elements were found pertaining to the direct message: reliability of account name, brevity of the message, and details of the phone numbers of psychological intervention centers and psychological assessment. Conclusions: This paper proposed strategies for engaging target populations in online suicide interventions. ",
doi="10.2196/jmir.8729",
url="http://www.jmir.org/2017/12/e381/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29233805"
}


@Article{info:doi/10.2196/resprot.8068,
author="Wang, L. Monica
and Waring, E. Molly
and Jake-Schoffman, E. Danielle
and Oleski, L. Jessica
and Michaels, Zachary
and Goetz, M. Jared
and Lemon, C. Stephenie
and Ma, Yunsheng
and Pagoto, L. Sherry",
title="Clinic Versus Online Social Network--Delivered Lifestyle Interventions: Protocol for the Get Social Noninferiority Randomized Controlled Trial",
journal="JMIR Res Protoc",
year="2017",
month="Dec",
day="11",
volume="6",
number="12",
pages="e243",
keywords="methods",
keywords="randomized controlled trial",
keywords="life style",
keywords="obesity",
keywords="weight loss",
keywords="social support",
abstract="Background: Online social networks may be a promising modality to deliver lifestyle interventions by reducing cost and burden. Although online social networks have been integrated as one component of multimodality lifestyle interventions, no randomized trials to date have compared a lifestyle intervention delivered entirely via online social network with a traditional clinic-delivered intervention. Objective: This paper describes the design and methods of a noninferiority randomized controlled trial, testing (1) whether a lifestyle intervention delivered entirely through an online social network would produce weight loss that would not be appreciably worse than that induced by a traditional clinic-based lifestyle intervention among overweight and obese adults and (2) whether the former would do so at a lower cost. Methods: Adults with body mass index (BMI) between 27 and 45 kg/m2 (N=328) will be recruited from the communities in central Massachusetts. These overweight or obese adults will be randomized to two conditions: a lifestyle intervention delivered entirely via the online social network Twitter (Get Social condition) and an in-person group-based lifestyle intervention (Traditional condition) among overweight and obese adults. Measures will be obtained at baseline, 6 months, and 12 months after randomization. The primary noninferiority outcome is percentage weight loss at 12 months. Secondary noninferiority outcomes include dietary intake and moderate intensity physical activity at 12 months. Our secondary aim is to compare the conditions on cost. Exploratory outcomes include treatment retention, acceptability, and burden. Finally, we will explore predictors of weight loss in the online social network condition. Results: The final wave of data collection is expected to conclude in June 2019. Data analysis will take place in the months following and is expected to be complete in September 2019. Conclusions: Findings will extend the literature by revealing whether delivering a lifestyle intervention via an online social network is an effective alternative to the traditional modality of clinic visits, given the former might be more scalable and feasible to implement in settings that cannot support clinic-based models. Trial Registration: ClinicalTrials.gov NCT02646618; https://clinicaltrials.gov/ct2/show/NCT02646618 (Archived by WebCite at http://www.webcitation.org/6v20waTFW) ",
doi="10.2196/resprot.8068",
url="http://www.researchprotocols.org/2017/12/e243/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29229591"
}


@Article{info:doi/10.2196/jmir.7624,
author="Groshek, Jacob
and Basil, Miles
and Guo, Ling
and Parker Ward, Sarah
and Farraye, A. Francis
and Reich, Jason",
title="Media Consumption and Creation in Attitudes Toward and Knowledge of Inflammatory Bowel Disease: Web-Based Survey",
journal="J Med Internet Res",
year="2017",
month="Dec",
day="08",
volume="19",
number="12",
pages="e403",
keywords="inflammatory bowel disease",
keywords="social media",
keywords="health communication",
keywords="social stigma",
abstract="Background: Inflammatory bowel disease (IBD) is a chronic gastrointestinal condition affecting over 5 million people globally and 1.6 million in the United States but currently lacks a precisely determined cause or cure. The range of symptoms IBD patients experience are often debilitating, and the societal stigmas associated with some such symptoms can further degrade their quality of life. Better understanding the nature of this public reproach then is a critical component for improving awareness campaigns and, ultimately, the experiences of IBD patients. Objective: The objective of this study was to explore and assess the public's awareness and knowledge of IBD, as well as what relationship, if any, exists between the social stigma surrounding IBD, knowledge of the disease, and various media usage, including social media. Methods: Utilizing a Web-based opt-in platform, we surveyed a nationally representative sample (n=1200) with demographics mirroring those of the US Census figures across baseline parameters. Using constructed indices based on factor analysis, we were able to build reliable measures of personal characteristics, media behaviors, and perceptions and knowledge of IBD. Results: Among the American public, IBD is the most stigmatized of seven diseases, including genital herpes and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). Additionally, IBD knowledge is generally low with 11.08\% (133/1200) of the sample indicating no familiarity with the disease and 85.50\% (1026/1200) of participants inaccurately answering two-thirds of the IBD index questions with which their knowledge was assessed. Increased knowledge of IBD is associated with lower levels of stigma. However, social media use is currently related to lower levels of IBD knowledge (P<.05). Furthermore, findings indicate that participants who most frequently engaged in producing social media content are less knowledgeable about IBD (P<.10), highlighting the potential for a dangerous cycle should they be contributing to a Web-based IBD dialogue. Conclusions: Greater efforts must be taken to stymie IBD misinformation across all media, but especially in social media channels, to increase IBD knowledge and reduce stigma surrounding IBD. These findings pave the way for further research qualitatively examining the pervasiveness of specific IBD messages found in today's social media landscape and their impact on enacted stigmas so as to better equip providers and patient advocacy organizations with impactful communication solutions. ",
doi="10.2196/jmir.7624",
url="http://www.jmir.org/2017/12/e403/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29222081"
}


@Article{info:doi/10.2196/jmir.7997,
author="Cao, Bolin
and Gupta, Somya
and Wang, Jiangtao
and Hightow-Weidman, B. Lisa
and Muessig, E. Kathryn
and Tang, Weiming
and Pan, Stephen
and Pendse, Razia
and Tucker, D. Joseph",
title="Social Media Interventions to Promote HIV Testing, Linkage, Adherence, and Retention: Systematic Review and Meta-Analysis",
journal="J Med Internet Res",
year="2017",
month="Nov",
day="24",
volume="19",
number="11",
pages="e394",
keywords="social media",
keywords="HIV",
keywords="MSM",
keywords="intervention",
keywords="testing",
keywords="adherence",
abstract="Background: Social media is increasingly used to deliver HIV interventions for key populations worldwide. However, little is known about the specific uses and effects of social media on human immunodeficiency virus (HIV) interventions. Objective: This systematic review examines the effectiveness of social media interventions to promote HIV testing, linkage, adherence, and retention among key populations. Methods: We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist and Cochrane guidelines for this review and registered it on the International Prospective Register of Systematic Reviews, PROSPERO. We systematically searched six databases and three conference websites using search terms related to HIV, social media, and key populations. We included studies where (1) the intervention was created or implemented on social media platforms, (2) study population included men who have sex with men (MSM), transgender individuals, people who inject drugs (PWID), and/or sex workers, and (3) outcomes included promoting HIV testing, linkage, adherence, and/or retention. Meta-analyses were conducted by Review Manager, version 5.3. Pooled relative risk (RR) and 95\% confidence intervals were calculated by random-effects models. Results: Among 981 manuscripts identified, 26 studies met the inclusion criteria. We found 18 studies from high-income countries, 8 in middle-income countries, and 0 in low-income countries. Eight were randomized controlled trials, and 18 were observational studies. All studies (n=26) included MSM; five studies also included transgender individuals. The focus of 21 studies was HIV testing, four on HIV testing and linkage to care, and one on antiretroviral therapy adherence. Social media interventions were used to do the following: build online interactive communities to encourage HIV testing/adherence (10 studies), provide HIV testing services (9 studies), disseminate HIV information (9 studies), and develop intervention materials (1 study). Of the studies providing HIV self-testing, 16\% of participants requested HIV testing kits from social media platforms. Existing social media platforms such as Facebook (n=15) and the gay dating app Grindr (n=10) were used most frequently. Data from four studies show that HIV testing uptake increased after social media interventions (n=1283, RR 1.50, 95\% CI 1.28-1.76). In the studies where social media interventions were participatory, HIV testing uptake was higher in the intervention arm than the comparison arm (n=1023, RR 1.64, 95\% CI 1.19-2.26). Conclusions: Social media interventions are effective in promoting HIV testing among MSM in many settings. Social media interventions to improve HIV services beyond HIV testing in low- and middle-income countries and among other key populations need to be considered. Trial Registration: International Prospective Register of Systematic Reviews (PROSPERO): CRD42016048073; http://www.crd.york.ac.uk/PROSPERO/display\_record.php?ID=CRD42016048073 (Archived by WebCite at http://www. webcitation.org/6usLCJK3v) ",
doi="10.2196/jmir.7997",
url="http://www.jmir.org/2017/11/e394/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29175811"
}


@Article{info:doi/10.2196/jmir.8739,
author="Das, Roopa
and Machalek, A. Dorothy
and Molesworth, G. Edmund
and Garland, M. Suzanne",
title="Using Facebook to Recruit Young Australian Men Into a Cross-Sectional Human Papillomavirus Study",
journal="J Med Internet Res",
year="2017",
month="Nov",
day="17",
volume="19",
number="11",
pages="e389",
keywords="social media",
keywords="Facebook",
keywords="human papillomavirus",
keywords="HPV",
keywords="online recruitment",
keywords="social networking",
keywords="social networking sites",
keywords="SNS",
abstract="Background: Young men can be difficult to engage in health research using traditional methods of recruitment. Social networking sites are increasingly being used to recruit participants into health research, due to their cost effectiveness, overall generalizability, and wide reach. Objective: The aim of this study was to determine the feasibility of using Facebook to recruit young Australian men into a human papillomavirus (HPV) prevalence study. Methods: We recruited male permanent residents of Australia, aged 18 to 35 years, into the HPV in Young Males (HYM) study through targeted advertising placed on Facebook. Consenting participants completed an online questionnaire and provided a self-collected penile swab for HPV DNA detection and genotyping. We compared sociodemographic characteristics of the study population with those of the general Australian male population, based on Australian 2011 census data. Results: Between February 2015 and February 2017, targeted Facebook advertisements reached 1,523,239 men, resulting in 41,811 clicks through to the study website, with 1072 (2.56\%) converting to lodgment of an expression of interest. Of these, 681 (63.53\%) provided written informed consent and 535 (78.6\% of recruited participants) completed all the study requirements. Reasons for participating in the study included altruism, past history of HPV, gaining more knowledge about HPV or the vaccine, working in the health industry, and the monetary compensation. The average advertising cost per completed study participant was Aus \$48. Compared with the census population, HYM study participants were more likely to be Australian born (P<.001), be from Victoria (P=.003) or the Australian Capital Territory (P=.004), reside in a major city (P<.001), and have completed undergraduate (P<.001) or postgraduate education (P<.001). HYM study participants were less likely to report being a current smoker (P=.03), but were more likely to identify as bisexual or homosexual (294/529, 55.6\%, P<.001), than the general population. Conclusions: Using Facebook is a feasible and efficient strategy for the recruitment of men from across Australia for HPV testing. This method could be used for monitoring the impact of HPV vaccination. Additional targeting may achieve a sample that is broadly demographically representative of the Australian population. Future research should explore how the sexual risk behavior characteristics of populations recruited through Facebook compare with those of traditional recruitment methods. ",
doi="10.2196/jmir.8739",
url="http://www.jmir.org/2017/11/e389/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29150417"
}


@Article{info:doi/10.2196/jmir.5989,
author="Iftikhar, Rahila
and Abaalkhail, Bahaa",
title="Health-Seeking Influence Reflected by Online Health-Related Messages Received on Social Media: Cross-Sectional Survey",
journal="J Med Internet Res",
year="2017",
month="Nov",
day="16",
volume="19",
number="11",
pages="e382",
keywords="online health information-seeking behaviors",
keywords="Facebook",
keywords="social media",
keywords="Twitter",
keywords="WhatsApp",
abstract="Background: Major social networking platforms, such as Facebook, WhatsApp, and Twitter, have become popular means through which people share health-related information, irrespective of whether messages disseminated through these channels are authentic. Objective: This study aims to describe the demographic characteristics of patients that may demonstrate their attitudes toward medical information shared on social media networks. Second, we address how information found through social media affects the way people deal with their health. Third, we examine whether patients initiate or alter/discontinue their medications based on information derived from social media. Methods: We conducted a cross-sectional survey between April and June 2015 on patients attending outpatient clinics at King Abdulaziz University, Jeddah, Saudi Arabia. Patients who used social media (Facebook, WhatsApp, and Twitter) were included. We designed a questionnaire with closed-ended and multiple-choice questions to assess the type of social media platforms patients used and whether information received on these platforms influenced their health care decisions. We used chi-square test to establish the relationship between categorical variables. Results: Of the 442 patients who filled in the questionnaires, 401 used Facebook, WhatsApp, or Twitter. The majority of respondents (89.8\%, 397/442) used WhatsApp, followed by Facebook (58.6\%, 259/442) and Twitter (42.3\%, 187/442). In most cases, respondents received health-related messages from WhatsApp and approximately 42.6\% (171/401) reported ever stopping treatment as advised on a social media platform. A significantly higher proportion of patients without heart disease (P=.001) and obese persons (P=.01) checked the authenticity of information received on social media. Social media messages influenced decision making among patients without heart disease (P=.04). Respondents without heart disease (P=.001) and obese persons (P=.01) were more likely to discuss health-related information received on social media channels with a health care professional. A significant proportion of WhatsApp users reported that health-related information received on this platform influenced decisions regarding their family's health care (P=.001). Respondents' decisions regarding family health care were more likely to be influenced when they used two or all three types of platforms (P=.003). Conclusions: Health education in the digital era needs to be accurate, evidence-based, and regulated. As technologies continue to evolve, we must be equipped to face the challenges it brings with it. ",
doi="10.2196/jmir.5989",
url="http://www.jmir.org/2017/11/e382/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29146568"
}


@Article{info:doi/10.2196/publichealth.8507,
author="Vickey, Theodore
and Breslin, G. John",
title="Online Influence and Sentiment of Fitness Tweets: Analysis of Two Million Fitness Tweets",
journal="JMIR Public Health Surveill",
year="2017",
month="Oct",
day="31",
volume="3",
number="4",
pages="e82",
keywords="Twitter",
keywords="physical activity",
keywords="mobile fitness apps",
keywords="fitness tweet classification",
keywords="sentiment",
abstract="Background: Publicly available fitness tweets may provide useful and in-depth insights into the real-time sentiment of a person's physical activity and provide motivation to others through online influence. Objective: The goal of this experimental approach using the fitness Twitter dataset is two-fold: (1) to determine if there is a correlation between the type of activity tweet (either workout or workout+, which contains the same information as a workout tweet but has additional user-generated information), gender, and one's online influence as measured by Klout Score and (2) to examine the sentiment of the activity-coded fitness tweets by looking at real-time shared thoughts via Twitter regarding their experiences with physical activity and the associated mobile fitness app. Methods: The fitness tweet dataset includes demographic and activity data points, including minutes of activity, Klout Score, classification of each fitness tweet, the first name of each fitness tweet user, and the tweet itself. Gender for each fitness tweet user was determined by a first name comparison with the US Social Security Administration database of first names and gender. Results: Over 184 days, 2,856,534 tweets were collected in 23 different languages. However, for the purposes of this study, only the English-language tweets were analyzed from the activity tweets, resulting in a total of 583,252 tweets. After assigning gender to Twitter usernames based on the Social Security Administration database of first names, analysis of minutes of activity by both gender and Klout influence was determined. The mean Klout Score for those who shared their workout data from within four mobile apps was 20.50 (13.78 SD), less than the general Klout Score mean of 40, as was the Klout Score at the 95th percentile (40 vs 63). As Klout Score increased, there was a decrease in the number of overall workout+ tweets. With regards to sentiment, fitness-related tweets identified as workout+ reflected a positive sentiment toward physical activity by a ratio of 4 to 1. Conclusions: The results of this research suggest that the users of mobile fitness apps who share their workouts via Twitter have a lower Klout Score than the general Twitter user and that users who chose to share additional insights into their workouts are more positive in sentiment than negative. We present a novel perspective into the physical activity messaging from within mobile fitness apps that are then shared over Twitter. By moving beyond the numbers and evaluating both the Twitter user and the emotions tied to physical activity, future research could analyze additional relationships between the user's online influence, the enjoyment of the physical activity, and with additional analysis a long-term retention strategy for the use of a fitness app. ",
doi="10.2196/publichealth.8507",
url="http://publichealth.jmir.org/2017/4/e82/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29089294"
}


@Article{info:doi/10.2196/jmir.6426,
author="Kim, Jung Sunny
and Marsch, A. Lisa
and Hancock, T. Jeffrey
and Das, K. Amarendra",
title="Scaling Up Research on Drug Abuse and Addiction Through Social Media Big Data",
journal="J Med Internet Res",
year="2017",
month="Oct",
day="31",
volume="19",
number="10",
pages="e353",
keywords="opioid epidemic",
keywords="opioid crisis",
keywords="opioid-related disorders",
keywords="substance use",
keywords="substance-related disorders",
keywords="prescription drug misuse",
keywords="addiction",
keywords="Facebook",
keywords="Twitter",
keywords="Instagram",
keywords="big data",
keywords="ethics",
abstract="Background: Substance use--related communication for drug use promotion and its prevention is widely prevalent on social media. Social media big data involve naturally occurring communication phenomena that are observable through social media platforms, which can be used in computational or scalable solutions to generate data-driven inferences. Despite the promising potential to utilize social media big data to monitor and treat substance use problems, the characteristics, mechanisms, and outcomes of substance use--related communications on social media are largely unknown. Understanding these aspects can help researchers effectively leverage social media big data and platforms for observation and health communication outreach for people with substance use problems. Objective: The objective of this critical review was to determine how social media big data can be used to understand communication and behavioral patterns of problematic use of prescription drugs. We elaborate on theoretical applications, ethical challenges and methodological considerations when using social media big data for research on drug abuse and addiction. Based on a critical review process, we propose a typology with key initiatives to address the knowledge gap in the use of social media for research on prescription drug abuse and addiction. Methods: First, we provided a narrative summary of the literature on drug use--related communication on social media. We also examined ethical considerations in the research processes of (1) social media big data mining, (2) subgroup or follow-up investigation, and (3) dissemination of social media data-driven findings. To develop a critical review-based typology, we searched the PubMed database and the entire e-collection theme of ``infodemiology and infoveillance'' in the Journal of Medical Internet Research / JMIR Publications. Studies that met our inclusion criteria (eg, use of social media data concerning non-medical use of prescription drugs, data informatics-driven findings) were reviewed for knowledge synthesis. User characteristics, communication characteristics, mechanisms and predictors of such communications, and the psychological and behavioral outcomes of social media use for problematic drug use--related communications are the dimensions of our typology. In addition to ethical practices and considerations, we also reviewed the methodological and computational approaches used in each study to develop our typology. Results: We developed a typology to better understand non-medical, problematic use of prescription drugs through the lens of social media big data. Highly relevant studies that met our inclusion criteria were reviewed for knowledge synthesis. The characteristics of users who shared problematic substance use--related communications on social media were reported by general group terms, such as adolescents, Twitter users, and Instagram users. All reviewed studies examined the communication characteristics, such as linguistic properties, and social networks of problematic drug use--related communications on social media. The mechanisms and predictors of such social media communications were not directly examined or empirically identified in the reviewed studies. The psychological or behavioral consequence (eg, increased behavioral intention for mimicking risky health behaviors) of engaging with and being exposed to social media communications regarding problematic drug use was another area of research that has been understudied. Conclusions: We offer theoretical applications, ethical considerations, and empirical evidence within the scope of social media communication and prescription drug abuse and addiction. Our critical review suggests that social media big data can be a tremendous resource to understand, monitor and intervene on drug abuse and addiction problems. ",
doi="10.2196/jmir.6426",
url="http://www.jmir.org/2017/10/e353/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29089287"
}


@Article{info:doi/10.2196/jmir.8164,
author="Sarker, Abeed
and Chandrashekar, Pramod
and Magge, Arjun
and Cai, Haitao
and Klein, Ari
and Gonzalez, Graciela",
title="Discovering Cohorts of Pregnant Women From Social Media for Safety Surveillance and Analysis",
journal="J Med Internet Res",
year="2017",
month="Oct",
day="30",
volume="19",
number="10",
pages="e361",
keywords="natural language processing",
keywords="machine learning",
keywords="text mining",
keywords="social media",
keywords="pregnancy",
keywords="cohort studies",
keywords="data analysis",
abstract="Background: Pregnancy exposure registries are the primary sources of information about the safety of maternal usage of medications during pregnancy. Such registries enroll pregnant women in a voluntary fashion early on in pregnancy and follow them until the end of pregnancy or longer to systematically collect information regarding specific pregnancy outcomes. Although the model of pregnancy registries has distinct advantages over other study designs, they are faced with numerous challenges and limitations such as low enrollment rate, high cost, and selection bias. Objective: The primary objectives of this study were to systematically assess whether social media (Twitter) can be used to discover cohorts of pregnant women and to develop and deploy a natural language processing and machine learning pipeline for the automatic collection of cohort information. In addition, we also attempted to ascertain, in a preliminary fashion, what types of longitudinal information may potentially be mined from the collected cohort information. Methods: Our discovery of pregnant women relies on detecting pregnancy-indicating tweets (PITs), which are statements posted by pregnant women regarding their pregnancies. We used a set of 14 patterns to first detect potential PITs. We manually annotated a sample of 14,156 of the retrieved user posts to distinguish real PITs from false positives and trained a supervised classification system to detect real PITs. We optimized the classification system via cross validation, with features and settings targeted toward optimizing precision for the positive class. For users identified to be posting real PITs via automatic classification, our pipeline collected all their available past and future posts from which other information (eg, medication usage and fetal outcomes) may be mined. Results: Our rule-based PIT detection approach retrieved over 200,000 posts over a period of 18 months. Manual annotation agreement for three annotators was very high at kappa ($\kappa$)=.79. On a blind test set, the implemented classifier obtained an overall F1 score of 0.84 (0.88 for the pregnancy class and 0.68 for the nonpregnancy class). Precision for the pregnancy class was 0.93, and recall was 0.84. Feature analysis showed that the combination of dense and sparse vectors for classification achieved optimal performance. Employing the trained classifier resulted in the identification of 71,954 users from the collected posts. Over 250 million posts were retrieved for these users, which provided a multitude of longitudinal information about them. Conclusions: Social media sources such as Twitter can be used to identify large cohorts of pregnant women and to gather longitudinal information via automated processing of their postings. Considering the many drawbacks and limitations of pregnancy registries, social media mining may provide beneficial complementary information. Although the cohort sizes identified over social media are large, future research will have to assess the completeness of the information available through them. ",
doi="10.2196/jmir.8164",
url="http://www.jmir.org/2017/10/e361/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29084707"
}


@Article{info:doi/10.2196/mental.8141,
author="Lachmar, Megan E.
and Wittenborn, K. Andrea
and Bogen, W. Katherine
and McCauley, L. Heather",
title="\#MyDepressionLooksLike: Examining Public Discourse About Depression on Twitter",
journal="JMIR Ment Health",
year="2017",
month="Oct",
day="18",
volume="4",
number="4",
pages="e43",
keywords="social media",
keywords="depression",
keywords="community networks",
keywords="social stigma",
abstract="Background: Social media provides a context for billions of users to connect, express sentiments, and provide in-the-moment status updates. Because Twitter users tend to tweet emotional updates from daily life, the platform provides unique insights into experiences of mental health problems. Depression is not only one of the most prevalent health conditions but also carries a social stigma. Yet, opening up about one's depression and seeking social support may provide relief from symptoms. Objective: The aim of this study was to examine the public discourse of the trending hashtag \#MyDepressionLooksLike to look more closely at how users talk about their depressive symptoms on Twitter. Methods: We captured 3225 original content tweets for the hashtag \#MyDepressionLooksLike that circulated in May of 2016. Eliminating public service announcements, spam, and tweets with links to pictures or videos resulted in a total of 1978 tweets. Using qualitative content analysis, we coded the tweets to detect themes. Results: The content analysis revealed seven themes: dysfunctional thoughts, lifestyle challenges, social struggles, hiding behind a mask, apathy and sadness, suicidal thoughts and behaviors, and seeking relief. Conclusions: The themes revealed important information about the content of the public messages that people share about depression on Twitter. More research is needed to understand the effects of the hashtag on increasing social support for users and reducing social stigma related to depression. ",
doi="10.2196/mental.8141",
url="http://mental.jmir.org/2017/4/e43/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29046270"
}


@Article{info:doi/10.2196/publichealth.8133,
author="Allem, Jon-Patrick
and Ramanujam, Jagannathan
and Lerman, Kristina
and Chu, Kar-Hai
and Boley Cruz, Tess
and Unger, B. Jennifer",
title="Identifying Sentiment of Hookah-Related Posts on Twitter",
journal="JMIR Public Health Surveill",
year="2017",
month="Oct",
day="18",
volume="3",
number="4",
pages="e74",
keywords="hookah",
keywords="waterpipe",
keywords="Twitter",
keywords="social media",
keywords="bots",
keywords="big data",
keywords="sentiment",
abstract="Background: The increasing popularity of hookah (or waterpipe) use in the United States and elsewhere has consequences for public health because it has similar health risks to that of combustible cigarettes. While hookah use rapidly increases in popularity, social media data (Twitter, Instagram) can be used to capture and describe the social and environmental contexts in which individuals use, perceive, discuss, and are marketed this tobacco product. These data may allow people to organically report on their sentiment toward tobacco products like hookah unprimed by a researcher, without instrument bias, and at low costs. Objective: This study describes the sentiment of hookah-related posts on Twitter and describes the importance of debiasing Twitter data when attempting to understand attitudes. Methods: Hookah-related posts on Twitter (N=986,320) were collected from March 24, 2015, to December 2, 2016. Machine learning models were used to describe sentiment on 20 different emotions and to debias the data so that Twitter posts reflected sentiment of legitimate human users and not of social bots or marketing-oriented accounts that would possibly provide overly positive or overly negative sentiment of hookah. Results: From the analytical sample, 352,116 tweets (59.50\%) were classified as positive while 177,537 (30.00\%) were classified as negative, and 62,139 (10.50\%) neutral. Among all positive tweets, 218,312 (62.00\%) were classified as highly positive emotions (eg, active, alert, excited, elated, happy, and pleasant), while 133,804 (38.00\%) positive tweets were classified as passive positive emotions (eg, contented, serene, calm, relaxed, and subdued). Among all negative tweets, 95,870 (54.00\%) were classified as subdued negative emotions (eg, sad, unhappy, depressed, and bored) while the remaining 81,667 (46.00\%) negative tweets were classified as highly negative emotions (eg, tense, nervous, stressed, upset, and unpleasant). Sentiment changed drastically when comparing a corpus of tweets with social bots to one without. For example, the probability of any one tweet reflecting joy was 61.30\% from the debiased (or bot free) corpus of tweets. In contrast, the probability of any one tweet reflecting joy was 16.40\% from the biased corpus. Conclusions: Social media data provide researchers the ability to understand public sentiment and attitudes by listening to what people are saying in their own words. Tobacco control programmers in charge of risk communication may consider targeting individuals posting positive messages about hookah on Twitter or designing messages that amplify the negative sentiments. Posts on Twitter communicating positive sentiment toward hookah could add to the normalization of hookah use and is an area of future research. Findings from this study demonstrated the importance of debiasing data when attempting to understand attitudes from Twitter data. ",
doi="10.2196/publichealth.8133",
url="http://publichealth.jmir.org/2017/4/e74/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29046267"
}


@Article{info:doi/10.2196/jmir.8421,
author="Lenoir, Philippe
and Moulahi, Bilel
and Az{\'e}, J{\'e}r{\^o}me
and Bringay, Sandra
and Mercier, Gregoire
and Carbonnel, Fran{\c{c}}ois",
title="Raising Awareness About Cervical Cancer Using Twitter: Content Analysis of the 2015 \#SmearForSmear Campaign",
journal="J Med Internet Res",
year="2017",
month="Oct",
day="16",
volume="19",
number="10",
pages="e344",
keywords="uterine cervical neoplasms",
keywords="Papanicolaou test",
keywords="social media",
keywords="early detection of cancer",
keywords="health promotion",
keywords="Twitter",
abstract="Background: Cervical cancer is the second most common cancer among women under 45 years of age. To deal with the decrease of smear test coverage in the United Kingdom, a Twitter campaign called \#SmearForSmear has been launched in 2015 for the European Cervical Cancer Prevention Week. Its aim was to encourage women to take a selfie showing their lipstick going over the edge and post it on Twitter with a raising awareness message promoting cervical cancer screening. The estimated audience was 500 million people. Other public health campaigns have been launched on social media such as Movember to encourage participation and self-engagement. Their result was unsatisfactory as their aim had been diluted to become mainly a social buzz. Objective: The objectives of this study were to identify the tweets delivering a raising awareness message promoting cervical cancer screening (sensitizing tweets) and to understand the characteristics of Twitter users posting about this campaign. Methods: We conducted a 3-step content analysis of the English tweets tagged \#SmearForSmear posted on Twitter for the 2015 European Cervical Cancer Prevention Week. Data were collected using the Twitter application programming interface. Their extraction was based on an analysis grid generated by 2 independent researchers using a thematic analysis, validated by a strong Cohen kappa coefficient. A total of 7 themes were coded for sensitizing tweets and 14 for Twitter users' status. Verbatims were thematically and then statistically analyzed. Results: A total of 3019 tweets were collected and 1881 were analyzed. Moreover, 69.96\% of tweets had been posted by people living in the United Kingdom. A total of 57.36\% of users were women, and sex was unknown in 35.99\% of cases. In addition, 54.44\% of the users had posted at least one selfie with smeared lipstick. Furthermore, 32.32\% of tweets were sensitizing. Independent factors associated with posting sensitizing tweets were women who experienced an abnormal smear test (OR [odds ratio] 13.456, 95\% CI 3.101-58.378, P<.001), female gender (OR 3.752, 95\% CI 2.133-6.598, P<.001), and people who live in the United Kingdom (OR 2.097, 95\% CI 1.447-3.038, P<.001). Nonsensitizing tweets were statistically more posted by a nonhealth or nonmedia company (OR 0.558, 95\% CI 0.383-0.814, P<.001). Conclusions: This study demonstrates that the success of a public health campaign using a social media platform depends on its ability to get its targets involved. It also suggests the need to use social marketing to help its dissemination. The clinical impact of this Twitter campaign to increase cervical cancer screening is yet to be evaluated. ",
doi="10.2196/jmir.8421",
url="http://www.jmir.org/2017/10/e344/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29038096"
}


@Article{info:doi/10.2196/jmir.7656,
author="Benetoli, Arcelio
and Chen, F. Timothy
and Aslani, Parisa",
title="Consumer Health-Related Activities on Social Media: Exploratory Study",
journal="J Med Internet Res",
year="2017",
month="Oct",
day="13",
volume="19",
number="10",
pages="e352",
keywords="social media",
keywords="social networking sites",
keywords="Facebook",
keywords="YouTube",
keywords="Wikipedia",
keywords="Twitter",
keywords="health",
keywords="consumers",
keywords="patients",
keywords="focus groups",
abstract="Background: Although a number of studies have investigated how consumers use social media for health-related purposes, there is a paucity of studies in the Australian context. Objective: This study aimed to explore how Australian consumers used social media for health-related purposes, specifically how they identified social media platforms, which were used, and which health-related activities commonly took place. Methods: A total of 5 focus groups (n=36 participants), each lasting 60 to 90 minutes, were conducted in the Sydney metropolitan area. The group discussions were audiorecorded and transcribed verbatim. The transcripts were coded line-by-line and thematically analyzed. Results: Participants used general search engines to locate health-related social media platforms. They accessed a wide range of social media on a daily basis, using several electronic devices (in particular, mobile phones). Although privacy was a concern, it did not prevent consumers from fully engaging in social media for health-related purposes. Blogs were used to learn from other people's experiences with the same condition. Facebook allowed consumers to follow health-related pages and to participate in disease-specific group discussions. Wikipedia was used for factual information about diseases and treatments. YouTube was accessed to learn about medical procedures such as surgery. No participant reported editing or contributing to Wikipedia or posting YouTube videos related to health topics. Twitter was rarely used for health-related purposes. Social media allowed consumers to obtain and provide disease and treatment-related information and social and emotional support for those living with the same condition. Most considered their participation as observational, but some also contributed (eg, responded to people's questions). Conclusions: Participants used a wide range of social media for health-related purposes. Medical information exchange (eg, disease and treatment) and social and emotional support were the cornerstones of their online activities. Social media appears to be used as a key tool to support disease self-management. ",
doi="10.2196/jmir.7656",
url="http://www.jmir.org/2017/10/e352/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29030326"
}


@Article{info:doi/10.2196/mental.7847,
author="Robinson, Jo
and Bailey, Eleanor
and Hetrick, Sarah
and Paix, Steve
and O'Donnell, Matt
and Cox, Georgina
and Ftanou, Maria
and Skehan, Jaelea",
title="Developing Social Media-Based Suicide Prevention Messages in Partnership With Young People: Exploratory Study",
journal="JMIR Ment Health",
year="2017",
month="Oct",
day="04",
volume="4",
number="4",
pages="e40",
keywords="suicide",
keywords="suicidal ideation",
keywords="social media",
keywords="youth",
keywords="adolescents",
keywords="mass media",
abstract="Background: Social media is increasingly being used by young people for health-related issues, including communicating about suicide. Due to the concerns about causing distress or inducing suicidal thoughts or behaviors, to date young people neither have been engaged in the development of social media--based suicide prevention interventions nor have interventions focused on educating young people about safe ways to communicate about suicide online. Given the potential that social media holds to deliver messages to vast numbers of people across space and time and the fact that young people often prefer to seek help from their friends and peers, safely educating and engaging young people to develop suicide prevention messages that can be delivered via social media is an obvious next step. Objectives: The objectives of this study were to (1) provide education to a small number of secondary school students about safe ways to communicate about suicide via social media; (2) engage the same young people in the development of a suite of social media--based suicide prevention multimedia messages; (3) assess the impact of this on participants; and (4) assess the acceptability and safety of the messages developed. Methods: This study involved two phases. In phase 1, 20 participants recruited from two schools took part in an 8- to 10-week program during which they were provided with psychoeducation about mental health and suicide, including how to talk safely about suicide online, and they were then supported to design and develop their own media messages. These participants completed an evaluation questionnaire at the conclusion of the program. In phase 2, a larger group of participants (n=69), recruited via an opt-in process, viewed the media messages and completed a short questionnaire about each one. Results: Participants in phase 1 enjoyed the program and reported that they learned new skills, such as how to talk safely about suicide online, and felt more able to provide emotional support to others (16/20, 80\%). No participants reported that the program made them feel suicidal. Participants in phase 2 generally rated the media messages as safe and acceptable, although some messages were rated more highly than others. Conclusions: This study suggests that young people can be safely engaged in developing suicide prevention messages, which can be disseminated via social media. Engaging young people in this process may improve the traction that such campaigns will have with other young people. The study also suggests that educating young people regarding how to talk safely about suicide online has multiple benefits and is not associated with distress. Overall, these findings pave the way for new approaches to prevent suicide among young people. ",
doi="10.2196/mental.7847",
url="https://mental.jmir.org/2017/4/e40/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28978499"
}


@Article{info:doi/10.2196/publichealth.6796,
author="Hart, Mark
and Stetten, Nichole
and Islam, Sabrina
and Pizarro, Katherine",
title="Twitter and Public Health (Part 2): Qualitative Analysis of How Individual Health Professionals Outside Organizations Use Microblogging to Promote and Disseminate Health-Related Information",
journal="JMIR Public Health Surveill",
year="2017",
month="Oct",
day="04",
volume="3",
number="4",
pages="e54",
keywords="Twitter",
keywords="social media",
keywords="public health",
keywords="technology transfer",
keywords="diffusion of innovation",
abstract="Background: Twitter is the most popular form of microblogging that is being utilized in public health to engage audiences and to communicate health-related information. Although there is some research showing the various forms of Twitter use in public health, little is known about how individual public health professionals are using their personal Twitter accounts to disseminate health information. Objective: The purpose of this research was to categorize public health professionals' tweets to evaluate how individual public health professionals are furthering the mission of public health. Methods: Twitter accounts held by public health professionals were identified, and researchers proceeded to record 6 months' worth of each individual's Twitter feed. During the 6-month period, a total of 15,236 tweets were collected and analyzed using the constant comparison method. Results: A total of 23 tweet categories among the 15,236 tweets were initially identified. Some of the most common topics among the 23 categories included the following: health nutrition (n=2008), conferences (n=815), Ebola (n=789), Affordable Care Act (ACA)/health care (n=627), and social justice (n=626). Each of these categories were then stratified into one of four themes: (1) informing and educating, (2) monitoring health statuses and trends, (3) social justice, and (4) professional development. Conclusions: Using Twitter, public health professionals are helping dispel misinformation through education and by translating technical research into lay terms, advocating for health inequalities, and using it as a means to promote professional development. ",
doi="10.2196/publichealth.6796",
url="https://publichealth.jmir.org/2017/4/e54/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28978500"
}


@Article{info:doi/10.2196/ijmr.7879,
author="Lavorgna, Luigi
and Lanzillo, Roberta
and Brescia Morra, Vincenzo
and Abbadessa, Gianmarco
and Tedeschi, Gioacchino
and Bonavita, Simona",
title="Social Media and Multiple Sclerosis in the Posttruth Age",
journal="Interact J Med Res",
year="2017",
month="Sep",
day="27",
volume="6",
number="2",
pages="e18",
keywords="social media",
keywords="multiple sclerosis",
keywords="social network",
keywords="digital health",
keywords="eHealth",
keywords="Web medicine",
doi="10.2196/ijmr.7879",
url="http://www.i-jmr.org/2017/2/e18/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28954717"
}


@Article{info:doi/10.2196/cardio.8152,
author="Kramer Freeman, Linda
and Richards, Keith
and Conti, B. Jamie
and Sears, F. Samuel",
title="Patients With Implantable Cardioverter Defibrillators on Social Media Report More Shock Anxiety Than Clinic Patients: Results From an Online Survey",
journal="JMIR Cardio",
year="2017",
month="Sep",
day="26",
volume="1",
number="2",
pages="e6",
keywords="health communication",
keywords="social media",
keywords="implantable cardioverter-defibrillator",
keywords="cardiology patients",
keywords="shock anxiety",
abstract="Background: Coping with heart disease and the potential for implantable cardioverter defibrillator (ICD) shocks challenges the psychological adjustment of patients with ICDs. Social media use may be used to seek education and support from others. Objective: The aim of this study was to examine the content of information sought online and whether a social media sample of patients with ICDs report more device-specific anxiety than clinic-based normative samples. Methods: A total of 196 participants were recruited via social media messages and invited to complete an online survey. Results: It was found that the information most often sought by online users (62.4\%, 123/196) involved both emotional support (eg, gaining emotional support from other patients with ICDs) and technical information (52.6\%, 103/196) (eg, dealing with magnetic interference). The online sample reported more shock anxiety than a typical clinical sample with mean values of 22.75 (SD 10.06) and 15.18 (SD 6.50), respectively (P<.001). Conclusions: Collectively, these results suggest that patients with ICDs that are online are seeking emotional information and support, and that they report increased shock anxiety relative to typical clinic-based patients. Future research should examine how online information and clinical-based information form a composite understanding and adjustment for patients ICDs. ",
doi="10.2196/cardio.8152",
url="http://cardio.jmir.org/2017/2/e6/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31758785"
}


@Article{info:doi/10.2196/publichealth.8060,
author="Kim, Annice
and Miano, Thomas
and Chew, Robert
and Eggers, Matthew
and Nonnemaker, James",
title="Classification of Twitter Users Who Tweet About E-Cigarettes",
journal="JMIR Public Health Surveill",
year="2017",
month="Sep",
day="26",
volume="3",
number="3",
pages="e63",
keywords="electronic cigarettes",
keywords="social media",
keywords="machine learning",
abstract="Background: Despite concerns about their health risks, e?cigarettes have gained popularity in recent years. Concurrent with the recent increase in e?cigarette use, social media sites such as Twitter have become a common platform for sharing information about e-cigarettes and to promote marketing of e?cigarettes. Monitoring the trends in e?cigarette--related social media activity requires timely assessment of the content of posts and the types of users generating the content. However, little is known about the diversity of the types of users responsible for generating e?cigarette--related content on Twitter. Objective: The aim of this study was to demonstrate a novel methodology for automatically classifying Twitter users who tweet about e?cigarette--related topics into distinct categories. Methods: We collected approximately 11.5 million e?cigarette--related tweets posted between November 2014 and October 2016 and obtained a random sample of Twitter users who tweeted about e?cigarettes. Trained human coders examined the handles' profiles and manually categorized each as one of the following user types: individual (n=2168), vaper enthusiast (n=334), informed agency (n=622), marketer (n=752), and?spammer (n=1021). Next, the Twitter metadata as well as a sample of tweets for each labeled user were gathered, and features that reflect users' metadata and tweeting behavior were analyzed. Finally, multiple machine learning algorithms were tested to identify a model with the best performance in classifying user types. Results: Using a classification model that included metadata and features associated with tweeting behavior, we were able to predict with relatively high accuracy five different types of Twitter users that tweet about e?cigarettes (average F1 score=83.3\%). Accuracy varied by user type, with F1 scores of individuals, informed agencies, marketers, spammers, and vaper enthusiasts being 91.1\%, 84.4\%, 81.2\%, 79.5\%, and 47.1\%, respectively. Vaper enthusiasts were the most challenging user type to predict accurately and were commonly misclassified as marketers. The inclusion of additional tweet-derived features that capture tweeting behavior was found to significantly improve the model performance---an overall F1 score gain of 10.6\%---beyond metadata features alone. Conclusions: This study provides a method for classifying five different types of users who tweet about e?cigarettes. Our model achieved high levels of classification performance for most groups, and examining the tweeting behavior was critical in improving the model performance. Results can help identify groups engaged in conversations about e?cigarettes online to help inform public health surveillance, education, and regulatory efforts. ",
doi="10.2196/publichealth.8060",
url="http://publichealth.jmir.org/2017/3/e63/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28951381"
}


@Article{info:doi/10.2196/publichealth.6795,
author="Hart, Mark
and Stetten, E. Nichole
and Islam, Sabrina
and Pizarro, Katherine",
title="Twitter and Public Health (Part 1): How Individual Public Health Professionals Use Twitter for Professional Development",
journal="JMIR Public Health Surveill",
year="2017",
month="Sep",
day="20",
volume="3",
number="3",
pages="e60",
keywords="Twitter",
keywords="social media",
keywords="public health",
keywords="technology transfer",
keywords="blogging",
abstract="Background: The use of social networking sites is increasingly being adopted in public health, in part, because of the barriers to funding and reduced resources. Public health professionals are using social media platforms, specifically Twitter, as a way to facilitate professional development. Objective: The objective of this study was to identify public health professionals using Twitter and to analyze how they use this platform to enhance their formal and informal professional development within the context of public health. Methods: Keyword searches were conducted to identify and invite potential participants to complete a survey related to their use of Twitter for public health and professional experiences. Data regarding demographic attributes, Twitter usage, and qualitative information were obtained through an anonymous Web-based survey. Open-response survey questions were analyzed using the constant comparison method. Results: ``Using Twitter makes it easier to expand my networking opportunities'' and ``I find Twitter useful for professional development'' scored highest, with a mean score of 4.57 (standard deviation [SD] 0.74) and 4.43 (SD 0.76) on a 5-point Likert scale. Analysis of the qualitative data shows the emergence of the following themes for why public health professionals mostly use Twitter: (1) geography, (2) continuing education, (3) professional gain, and (4) communication. Conclusions: For public health professionals in this study, Twitter is a platform best used for their networking and professional development. Furthermore, the use of Twitter allows public health professionals to overcome a series of barriers and enhances opportunities for growth. ",
doi="10.2196/publichealth.6795",
url="http://publichealth.jmir.org/2017/3/e60/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28931499"
}


@Article{info:doi/10.2196/jmir.8081,
author="Partridge, R. Stephanie
and Grunseit, C. Anne
and Gallagher, Patrick
and Freeman, Becky
and O'Hara, J. Blythe
and Neubeck, Lis
and Due, Sarah
and Paull, Glenn
and Ding, Ding
and Bauman, Adrian
and Phongsavan, Philayrath
and Roach, Kellie
and Sadler, Leonie
and Glinatsis, Helen
and Gallagher, Robyn",
title="Cardiac Patients' Experiences and Perceptions of Social Media: Mixed-Methods Study",
journal="J Med Internet Res",
year="2017",
month="Sep",
day="15",
volume="19",
number="9",
pages="e323",
keywords="cardiovascular disease",
keywords="cardiac rehabilitation",
keywords="qualitative research",
keywords="secondary prevention",
keywords="social media",
abstract="Background: Traditional in-person cardiac rehabilitation has substantial benefits for cardiac patients, which are offset by poor attendance. The rapid increase in social media use in older adults provides an opportunity to reach patients who are eligible for cardiac rehabilitation but unable to attend traditional face-to-face groups. However, there is a paucity of research on cardiac patients' experiences and perspectives on using social media to support their health. Objective: The aim of this study was to describe cardiac rehabilitation patients' experiences in using social media in general and their perspective on using social media, particularly Facebook, to support their cardiac health and secondary prevention efforts. Methods: A mixed-methods study was undertaken among cardiac rehabilitation patients in both urban and rural areas. First, this study included a survey (n=284) on social media use and capability. Second, six focus group interviews were conducted with current Facebook users (n=18) to elucidate Facebook experience and perspectives. Results: Social media use was low (28.0\%, 79/282) but more common in participants who were under 70 years of age, employed, and had completed high school. Social media users accessed Web-based information on general health issues (65\%, 51/79), medications (56\%, 44/79), and heart health (43\%, 34/79). Participants were motivated to invest time in using Facebook for ``keeping in touch'' with family and friends and to be informed by expert cardiac health professionals and fellow cardiac participants if given the opportunity. It appeared that participants who had a higher level of Facebook capability (understanding of features and the consequences of their use and efficiency in use) spent more time on Facebook and reported higher levels of ``liking,'' commenting, or sharing posts. Furthermore, higher Facebook capability appeared to increase a participants' willingness to participate in a cardiac Facebook support group. More capable users were more receptive to the use of Facebook for cardiac rehabilitation and more likely to express interest in providing peer support. Recommended features for a cardiac rehabilitation Facebook group included a closed group, expert cardiac professional involvement, provision of cardiac health information, and ensuring trustworthiness of the group. Conclusions: Cardiac health professionals have an opportunity to capitalize on cardiac patients' motivations and social media, mostly Facebook, as well as the capability for supporting cardiac rehabilitation and secondary prevention. Participants' favored purposeful time spent on Facebook and their cardiac health provides such a purpose for a Facebook intervention. The study results will inform the development of a Facebook intervention for secondary prevention of cardiovascular disease. ",
doi="10.2196/jmir.8081",
url="http://www.jmir.org/2017/9/e323/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28916507"
}


@Article{info:doi/10.2196/jmir.7393,
author="Kagashe, Ireneus
and Yan, Zhijun
and Suheryani, Imran",
title="Enhancing Seasonal Influenza Surveillance: Topic Analysis of Widely Used Medicinal Drugs Using Twitter Data",
journal="J Med Internet Res",
year="2017",
month="Sep",
day="12",
volume="19",
number="9",
pages="e315",
keywords="machine learning",
keywords="Twitter messaging",
keywords="social media",
keywords="disease outbreaks",
keywords="influenza",
keywords="public health surveillance",
keywords="natural language processing",
keywords="influenza vaccines",
abstract="Background: Uptake of medicinal drugs (preventive or treatment) is among the approaches used to control disease outbreaks, and therefore, it is of vital importance to be aware of the counts or frequencies of most commonly used drugs and trending topics about these drugs from consumers for successful implementation of control measures. Traditional survey methods would have accomplished this study, but they are too costly in terms of resources needed, and they are subject to social desirability bias for topics discovery. Hence, there is a need to use alternative efficient means such as Twitter data and machine learning (ML) techniques. Objective: Using Twitter data, the aim of the study was to (1) provide a methodological extension for efficiently extracting widely consumed drugs during seasonal influenza and (2) extract topics from the tweets of these drugs and to infer how the insights provided by these topics can enhance seasonal influenza surveillance. Methods: From tweets collected during the 2012-13 flu season, we first identified tweets with mentions of drugs and then constructed an ML classifier using dependency words as features. The classifier was used to extract tweets that evidenced consumption of drugs, out of which we identified the mostly consumed drugs. Finally, we extracted trending topics from each of these widely used drugs' tweets using latent Dirichlet allocation (LDA). Results: Our proposed classifier obtained an F1 score of 0.82, which significantly outperformed the two benchmark classifiers (ie, P<.001 with the lexicon-based and P=.048 with the 1-gram term frequency [TF]). The classifier extracted 40,428 tweets that evidenced consumption of drugs out of 50,828 tweets with mentions of drugs. The most widely consumed drugs were influenza virus vaccines that had around 76.95\% (31,111/40,428) share of the total; other notable drugs were Theraflu, DayQuil, NyQuil, vitamins, acetaminophen, and oseltamivir. The topics of each of these drugs exhibited common themes or experiences from people who have consumed these drugs. Among these were the enabling and deterrent factors to influenza drugs uptake, which are keys to mitigating the severity of seasonal influenza outbreaks. Conclusions: The study results showed the feasibility of using tweets of widely consumed drugs to enhance seasonal influenza surveillance in lieu of the traditional or conventional surveillance approaches. Public health officials and other stakeholders can benefit from the findings of this study, especially in enhancing strategies for mitigating the severity of seasonal influenza outbreaks. The proposed methods can be extended to the outbreaks of other diseases. ",
doi="10.2196/jmir.7393",
url="http://www.jmir.org/2017/9/e315/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28899847"
}


@Article{info:doi/10.2196/jmir.7819,
author="Dyson, P. Michele
and Newton, S. Amanda
and Shave, Kassi
and Featherstone, M. Robin
and Thomson, Denise
and Wingert, Aireen
and Fernandes, M. Ricardo
and Hartling, Lisa",
title="Social Media for the Dissemination of Cochrane Child Health Evidence: Evaluation Study",
journal="J Med Internet Res",
year="2017",
month="Sep",
day="01",
volume="19",
number="9",
pages="e308",
keywords="social media",
keywords="translational medical research",
keywords="health knowledge, attitudes, practice",
keywords="pediatrics",
abstract="Background: Health care providers value ready access to reliable synthesized information to support point-of-care decision making. Web-based communities, facilitated by the adoption of social media tools such as Facebook, Twitter, and YouTube, are increasingly being used for knowledge dissemination, bridging the gap between knowledge generation and synthesis and knowledge implementation. Objective: Our objective was to implement and evaluate a structured social media strategy, using multiple platforms, to disseminate Cochrane Child Health evidence to health care providers caring for children. Methods: Our social media strategy had three components: daily ``tweets'' using the Cochrane Child Health Twitter account, weekly WordPress blog posts, and a monthly journal club on Twitter (``tweet chat''). Each tweet, blog, and journal club shared Cochrane evidence on a child health topic. We evaluated the strategy through (1) Twitter and blog site analytics, (2) traceable link (Bitly) statistics, (3) Altmetric.com scores for promoted evidence, and (4) participant feedback. We also tracked the resources required to write the blog, tweet content, and manage the strategy. Results: The 22-week social media strategy ran between November 2014 and April 2015. We created 25 blog posts, sent 585 tweets, and hosted 3 tweet chats. Monthly blog visits and views and Twitter account followers increased over time. During the study period, the blog received 2555 visitors and 3967 page views from a geographically diverse audience of health care providers, academics, and health care organizations. In total, 183 traceable Bitly links received 3463 clicks, and the Twitter account gained 469 new followers. The most visited and viewed blog posts included gastrointestinal topics (lactose avoidance), research on respiratory conditions (honey for cough and treatments for asthma), and maternal newborn care (skin-to-skin contact). On Twitter, popular topics were related to public health (vaccination) and pain management. We collected Altmetric.com scores for 61 studies promoted during the study period and recorded an average increase of 11 points. Research staff (n=3) contributed approximately 433 hours to promotion activities and planning (6.5 hours each per week) to implement the social media strategy, and study investigators reviewed all content (blog posts and tweets). Conclusions: This study provides empirical evidence on the use of a coordinated social media strategy for the dissemination of evidence to professionals providing health services to children and youth. The results and lessons learned from our study provide guidance for future knowledge dissemination activities using social media tools. ",
doi="10.2196/jmir.7819",
url="http://www.jmir.org/2017/9/e308/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28864427"
}


@Article{info:doi/10.2196/jmir.7071,
author="Whitaker, Christopher
and Stevelink, Sharon
and Fear, Nicola",
title="The Use of Facebook in Recruiting Participants for Health Research Purposes: A Systematic Review",
journal="J Med Internet Res",
year="2017",
month="Aug",
day="28",
volume="19",
number="8",
pages="e290",
keywords="epidemiology",
keywords="social media",
keywords="review",
keywords="research",
abstract="Background: Social media is a popular online tool that allows users to communicate and exchange information. It allows digital content such as pictures, videos and websites to be shared, discussed, republished and endorsed by its users, their friends and businesses. Adverts can be posted and promoted to specific target audiences by demographics such as region, age or gender. Recruiting for health research is complex with strict requirement criteria imposed on the participants. Traditional research recruitment relies on flyers, newspaper adverts, radio and television broadcasts, letters, emails, website listings, and word of mouth. These methods are potentially poor at recruiting hard to reach demographics, can be slow and expensive. Recruitment via social media, in particular Facebook, may be faster and cheaper. Objective: The aim of this study was to systematically review the literature regarding the current use and success of Facebook to recruit participants for health research purposes. Methods: A literature review was completed in March 2017 in the English language using MEDLINE, EMBASE, Web of Science, PubMed, PsycInfo, Google Scholar, and a hand search of article references. Papers from the past 12 years were included and number of participants, recruitment period, number of impressions, cost per click or participant, and conversion rate extracted. Results: A total of 35 studies were identified from the United States (n=22), Australia (n=9), Canada (n=2), Japan (n=1), and Germany (n=1) and appraised using the Critical Appraisal Skills Programme (CASP) checklist. All focused on the feasibility of recruitment via Facebook, with some (n=10) also testing interventions, such as smoking cessation and depression reduction. Most recruited young age groups (16-24 years), with the remaining targeting specific demographics, for example, military veterans. Information from the 35 studies was analyzed with median values being 264 recruited participants, a 3-month recruitment period, 3.3 million impressions, cost per click of US \$0.51, conversion rate of 4\% (range 0.06-29.50), eligibility of 61\% (range 17-100), and cost per participant of US \$14.41. The studies showed success in penetrating hard to reach populations, finding the results representative of their control or comparison demographic, except for an over representation of young white women. Conclusions: There is growing evidence to suggest that Facebook is a useful recruitment tool and its use, therefore, should be considered when implementing future health research. When compared with traditional recruitment methods (print, radio, television, and email), benefits include reduced costs, shorter recruitment periods, better representation, and improved participant selection in young and hard to reach demographics. It however, remains limited by Internet access and the over representation of young white women. Future studies should recruit across all ages and explore recruitment via other forms of social media. ",
doi="10.2196/jmir.7071",
url="http://www.jmir.org/2017/8/e290/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28851679"
}


@Article{info:doi/10.2196/jmir.8049,
author="Utengen, Audun
and Rouholiman, Dara
and Gamble, G. Jamison
and Grajales III, Jose Francisco
and Pradhan, Nisha
and Staley, C. Alicia
and Bernstein, Liza
and Young, D. Sean
and Clauson, A. Kevin
and Chu, F. Larry",
title="Patient Participation at Health Care Conferences: Engaged Patients Increase Information Flow, Expand Propagation, and Deepen Engagement in the Conversation of Tweets Compared to Physicians or Researchers",
journal="J Med Internet Res",
year="2017",
month="Aug",
day="17",
volume="19",
number="8",
pages="e280",
keywords="social media",
keywords="patients",
keywords="physicians",
keywords="patient participation",
keywords="congresses as topic",
keywords="social networking, network analysis",
abstract="Background: Health care conferences present a unique opportunity to network, spark innovation, and disseminate novel information to a large audience, but the dissemination of information typically stays within very specific networks. Social network analysis can be adopted to understand the flow of information between virtual social communities and the role of patients within the network. Objective: The purpose of this study is to examine the impact engaged patients bring to health care conference social media information flow and how they expand dissemination and distribution of tweets compared to other health care conference stakeholders such as physicians and researchers. Methods: From January 2014 through December 2016, 7,644,549 tweets were analyzed from 1672 health care conferences with at least 1000 tweets who had registered in Symplur's Health Care Hashtag Project from 2014 to 2016. The tweet content was analyzed to create a list of the top 100 influencers by mention from each conference, who were then subsequently categorized by stakeholder group. Multivariate linear regression models were created using stepwise function building to identify factors explaining variability as predictor variables for the model in which conference tweets were taken as the dependent variable. Results: Inclusion of engaged patients in health care conference social media was low compared to that of physicians and has not significantly changed over the last 3 years. When engaged patient voices are included in health care conferences, they greatly increase information flow as measured by total tweet volume (beta=301.6) compared to physicians (beta=137.3, P<.001), expand propagation of information tweeted during a conference as measured by social media impressions created (beta=1,700,000) compared to physicians (beta=270,000, P<.001), and deepen engagement in the tweet conversation as measured by replies to their tweets (beta=24.4) compared to physicians (beta=5.5, P<.001). Social network analysis of hubs and authorities revealed that patients had statistically significant higher hub scores (mean 8.26{\texttimes}10-4, SD 2.96{\texttimes}10-4) compared to other stakeholder groups' Twitter accounts (mean 7.19{\texttimes}10-4, SD 3.81{\texttimes}10-4; t273.84=4.302, P<.001). Conclusions: Although engaged patients are powerful accelerators of information flow, expanders of tweet propagation, and greatly deepen engagement in conversation of tweets on social media of health care conferences compared to physicians, they represent only 1.4\% of the stakeholder mix of the top 100 influencers in the conversation. Health care conferences that fail to engage patients in their proceedings may risk limiting their engagement with the public, disseminating scientific information to a narrow community and slowing flow of information across social media channels. ",
doi="10.2196/jmir.8049",
url="http://www.jmir.org/2017/8/e280/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28818821"
}


@Article{info:doi/10.2196/jmir.7956,
author="Birnbaum, L. Michael
and Ernala, Kiranmai Sindhu
and Rizvi, F. Asra
and De Choudhury, Munmun
and Kane, M. John",
title="A Collaborative Approach to Identifying Social Media Markers of Schizophrenia by Employing Machine Learning and Clinical Appraisals",
journal="J Med Internet Res",
year="2017",
month="Aug",
day="14",
volume="19",
number="8",
pages="e289",
keywords="schizophrenia",
keywords="psychotic disorders",
keywords="online social networks",
keywords="machine learning",
keywords="linguistic analysis",
keywords="Twitter",
abstract="Background: Linguistic analysis of publicly available Twitter feeds have achieved success in differentiating individuals who self-disclose online as having schizophrenia from healthy controls. To date, limited efforts have included expert input to evaluate the authenticity of diagnostic self-disclosures. Objective: This study aims to move from noisy self-reports of schizophrenia on social media to more accurate identification of diagnoses by exploring a human-machine partnered approach, wherein computational linguistic analysis of shared content is combined with clinical appraisals. Methods: Twitter timeline data, extracted from 671 users with self-disclosed diagnoses of schizophrenia, was appraised for authenticity by expert clinicians. Data from disclosures deemed true were used to build a classifier aiming to distinguish users with schizophrenia from healthy controls. Results from the classifier were compared to expert appraisals on new, unseen Twitter users. Results: Significant linguistic differences were identified in the schizophrenia group including greater use of interpersonal pronouns (P<.001), decreased emphasis on friendship (P<.001), and greater emphasis on biological processes (P<.001). The resulting classifier distinguished users with disclosures of schizophrenia deemed genuine from control users with a mean accuracy of 88\% using linguistic data alone. Compared to clinicians on new, unseen users, the classifier's precision, recall, and accuracy measures were 0.27, 0.77, and 0.59, respectively. Conclusions: These data reinforce the need for ongoing collaborations integrating expertise from multiple fields to strengthen our ability to accurately identify and effectively engage individuals with mental illness online. These collaborations are crucial to overcome some of mental illnesses' biggest challenges by using digital technology. ",
doi="10.2196/jmir.7956",
url="http://www.jmir.org/2017/8/e289/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28807891"
}


@Article{info:doi/10.2196/publichealth.7032,
author="Parackal, Mathew
and Parackal, Sherly
and Eusebius, Shobhit
and Mather, Damien",
title="The Use of Facebook Advertising for Communicating Public Health Messages: A Campaign Against Drinking During Pregnancy in New Zealand",
journal="JMIR Public Health Surveill",
year="2017",
month="Aug",
day="10",
volume="3",
number="3",
pages="e49",
keywords="social media",
keywords="health promotion",
keywords="alcohol",
keywords="pregnancy",
keywords="New Zealand",
abstract="Background: Social media is gaining recognition as a platform for delivering public health messages. One area attracting attention from public health researchers and professionals is Facebook's advertising channel. This channel is reported to have a broad reach and generate high user engagement with the disseminated campaign materials. However, to date, no study has examined the communication process via this channel which this study aimed to address. Objective: The specific objectives of the study were to (1) examine user engagement for a public health campaign based on the metadata provided by Facebook, (2) analyze comments generated by the campaign materials using text mining, and (3) investigate the relationship between the themes identified in the comments and the message and the sentiments prevalent in the themes that exhibited significant relationships. Methods: This study examined a New Zealand public health pilot campaign called ``Don't Know? Don't Drink,'' which warned against drinking alcohol during pregnancy. The campaign conveyed the warning through a video and three banner ads that were delivered as news feeds to women aged 18-30 years. Thematic analysis using text mining performed on the comments (n=819) identified four themes. Logistic regression was used to identify meaning-making themes that exhibited association with the message. Results: The users' engagement was impressive with the video receiving 203,754 views. The combined likes and shares for the promotional materials (video and banner ads) amounted to 6125 and 300, respectively. The logistic regression analysis showed two meaning-making themes, namely, risk of pregnancy (P=.003) and alcohol and culture (P<.001) exhibited association with the message. The sentiment analysis carried out on the two themes revealed there were more negative than positive comments (47\% vs 28\%). Conclusions: The user engagement observed in this study was consistent with previous research. The numbers reported for views, likes, and shares may be seen as unique interactions over the fixed period of the campaign; however, survey research would be required to find out the true evaluative worth of these metadata. A close examination of the comments, employing text mining, revealed that the message was not accepted by a majority of the target segment. Self-identity and conformity theories may help to explain these observed reactions, albeit warrant further investigations. Although the comments were predominantly negative, they provide opportunities to engage back with the women. The one-way communication format followed in this campaign did not support any two-way engagement. Further investigation is warranted to establish whether using a two-way communication format would have improved the acceptability of such public health messages delivered via social media. The findings of this study caution using a one-way communication format to convey public health messages via Facebook's advertising channel. ",
doi="10.2196/publichealth.7032",
url="http://publichealth.jmir.org/2017/3/e49/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28798011"
}


@Article{info:doi/10.2196/jmir.7403,
author="Sun, Han Wai
and Wong, Ho Carlos King
and Wong, Wai William Chi",
title="A Peer-Led, Social Media-Delivered, Safer Sex Intervention for Chinese College Students: Randomized Controlled Trial",
journal="J Med Internet Res",
year="2017",
month="Aug",
day="09",
volume="19",
number="8",
pages="e284",
keywords="sex education",
keywords="social media",
keywords="randomized controlled trial",
abstract="Background: The peer-led, social media-delivered intervention is an emerging method in sexual health promotion. However, no research has yet investigated its effectiveness as compared with other online channels or in an Asian population. Objective: The objective of this study is to compare a peer-led, social media-delivered, safer sex intervention with a sexual health website. Both conditions target Chinese college students in Hong Kong. Methods: A randomized controlled trial was conducted with a peer-led, safer sex Facebook group as the intervention and an existing online sexual health website as the control. The intervention materials were developed with peer input and followed the information-motivation-behavioral skills model; the intervention was moderated by peer educators. The participants filled out the online questionnaires before and after the 6-week intervention period. Outcome evaluations included safer sex attitudes, behavioral skills, and behaviors, while process evaluation focused on online experience, online-visiting frequency, and online engagement. The effect of online-visiting frequency and online engagement on outcome variables was investigated. Results: Of 196 eligible participants---100 in the control group and 96 in the intervention group---who joined the study, 2 (1.0\%) control participants joined the Facebook group and 24 of the remaining 194 participants (12.4\%) were lost to follow-up. For the process evaluation, participants in the intervention group reported more satisfying online experiences (P<.001) and a higher level of online-visiting frequency (P<.001). They also had more positive comments when compared with the control group. For outcome evaluation, within-group analysis showed significant improvement in condom use attitude (P=.02) and behavioral skills (P<.001) in the intervention group, but not in the control group. No significant between-group difference was found. After adjusting for demographic data, increased online-visiting frequency was associated with better contraceptive use behavioral intention (P=.05), better behavioral skills (P=.02), and more frequent condom use (P=.04). Conclusions: A peer-led, social media-delivered, safer sex intervention was found to be feasible and effective in improving attitudes toward condom use and behavioral skills, but was not significantly more effective than a website. Future research may focus on the long-term effectiveness and cost-effectiveness of this popular method, as well as the potential cultural differences of using social media between different countries. Trial Registration: Chinese Clinical Trial Registry (ChiCTR): ChiCTR-IOR-16009495; http://www.chictr.org.cn/showprojen.aspx?proj=16234 (Archived by WebCite at http://www.webcitation.org/6s0Fc2L9T) ",
doi="10.2196/jmir.7403",
url="http://www.jmir.org/2017/8/e284/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28793980"
}


@Article{info:doi/10.2196/jmir.7660,
author="Choi, Min-Je
and Kim, Sung-Hee
and Lee, Sukwon
and Kwon, Chul Bum
and Yi, Soo Ji
and Choo, Jaegul
and Huh, Jina",
title="Toward Predicting Social Support Needs in Online Health Social Networks",
journal="J Med Internet Res",
year="2017",
month="Aug",
day="02",
volume="19",
number="8",
pages="e272",
keywords="online health social network",
keywords="machine learning",
keywords="gradient boosting trees",
keywords="prediction models",
keywords="social media",
keywords="online health community",
abstract="Background: While online health social networks (OHSNs) serve as an effective platform for patients to fulfill their various social support needs, predicting the needs of users and providing tailored information remains a challenge. Objective: The objective of this study was to discriminate important features for identifying users' social support needs based on knowledge gathered from survey data. This study also provides guidelines for a technical framework, which can be used to predict users' social support needs based on raw data collected from OHSNs. Methods: We initially conducted a Web-based survey with 184 OHSN users. From this survey data, we extracted 34 features based on 5 categories: (1) demographics, (2) reading behavior, (3) posting behavior, (4) perceived roles in OHSNs, and (5) values sought in OHSNs. Features from the first 4 categories were used as variables for binary classification. For the prediction outcomes, we used features from the last category: the needs for emotional support, experience-based information, unconventional information, and medical facts. We compared 5 binary classifier algorithms: gradient boosting tree, random forest, decision tree, support vector machines, and logistic regression. We then calculated the scores of the area under the receiver operating characteristic (ROC) curve (AUC) to understand the comparative effectiveness of the used features. Results: The best performance was AUC scores of 0.89 for predicting users seeking emotional support, 0.86 for experience-based information, 0.80 for unconventional information, and 0.83 for medical facts. With the gradient boosting tree as our best performing model, we analyzed the strength of individual features in predicting one's social support need. Among other discoveries, we found that users seeking emotional support tend to post more in OHSNs compared with others. Conclusions: We developed an initial framework for automatically predicting social support needs in OHSNs using survey data. Future work should involve nonsurvey data to evaluate the feasibility of the framework. Our study contributes to providing personalized social support in OHSNs. ",
doi="10.2196/jmir.7660",
url="http://www.jmir.org/2017/8/e272/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28768609"
}


@Article{info:doi/10.2196/medinform.7779,
author="Tapi Nzali, Donald Mike
and Bringay, Sandra
and Lavergne, Christian
and Mollevi, Caroline
and Opitz, Thomas",
title="What Patients Can Tell Us: Topic Analysis for Social Media on Breast Cancer",
journal="JMIR Med Inform",
year="2017",
month="Jul",
day="31",
volume="5",
number="3",
pages="e23",
keywords="breast cancer",
keywords="text mining",
keywords="social media",
keywords="unsupervised learning",
abstract="Background: Social media dedicated to health are increasingly used by patients and health professionals. They are rich textual resources with content generated through free exchange between patients. We are proposing a method to tackle the problem of retrieving clinically relevant information from such social media in order to analyze the quality of life of patients with breast cancer. Objective: Our aim was to detect the different topics discussed by patients on social media and to relate them to functional and symptomatic dimensions assessed in the internationally standardized self-administered questionnaires used in cancer clinical trials (European Organization for Research and Treatment of Cancer [EORTC] Quality of Life Questionnaire Core 30 [QLQ-C30] and breast cancer module [QLQ-BR23]). Methods: First, we applied a classic text mining technique, latent Dirichlet allocation (LDA), to detect the different topics discussed on social media dealing with breast cancer. We applied the LDA model to 2 datasets composed of messages extracted from public Facebook groups and from a public health forum (cancerdusein.org, a French breast cancer forum) with relevant preprocessing. Second, we applied a customized Jaccard coefficient to automatically compute similarity distance between the topics detected with LDA and the questions in the self-administered questionnaires used to study quality of life. Results: Among the 23 topics present in the self-administered questionnaires, 22 matched with the topics discussed by patients on social media. Interestingly, these topics corresponded to 95\% (22/23) of the forum and 86\% (20/23) of the Facebook group topics. These figures underline that topics related to quality of life are an important concern for patients. However, 5 social media topics had no corresponding topic in the questionnaires, which do not cover all of the patients' concerns. Of these 5 topics, 2 could potentially be used in the questionnaires, and these 2 topics corresponded to a total of 3.10\% (523/16,868) of topics in the cancerdusein.org corpus and 4.30\% (3014/70,092) of the Facebook corpus. Conclusions: We found a good correspondence between detected topics on social media and topics covered by the self-administered questionnaires, which substantiates the sound construction of such questionnaires. We detected new emerging topics from social media that can be used to complete current self-administered questionnaires. Moreover, we confirmed that social media mining is an important source of information for complementary analysis of quality of life. ",
doi="10.2196/medinform.7779",
url="http://medinform.jmir.org/2017/3/e23/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28760725"
}


@Article{info:doi/10.2196/jmir.7868,
author="Melkers, Julia
and Hicks, Diana
and Rosenblum, Simone
and Isett, R. Kimberley
and Elliott, Jacqueline",
title="Dental Blogs, Podcasts, and Associated Social Media: Descriptive Mapping and Analysis",
journal="J Med Internet Res",
year="2017",
month="Jul",
day="26",
volume="19",
number="7",
pages="e269",
keywords="social media",
keywords="blogs",
keywords="podcasts",
keywords="clinical information",
keywords="dentistry",
abstract="Background: Studies of social media in both medicine and dentistry have largely focused on the value of social media for marketing to and communicating with patients and for clinical education. There is limited evidence of how dental clinicians contribute to and use social media to disseminate and access information relevant to clinical care. Objective: The purpose of this study was to inventory and assess the entry, growth, sources, and content of clinically relevant social media in dentistry. Methods: We developed an inventory of blogs, podcasts, videos, and associated social media disseminating clinical information to dentists. We assessed hosts' media activity in terms of their combinations of modalities, entry and exit dates, frequency of posting, types of content posted, and size of audience. Results: Our study showed that clinically relevant information is posted by dentists and hygienists on social media. Clinically relevant information was provided in 89 blogs and podcasts, and topic analysis showed motives for blogging by host type: 55\% (49 hosts) were practicing dentists or hygienists, followed by consultants (27 hosts, 30\%), media including publishers and discussion board hosts (8 hosts, 9\%), and professional organizations and corporations. Conclusions: We demonstrated the participation of and potential for practicing dentists and hygienists to use social media to share clinical and other information with practicing colleagues. There is a clear audience for these social media sites, suggesting a changing mode of information diffusion in dentistry. This study was a first effort to fill the gap in understanding the nature and potential role of social media in clinical dentistry. ",
doi="10.2196/jmir.7868",
url="http://www.jmir.org/2017/7/e269/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28747291"
}


@Article{info:doi/10.2196/jmir.7452,
author="Jung, Hyesil
and Park, Hyeoun-Ae
and Song, Tae-Min",
title="Ontology-Based Approach to Social Data Sentiment Analysis: Detection of Adolescent Depression Signals",
journal="J Med Internet Res",
year="2017",
month="Jul",
day="24",
volume="19",
number="7",
pages="e259",
keywords="ontology",
keywords="adolescent",
keywords="depression",
keywords="data mining",
keywords="social media data",
abstract="Background: Social networking services (SNSs) contain abundant information about the feelings, thoughts, interests, and patterns of behavior of adolescents that can be obtained by analyzing SNS postings. An ontology that expresses the shared concepts and their relationships in a specific field could be used as a semantic framework for social media data analytics. Objective: The aim of this study was to refine an adolescent depression ontology and terminology as a framework for analyzing social media data and to evaluate description logics between classes and the applicability of this ontology to sentiment analysis. Methods: The domain and scope of the ontology were defined using competency questions. The concepts constituting the ontology and terminology were collected from clinical practice guidelines, the literature, and social media postings on adolescent depression. Class concepts, their hierarchy, and the relationships among class concepts were defined. An internal structure of the ontology was designed using the entity-attribute-value (EAV) triplet data model, and superclasses of the ontology were aligned with the upper ontology. Description logics between classes were evaluated by mapping concepts extracted from the answers to frequently asked questions (FAQs) onto the ontology concepts derived from description logic queries. The applicability of the ontology was validated by examining the representability of 1358 sentiment phrases using the ontology EAV model and conducting sentiment analyses of social media data using ontology class concepts. Results: We developed an adolescent depression ontology that comprised 443 classes and 60 relationships among the classes; the terminology comprised 1682 synonyms of the 443 classes. In the description logics test, no error in relationships between classes was found, and about 89\% (55/62) of the concepts cited in the answers to FAQs mapped onto the ontology class. Regarding applicability, the EAV triplet models of the ontology class represented about 91.4\% of the sentiment phrases included in the sentiment dictionary. In the sentiment analyses, ``academic stresses'' and ``suicide'' contributed negatively to the sentiment of adolescent depression. Conclusions: The ontology and terminology developed in this study provide a semantic foundation for analyzing social media data on adolescent depression. To be useful in social media data analysis, the ontology, especially the terminology, needs to be updated constantly to reflect rapidly changing terms used by adolescents in social media postings. In addition, more attributes and value sets reflecting depression-related sentiments should be added to the ontology. ",
doi="10.2196/jmir.7452",
url="http://www.jmir.org/2017/7/e259/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28739560"
}


@Article{info:doi/10.2196/publichealth.6870,
author="Tustin, Lee Jordan
and Crowcroft, Sarah Natasha
and Gesink, Dionne
and Johnson, Ian
and Keelan, Jennifer
and Lachapelle, Barbara",
title="Facebook Recruitment of Vaccine-Hesitant Canadian Parents: Cross-Sectional Study",
journal="JMIR Public Health Surveill",
year="2017",
month="Jul",
day="24",
volume="3",
number="3",
pages="e47",
keywords="immunization",
keywords="vaccination",
keywords="social media",
keywords="Canada",
keywords="parents",
abstract="Background: There is concern over the increase in the number of ``vaccine-hesitant'' parents, which contributes to under-vaccinated populations and reduced herd immunity. Traditional studies investigating parental immunization beliefs and practices have relied on random digit dialing (RDD); however, this method presents increasing limitations. Facebook is the most used social media platform in Canada and presents an opportunity to recruit vaccine-hesitant parents in a novel manner. Objective: The study aimed to explore the use of Facebook as a tool to reach vaccine-hesitant parents, as compared with RDD methods. Methods: We recruited Canadian parents over 4 weeks in 2013-14 via targeted Facebook advertisements linked to a Web-based survey. We compared methodological parameters, key parental demographics, and three vaccine hesitancy indicators to an RDD sample of Canadian parents. Two raters categorized respondent reasons for difficulties in deciding to vaccinate, according to the model of determinants of vaccine hesitancy developed by the World Health Organization's Strategic Advisory Group of Experts on Immunization. Results: The Facebook campaign received a total of 4792 clicks from unique users, of whom 1696 started the Web-based survey. The total response rate of fully completed unique Web-based surveys was 22.89\% (1097/4792) and the survey completion rate was 64.68\% (1097/1696). The total cost including incentives was reasonable (Can \$4861.19). The Web-based sample yielded younger parents, with 85.69\% (940/1097) under the age of 40 years as compared with 23.38\% (408/1745) in the RDD sample; 91.43\% (1003/1097) of the Facebook respondents were female as compared with 59.26\% (1034/1745) in the RDD sample. Facebook respondents had a lower median age of their youngest child (1 year vs 8 years for RDD). When compared with the RDD sample, the Web-based sample yielded a significantly higher proportion of respondents reporting vaccines as moderately safe to not safe (26.62\% [292/1097] vs 18.57\% [324/1745]), partially or not at all up-to-date vaccination status of youngest child (22.06\% [242/1097] vs 9.57\% [167/1745]), and difficulty in making the decision to vaccinate their youngest child (21.06\% [231/1097] vs 10.09\% [176/1745]). Out of the Web-based respondents who reported reasons for the difficulties in deciding to vaccinate, 37.2\% (83/223) reported lack of knowledge or trust due to conflicting information and 23.8\% (53/223) reported the perception of the risk of the adverse effects of vaccines being higher than the risk of disease acquisition. Conclusions: We successfully recruited a large sample of our target population at low cost and achieved a high survey completion rate using Facebook. When compared with the RDD sampling strategy, we reached more vaccine-hesitant parents and younger parents with younger children---a population more likely to be making decisions on childhood immunizations. Facebook is a promising economical modality for reaching vaccine-hesitant parents for studies on the determinants of vaccine uptake. ",
doi="10.2196/publichealth.6870",
url="http://publichealth.jmir.org/2017/3/e47/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28739557"
}


@Article{info:doi/10.2196/jmir.7251,
author="Cao, Bolin
and Liu, Chuncheng
and Durvasula, Maya
and Tang, Weiming
and Pan, Stephen
and Saffer, J. Adam
and Wei, Chongyi
and Tucker, D. Joseph",
title="Social Media Engagement and HIV Testing Among Men Who Have Sex With Men in China: A Nationwide Cross-Sectional Survey",
journal="J Med Internet Res",
year="2017",
month="Jul",
day="19",
volume="19",
number="7",
pages="e251",
keywords="social Media",
keywords="HIV",
keywords="China",
keywords="homosexuality",
keywords="male",
keywords="mobile application",
abstract="Background: Many interventions find that social media engagement with health promotion materials can translate into behavioral changes. However, only a few studies have examined the ways in which specific actions on various social media platforms are correlated with health behaviors. Objective: The objective of this study was to examine the association between social media use and HIV testing behaviors among Chinese men who have sex with men (MSM). Methods: In July 2016, a Web-based survey was conducted to recruit MSM in 8 Chinese cities through Blued (Blue City Holdings Ltd.), the world's largest gay mobile phone app. Data on sociodemographic variables, social media use platforms and behaviors, sexual behaviors, and HIV testing histories were collected. HIV testing--related social media use was defined as having ever engaged with HIV testing content on social media, which was further divided into observing (ie, receiving), endorsing (eg, liking and sharing), and contributing (eg, posting or commenting on HIV testing materials). Confirmatory factor analysis (CFA) was conducted to determine the best division of HIV testing--related social media use. Univariate and multivariable logistic regressions were used to examine the association between HIV testing--related social media use and HIV testing behaviors. Results: A total of 2105 individuals participated in the survey. Among them, 46.75\% (984) were under the age of 24 years, 35.43\% (746) had high school education or less, and 47.74\% (587) had condomless sex in the last 3 months. More than half of the respondents (58.14\%, 1224/2105) reported HIV testing--related social media use. Additionally, HIV testing--related social media use, especially on multifunctional platforms such as WeChat, was found to be associated with recent HIV testing (adjusted odds ratio [aOR] 2.32, 95\% CI 1.66-3.24). Contributing on social media was correlated with recent HIV testing (aOR 2.10, 95\% CI 1.40-3.16), but neither observing (aOR 0.66, 95\% CI 0.38-1.15) nor endorsing (aOR 1.29, 95\% CI 0.88-1.90) were correlated. Conclusions: Our data suggest that social media use, particularly on multifunctional platforms such as WeChat and with contributing behaviors, is correlated with HIV testing among MSM in China. Campaigns that promote active participant contribution on social media beyond passive observation and endorsement of promotional materials are needed. This study has implications for the design and implementation of social media interventions to promote HIV testing. ",
doi="10.2196/jmir.7251",
url="http://www.jmir.org/2017/7/e251/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28724510"
}


@Article{info:doi/10.2196/jmir.7634,
author="Allem, Jon-Patrick
and Escobedo, Patricia
and Chu, Kar-Hai
and Boley Cruz, Tess
and Unger, B. Jennifer",
title="Images of Little Cigars and Cigarillos on Instagram Identified by the Hashtag \#swisher: Thematic Analysis",
journal="J Med Internet Res",
year="2017",
month="Jul",
day="14",
volume="19",
number="7",
pages="e255",
keywords="Instagram",
keywords="Swisher",
keywords="little cgars",
keywords="cigarillos",
keywords="social media",
keywords="blunts",
keywords="health behavior",
keywords="tobacco use",
abstract="Background: Little cigar and cigarillo use is becoming more prevalent in the United States and elsewhere, with implications for public health. As little cigar and cigarillo use grows in popularity, big social media data (eg, Instagram, Google Web Search, Twitter) can be used to capture and document the context in which individuals use, and are marketed, these tobacco products. Big social media data may allow people to organically demonstrate how and why they use little cigars and cigarillos, unprimed by a researcher, without instrument bias and at low costs. Objective: This study characterized Swisher (the most popular brand of cigars in the United States, controlling over 75\% of the market share) little cigar- and cigarillo-related posts on Instagram to inform the design of tobacco education campaigns and the development of future tobacco control efforts, and to demonstrate the utility in using big social media data in understanding health behaviors. Methods: We collected images from Instagram, an image-based social media app allowing users to capture, customize, and post photos on the Internet with over 400 million active users. Inclusion criteria for this study consisted of an Instagram post with the hashtag ``\#swisher''. We established rules for coding themes of images. Results: Of 1967 images collected, 486 (24.71\%) were marijuana related, 348 (17.69\%) were of tobacco products or promotional material, 324 (16.47\%) showed individuals smoking, 225 (11.44\%) were memes, and 584 (29.69\%) were classified as other (eg, selfies, food, sexually explicit images). Of the marijuana-related images, 157/486 (32.3\%) contained a Swisher wrapper, indicating that a Swisher product was used in blunt making, which involves hollowing out a cigar and refilling it with marijuana. Conclusions: Images from Instagram may be used to complement and extend the study of health behaviors including tobacco use. Images may be as valuable as, or more valuable than, words from other social media platforms alone. Posts on Instagram showing Swisher products, including blunt making, could add to the normalization of little cigar and cigarillo use and is an area of future research. Tobacco control researchers should design social media campaigns to combat smoking imagery found on popular sites such as Instagram. ",
doi="10.2196/jmir.7634",
url="http://www.jmir.org/2017/7/e255/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28710057"
}


@Article{info:doi/10.2196/ijmr.7402,
author="Lavorgna, Luigi
and Russo, Antonio
and De Stefano, Manuela
and Lanzillo, Roberta
and Esposito, Sabrina
and Moshtari, Fatemeh
and Rullani, Francesco
and Piscopo, Kyrie
and Buonanno, Daniela
and Brescia Morra, Vincenzo
and Gallo, Antonio
and Tedeschi, Gioacchino
and Bonavita, Simona",
title="Health-Related Coping and Social Interaction in People with Multiple Sclerosis Supported by a Social Network: Pilot Study With a New Methodological Approach",
journal="Interact J Med Res",
year="2017",
month="Jul",
day="14",
volume="6",
number="2",
pages="e10",
keywords="social media",
keywords="eHealth",
keywords="digital health",
keywords="multiple sclerosis",
keywords="social network",
keywords="Web medicine",
abstract="Background: Social media are a vital link for people with health concerns who find in Web communities a valid and comforting source for information exchange, debate, and knowledge enrichment. This aspect is important for people affected by chronic diseases like multiple sclerosis (MS), who are very well informed about the disease but are vulnerable to hopes of being cured or saved by therapies whose efficacy is not always scientifically proven. To improve health-related coping and social interaction for people with MS, we created an MS social network (SMsocialnetwork.com) with a medical team constantly online to intervene promptly when false or inappropriate medical information are shared. Objective: The goal of this study was to assess the impact of SMsocialnetwork.com on the health-related coping and social interaction of people with MS by analyzing areas of interest through a Web-based survey. Methods: Referring to previous marketing studies analyzing the online platform's role in targeted health care, we conducted a 39-item Web-based survey. We then performed a construct validation procedure using a factorial analysis, gathering together like items of the survey related to different areas of interest such as utility, proximity, sharing, interaction, solving uncertainty, suggestion attitude, and exploration. Results: We collected 130 Web-based surveys. The areas of interest analysis demonstrated that the users positively evaluated SMsocialnetwork.com to obtain information, approach and solve problems, and to make decisions (utility: median 4.2); improve feeling of closeness (proximity: median 5); catalyze relationships and text general personal opinions (sharing: median 5.6); get in touch with other users to receive innovative, effective, and practical solutions (interaction, solving uncertainty, and suggestion attitude medians were respectively: 4.1, 3, and 3); and share information about innovative therapeutic approaches and treatment options (suggestion attitude: median: 3.3). Conclusions: SMsocialnetwork.com was perceived by users to be a useful tool to support health-related coping and social interaction, and may suggest a new kind of therapeutic alliance between physicians and people with MS. ",
doi="10.2196/ijmr.7402",
url="http://www.i-jmr.org/2017/2/e10/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28710056"
}


@Article{info:doi/10.2196/jmir.7072,
author="Roland, Damian
and Spurr, Jesse
and Cabrera, Daniel",
title="Preliminary Evidence for the Emergence of a Health Care Online Community of Practice: Using a Netnographic Framework for Twitter Hashtag Analytics",
journal="J Med Internet Res",
year="2017",
month="Jul",
day="14",
volume="19",
number="7",
pages="e252",
keywords="social media",
keywords="network",
keywords="community networks",
keywords="community of practice",
keywords="\#FOAMed",
keywords="Twitter",
abstract="Background: Online communities of practice (oCoPs) may emerge from interactions on social media. These communities offer an open digital space and flat role hierarchy for information sharing and provide a strong group identity, rapid flow of information, content curation, and knowledge translation. To date, there is only a small body of evidence in medicine or health care to verify the existence of an oCoP. Objective: We aimed to examine the emergence of an oCoP through the study of social media interactions of the free open access medical education (FOAM) movement. Methods: We examined social media activity in Twitter by analyzing the network centrality metrics of tweets with the \#FOAMed hashtag and compared them with previously validated criteria of a community of practice (CoP). Results: The centrality analytics of the FOAM community showed concordance with aspects of a general CoP (in terms of community, domain, and practice), as well as some specific traits of a health care community, including social control, common purpose, flat hierarchy, and network-based and concrete achievement. Conclusions: This study demonstrated preliminary evidence of an oCoP focused on education and based on social media interactions. Further examination of the topology of the network is needed to definitely prove the existence of an oCoP. Given that these communities result in significant knowledge translation and practice change, further research in this area appears warranted. ",
doi="10.2196/jmir.7072",
url="http://www.jmir.org/2017/7/e252/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28710054"
}


@Article{info:doi/10.2196/jmir.7276,
author="Cheng, Qijin
and Li, MH Tim
and Kwok, Chi-Leung
and Zhu, Tingshao
and Yip, SF Paul",
title="Assessing Suicide Risk and Emotional Distress in Chinese Social Media: A Text Mining and Machine Learning Study",
journal="J Med Internet Res",
year="2017",
month="Jul",
day="10",
volume="19",
number="7",
pages="e243",
keywords="suicide",
keywords="psychological stress",
keywords="social media",
keywords="Chinese",
keywords="natural language",
keywords="machine learning",
abstract="Background: Early identification and intervention are imperative for suicide prevention. However, at-risk people often neither seek help nor take professional assessment. A tool to automatically assess their risk levels in natural settings can increase the opportunity for early intervention. Objective: The aim of this study was to explore whether computerized language analysis methods can be utilized to assess one's suicide risk and emotional distress in Chinese social media. Methods: A Web-based survey of Chinese social media (ie, Weibo) users was conducted to measure their suicide risk factors including suicide probability, Weibo suicide communication (WSC), depression, anxiety, and stress levels. Participants' Weibo posts published in the public domain were also downloaded with their consent. The Weibo posts were parsed and fitted into Simplified Chinese-Linguistic Inquiry and Word Count (SC-LIWC) categories. The associations between SC-LIWC features and the 5 suicide risk factors were examined by logistic regression. Furthermore, the support vector machine (SVM) model was applied based on the language features to automatically classify whether a Weibo user exhibited any of the 5 risk factors. Results: A total of 974 Weibo users participated in the survey. Those with high suicide probability were marked by a higher usage of pronoun (odds ratio, OR=1.18, P=.001), prepend words (OR=1.49, P=.02), multifunction words (OR=1.12, P=.04), a lower usage of verb (OR=0.78, P<.001), and a greater total word count (OR=1.007, P=.008). Second-person plural was positively associated with severe depression (OR=8.36, P=.01) and stress (OR=11, P=.005), whereas work-related words were negatively associated with WSC (OR=0.71, P=.008), severe depression (OR=0.56, P=.005), and anxiety (OR=0.77, P=.02). Inconsistently, third-person plural was found to be negatively associated with WSC (OR=0.02, P=.047) but positively with severe stress (OR=41.3, P=.04). Achievement-related words were positively associated with depression (OR=1.68, P=.003), whereas health- (OR=2.36, P=.004) and death-related (OR=2.60, P=.01) words positively associated with stress. The machine classifiers did not achieve satisfying performance in the full sample set but could classify high suicide probability (area under the curve, AUC=0.61, P=.04) and severe anxiety (AUC=0.75, P<.001) among those who have exhibited WSC. Conclusions: SC-LIWC is useful to examine language markers of suicide risk and emotional distress in Chinese social media and can identify characteristics different from previous findings in the English literature. Some findings are leading to new hypotheses for future verification. Machine classifiers based on SC-LIWC features are promising but still require further optimization for application in real life. ",
doi="10.2196/jmir.7276",
url="http://www.jmir.org/2017/7/e243/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28694239"
}


@Article{info:doi/10.2196/jmir.7215,
author="Wongkoblap, Akkapon
and Vadillo, A. Miguel
and Curcin, Vasa",
title="Researching Mental Health Disorders in the Era of Social Media: Systematic Review",
journal="J Med Internet Res",
year="2017",
month="Jun",
day="29",
volume="19",
number="6",
pages="e228",
keywords="mental health",
keywords="mental disorders",
keywords="social networking",
keywords="artificial intelligence",
keywords="machine learning",
keywords="public health informatics",
keywords="depression",
keywords="anxiety",
keywords="infodemiology",
abstract="Background: Mental illness is quickly becoming one of the most prevalent public health problems worldwide. Social network platforms, where users can express their emotions, feelings, and thoughts, are a valuable source of data for researching mental health, and techniques based on machine learning are increasingly used for this purpose. Objective: The objective of this review was to explore the scope and limits of cutting-edge techniques that researchers are using for predictive analytics in mental health and to review associated issues, such as ethical concerns, in this area of research. Methods: We performed a systematic literature review in March 2017, using keywords to search articles on data mining of social network data in the context of common mental health disorders, published between 2010 and March 8, 2017 in medical and computer science journals. Results: The initial search returned a total of 5386 articles. Following a careful analysis of the titles, abstracts, and main texts, we selected 48 articles for review. We coded the articles according to key characteristics, techniques used for data collection, data preprocessing, feature extraction, feature selection, model construction, and model verification. The most common analytical method was text analysis, with several studies using different flavors of image analysis and social interaction graph analysis. Conclusions: Despite an increasing number of studies investigating mental health issues using social network data, some common problems persist. Assembling large, high-quality datasets of social media users with mental disorder is problematic, not only due to biases associated with the collection methods, but also with regard to managing consent and selecting appropriate analytics techniques. ",
doi="10.2196/jmir.7215",
url="http://www.jmir.org/2017/6/e228/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28663166"
}


@Article{info:doi/10.2196/jmir.7017,
author="Zhang, Ni
and Campo, Shelly
and Yang, Jingzhen
and Eckler, Petya
and Snetselaar, Linda
and Janz, Kathleen
and Leary, Emily",
title="What Motivates Young Adults to Talk About Physical Activity on Social Network Sites?",
journal="J Med Internet Res",
year="2017",
month="Jun",
day="22",
volume="19",
number="6",
pages="e226",
keywords="physical activity",
keywords="social marketing",
keywords="social media",
abstract="Background: Electronic word-of-mouth on social network sites has been used successfully in marketing. In social marketing, electronic word-of-mouth about products as health behaviors has the potential to be more effective and reach more young adults than health education through traditional mass media. However, little is known about what motivates people to actively initiate electronic word-of-mouth about health behaviors on their personal pages or profiles on social network sites, thus potentially reaching all their contacts on those sites. Objective: This study filled the gap by applying a marketing theoretical model to explore the factors associated with electronic word-of-mouth on social network sites about leisure-time physical activity. Methods: A Web survey link was sent to undergraduate students at one of the Midwestern universities and 439 of them completed the survey. Results: The average age of the 439 participants was 19 years (SD=1 year, range: 18-24). Results suggested that emotional engagement with leisure-time physical activity (ie, affective involvement in leisure-time physical activity) predicted providing relevant opinions or information on social network sites. Social network site users who perceived stronger ties with all their contacts were more likely to provide and seek leisure-time physical activity opinions and information. People who provided leisure-time physical activity opinions and information were more likely to seek opinions and information, and people who forwarded information about leisure-time physical activity were more likely to chat about it. Conclusions: This study shed light on the application of the electronic word-of-mouth theoretical framework in promoting health behaviors. The findings can also guide the development of future social marketing interventions using social network sites to promote leisure-time physical activity. ",
doi="10.2196/jmir.7017",
url="http://www.jmir.org/2017/6/e226/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28642215"
}


@Article{info:doi/10.2196/publichealth.7157,
author="Miller, Michele
and Banerjee, Tanvi
and Muppalla, Roopteja
and Romine, William
and Sheth, Amit",
title="What Are People Tweeting About Zika? An Exploratory Study Concerning Its Symptoms, Treatment, Transmission, and Prevention",
journal="JMIR Public Health Surveill",
year="2017",
month="Jun",
day="19",
volume="3",
number="2",
pages="e38",
keywords="viruses",
keywords="epidemiology",
keywords="social media",
keywords="machine learning",
abstract="Background: In order to harness what people are tweeting about Zika, there needs to be a computational framework that leverages machine learning techniques to recognize relevant Zika tweets and, further, categorize these into disease-specific categories to address specific societal concerns related to the prevention, transmission, symptoms, and treatment of Zika virus. Objective: The purpose of this study was to determine the relevancy of the tweets and what people were tweeting about the 4 disease characteristics of Zika: symptoms, transmission, prevention, and treatment. Methods: A combination of natural language processing and machine learning techniques was used to determine what people were tweeting about Zika. Specifically, a two-stage classifier system was built to find relevant tweets about Zika, and then the tweets were categorized into 4 disease categories. Tweets in each disease category were then examined using latent Dirichlet allocation (LDA) to determine the 5 main tweet topics for each disease characteristic. Results: Over 4 months, 1,234,605 tweets were collected. The number of tweets by males and females was similar (28.47\% [351,453/1,234,605] and 23.02\% [284,207/1,234,605], respectively). The classifier performed well on the training and test data for relevancy (F1 score=0.87 and 0.99, respectively) and disease characteristics (F1 score=0.79 and 0.90, respectively). Five topics for each category were found and discussed, with a focus on the symptoms category. Conclusions: We demonstrate how categories of discussion on Twitter about an epidemic can be discovered so that public health officials can understand specific societal concerns within the disease-specific categories. Our two-stage classifier was able to identify relevant tweets to enable more specific analysis, including the specific aspects of Zika that were being discussed as well as misinformation being expressed. Future studies can capture sentiments and opinions on epidemic outbreaks like Zika virus in real time, which will likely inform efforts to educate the public at large. ",
doi="10.2196/publichealth.7157",
url="http://publichealth.jmir.org/2017/2/e38/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28630032"
}


@Article{info:doi/10.2196/jmir.6676,
author="Allot, Alexis
and Chennen, Kirsley
and Nevers, Yannis
and Poidevin, Laetitia
and Kress, Arnaud
and Ripp, Raymond
and Thompson, Dawn Julie
and Poch, Olivier
and Lecompte, Odile",
title="MyGeneFriends: A Social Network Linking Genes, Genetic Diseases, and Researchers",
journal="J Med Internet Res",
year="2017",
month="Jun",
day="16",
volume="19",
number="6",
pages="e212",
keywords="health care",
keywords="social media",
keywords="genetic variation",
keywords="hereditary disease",
abstract="Background: The constant and massive increase of biological data offers unprecedented opportunities to decipher the function and evolution of genes and their roles in human diseases. However, the multiplicity of sources and flow of data mean that efficient access to useful information and knowledge production has become a major challenge. This challenge can be addressed by taking inspiration from Web 2.0 and particularly social networks, which are at the forefront of big data exploration and human-data interaction. Objective: MyGeneFriends is a Web platform inspired by social networks, devoted to genetic disease analysis, and organized around three types of proactive agents: genes, humans, and genetic diseases. The aim of this study was to improve exploration and exploitation of biological, postgenomic era big data. Methods: MyGeneFriends leverages conventions popularized by top social networks (Facebook, LinkedIn, etc), such as networks of friends, profile pages, friendship recommendations, affinity scores, news feeds, content recommendation, and data visualization. Results: MyGeneFriends provides simple and intuitive interactions with data through evaluation and visualization of connections (friendships) between genes, humans, and diseases. The platform suggests new friends and publications and allows agents to follow the activity of their friends. It dynamically personalizes information depending on the user's specific interests and provides an efficient way to share information with collaborators. Furthermore, the user's behavior itself generates new information that constitutes an added value integrated in the network, which can be used to discover new connections between biological agents. Conclusions: We have developed MyGeneFriends, a Web platform leveraging conventions from popular social networks to redefine the relationship between humans and biological big data and improve human processing of biomedical data. MyGeneFriends is available at lbgi.fr/mygenefriends. ",
doi="10.2196/jmir.6676",
url="http://www.jmir.org/2017/6/e212/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28623182"
}


@Article{info:doi/10.2196/publichealth.5939,
author="Doan, Son
and Ritchart, Amanda
and Perry, Nicholas
and Chaparro, D. Juan
and Conway, Mike",
title="How Do You \#relax When You're \#stressed? A Content Analysis and Infodemiology Study of Stress-Related Tweets",
journal="JMIR Public Health Surveill",
year="2017",
month="Jun",
day="13",
volume="3",
number="2",
pages="e35",
keywords="social media",
keywords="Twitter",
keywords="stress",
keywords="relaxation",
keywords="natural language processing",
keywords="machine learning",
abstract="Background: Stress is a contributing factor to many major health problems in the United States, such as heart disease, depression, and autoimmune diseases. Relaxation is often recommended in mental health treatment as a frontline strategy to reduce stress, thereby improving health conditions. Twitter is a microblog platform that allows users to post their own personal messages (tweets), including their expressions about feelings and actions related to stress and stress management (eg, relaxing). While Twitter is increasingly used as a source of data for understanding mental health from a population perspective, the specific issue of stress---as manifested on Twitter---has not yet been the focus of any systematic study. Objective: The objective of our study was to understand how people express their feelings of stress and relaxation through Twitter messages. In addition, we aimed at investigating automated natural language processing methods to (1) classify stress versus nonstress and relaxation versus nonrelaxation tweets, and (2) identify first-hand experience---that is, who is the experiencer---in stress and relaxation tweets. Methods: We first performed a qualitative content analysis of 1326 and 781 tweets containing the keywords ``stress'' and ``relax,'' respectively. We then investigated the use of machine learning algorithms---in particular naive Bayes and support vector machines---to automatically classify tweets as stress versus nonstress and relaxation versus nonrelaxation. Finally, we applied these classifiers to sample datasets drawn from 4 cities in the United States (Los Angeles, New York, San Diego, and San Francisco) obtained from Twitter's streaming application programming interface, with the goal of evaluating the extent of any correlation between our automatic classification of tweets and results from public stress surveys. Results: Content analysis showed that the most frequent topic of stress tweets was education, followed by work and social relationships. The most frequent topic of relaxation tweets was rest \& vacation, followed by nature and water. When we applied the classifiers to the cities dataset, the proportion of stress tweets in New York and San Diego was substantially higher than that in Los Angeles and San Francisco. In addition, we found that characteristic expressions of stress and relaxation varied for each city based on its geolocation. Conclusions: This content analysis and infodemiology study revealed that Twitter, when used in conjunction with natural language processing techniques, is a useful data source for understanding stress and stress management strategies, and can potentially supplement infrequently collected survey-based stress data. ",
doi="10.2196/publichealth.5939",
url="http://publichealth.jmir.org/2017/2/e35/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28611016"
}


@Article{info:doi/10.2196/jmir.7219,
author="van Lent, GG Liza
and Sungur, Hande
and Kunneman, A. Florian
and van de Velde, Bob
and Das, Enny",
title="Too Far to Care? Measuring Public Attention and Fear for Ebola Using Twitter",
journal="J Med Internet Res",
year="2017",
month="Jun",
day="13",
volume="19",
number="6",
pages="e193",
keywords="psychological theory",
keywords="epidemics",
keywords="fear",
keywords="distance perception",
keywords="social media",
abstract="Background: In 2014, the world was startled by a sudden outbreak of Ebola. Although Ebola infections and deaths occurred almost exclusively in Guinea, Sierra Leone, and Liberia, few potential Western cases, in particular, caused a great stir among the public in Western countries. Objective: This study builds on the construal level theory to examine the relationship between psychological distance to an epidemic and public attention and sentiment expressed on Twitter. Whereas previous research has shown the potential of social media to assess real-time public opinion and sentiment, generalizable insights that further the theory development lack. Methods: Epidemiological data (number of Ebola infections and fatalities) and media data (tweet volume and key events reported in the media) were collected for the 2014 Ebola outbreak, and Twitter content from the Netherlands was coded for (1) expressions of fear for self or fear for others and (2) psychological distance of the outbreak to the tweet source. Longitudinal relations were compared using vector error correction model (VECM) methodology. Results: Analyses based on 4500 tweets revealed that increases in public attention to Ebola co-occurred with severe world events related to the epidemic, but not all severe events evoked fear. As hypothesized, Web-based public attention and expressions of fear responded mainly to the psychological distance of the epidemic. A chi-square test showed a significant positive relation between proximity and fear: $\chi$22=103.2 (P<.001). Public attention and fear for self in the Netherlands showed peaks when Ebola became spatially closer by crossing the Mediterranean Sea and Atlantic Ocean. Fear for others was mostly predicted by the social distance to the affected parties. Conclusions: Spatial and social distance are important predictors of public attention to worldwide crisis such as epidemics. These factors need to be taken into account when communicating about human tragedies. ",
doi="10.2196/jmir.7219",
url="http://www.jmir.org/2017/6/e193/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28611015"
}


@Article{info:doi/10.2196/jmir.7508,
author="Huesch, Marco
and Chetlen, Alison
and Segel, Joel
and Schetter, Susann",
title="Frequencies of Private Mentions and Sharing of Mammography and Breast Cancer Terms on Facebook: A Pilot Study",
journal="J Med Internet Res",
year="2017",
month="Jun",
day="09",
volume="19",
number="6",
pages="e201",
keywords="Facebook",
keywords="online social network",
keywords="social media",
keywords="breast cancer screening",
keywords="mammography",
keywords="user comments",
keywords="websites",
keywords="links",
abstract="Background: The most popular social networking site in the United States is Facebook, an online forum where circles of friends create, share, and interact with each other's content in a nonpublic way. Objective: Our objectives were to understand (1) the most commonly used terms and phrases relating to breast cancer screening, (2) the most commonly shared website links that other women interacted with, and (3) the most commonly shared website links, by age groups. Methods: We used a novel proprietary tool from Facebook to analyze all of the more than 1.7 million unique interactions (comments on stories, reshares, and emoji reactions) and stories associated with breast cancer screening keywords that were generated by more than 1.1 million unique female Facebook users over the 1 month between November 15 and December 15, 2016. We report frequency distributions of the most popular shared Web content by age group and keywords. Results: On average, each of 59,000 unique stories during the month was reshared 1.5 times, commented on nearly 8 times, and reacted to more than 20 times by other users. Posted stories were most often authored by women aged 45-54 years. Users shared, reshared, commented on, and reacted to website links predominantly to e-commerce sites (12,200/1.7 million, 36\% of all the most popular links), celebrity news (n=8800, 26\%), and major advocacy organizations (n=4900, 15\%; almost all accounted for by the American Cancer Society breast cancer site). Conclusions: On Facebook, women shared and reacted to links to commercial and informative websites regarding breast cancer and screening. This information could inform patient outreach regarding breast cancer screening, indirectly through better understanding of key issues, and directly through understanding avenues for paid messaging to women authoring and reacting to content in this space. ",
doi="10.2196/jmir.7508",
url="http://www.jmir.org/2017/6/e201/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28600279"
}


@Article{info:doi/10.2196/publichealth.7181,
author="Rabarison, M. Kristina
and Croston, A. Merriah
and Englar, K. Naomi
and Bish, L. Connie
and Flynn, M. Shelbi
and Johnson, C. Carolyn",
title="Measuring Audience Engagement for Public Health Twitter Chats: Insights From \#LiveFitNOLA",
journal="JMIR Public Health Surveill",
year="2017",
month="Jun",
day="08",
volume="3",
number="2",
pages="e34",
keywords="social media",
keywords="Twitter",
keywords="Twitter chat",
keywords="public health, communication",
keywords="content analysis",
keywords="social network analysis",
abstract="Background: Little empirical evidence exists on the effectiveness of using Twitter as a two-way communication tool for public health practice, such as Twitter chats. Objective: We analyzed whether Twitter chats facilitate engagement in two-way communications between public health entities and their audience. We also describe how to measure two-way communications, incoming and outgoing mentions, between users in a protocol using free and publicly available tools (Symplur, OpenRefine, and Gephi). Methods: We used a mixed-methods approach, social network analysis, and content analysis. The study population comprised individuals and organizations participating or who were mentioned in the first \#LiveFitNOLA chat, during a 75-min period on March 5, 2015, from 12:00 PM to 1:15 PM Central Time. We assessed audience engagement in two-way communications with two metrics: engagement ratio and return on engagement (ROE). Results: The \#LiveFitNOLA chat had 744 tweets and 66 participants with an average of 11 tweets per participant. The resulting network had 134 network members and 474 engagements. The engagement ratios and ROEs for the \#LiveFitNOLA organizers were 1:1, 40\% (13/32) (@TulanePRC) and 2:1, ?40\% (?25/63) (@FitNOLA). Content analysis showed information sharing (63.9\%, 314/491) and health information (27.9\%, 137/491) as the most salient theme and sub-theme, respectively. Conclusions: Our findings suggest Twitter chats facilitate audience engagement in two-way communications between public health entities and their audience. The \#LiveFitNOLA organizers' engagement ratios and ROEs indicated a moderate level of engagement with their audience. The practical significance of the engagement ratio and ROE depends on the audience, context, scope, scale, and goal of a Twitter chat or other organized hashtag-based communications on Twitter. ",
doi="10.2196/publichealth.7181",
url="http://publichealth.jmir.org/2017/2/e34/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28596149"
}


@Article{info:doi/10.2196/diabetes.7693,
author="Petrovski, Goran
and Zivkovic, Marija",
title="Impact of Facebook on Glucose Control in Type 1 Diabetes: A Three-Year Cohort Study",
journal="JMIR Diabetes",
year="2017",
month="Jun",
day="07",
volume="2",
number="1",
pages="e9",
keywords="social media",
keywords="type 1 diabetes",
keywords="insulin pump",
keywords="Facebook",
abstract="Background: As the world is changing, traditional health care services should be adapted for the new era of technology and the Internet. One of the possible ways for communication between health care providers and patients is social media. There are several benefits of social media in health: increased interactions with others; more available and shared information; increased accessibility; social or emotional support. Objective: The aim of this study was to evaluate the results of Facebook and CareLink software as a possible Internet tool to improve diabetes control in type 1 diabetes patients using a sensor augmented pump. Methods: A total of 67 adolescents with type 1 diabetes and in the age range of 14-23 years were randomized in 2 groups: (1) Traditional group and (2) Internet group. In the traditional group, 34 patients were treated using standard medical protocol with regular clinic visits, where data were uploaded at the clinic and interventions (pump settings-basal bolus insulin and education) were delivered to the patient. In the Internet group, 33 patients were treated using Facebook and CareLink software (Medtronic Diabetes) on a monthly basis, where the data were uploaded by the patient at home and interventions (same as traditional group) were delivered via Facebook (written reports and chats). Both the traditional and Internet group had regular visits every 3 months with standard medical protocol. Glycosylated hemoglobin (HbA1c) was obtained before and every 3 months during the study for a 3-year-period. Results: The improvement in glucose control was found in both groups: 7.9\% (SD 1.4) [62.8 mmol/mol (SD 12.9)] to 6.9\% (SD 1.2) [51.9 mmol/mol (SD 10.8)] in the traditional group, and 7.8\% (SD 1.8) [61.7 mmol/mol (SD 17.2)] to 6.7\% (SD 1.8) [49.7 mmol/mol (SD 17.3)] in the Internet group). Significant improvement of HbA1c (P<.05) was found in favor of the Internet group. Conclusions: Social media such as Facebook as a tool can assist in standard medical care to improve glucose control in a long term period in adolescents with type 1 diabetes using insulin pump therapy. ",
doi="10.2196/diabetes.7693",
url="http://diabetes.jmir.org/2017/1/e9/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30291064"
}


@Article{info:doi/10.2196/jmir.7303,
author="Villanti, C. Andrea
and Johnson, L. Amanda
and Ilakkuvan, Vinu
and Jacobs, A. Megan
and Graham, L. Amanda
and Rath, M. Jessica",
title="Social Media Use and Access to Digital Technology in US Young Adults in 2016",
journal="J Med Internet Res",
year="2017",
month="Jun",
day="07",
volume="19",
number="6",
pages="e196",
keywords="social media",
keywords="technology",
keywords="young adults",
abstract="Background: In 2015, 90\% of US young adults with Internet access used social media. Digital and social media are highly prevalent modalities through which young adults explore identity formation, and by extension, learn and transmit norms about health and risk behaviors during this developmental life stage. Objective: The purpose of this study was to provide updated estimates of social media use from 2014 to 2016 and correlates of social media use and access to digital technology in data collected from a national sample of US young adults in 2016. Methods: Young adult participants aged 18-24 years in Wave 7 (October 2014, N=1259) and Wave 9 (February 2016, N=989) of the Truth Initiative Young Adult Cohort Study were asked about use frequency for 11 social media sites and access to digital devices, in addition to sociodemographic characteristics. Regular use was defined as using a given social media site at least weekly. Weighted analyses estimated the prevalence of use of each social media site, overlap between regular use of specific sites, and correlates of using a greater number of social media sites regularly. Bivariate analyses identified sociodemographic correlates of access to specific digital devices. Results: In 2014, 89.42\% (weighted n, 1126/1298) of young adults reported regular use of at least one social media site. This increased to 97.5\% (weighted n, 965/989) of young adults in 2016. Among regular users of social media sites in 2016, the top five sites were Tumblr (85.5\%), Vine (84.7\%), Snapchat (81.7\%), Instagram (80.7\%), and LinkedIn (78.9\%). Respondents reported regularly using an average of 7.6 social media sites, with 85\% using 6 or more sites regularly. Overall, 87\% of young adults reported access or use of a smartphone with Internet access, 74\% a desktop or laptop computer with Internet access, 41\% a tablet with Internet access, 29\% a smart TV or video game console with Internet access, 11\% a cell phone without Internet access, and 3\% none of these. Access to all digital devices with Internet was lower in those reporting a lower subjective financial situation; there were also significant differences in access to specific digital devices with Internet by race, ethnicity, and education. Conclusions: The high mean number of social media sites used regularly and the substantial overlap in use of multiple social media sites reflect the rapidly changing social media environment. Mobile devices are a primary channel for social media, and our study highlights disparities in access to digital technologies with Internet access among US young adults by race/ethnicity, education, and subjective financial status. Findings from this study may guide the development and implementation of future health interventions for young adults delivered via the Internet or social media sites. ",
doi="10.2196/jmir.7303",
url="http://www.jmir.org/2017/6/e196/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28592394"
}


@Article{info:doi/10.2196/jmir.7485,
author="Metwally, Omar
and Blumberg, Seth
and Ladabaum, Uri
and Sinha, R. Sidhartha",
title="Using Social Media to Characterize Public Sentiment Toward Medical Interventions Commonly Used for Cancer Screening: An Observational Study",
journal="J Med Internet Res",
year="2017",
month="Jun",
day="07",
volume="19",
number="6",
pages="e200",
keywords="Twitter",
keywords="sentiment analysis",
keywords="cancer screening",
keywords="colonoscopy",
keywords="mammography",
keywords="Pap smear",
keywords="Papanicolaou test",
keywords="social media",
keywords="early detection of cancer",
abstract="Background: Although cancer screening reduces morbidity and mortality, millions of people worldwide remain unscreened. Social media provide a unique platform to understand public sentiment toward tools that are commonly used for cancer screening. Objective: The objective of our study was to examine public sentiment toward colonoscopy, mammography, and Pap smear and how this sentiment spreads by analyzing discourse on Twitter. Methods: In this observational study, we classified 32,847 tweets (online postings on Twitter) related to colonoscopy, mammography, or Pap smears using a naive Bayes algorithm as containing positive, negative, or neutral sentiment. Additionally, we characterized the spread of sentiment on Twitter using an established model to study contagion. Results: Colonoscopy-related tweets were more likely to express negative than positive sentiment (negative to positive ratio 1.65, 95\% CI 1.51-1.80, P<.001), in contrast to the more positive sentiment expressed regarding mammography (negative to positive ratio 0.43, 95\% CI 0.39-0.47, P<.001). The proportions of negative versus positive tweets about Pap smear were not significantly different (negative to positive ratio 0.95, 95\% CI 0.87-1.04, P=.18). Positive and negative tweets tended to share lexical features across screening modalities. Positive tweets expressed resonance with the benefits of early detection. Fear and pain were the principal lexical features seen in negative tweets. Negative sentiment for colonoscopy and mammography spread more than positive sentiment; no correlation with sentiment and spread was seen for Pap smear. Conclusions: Analysis of social media data provides a unique, quantitative framework to better understand the public's perception of medical interventions that are commonly used for cancer screening. Given the growing use of social media, public health interventions to improve cancer screening should use the health perceptions of the population as expressed in social network postings about tests that are frequently used for cancer screening, as well as other people they may influence with such postings. ",
doi="10.2196/jmir.7485",
url="http://www.jmir.org/2017/6/e200/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28592395"
}


@Article{info:doi/10.2196/publichealth.7545,
author="Reiter, L. Paul
and Katz, L. Mira
and Bauermeister, A. Jose
and Shoben, B. Abigail
and Paskett, D. Electra
and McRee, Annie-Laurie",
title="Recruiting Young Gay and Bisexual Men for a Human Papillomavirus Vaccination Intervention Through Social Media: The Effects of Advertisement Content",
journal="JMIR Public Health Surveill",
year="2017",
month="Jun",
day="02",
volume="3",
number="2",
pages="e33",
keywords="HPV",
keywords="HPV vaccine",
keywords="gay and bisexual men",
keywords="social media",
abstract="Background: Web-based approaches, specifically social media sites, represent a promising approach for recruiting young gay and bisexual men for research studies. Little is known, however, about how the performance of social media advertisements (ads) used to recruit this population is affected by ad content (ie, image and text). Objective: The aim of this study was to evaluate the effects of different images and text included in social media ads used to recruit young gay and bisexual men for the pilot test of a Web-based human papillomavirus (HPV) vaccination intervention. Methods: In July and September 2016, we used paid Facebook advertisements to recruit men who were aged 18-25 years, self-identified as gay or bisexual, US resident, and had not received HPV vaccine. A 4x2x2 factorial experiment varied ad image (a single young adult male, a young adult male couple, a group of young adult men, or a young adult male talking to a doctor), content focus (text mentioning HPV or HPV vaccine), and disease framing (text mentioning cancer or a sexually transmitted disease [STD]). Poisson regression determined whether these experimental factors affected ad performance. Results: The recruitment campaign reached a total of 35,646 users who viewed ads for 36,395 times. This resulted in an overall unique click-through rate of 2.01\% (717/35,646) and an overall conversion rate of 0.66\% (241/36,395). Reach was higher for ads that included an image of a couple (incidence rate ratio, IRR=4.91, 95\% CI 2.68-8.97, P<.001) or a group (IRR=2.65, 95\% CI 1.08-6.50, P=.03) compared with those that included an image of a single person. Ads that included an image of a couple also had a higher conversion rate (IRR=2.56, 95\% CI 1.13-5.77, P=.02) than ads that included an image of a single person. Ads with text mentioning an STD had a higher unique click-through rate compared with ads with text mentioning cancer (IRR=1.34, 95\% CI 1.06-1.69, P=.01). The campaign cost a total of US \$413.72 and resulted in 150 eligible and enrolled individuals (US \$2.76 per enrolled participant). Conclusions: Facebook ads are a convenient and cost-efficient strategy for reaching and recruiting young gay and bisexual men for a Web-based HPV vaccination intervention. To help optimize ad performance among this population, researchers should consider the importance of the text and image included in the social media recruitment ads. ",
doi="10.2196/publichealth.7545",
url="http://publichealth.jmir.org/2017/2/e33/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28576758"
}


@Article{info:doi/10.2196/jmir.6946,
author="Davis, A. Matthew
and Zheng, Kai
and Liu, Yang
and Levy, Helen",
title="Public Response to Obamacare on Twitter",
journal="J Med Internet Res",
year="2017",
month="May",
day="26",
volume="19",
number="5",
pages="e167",
keywords="Patient Protection and Affordable Care Act",
keywords="health care reform",
keywords="social media",
keywords="data collection",
abstract="Background: The Affordable Care Act (ACA), often called ``Obamacare,'' is a controversial law that has been implemented gradually since its enactment in 2010. Polls have consistently shown that public opinion of the ACA is quite negative. Objective: The aim of our study was to examine the extent to which Twitter data can be used to measure public opinion of the ACA over time. Methods: We prospectively collected a 10\% random sample of daily tweets (approximately 52 million since July 2011) using Twitter's streaming application programming interface (API) from July 10, 2011 to July 31, 2015. Using a list of key terms and ACA-specific hashtags, we identified tweets about the ACA and examined the overall volume of tweets about the ACA in relation to key ACA events. We applied standard text sentiment analysis to assign each ACA tweet a measure of positivity or negativity and compared overall sentiment from Twitter with results from the Kaiser Family Foundation health tracking poll. Results: Public opinion on Twitter (measured via sentiment analysis) was slightly more favorable than public opinion measured by the Kaiser poll (approximately 50\% vs 40\%, respectively) but trends over time in both favorable and unfavorable views were similar in both sources. The Twitter-based measures of opinion as well as the Kaiser poll changed very little over time: correlation coefficients for favorable and unfavorable public opinion were .43 and .37, respectively. However, we found substantial spikes in the volume of ACA-related tweets in response to key events in the law's implementation, such as the first open enrollment period in October 2013 and the Supreme Court decision in June 2012. Conclusions: Twitter may be useful for tracking public opinion of health care reform as it appears to be comparable with conventional polling results. Moreover, in contrast with conventional polling, the overall amount of tweets also provides a potential indication of public interest of a particular issue at any point in time. ",
doi="10.2196/jmir.6946",
url="http://www.jmir.org/2017/5/e167/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28550002"
}


@Article{info:doi/10.2196/jmir.6763,
author="Martinez-Millana, Antonio
and Fernandez-Llatas, Carlos
and Basagoiti Bilbao, Ignacio
and Traver Salcedo, Manuel
and Traver Salcedo, Vicente",
title="Evaluating the Social Media Performance of Hospitals in Spain: A Longitudinal and Comparative Study",
journal="J Med Internet Res",
year="2017",
month="May",
day="23",
volume="19",
number="5",
pages="e181",
keywords="public health",
keywords="delivery of health care",
keywords="Internet",
keywords="social media",
keywords="hospitals",
abstract="Background: Social media is changing the way in which citizens and health professionals communicate. Previous studies have assessed the use of Health 2.0 by hospitals, showing clear evidence of growth in recent years. In order to understand if this happens in Spain, it is necessary to assess the performance of health care institutions on the Internet social media using quantitative indicators. Objectives: The study aimed to analyze how hospitals in Spain perform on the Internet and social media networks by determining quantitative indicators in 3 different dimensions: presence, use, and impact and assess these indicators on the 3 most commonly used social media - Facebook, Twitter, YouTube. Further, we aimed to find out if there was a difference between private and public hospitals in their use of the aforementioned social networks. Methods: The evolution of presence, use, and impact metrics is studied over the period 2011- 2015. The population studied accounts for all the hospitals listed in the National Hospitals Catalog (NHC). The percentage of hospitals having Facebook, Twitter, and YouTube profiles has been used to show the presence and evolution of hospitals on social media during this time. Usage was assessed by analyzing the content published on each social network. Impact evaluation was measured by analyzing the trend of subscribers for each social network. Statistical analysis was performed using a lognormal transformation and also using a nonparametric distribution, with the aim of comparing t student and Wilcoxon independence tests for the observed variables. Results: From the 787 hospitals identified, 69.9\% (550/787) had an institutional webpage and 34.2\% (269/787) had at least one profile in one of the social networks (Facebook, Twitter, and YouTube) in December 2015. Hospitals' Internet presence has increased by more than 450.0\% (787/172) and social media presence has increased ten times since 2011. Twitter is the preferred social network for public hospitals, whereas private hospitals showed better performance on Facebook and YouTube. The two-sided Wilcoxon test and t student test at a CI of 95\% show that the use of Twitter distribution is higher (P<.001) for private and public hospitals in Spain, whereas other variables show a nonsignificant different distribution. Conclusions: The Internet presence of Spanish hospitals is high; however, their presence on the 3 main social networks is still not as high compared to that of hospitals in the United States and Western Europe. Public hospitals are found to be more active on Twitter, whereas private hospitals show better performance on Facebook and YouTube. This study suggests that hospitals, both public and private, should devote more effort to and be more aware of social media, with a clear strategy as to how they can foment new relationships with patients and citizens. ",
doi="10.2196/jmir.6763",
url="http://www.jmir.org/2017/5/e181/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28536091"
}


@Article{info:doi/10.2196/jmir.6681,
author="Kim, Jung Sunny
and Marsch, A. Lisa
and Brunette, F. Mary
and Dallery, Jesse",
title="Harnessing Facebook for Smoking Reduction and Cessation Interventions: Facebook User Engagement and Social Support Predict Smoking Reduction",
journal="J Med Internet Res",
year="2017",
month="May",
day="23",
volume="19",
number="5",
pages="e168",
keywords="social media",
keywords="social support",
keywords="behavior and behavior mechanisms",
keywords="smoking cessation",
keywords="persuasive communication",
keywords="social networking",
keywords="technology",
keywords="health promotion",
abstract="Background: Social media technologies offer a novel opportunity for scalable health interventions that can facilitate user engagement and social support, which in turn may reinforce positive processes for behavior change. Objective: By using principles from health communication and social support literature, we implemented a Facebook group--based intervention that targeted smoking reduction and cessation. This study hypothesized that participants' engagement with and perceived social support from our Facebook group intervention would predict smoking reduction. Methods: We recruited 16 regular smokers who live in the United States and who were motivated in quitting smoking at screening. We promoted message exposure as well as engagement and social support systems throughout the intervention. For message exposure, we posted prevalidated, antismoking messages (such as national antismoking campaigns) on our smoking reduction and cessation Facebook group. For engagement and social support systems, we delivered a high degree of engagement and social support systems during the second and third week of the intervention and a low degree of engagement and social support systems during the first and fourth week. A total of six surveys were conducted via Amazon Mechanical Turk (MTurk) at baseline on a weekly basis and at a 2-week follow-up. Results: Of the total 16 participants, most were female (n=13, 81\%), white (n=15, 94\%), and between 25 and 50 years of age (mean 34.75, SD 8.15). There was no study attrition throughout the 6-time-point baseline, weekly, and follow-up surveys. We generated Facebook engagement and social support composite scores (mean 19.19, SD 24.35) by combining the number of likes each participant received and the number of comments or wall posts each participant posted on our smoking reduction and cessation Facebook group during the intervention period. The primary outcome was smoking reduction in the past 7 days measured at baseline and at the two-week follow-up. Compared with the baseline, participants reported smoking an average of 60.56 fewer cigarettes per week (SD 38.83) at the follow-up, and 4 participants out of 16 (25\%) reported 7-day point prevalence smoking abstinence at the follow-up. Adjusted linear regression models revealed that a one-unit increase in the Facebook engagement and social support composite scores predicted a 0.56-unit decrease in cigarettes smoked per week (standard error =.24, P=.04, 95\% CI 0.024-1.09) when baseline readiness to quit, gender, and baseline smoking status were controlled (F4, 11=8.85, P=.002). Conclusions: This study is the first Facebook group--based intervention that systemically implemented health communication strategies and engagement and social support systems to promote smoking reduction and cessation. Our findings imply that receiving one like or posting on the Facebook-based intervention platform predicted smoking approximately one less cigarette in the past 7 days, and that interventions should facilitate user interactions to foster user engagement and social support. ",
doi="10.2196/jmir.6681",
url="http://www.jmir.org/2017/5/e168/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28536096"
}


@Article{info:doi/10.2196/publichealth.7149,
author="Landry, Megan
and Turner, Monique
and Vyas, Amita
and Wood, Susan",
title="Social Media and Sexual Behavior Among Adolescents: Is there a link?",
journal="JMIR Public Health Surveill",
year="2017",
month="May",
day="19",
volume="3",
number="2",
pages="e28",
keywords="text messaging",
keywords="social media",
keywords="parent-child relations",
keywords="sexual behavior",
keywords="adolescent",
abstract="Background: Adolescent sexual risk taking and its consequences remain a global public health concern. Empirical evidence on the impact that social media has on sexual health behaviors among youth is sparse. Objective: The study aimed to examine the relationship between social media and the change in sexual risk over time and whether parental monitoring moderates this relationship. Methods: This study comprised a sample of 555 Latino youth aged 13-19 years from Maryland, United States completing baseline and follow-up surveys. Mixed-effects linear regression was used to examine the relationship between social media and the change in sexual risk over time and whether parental monitoring moderated the relationship. Results: Sexual risk behaviors significantly increased between baseline (T1) and follow up (T2) (mean=0.432 vs mean=0.734, P<.001). Youth sending more than 100 text messages per day had significantly higher sexual risk scores (beta=1.008, P<.001) but significantly larger declines in sexual risk scores for higher levels of parental monitoring (beta=?.237, P=.009). Conclusions: Although adolescents exchange SMS at high rates, parental monitoring remains vital to parent-child relationships and can moderate SMS frequency and sexual risk behaviors, despite parental influence diminishing and peer pressure and social influences increasing during adolescence. ",
doi="10.2196/publichealth.7149",
url="http://publichealth.jmir.org/2017/2/e28/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28526670"
}


@Article{info:doi/10.2196/jmir.6815,
author="Saha, Koustuv
and Weber, Ingmar
and Birnbaum, L. Michael
and De Choudhury, Munmun",
title="Characterizing Awareness of Schizophrenia Among Facebook Users by Leveraging Facebook Advertisement Estimates",
journal="J Med Internet Res",
year="2017",
month="May",
day="08",
volume="19",
number="5",
pages="e156",
keywords="schizophrenia",
keywords="psychotic disorders",
keywords="online social networks",
keywords="health awareness",
keywords="mental health",
keywords="public health",
keywords="Facebook",
abstract="Background: Schizophrenia is a rare but devastating condition, affecting about 1\% of the world's population and resulting in about 2\% of the US health care expenditure. Major impediments to appropriate and timely care include misconceptions, high levels of stigma, and lack of public awareness. Facebook offers novel opportunities to understand public awareness and information access related to schizophrenia, and thus can complement survey-based approaches to assessing awareness that are limited in scale, robustness, and temporal and demographic granularity. Objective: The aims of this study were to (1) construct an index that measured the awareness of different demographic groups around schizophrenia-related information on Facebook; (2) study how this index differed across demographic groups and how it correlated with complementary Web-based (Google Trends) and non--Web-based variables about population well-being (mental health indicators and infrastructure), and (3) examine the relationship of Facebook derived schizophrenia index with other types of online activity as well as offline health and mental health outcomes and indicators. Methods: Data from Facebook's advertising platform was programmatically collected to compute the proportion of users in a target demographic group with an interest related to schizophrenia. On consultation with a clinical expert, several topics were combined to obtain a single index measuring schizophrenia awareness. This index was then analyzed for differences across US states, gender, age, ethnic affinity, and education level. A statistical approach was developed to model a group's awareness index based on the group's characteristics. Results: Overall, 1.03\% of Facebook users in the United States have a schizophrenia-related interest. The schizophrenia awareness index (SAI) is higher for females than for males (1.06 vs 0.97, P<.001), and it is highest for the people who are aged 25-44 years (1.35 vs 1.03 for all ages, P<.001). The awareness index drops for higher education levels (0.68 for MA or PhD vs 1.92 for no high school degree, P<.001), and Hispanics have the highest level of interest (1.57 vs 1.03 for all ethnic affinities, P<.001). A regression model fit to predict a group's interest level achieves an adjusted R2=0.55. We also observe a positive association between our SAI and mental health services (or institutions) per 100,000 residents in a US state (Pearson r=.238, P<.001), but a negative association with the state-level human development index (HDI) in United States (Pearson r=?.145, P<.001) and state-level volume of mental health issues in United States (Pearson r=?.145, P<.001). Conclusions: Facebook's advertising platform can be used to construct a plausible index of population-scale schizophrenia awareness. However, only estimates of awareness can be obtained, and the index provides no information on the quality of the information users receive online. ",
doi="10.2196/jmir.6815",
url="http://www.jmir.org/2017/5/e156/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28483739"
}


@Article{info:doi/10.2196/ijmr.7210,
author="Winchester, E. David
and Baxter, Diana
and Markham, J. Merry
and Beyth, J. Rebecca",
title="Quality of Social Media and Web-Based Information Regarding Inappropriate Nuclear Cardiac Stress Testing and the Choosing Wisely Campaign: A Cross-Sectional Study",
journal="Interact J Med Res",
year="2017",
month="May",
day="04",
volume="6",
number="1",
pages="e6",
keywords="myocardial perfusion imaging",
keywords="health services research",
keywords="Internet",
keywords="unnecessary procedures",
abstract="Background: The World Wide Web and social media provide the public with access to medical information unlike any other time in human history. However, the quality of content related to cardiac stress testing is not well understood. Objective: The aim of our study was to evaluate the quality of content on the Internet relating to the use of cardiac nuclear stress testing and the Choosing Wisely campaign. Methods: We searched the World Wide Web, Google Video (including YouTube), and Twitter for information relating to these two topics. Searches were performed using English language terms from a computer in the United States not logged into any personal user accounts. Search results were reviewed for discussion of specific topics including radiation risk, accuracy of testing, alternative testing options, and discouragement of inappropriate test use. Results: We evaluated a total of 348 items of content from our searches. Relevant search results for Choosing Wisely were fewer than for other search terms (45 vs 303). We did not find any content which encouraged inappropriate testing (ie, screening in low risk individuals or testing prior to low risk operations). Content related to Choosing Wisely was more likely to discourage inappropriate testing than search results for other terms (29/45, 64\% vs 12/303, 4.0\%, odds ratio 43.95, 95\% CI 17.6-112.2, P<.001). Conclusions: The Internet content on nuclear stress tests consistently discouraged inappropriate testing. The Choosing Wisely content was more likely to discourage inappropriate testing, less relevant content was available. Generating authoritative content on the Internet relating to judicious use of medical interventions may be an important role for the Choosing Wisely campaign. ",
doi="10.2196/ijmr.7210",
url="http://www.i-jmr.org/2017/1/e6/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28473305"
}


@Article{info:doi/10.2196/jmir.6834,
author="Wang, Xi
and Zhao, Kang
and Street, Nick",
title="Analyzing and Predicting User Participations in Online Health Communities: A Social Support Perspective",
journal="J Med Internet Res",
year="2017",
month="Apr",
day="24",
volume="19",
number="4",
pages="e130",
keywords="social support",
keywords="machine learning",
keywords="community networks",
keywords="patient engagement",
keywords="prediction",
abstract="Background: Online health communities (OHCs) have become a major source of social support for people with health problems. Members of OHCs interact online with similar peers to seek, receive, and provide different types of social support, such as informational support, emotional support, and companionship. As active participations in an OHC are beneficial to both the OHC and its users, it is important to understand factors related to users' participations and predict user churn for user retention efforts. Objective: This study aimed to analyze OHC users' Web-based interactions, reveal which types of social support activities are related to users' participation, and predict whether and when a user will churn from the OHC. Methods: We collected a large-scale dataset from a popular OHC for cancer survivors. We used text mining techniques to decide what kinds of social support each post contained. We illustrated how we built text classifiers for 5 different social support categories: seeking informational support (SIS), providing informational support (PIS), seeking emotional support (SES), providing emotional support (PES), and companionship (COM). We conducted survival analysis to identify types of social support related to users' continued participation. Using supervised machine learning methods, we developed a predictive model for user churn. Results: Users' behaviors to PIS, SES, and COM had hazard ratios significantly lower than 1 (0.948, 0.972, and 0.919, respectively) and were indicative of continued participations in the OHC. The churn prediction model based on social support activities offers accurate predictions on whether and when a user will leave the OHC. Conclusions: Detecting different types of social support activities via text mining contributes to better understanding and prediction of users' participations in an OHC. The outcome of this study can help the management and design of a sustainable OHC via more proactive and effective user retention strategies. ",
doi="10.2196/jmir.6834",
url="http://www.jmir.org/2017/4/e130/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28438725"
}


@Article{info:doi/10.2196/publichealth.6925,
author="Stefanidis, Anthony
and Vraga, Emily
and Lamprianidis, Georgios
and Radzikowski, Jacek
and Delamater, L. Paul
and Jacobsen, H. Kathryn
and Pfoser, Dieter
and Croitoru, Arie
and Crooks, Andrew",
title="Zika in Twitter: Temporal Variations of Locations, Actors, and Concepts",
journal="JMIR Public Health Surveill",
year="2017",
month="Apr",
day="20",
volume="3",
number="2",
pages="e22",
keywords="Zika virus",
keywords="social media",
keywords="Twitter messaging",
keywords="geographic information systems",
abstract="Background: The recent Zika outbreak witnessed the disease evolving from a regional health concern to a global epidemic. During this process, different communities across the globe became involved in Twitter, discussing the disease and key issues associated with it. This paper presents a study of this discussion in Twitter, at the nexus of location, actors, and concepts. Objective: Our objective in this study was to demonstrate the significance of 3 types of events: location related, actor related, and concept related, for understanding how a public health emergency of international concern plays out in social media, and Twitter in particular. Accordingly, the study contributes to research efforts toward gaining insights on the mechanisms that drive participation, contributions, and interaction in this social media platform during a disease outbreak. Methods: We collected 6,249,626 tweets referring to the Zika outbreak over a period of 12 weeks early in the outbreak (December 2015 through March 2016). We analyzed this data corpus in terms of its geographical footprint, the actors participating in the discourse, and emerging concepts associated with the issue. Data were visualized and evaluated with spatiotemporal and network analysis tools to capture the evolution of interest on the topic and to reveal connections between locations, actors, and concepts in the form of interaction networks. Results: The spatiotemporal analysis of Twitter contributions reflects the spread of interest in Zika from its original hotspot in South America to North America and then across the globe. The Centers for Disease Control and World Health Organization had a prominent presence in social media discussions. Tweets about pregnancy and abortion increased as more information about this emerging infectious disease was presented to the public and public figures became involved in this. Conclusions: The results of this study show the utility of analyzing temporal variations in the analytic triad of locations, actors, and concepts. This contributes to advancing our understanding of social media discourse during a public health emergency of international concern. ",
doi="10.2196/publichealth.6925",
url="http://publichealth.jmir.org/2017/2/e22/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28428164"
}


@Article{info:doi/10.2196/resprot.6622,
author="Caplette, Marie-Eve
and Provencher, V{\'e}ronique
and Bissonnette-Maheux, V{\'e}ronique
and Dugrenier, Marilyn
and Lapointe, Annie
and Gagnon, Marie-Pierre
and Straus, Sharon
and Desroches, Sophie",
title="Increasing Fruit and Vegetable Consumption Through a Healthy Eating Blog: A Feasibility Study",
journal="JMIR Res Protoc",
year="2017",
month="Apr",
day="18",
volume="6",
number="4",
pages="e59",
keywords="blogs",
keywords="nutrition",
keywords="healthy eating",
keywords="knowledge translation",
keywords="feasibility",
abstract="Background: Despite efforts made by public health organizations to improve consumption of fruits and vegetables, populations in developed countries usually eat less than the minimum recommended. Social media, such as blogs, represent a unique opportunity for improving knowledge translation in health care because they facilitate interactive communication between the public and health professionals. However, no studies have yet evaluated the effect of blogs to promote dietary behavior changes. Objective: Our study aims to conduct a preliminary assessment before undertaking a full randomized controlled trial (RCT) of the feasibility of using an evidence-based healthy eating blog promoting the consumption of fruits and vegetables among adult women. Methods: A total of 80 women aged 18 years and older (mean 42, SD 13 years) eating less than five servings per day of fruit and vegetables (mean 2.75, SD 1.84 servings) were recruited. Participants were randomized to the healthy eating blog group (n=40), which included a weekly blog post over a 6-month period, or to a control group (n=40) that had no exposure to the healthy eating blog. Blog posts were written by a registered dietitian and focused on the improvement of fruit and vegetable consumption. We targeted four main determinants of the behavior that were identified as the best predictors for fruit and vegetable intake by two systematic reviews: (1) knowledge, (2) attitude, (3) self-efficacy, and (4) motivation. The intervention was considered feasible if (1) more than 70\% of questionnaires were completed, (2) attendance rate was more than 90\% for in-person appointments with the research coordinator, (3) participants accessed at least 75\% of the blog posts, and (4) the attrition rate was less than 25\%. Blog access was assessed by collecting the blog browsing history data for each participant. Results: During the intervention, 26 posts were published on the blog. Pre- (baseline) and postintervention (6 months) questionnaires were completed by mean 97\% (SD 3\%) of participants. All participants attended their in-person appointments. Women accessed mean 87\% (SD 7\%) of the posts published during the intervention. Only 3\% (2/80) of participants dropped out of the study. Between the healthy eating blog and control groups, a difference of 1.0 servings of fruits and vegetables (P<.001) indicated moderate effects of the intervention (Cohen d=0.54). Conclusions: These results suggest that an intervention using a healthy eating blog meets preestablished feasibility criteria. A larger-scale RCT using the same methodology will be conducted to assess the impact of a healthy eating blog on the dietary habits of women. ",
doi="10.2196/resprot.6622",
url="http://www.researchprotocols.org/2017/4/e59/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28420600"
}


@Article{info:doi/10.2196/resprot.6904,
author="Bateman, Robert Daniel
and Brady, Erin
and Wilkerson, David
and Yi, Eun-Hye
and Karanam, Yamini
and Callahan, M. Christopher",
title="Comparing Crowdsourcing and Friendsourcing: A Social Media-Based Feasibility Study to Support Alzheimer Disease Caregivers",
journal="JMIR Res Protoc",
year="2017",
month="Apr",
day="10",
volume="6",
number="4",
pages="e56",
keywords="Alzheimer disease",
keywords="Alzheimer disease and related dementias",
keywords="caregivers",
keywords="mobile health",
keywords="social media",
keywords="crowdsourcing",
keywords="friendsourcing",
keywords="emotional support",
keywords="informational support",
keywords="online support",
abstract="Background: In the United States, over 15 million informal caregivers provide unpaid care to people with Alzheimer disease (AD). Compared with others in their age group, AD caregivers have higher rates of stress, and medical and psychiatric illnesses. Psychosocial interventions improve the health of caregivers. However, constraints of time, distance, and availability inhibit the use of these services. Newer online technologies, such as social media, online groups, friendsourcing, and crowdsourcing, present alternative methods of delivering support. However, limited work has been done in this area with caregivers. Objective: The primary aims of this study were to determine (1) the feasibility of innovating peer support group work delivered through social media with friendsourcing, (2) whether the intervention provides an acceptable method for AD caregivers to obtain support, and (3) whether caregiver outcomes were affected by the intervention. A Facebook app provided support to AD caregivers through collecting friendsourced answers to caregiver questions from participants' social networks. The study's secondary aim was to descriptively compare friendsourced answers versus crowdsourced answers. Methods: We recruited AD caregivers online to participate in a 6-week-long asynchronous, online, closed group on Facebook, where caregivers received support through moderator prompts, group member interactions, and friendsourced answers to caregiver questions. We surveyed and interviewed participants before and after the online group to assess their needs, views on technology, and experience with the intervention. Caregiver questions were pushed automatically to the participants' Facebook News Feed, allowing participants' Facebook friends to see and post answers to the caregiver questions (Friendsourced answers). Of these caregiver questions, 2 were pushed to crowdsource workers through the Amazon Mechanical Turk platform. We descriptively compared characteristics of these crowdsourced answers with the friendsourced answers. Results: In total, 6 AD caregivers completed the initial online survey and semistructured telephone interview. Of these, 4 AD caregivers agreed to participate in the online Facebook closed group activity portion of the study. Friendsourcing and crowdsourcing answers to caregiver questions had similar rates of acceptability as rated by content experts: 90\% (27/30) and 100\% (45/45), respectively. Rates of emotional support and informational support for both groups of answers appeared to trend with the type of support emphasized in the caregiver question (emotional vs informational support question). Friendsourced answers included more shared experiences (20/30, 67\%) than did crowdsourced answers (4/45, 9\%). Conclusions: We found an asynchronous, online, closed group on Facebook to be generally acceptable as a means to deliver support to caregivers of people with AD. This pilot is too small to make judgments on effectiveness; however, results trended toward an improvement in caregivers' self-efficacy, sense of support, and perceived stress, but these results were not statistically significant. Both friendsourced and crowdsourced answers may be an acceptable way to provide informational and emotional support to caregivers of people with AD. ",
doi="10.2196/resprot.6904",
url="http://www.researchprotocols.org/2017/4/e56/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28396304"
}


@Article{info:doi/10.2196/jmir.7087,
author="Lu, Yingjie
and Wu, Yang
and Liu, Jingfang
and Li, Jia
and Zhang, Pengzhu",
title="Understanding Health Care Social Media Use From Different Stakeholder Perspectives: A Content Analysis of an Online Health Community",
journal="J Med Internet Res",
year="2017",
month="Apr",
day="07",
volume="19",
number="4",
pages="e109",
keywords="health care social media",
keywords="stakeholder analysis",
keywords="topic analysis",
keywords="sentiment analysis",
abstract="Background: Health care social media used for health information exchange and emotional communication involves different types of users, including patients, caregivers, and health professionals. However, it is difficult to identify different stakeholders because user identification data are lacking due to privacy protection and proprietary interests. Therefore, identifying the concerns of different stakeholders and how they use health care social media when confronted with huge amounts of health-related messages posted by users is a critical problem. Objective: We aimed to develop a new content analysis method using text mining techniques applied in health care social media to (1) identify different health care stakeholders, (2) determine hot topics of concern, and (3) measure sentiment expression by different stakeholders. Methods: We collected 138,161 messages posted by 39,606 members in lung cancer, diabetes, and breast cancer forums in the online community MedHelp.org over 10 years (January 2007 to October 2016) as experimental data. We used text mining techniques to process text data to identify different stakeholders and determine health-related hot topics, and then analyzed sentiment expression. Results: We identified 3 significantly different stakeholder groups using expectation maximization clustering (3 performance metrics: Rand=0.802, Jaccard=0.393, Fowlkes-Mallows=0.537; P<.001), in which patients (24,429/39,606, 61.68\%) and caregivers (12,232/39,606, 30.88\%) represented the majority of the population, in contrast to specialists (2945/39,606, 7.43\%). We identified 5 significantly different health-related topics: symptom, examination, drug, procedure, and complication (Rand=0.783, Jaccard=0.369, Fowlkes-Mallows=0.495; P<.001). Patients were concerned most about symptom topics related to lung cancer (536/1657, 32.34\%), drug topics related to diabetes (1883/5904, 31.89\%), and examination topics related to breast cancer (8728/23,934, 36.47\%). By comparison, caregivers were more concerned about drug topics related to lung cancer (300/2721, 11.03\% vs 109/1657, 6.58\%), procedure topics related to breast cancer (3952/13,954, 28.32\% vs 5822/23,934, 24.33\%), and complication topics (4449/25,701, 17.31\% vs 4070/31,495, 12.92\%). In addition, patients (9040/36,081, 25.05\%) were more likely than caregivers (2659/18,470, 14.39\%) and specialists (17,943/83,610, 21.46\%) to express their emotions. However, patients' sentiment intensity score (2.46) was lower than those of caregivers (4.66) and specialists (5.14). In particular, for caregivers, negative sentiment scores were higher than positive scores (2.56 vs 2.18), with the opposite among specialists (2.62 vs 2.46). Overall, the proportion of negative messages was greater than that of positive messages related to symptom, complication, and examination. The pattern was opposite for drug and procedure topics. A trend analysis showed that patients and caregivers gradually changed their emotional state in a positive direction. Conclusions: The hot topics of interest and sentiment expression differed significantly among different stakeholders in different disease forums. These findings could help improve social media services to facilitate diverse stakeholder engagement for health information sharing and social interaction more effectively. ",
doi="10.2196/jmir.7087",
url="http://www.jmir.org/2017/4/e109/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28389418"
}


@Article{info:doi/10.2196/jmir.7029,
author="Bender, Lorene Jacqueline
and Cyr, B. Alaina
and Arbuckle, Luk
and Ferris, E. Lorraine",
title="Ethics and Privacy Implications of Using the Internet and Social Media to Recruit Participants for Health Research: A Privacy-by-Design Framework for Online Recruitment",
journal="J Med Internet Res",
year="2017",
month="Apr",
day="06",
volume="19",
number="4",
pages="e104",
keywords="Internet",
keywords="social media",
keywords="ethics",
keywords="privacy",
keywords="recruitment",
keywords="cancer",
abstract="Background: The Internet and social media offer promising ways to improve the reach, efficiency, and effectiveness of recruitment efforts at a reasonable cost, but raise unique ethical dilemmas. We describe how we used social media to recruit cancer patients and family caregivers for a research study, the ethical issues we encountered, and the strategies we developed to address them. Objective: Drawing on the principles of Privacy by Design (PbD), a globally recognized standard for privacy protection, we aimed to develop a PbD framework for online health research recruitment. Methods: We proposed a focus group study on the dietary behaviors of cancer patients and their families, and the role of Web-based dietary self-management tools. Using an established blog on our hospital website, we proposed publishing a recruitment post and sharing the link on our Twitter and Facebook pages. The Research Ethics Board (REB) raised concern about the privacy risks associated with our recruitment strategy; by clicking on a recruitment post, an individual could inadvertently disclose personal health information to third-party companies engaged in tracking online behavior. The REB asked us to revise our social media recruitment strategy with the following questions in mind: (1) How will you inform users about the potential for privacy breaches and their implications? and (2) How will you protect users from privacy breaches or inadvertently sharing potentially identifying information about themselves? Results: Ethical guidelines recommend a proportionate approach to ethics assessment, which advocates for risk mitigation strategies that are proportional to the magnitude and probability of risks. We revised our social media recruitment strategy to inform users about privacy risks and to protect their privacy, while at the same time meeting our recruitment objectives. We provide a critical reflection of the perceived privacy risks associated with our social media recruitment strategy and the appropriateness of the risk mitigation strategies that we employed by assessing their alignment with PbD and by discussing the following: (1) What are the potential risks and who is at risk? (2) Is cancer considered ``sensitive'' personal information? (3) What is the probability of online disclosure of a cancer diagnosis in everyday life? and (4) What are the public's expectations for privacy online and their views about online tracking, profiling, and targeting? We conclude with a PbD framework for online health research recruitment. Conclusions: Researchers, REBs, ethicists, students, and potential study participants are often unaware of the privacy risks of social media research recruitment and there is no official guidance. Our PbD framework for online health research recruitment is a resource for these wide audiences. ",
doi="10.2196/jmir.7029",
url="http://www.jmir.org/2017/4/e104/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28385682"
}


@Article{info:doi/10.2196/jmir.6173,
author="Berry, Natalie
and Lobban, Fiona
and Belousov, Maksim
and Emsley, Richard
and Nenadic, Goran
and Bucci, Sandra",
title="\#WhyWeTweetMH: Understanding Why People Use Twitter to Discuss Mental Health Problems",
journal="J Med Internet Res",
year="2017",
month="Apr",
day="05",
volume="19",
number="4",
pages="e107",
keywords="mental health",
keywords="Twitter",
keywords="social media",
abstract="Background: Use of the social media website Twitter is highly prevalent and has led to a plethora of Web-based social and health-related data available for use by researchers. As such, researchers are increasingly using data from social media to retrieve and analyze mental health-related content. However, there is limited evidence regarding why people use this emerging platform to discuss mental health problems in the first place. Objectives: The aim of this study was to explore the reasons why individuals discuss mental health on the social media website Twitter. The study was the first of its kind to implement a study-specific hashtag for research; therefore, we also examined how feasible it was to circulate and analyze a study-specific hashtag for mental health research. Methods: Text mining methods using the Twitter Streaming Application Programming Interface (API) and Twitter Search API were used to collect and organize tweets from the hashtag \#WhyWeTweetMH, circulated between September 2015 and November 2015. Tweets were analyzed thematically to understand the key reasons for discussing mental health using the Twitter platform. Results: Four overarching themes were derived from the 132 tweets collected: (1) sense of community; (2) raising awareness and combatting stigma; (3) safe space for expression; and (4) coping and empowerment. In addition, 11 associated subthemes were also identified. Conclusions: The themes derived from the content of the tweets highlight the perceived therapeutic benefits of Twitter through the provision of support and information and the potential for self-management strategies. The ability to use Twitter to combat stigma and raise awareness of mental health problems indicates the societal benefits that can be facilitated via the platform. The number of tweets and themes identified demonstrates the feasibility of implementing study-specific hashtags to explore research questions in the field of mental health and can be used as a basis for other health-related research. ",
doi="10.2196/jmir.6173",
url="http://www.jmir.org/2017/4/e107/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28381392"
}


@Article{info:doi/10.2196/jmir.7022,
author="Lienemann, A. Brianna
and Unger, B. Jennifer
and Cruz, Boley Tess
and Chu, Kar-Hai",
title="Methods for Coding Tobacco-Related Twitter Data: A Systematic Review",
journal="J Med Internet Res",
year="2017",
month="Mar",
day="31",
volume="19",
number="3",
pages="e91",
keywords="tobacco",
keywords="Internet",
keywords="social marketing",
keywords="review",
abstract="Background: As Twitter has grown in popularity to 313 million monthly active users, researchers have increasingly been using it as a data source for tobacco-related research. Objective: The objective of this systematic review was to assess the methodological approaches of categorically coded tobacco Twitter data and make recommendations for future studies. Methods: Data sources included PsycINFO, Web of Science, PubMed, ABI/INFORM, Communication Source, and Tobacco Regulatory Science. Searches were limited to peer-reviewed journals and conference proceedings in English from January 2006 to July 2016. The initial search identified 274 articles using a Twitter keyword and a tobacco keyword. One coder reviewed all abstracts and identified 27 articles that met the following inclusion criteria: (1) original research, (2) focused on tobacco or a tobacco product, (3) analyzed Twitter data, and (4) coded Twitter data categorically. One coder extracted data collection and coding methods. Results: E-cigarettes were the most common type of Twitter data analyzed, followed by specific tobacco campaigns. The most prevalent data sources were Gnip and Twitter's Streaming application programming interface (API). The primary methods of coding were hand-coding and machine learning. The studies predominantly coded for relevance, sentiment, theme, user or account, and location of user. Conclusions: Standards for data collection and coding should be developed to be able to more easily compare and replicate tobacco-related Twitter results. Additional recommendations include the following: sample Twitter's databases multiple times, make a distinction between message attitude and emotional tone for sentiment, code images and URLs, and analyze user profiles. Being relatively novel and widely used among adolescents and black and Hispanic individuals, Twitter could provide a rich source of tobacco surveillance data among vulnerable populations. ",
doi="10.2196/jmir.7022",
url="http://www.jmir.org/2017/3/e91/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28363883"
}


@Article{info:doi/10.2196/mededu.6357,
author="Maloney, Stephen
and Tunnecliff, Jacqueline
and Morgan, Prue
and Gaida, James
and Keating, Jennifer
and Clearihan, Lyn
and Sadasivan, Sivalal
and Ganesh, Shankar
and Mohanty, Patitapaban
and Weiner, John
and Rivers, George
and Ilic, Dragan",
title="Continuing Professional Development via Social Media or Conference Attendance: A Cost Analysis",
journal="JMIR Med Educ",
year="2017",
month="Mar",
day="30",
volume="3",
number="1",
pages="e5",
keywords="social media",
keywords="knowledge translation",
keywords="continuing medical education",
abstract="Background: Professional development is essential in the health disciplines. Knowing the cost and value of educational approaches informs decisions and choices about learning and teaching practices. Objective: The primary aim of this study was to conduct a cost analysis of participation in continuing professional development via social media compared with live conference attendance. Methods: Clinicians interested in musculoskeletal care were invited to participate in the study activities. Quantitative data were obtained from an anonymous electronic questionnaire. Results: Of the 272 individuals invited to contribute data to this study, 150 clinicians predominantly from Australia, United States, United Kingdom, India, and Malaysia completed the outcome measures. Half of the respondents (78/150, 52.0\%) believed that they would learn more with the live conference format. The median perceived participation costs for the live conference format was Aus \$1596 (interquartile range, IQR 172.50-2852.00). The perceived cost of participation for equivalent content delivered via social media was Aus \$15 (IQR 0.00-58.50). The majority of the clinicians (114/146, 78.1\%, missing data n=4) indicated that they would pay for a subscription-based service, delivered by social media, to the median value of Aus \$59.50. Conclusions: Social media platforms are evolving into an acceptable and financially sustainable medium for the continued professional development of health professionals. When factoring in the reduced costs of participation and the reduced loss of employable hours from the perspective of the health service, professional development via social media has unique strengths that challenge the traditional live conference delivery format. ",
doi="10.2196/mededu.6357",
url="http://mededu.jmir.org/2017/1/e5/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28360023"
}


@Article{info:doi/10.2196/jmir.6368,
author="Carrotte, Rose Elise
and Prichard, Ivanka
and Lim, Cheng Megan Su",
title="``Fitspiration'' on Social Media: A Content Analysis of Gendered Images",
journal="J Med Internet Res",
year="2017",
month="Mar",
day="29",
volume="19",
number="3",
pages="e95",
keywords="social media",
keywords="physical fitness",
keywords="women's health",
keywords="men's health",
keywords="body image",
abstract="Background: ``Fitspiration'' (also known as ``fitspo'') aims to inspire individuals to exercise and be healthy, but emerging research indicates exposure can negatively impact female body image. Fitspiration is frequently accessed on social media; however, it is currently unclear the degree to which messages about body image and exercise differ by gender of the subject. Objective: The aim of our study was to conduct a content analysis to identify the characteristics of fitspiration content posted across social media and whether this differs according to subject gender. Methods: Content tagged with \#fitspo across Instagram, Facebook, Twitter, and Tumblr was extracted over a composite 30-minute period. All posts were analyzed by 2 independent coders according to a codebook. Results: Of the 415/476 (87.2\%) relevant posts extracted, most posts were on Instagram (360/415, 86.8\%). Most posts (308/415, 74.2\%) related thematically to exercise, and 81/415 (19.6\%) related thematically to food. In total, 151 (36.4\%) posts depicted only female subjects and 114/415 (27.5\%) depicted only male subjects. Female subjects were typically thin but toned; male subjects were often muscular or hypermuscular. Within the images, female subjects were significantly more likely to be aged under 25 years (P<.001) than the male subjects, to have their full body visible (P=.001), and to have their buttocks emphasized (P<.001). Male subjects were more likely to have their face visible in the post (P=.005) than the female subjects. Female subjects were more likely to be sexualized than the male subjects (P=.002). Conclusions: Female \#fitspo subjects typically adhered to the thin or athletic ideal, and male subjects typically adhered to the muscular ideal. Future research and interventional efforts should consider the potential objectifying messages in fitspiration, as it relates to both female and male body image. ",
doi="10.2196/jmir.6368",
url="http://www.jmir.org/2017/3/e95/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28356239"
}


@Article{info:doi/10.2196/publichealth.6313,
author="Gough, Aisling
and Hunter, F. Ruth
and Ajao, Oluwaseun
and Jurek, Anna
and McKeown, Gary
and Hong, Jun
and Barrett, Eimear
and Ferguson, Marbeth
and McElwee, Gerry
and McCarthy, Miriam
and Kee, Frank",
title="Tweet for Behavior Change: Using Social Media for the Dissemination of Public Health Messages",
journal="JMIR Public Health Surveill",
year="2017",
month="Mar",
day="23",
volume="3",
number="1",
pages="e14",
keywords="social media",
keywords="Twitter",
keywords="awareness",
keywords="public heath",
keywords="skin cancer",
keywords="behavior change",
keywords="communication",
abstract="Background: Social media public health campaigns have the advantage of tailored messaging at low cost and large reach, but little is known about what would determine their feasibility as tools for inducing attitude and behavior change. Objective: The aim of this study was to test the feasibility of designing, implementing, and evaluating a social media--enabled intervention for skin cancer prevention. Methods: A quasi-experimental feasibility study used social media (Twitter) to disseminate different message ``frames'' related to care in the sun and cancer prevention. Phase 1 utilized the Northern Ireland cancer charity's Twitter platform (May 1 to July 14, 2015). Following a 2-week ``washout'' period, Phase 2 commenced (August 1 to September 30, 2015) using a bespoke Twitter platform. Phase 2 also included a Thunderclap, whereby users allowed their social media accounts to automatically post a bespoke message on their behalf. Message frames were categorized into 5 broad categories: humor, shock or disgust, informative, personal stories, and opportunistic. Seed users with a notable following were contacted to be ``influencers'' in retweeting campaign content. A pre- and postintervention Web-based survey recorded skin cancer prevention knowledge and attitudes in Northern Ireland (population 1.8 million). Results: There were a total of 417,678 tweet impressions, 11,213 engagements, and 1211 retweets related to our campaign. Shocking messages generated the greatest impressions (shock, n=2369; informative, n=2258; humorous, n=1458; story, n=1680), whereas humorous messages generated greater engagement (humorous, n=148; shock, n=147; story, n=117; informative, n=100) and greater engagement rates compared with story tweets. Informative messages, resulted in the greatest number of shares (informative, n=17; humorous, n=10; shock, n=9; story, n=7). The study findings included improved knowledge of skin cancer severity in a pre- and postintervention Web-based survey, with greater awareness that skin cancer is the most common form of cancer (preintervention: 28.4\% [95/335] vs postintervention: 39.3\% [168/428] answered ``True'') and that melanoma is most serious (49.1\% [165/336] vs 55.5\% [238/429]). The results also show improved attitudes toward ultraviolet (UV) exposure and skin cancer with a reduction in agreement that respondents ``like to tan'' (60.5\% [202/334] vs 55.6\% [238/428]). Conclusions: Social media--disseminated public health messages reached more than 23\% of the Northern Ireland population. A Web-based survey suggested that the campaign might have contributed to improved knowledge and attitudes toward skin cancer among the target population. Findings suggested that shocking and humorous messages generated greatest impressions and engagement, but information-based messages were likely to be shared most. The extent of behavioral change as a result of the campaign remains to be explored, however, the change of attitudes and knowledge is promising. Social media is an inexpensive, effective method for delivering public health messages. However, existing and traditional process evaluation methods may not be suitable for social media. ",
doi="10.2196/publichealth.6313",
url="http://publichealth.jmir.org/2017/1/e14/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28336503"
}


@Article{info:doi/10.2196/jmir.6655,
author="Dyson, P. Michele
and Shave, Kassi
and Fernandes, M. Ricardo
and Scott, D. Shannon
and Hartling, Lisa",
title="Outcomes in Child Health: Exploring the Use of Social Media to Engage Parents in Patient-Centered Outcomes Research",
journal="J Med Internet Res",
year="2017",
month="Mar",
day="16",
volume="19",
number="3",
pages="e78",
keywords="social media",
keywords="child health",
keywords="patient outcome assessment",
keywords="patient engagement",
abstract="Background: With the rapid growth of technology and its improved accessibility globally, social media is gaining an increasingly important role in health care. Patients are frequently engaging with social media to access information, share content, and interact with others in online health communities. However, the use of social media as a stakeholder engagement strategy has been minimally explored, and effective methods for involving participants in research on the identification of patient-centered outcomes remain unknown. Objective: The aim of this study was to evaluate the process of using social media to engage parents in identifying patient-centered outcomes, using acute respiratory infections in children as an example to gauge feasibility. Methods: We conducted a process evaluation of a two-phase Web-based strategy to engage parents in research on patient-centered outcomes. In the first phase, we developed a website and study-specific Facebook and Twitter accounts to recruit parents to complete a Web-based survey identifying patient-centered outcomes. In the second phase, we used Facebook to host discussion with parents based on the survey results. The reach of social media as an engagement strategy and the characteristics of the population recruited were assessed. Results: During the first phase, there were 5027 visits to the survey site, 110 participants completed the survey, 553 unique users visited the study website (675 visits), the Facebook page received 104 likes, and the Twitter account gained 52 followers over the 14-week study period. Most survey respondents identified Facebook (51.8\%, 57/110) or a friend (45.5\%, 50/110) as their source of referral. It was found that 70.0\% (77/110) of respondents resided in Canada, in urban centers (92.7\%, 102/110), and 88.2\% (97/110) had a college or university degree or higher. The median year of birth was 1978 and 90.0\% (99/110) were female. Most survey responses (88.2\%, 97/110) were completed during the first month of the study. In the second phase, 4 parents participated in the discussion, our Facebook page gained 43 followers, and our posts reached 5866 users. Mirroring the first phase, most followers were female (79\%, 34/43), between 35 and 44 years (49\%, 21/43), and resided in Canada (98\%, 42/43). User engagement was variable, with no clear patterns emerging in timing, topic, or type of post. Conclusions: Most participants were highly educated, urban dwelling, and female, limiting diversity and representativeness. The source of referral for most survey respondents was through Facebook or a friend, suggesting the importance of personal connections in the dissemination and uptake of information. User engagement with the Facebook-based discussion threads was inconsistent and difficult to initiate. Although there is substantial interest in the use of social media as a component of an effective patient engagement strategy, challenges regarding participant engagement, representativeness, obtaining buy-in, and resources required must be carefully considered. ",
doi="10.2196/jmir.6655",
url="http://www.jmir.org/2017/3/e78/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28302593"
}


@Article{info:doi/10.2196/jmir.7048,
author="Motoki, Yoko
and Miyagi, Etsuko
and Taguri, Masataka
and Asai-Sato, Mikiko
and Enomoto, Takayuki
and Wark, Dennis John
and Garland, Marie Suzanne",
title="Comparison of Different Recruitment Methods for Sexual and Reproductive Health Research: Social Media--Based Versus Conventional Methods",
journal="J Med Internet Res",
year="2017",
month="Mar",
day="10",
volume="19",
number="3",
pages="e73",
keywords="papillomavirus vaccines",
keywords="reproductive health",
keywords="sexual health",
keywords="sexual behavior",
keywords="Japan",
keywords="uterine cervical neoplasms",
abstract="Background: Prior research about the sexual and reproductive health of young women has relied mostly on self-reported survey studies. Thus, participant recruitment using Web-based methods can improve sexual and reproductive health research about cervical cancer prevention. In our prior study, we reported that Facebook is a promising way to reach young women for sexual and reproductive health research. However, it remains unknown whether Web-based or other conventional recruitment methods (ie, face-to-face or flyer distribution) yield comparable survey responses from similar participants. Objective: We conducted a survey to determine whether there was a difference in the sexual and reproductive health survey responses of young Japanese women based on recruitment methods: social media--based and conventional methods. Methods: From July 2012 to March 2013 (9 months), we invited women of ages 16-35 years in Kanagawa, Japan, to complete a Web-based questionnaire. They were recruited through either a social media--based (social networking site, SNS, group) or by conventional methods (conventional group). All participants enrolled were required to fill out and submit their responses through a Web-based questionnaire about their sexual and reproductive health for cervical cancer prevention. Results: Of the 243 participants, 52.3\% (127/243) were recruited by SNS, whereas 47.7\% (116/243) were recruited by conventional methods. We found no differences between recruitment methods in responses to behaviors and attitudes to sexual and reproductive health survey, although more participants from the conventional group (15\%, 14/95) chose not to answer the age of first intercourse compared with those from the SNS group (5.2\%, 6/116; P=.03). Conclusions: No differences were found between recruitment methods in the responses of young Japanese women to a Web--based sexual and reproductive health survey. ",
doi="10.2196/jmir.7048",
url="http://www.jmir.org/2017/3/e73/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28283466"
}


@Article{info:doi/10.2196/jmir.6895,
author="Mowery, Danielle
and Smith, Hilary
and Cheney, Tyler
and Stoddard, Greg
and Coppersmith, Glen
and Bryan, Craig
and Conway, Mike",
title="Understanding Depressive Symptoms and Psychosocial Stressors on Twitter: A Corpus-Based Study",
journal="J Med Internet Res",
year="2017",
month="Feb",
day="28",
volume="19",
number="2",
pages="e48",
keywords="social media",
keywords="Twitter messaging",
keywords="natural language processing",
keywords="major depressive disorder",
keywords="data annotation",
keywords="machine learning",
abstract="Background: With a lifetime prevalence of 16.2\%, major depressive disorder is the fifth biggest contributor to the disease burden in the United States. Objective: The aim of this study, building on previous work qualitatively analyzing depression-related Twitter data, was to describe the development of a comprehensive annotation scheme (ie, coding scheme) for manually annotating Twitter data with Diagnostic and Statistical Manual of Mental Disorders, Edition 5 (DSM 5) major depressive symptoms (eg, depressed mood, weight change, psychomotor agitation, or retardation) and Diagnostic and Statistical Manual of Mental Disorders, Edition IV (DSM-IV) psychosocial stressors (eg, educational problems, problems with primary support group, housing problems). Methods: Using this annotation scheme, we developed an annotated corpus, Depressive Symptom and Psychosocial Stressors Acquired Depression, the SAD corpus, consisting of 9300 tweets randomly sampled from the Twitter application programming interface (API) using depression-related keywords (eg, depressed, gloomy, grief). An analysis of our annotated corpus yielded several key results. Results: First, 72.09\% (6829/9473) of tweets containing relevant keywords were nonindicative of depressive symptoms (eg, ``we're in for a new economic depression''). Second, the most prevalent symptoms in our dataset were depressed mood and fatigue or loss of energy. Third, less than 2\% of tweets contained more than one depression related category (eg, diminished ability to think or concentrate, depressed mood). Finally, we found very high positive correlations between some depression-related symptoms in our annotated dataset (eg, fatigue or loss of energy and educational problems; educational problems and diminished ability to think). Conclusions: We successfully developed an annotation scheme and an annotated corpus, the SAD corpus, consisting of 9300 tweets randomly-selected from the Twitter application programming interface using depression-related keywords. Our analyses suggest that keyword queries alone might not be suitable for public health monitoring because context can change the meaning of keyword in a statement. However, postprocessing approaches could be useful for reducing the noise and improving the signal needed to detect depression symptoms using social media. ",
doi="10.2196/jmir.6895",
url="http://www.jmir.org/2017/2/e48/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28246066"
}


@Article{info:doi/10.2196/jmir.6706,
author="Sugawara, Yuya
and Tanimoto, Tetsuya
and Miyagawa, Shoko
and Murakami, Masayasu
and Tsuya, Atsushi
and Tanaka, Atsushi
and Kami, Masahiro
and Narimatsu, Hiroto",
title="Scientific Misconduct and Social Media: Role of Twitter in the Stimulus Triggered Acquisition of Pluripotency Cells Scandal",
journal="J Med Internet Res",
year="2017",
month="Feb",
day="28",
volume="19",
number="2",
pages="e57",
keywords="web 2.0",
keywords="bioethics",
keywords="Internet",
keywords="mass media",
abstract="Background: The academic scandal on a study on stimulus?triggered acquisition of pluripotency (STAP) cells in Japan in 2014 involved suspicions of scientific misconduct by the lead author of the study after the paper had been reviewed on a peer?review website. This study investigated the discussions on STAP cells on Twitter and content of newspaper articles in an attempt to assess the role of social compared with traditional media in scientific peer review. Objective: This study examined Twitter utilization in scientific peer review on STAP cells misconduct. Methods: Searches for tweets and newspaper articles containing the term ``STAP cells'' were carried out through Twitter's search engine and Nikkei Telecom database, respectively. The search period was from January 1 to July 1, 2014. The nouns appearing in the ``top tweets'' and newspaper articles were extracted through a morphological analysis, and their frequency of appearance and changes over time were investigated. Results: The total numbers of top tweets and newspaper articles containing the term were 134,958 and 1646, respectively. Negative words concerning STAP cells began to appear on Twitter by February 9-15, 2014, or 3 weeks after Obokata presented a paper on STAP cells. The number of negative words in newspaper articles gradually increased beginning in the week of March 12-18, 2014. A total of 1000 tweets were randomly selected, and they were found to contain STAP-related opinions (43.3\%, 433/1000), links to news sites and other sources (41.4\%, 414/1000), false scientific or medical claims (8.9\%, 89/1000), and topics unrelated to STAP (6.4\%, 64/1000). Conclusions: The discussion on scientific misconduct during the STAP cells scandal took place at an earlier stage on Twitter than in newspapers, a traditional medium. ",
doi="10.2196/jmir.6706",
url="http://www.jmir.org/2017/2/e57/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28246071"
}


@Article{info:doi/10.2196/jmir.5694,
author="Rose, W. Shyanika
and Jo, L. Catherine
and Binns, Steven
and Buenger, Melissa
and Emery, Sherry
and Ribisl, M. Kurt",
title="Perceptions of Menthol Cigarettes Among Twitter Users: Content and Sentiment Analysis",
journal="J Med Internet Res",
year="2017",
month="Feb",
day="27",
volume="19",
number="2",
pages="e56",
keywords="tobacco products",
keywords="menthol",
keywords="smoking",
keywords="social media",
keywords="Twitter messaging",
keywords="policy",
keywords="public opinion",
abstract="Background: Menthol cigarettes are used disproportionately by African American, female, and adolescent smokers. Twitter is also used disproportionately by minority and younger populations, providing a unique window into conversations reflecting social norms, behavioral intentions, and sentiment toward menthol cigarettes. Objective: Our purpose was to identify the content and frequency of conversations about menthol cigarettes, including themes, populations, user smoking status, other tobacco or substances, tweet characteristics, and sentiment. We also examined differences in menthol cigarette sentiment by prevalent categories, which allowed us to assess potential perceptions, misperceptions, and social norms about menthol cigarettes on Twitter. This approach can inform communication about these products, particularly to subgroups who are at risk for menthol cigarette use. Methods: Through a combination of human and machine classification, we identified 94,627 menthol cigarette-relevant tweets from February 1, 2012 to January 31, 2013 (1 year) from over 47 million tobacco-related messages gathered prospectively from the Twitter Firehose of all public tweets and metadata. Then, 4 human coders evaluated a random sample of 7000 tweets for categories, including sentiment toward menthol cigarettes. Results: We found that 47.98\% (3194/6657) of tweets expressed positive sentiment, while 40.26\% (2680/6657) were negative toward menthol cigarettes. The majority of tweets by likely smokers (2653/4038, 65.70\%) expressed positive sentiment, while 91.2\% (320/351) of nonsmokers and 71.7\% (91/127) of former smokers indicated negative views. Positive views toward menthol cigarettes were predominant in tweets that discussed addiction or craving, marijuana, smoking, taste or sensation, song lyrics, and tobacco industry or marketing or tweets that were commercial in nature. Negative views toward menthol were more common in tweets about smoking cessation, health, African Americans, women, and children and adolescents---largely due to expression of negative stereotypes associated with these groups' use of menthol cigarettes. Conclusions: Examinations of public opinions toward menthol cigarettes through social media can help to inform the framing of public communication about menthol cigarettes, particularly in light of potential regulation by the European Union, US Food and Drug Administration, other jurisdictions, and localities. ",
doi="10.2196/jmir.5694",
url="http://www.jmir.org/2017/2/e56/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28242592"
}


@Article{info:doi/10.2196/publichealth.6872,
author="Matsuda, Shinichi
and Aoki, Kotonari
and Tomizawa, Shiho
and Sone, Masayoshi
and Tanaka, Riwa
and Kuriki, Hiroshi
and Takahashi, Yoichiro",
title="Analysis of Patient Narratives in Disease Blogs on the Internet: An Exploratory Study of Social Pharmacovigilance",
journal="JMIR Public Health Surveill",
year="2017",
month="Feb",
day="24",
volume="3",
number="1",
pages="e10",
keywords="Internet",
keywords="social media",
keywords="adverse drug reaction",
keywords="pharmacovigilance",
keywords="text mining",
abstract="Background: Although several reports have suggested that patient-generated data from Internet sources could be used to improve drug safety and pharmacovigilance, few studies have identified such data sources in Japan. We introduce a unique Japanese data source: t?by?ki, which translates literally as ``an account of a struggle with disease.'' Objective: The objective of this study was to evaluate the basic characteristics of the TOBYO database, a collection of t?by?ki blogs on the Internet, and discuss potential applications for pharmacovigilance. Methods: We analyzed the overall gender and age distribution of the patient-generated TOBYO database and compared this with other external databases generated by health care professionals. For detailed analysis, we prepared separate datasets for blogs written by patients with depression and blogs written by patients with rheumatoid arthritis (RA), because these conditions were expected to entail subjective patient symptoms such as discomfort, insomnia, and pain. Frequently appearing medical terms were counted, and their variations were compared with those in an external adverse drug reaction (ADR) reporting database. Frequently appearing words regarding patients with depression and patients with RA were visualized using word clouds and word cooccurrence networks. Results: As of June 4, 2016, the TOBYO database comprised 54,010 blogs representing 1405 disorders. Overall, more entries were written by female bloggers (68.8\%) than by male bloggers (30.8\%). The most frequently observed disorders were breast cancer (4983 blogs), depression (3556), infertility (2430), RA (1118), and panic disorder (1090). Comparison of medical terms observed in t?by?ki blogs with those in an external ADR reporting database showed that subjective and symptomatic events and general terms tended to be frequently observed in t?by?ki blogs (eg, anxiety, headache, and pain), whereas events using more technical medical terms (eg, syndrome and abnormal laboratory test result) tended to be observed frequently in the ADR database. We also confirmed the feasibility of using visualization techniques to obtain insights from unstructured text-based t?by?ki blog data. Word clouds described the characteristics of each disorder, such as ``sleeping'' and ``anxiety'' in depression and ``pain'' and ``painful'' in RA. Conclusions: Pharmacovigilance should maintain a strong focus on patients' actual experiences, concerns, and outcomes, and this approach can be expected to uncover hidden adverse event signals earlier and to help us understand adverse events in a patient-centered way. Patient-generated t?by?ki blogs in the TOBYO database showed unique characteristics that were different from the data in existing sources generated by health care professionals. Analysis of t?by?ki blogs would add value to the assessment of disorders with a high prevalence in women, psychiatric disorders in which subjective symptoms have important clinical meaning, refractory disorders, and other chronic disorders. ",
doi="10.2196/publichealth.6872",
url="http://publichealth.jmir.org/2017/1/e10/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28235749"
}


@Article{info:doi/10.2196/mhealth.6684,
author="Anguiano, Beatriz
and Brown-Johnson, Cati
and Rosas, G. Lisa
and Pechmann, Cornelia
and Prochaska, J. Judith",
title="Latino Adults' Perspectives on Treating Tobacco Use Via Social Media",
journal="JMIR Mhealth Uhealth",
year="2017",
month="Feb",
day="08",
volume="5",
number="2",
pages="e12",
keywords="smoking cessation",
keywords="tobacco",
keywords="Latino",
keywords="Hispanic",
keywords="social media",
keywords="focus group",
abstract="Background: Latinos are the largest minority group in the United States, and in California they outnumber non-Hispanic whites. Smoking cessation programs tailored for Latino culture, and this population's specific smoking patterns, are needed. Online social networks for smoking cessation have high potential for Latinos, but have not been tested to date. Objective: Building a research program on social media apps for cancer prevention in diverse populations, this qualitative study assessed acceptability of tobacco treatment that was distributed via social media for Latino smokers. Methods: We conducted three focus groups with Latino adults who were former and current smokers recruited from Santa Clara County, California in 2015 (N=32). We assessed participants' smoking histories, attempts to quit, social media exposure, and receptivity to a social media-based smoking cessation intervention. Audio transcripts were translated and coded for themes. Results: Participants reported factors driving their tobacco use and motivations to quit, and emphasized the importance of community and family in influencing their smoking initiation, cravings and triggers, attempts to quit, and abstinence. Participants valued the communal aspect of social media and suggested strategically tailoring groups based on key features (eg, age, gender, language preference). Participants reported preferring visual, educational, and motivational messages that were connected with existing services. Conclusions: Participants generally voiced acceptability of a social media-delivered intervention to help them quit smoking, viewed the intervention as well-equipped for catering to the strong community orientation of Latinos, and suggested that the platform was able to address variation within the population through strategic group creation. As a group member reflected, ``Podemos hacerlo juntos'' (We can do it together). ",
doi="10.2196/mhealth.6684",
url="http://mhealth.jmir.org/2017/2/e12/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28179217"
}


@Article{info:doi/10.2196/publichealth.6174,
author="Anderson, S. Laurie
and Bell, G. Heidi
and Gilbert, Michael
and Davidson, E. Julie
and Winter, Christina
and Barratt, J. Monica
and Win, Beta
and Painter, L. Jeffery
and Menone, Christopher
and Sayegh, Jonathan
and Dasgupta, Nabarun",
title="Using Social Listening Data to Monitor Misuse and Nonmedical Use of Bupropion: A Content Analysis",
journal="JMIR Public Health Surveill",
year="2017",
month="Feb",
day="1",
volume="3",
number="1",
pages="e6",
keywords="social media",
keywords="Internet",
keywords="prescription drug misuse",
keywords="substance-related disorders",
keywords="pharmacovigilance",
keywords="harm reduction",
keywords="community-based participatory research",
keywords="bupropion",
keywords="amitriptyline",
keywords="venlafaxine hydrochloride",
abstract="Background: The nonmedical use of pharmaceutical products has become a significant public health concern. Traditionally, the evaluation of nonmedical use has focused on controlled substances with addiction risk. Currently, there is no effective means of evaluating the nonmedical use of noncontrolled antidepressants. Objective: Social listening, in the context of public health sometimes called infodemiology or infoveillance, is the process of identifying and assessing what is being said about a company, product, brand, or individual, within forms of electronic interactive media. The objectives of this study were (1) to determine whether content analysis of social listening data could be utilized to identify posts discussing potential misuse or nonmedical use of bupropion and two comparators, amitriptyline and venlafaxine, and (2) to describe and characterize these posts. Methods: Social listening was performed on all publicly available posts cumulative through July 29, 2015, from two harm-reduction Web forums, Bluelight and Opiophile, which mentioned the study drugs. The acquired data were stripped of personally identifiable identification (PII). A set of generic, brand, and vernacular product names was used to identify product references in posts. Posts were obtained using natural language processing tools to identify vernacular references to drug misuse-related Preferred Terms from the English Medical Dictionary for Regulatory Activities (MedDRA) version 18 terminology. Posts were reviewed manually by coders, who extracted relevant details. Results: A total of 7756 references to at least one of the study antidepressants were identified within posts gathered for this study. Of these posts, 668 (8.61\%, 668/7756) referenced misuse or nonmedical use of the drug, with bupropion accounting for 438 (65.6\%, 438/668). Of the 668 posts, nonmedical use was discouraged by 40.6\% (178/438), 22\% (22/100), and 18.5\% (24/130) and encouraged by 12.3\% (54/438), 10\% (10/100), and 10.8\% (14/130) for bupropion, amitriptyline, and venlafaxine, respectively. The most commonly reported desired effects were similar to stimulants with bupropion, sedatives with amitriptyline, and dissociatives with venlafaxine. The nasal route of administration was most frequently reported for bupropion, whereas the oral route was most frequently reported for amitriptyline and venlafaxine. Bupropion and venlafaxine were most commonly procured from health care providers, whereas amitriptyline was most commonly obtained or stolen from a third party. The Fleiss kappa for interrater agreement among 20 items with 7 categorical response options evaluated by all 11 raters was 0.448 (95\% CI 0.421-0.457). Conclusions: Social listening, conducted in collaboration with harm-reduction Web forums, offers a valuable new data source that can be used for monitoring nonmedical use of antidepressants. Additional work on the capabilities of social listening will help further delineate the benefits and limitations of this rapidly evolving data source. ",
doi="10.2196/publichealth.6174",
url="http://publichealth.jmir.org/2017/1/e6/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28148472"
}


@Article{info:doi/10.2196/mededu.5993,
author="Dawkins, Rachel
and King, D. William
and Boateng, Beatrice
and Nichols, Michele
and Desselle, C. Bonnie",
title="Pediatric Residents' Perceptions of Potential Professionalism Violations on Social Media: A US National Survey",
journal="JMIR Med Educ",
year="2017",
month="Jan",
day="31",
volume="3",
number="1",
pages="e2",
keywords="social media",
keywords="professionalism",
keywords="resident education",
keywords="pediatrics",
keywords="graduate medical education",
abstract="Background: The ubiquitous use of social media by physicians poses professionalism challenges. Regulatory bodies have disseminated guidelines related to physicians' use of social media. Objective: This study had 2 objectives: (1) to understand what pediatric residents view as appropriate social media postings, and (2) to recognize the degree to which these residents are exposed to postings that violate social media professionalism guidelines. Methods: We distributed an electronic survey to pediatric residents across the United States. The survey consisted of 5 postings from a hypothetical resident's personal Facebook page. The vignettes highlighted common scenarios that challenge published social media professionalism guidelines. We asked 2 questions for each vignette regarding (1) the resident's opinion of the posting's appropriateness, and (2) their frequency of viewing similar posts. We also elicited demographic data (age, sex, postgraduate year level), frequency of Facebook use, awareness of their institutional policies, and prior social media training. Results: Of 1628 respondents, 1498 (92.01\%) of the pediatric residents acknowledged having a Facebook account, of whom 888/1628 (54.55\%) reported daily use and 346/1628 (21.25\%) reported using Facebook a few times a week. Residents frequently viewed posts that violated professionalism standards, including use of derogatory remarks about patients (1756/3256, 53.93\%) and, much less frequently, about attending physicians (114/1628, 7.00\%). The majority of the residents properly identified these postings as inappropriate. Residents had frequently viewed a post similar to one showing physicians drinking alcoholic beverages while in professional attire or scrubs and were neutral on this post's appropriateness. Residents also reported a lack of knowledge about institutional policies on social media (651/1628, or 40.00\%, were unaware of a policy; 204/1628, or 12.53\%, said that no policy existed). A total of 372/1628 respondents (22.85\%) stated that they had never received any structured training on social media professionalism. Conclusions: Today's residents, like others of their generation, use social media sites to converse with peers without considering the implications for the profession. The frequent use of social media by learners needs to change the emphasis educators and regulatory bodies place on social media guidelines and teaching professionalism in the digital age. ",
doi="10.2196/mededu.5993",
url="http://mededu.jmir.org/2017/1/e2/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28143804"
}


@Article{info:doi/10.2196/mental.6605,
author="Gwynette, Frampton McLeod
and Morriss, Danielle
and Warren, Nancy
and Truelove, James
and Warthen, Jennifer
and Ross, Paul Charles
and Mood, George
and Snook, Anne Charlotte
and Borckardt, Jeffrey",
title="Social Skills Training for Adolescents With Autism Spectrum Disorder Using Facebook (Project Rex Connect): A Survey Study",
journal="JMIR Ment Health",
year="2017",
month="Jan",
day="23",
volume="4",
number="1",
pages="e4",
keywords="autism",
keywords="social media",
keywords="social skills",
abstract="Background: Adolescents with autism spectrum disorder (ASD) spend more time using electronic screen media than neurotypical peers; preliminary evidence suggests that computer-assisted or Web-based interventions may be beneficial for social skills acquisition. The current generation of adolescents accesses the Internet through computers or phones almost daily, and Facebook is the most frequently used social media platform among teenagers. This is the first research study to explore the use of Facebook as a therapeutic tool for adolescents with ASD. Objective: To study the feasibility and clinical impact of using a Web-based social platform in combination with social skills training for adolescents with ASD. Methods: This pilot study enrolled 6 participants (all males; mean age 14.1 years) in an online social skills training group using Facebook. Data was collected on the participants' social and behavioral functioning at the start and conclusion of the intervention. Outcome measures included the Social Responsiveness Scale-2, the Social Skills Improvement System Rating Scale, and the Project Rex Parent Survey. Participants were surveyed at the conclusion of the intervention regarding their experience. Results: No statistically significant differences in measurable outcomes were observed. However, the online addition of Facebook was well received by participants and their parents. The Facebook intervention was able to be executed with a careful privacy protocol in place and at minimal safety risk to participants. Conclusions: The utilization of Facebook to facilitate delivery of social skills training for adolescents with ASD appears to be feasible, although the clinical impact of such an addition is still unclear. It is important to note that social difficulties of participants persisted with the addition of the online platform and participants still required assistance to engage with peers in an online environment. A Web-based intervention such as the one utilized in this study has the potential to reach a mass number of patients with ASD and could address disparities in access to in-person treatment services. However, the complexity and evolving nature of Facebook's website and privacy settings leads to a number of unique online safety concerns that may limit its clinical utility. Issues encountered in our study support the development of an alternative and closed Web-based social platform designed specifically for the target audience with ASD; this platform could be a safer and more easily moderated setting for aiding in social skills development. Despite a small sample size with no statistically significant improvements of target symptoms, the use of electronic screen media as a therapeutic tool for adolescents with ASD is still a promising area of research warranting further investigation. Our study helps inform future obstacles regarding feasibility and safety. ",
doi="10.2196/mental.6605",
url="http://mental.jmir.org/2017/1/e4/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28115297"
}


@Article{info:doi/10.2196/jmir.5780,
author="Zhan, Yongcheng
and Liu, Ruoran
and Li, Qiudan
and Leischow, James Scott
and Zeng, Dajun Daniel",
title="Identifying Topics for E-Cigarette User-Generated Contents: A Case Study From Multiple Social Media Platforms",
journal="J Med Internet Res",
year="2017",
month="Jan",
day="20",
volume="19",
number="1",
pages="e24",
keywords="electronic cigarettes",
keywords="topic modeling",
keywords="Latent Dirichlet Allocation",
keywords="social media",
keywords="infodemiology",
abstract="Background: Electronic cigarette (e-cigarette) is an emerging product with a rapid-growth market in recent years. Social media has become an important platform for information seeking and sharing. We aim to mine hidden topics from e-cigarette datasets collected from different social media platforms. Objective: This paper aims to gain a systematic understanding of the characteristics of various types of social media, which will provide deep insights into how consumers and policy makers effectively use social media to track e-cigarette-related content and adjust their decisions and policies. Methods: We collected data from Reddit (27,638 e-cigarette flavor-related posts from January 1, 2011, to June 30, 2015), JuiceDB (14,433 e-juice reviews from June 26, 2013 to November 12, 2015), and Twitter (13,356 ``e-cig ban''-related tweets from January, 1, 2010 to June 30, 2015). Latent Dirichlet Allocation, a generative model for topic modeling, was used to analyze the topics from these data. Results: We found four types of topics across the platforms: (1) promotions, (2) flavor discussions, (3) experience sharing, and (4) regulation debates. Promotions included sales from vendors to users, as well as trades among users. A total of 10.72\% (2,962/27,638) of the posts from Reddit were related to trading. Promotion links were found between social media platforms. Most of the links (87.30\%) in JuiceDB were related to Reddit posts. JuiceDB and Reddit identified consistent flavor categories. E-cigarette vaping methods and features such as steeping, throat hit, and vapor production were broadly discussed both on Reddit and on JuiceDB. Reddit provided space for policy discussions and majority of the posts (60.7\%) holding a negative attitude toward regulations, whereas Twitter was used to launch campaigns using certain hashtags. Our findings are based on data across different platforms. The topic distribution between Reddit and JuiceDB was significantly different (P<.001), which indicated that the user discussions focused on different perspectives across the platforms. Conclusions: This study examined Reddit, JuiceDB, and Twitter as social media data sources for e-cigarette research. These mined findings could be further used by other researchers and policy makers. By utilizing the automatic topic-modeling method, the proposed unified feedback model could be a useful tool for policy makers to comprehensively consider how to collect valuable feedback from social media. ",
doi="10.2196/jmir.5780",
url="http://www.jmir.org/2017/1/e24/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28108428"
}


@Article{info:doi/10.2196/publichealth.6344,
author="Delir Haghighi, Pari
and Kang, Yong-Bin
and Buchbinder, Rachelle
and Burstein, Frada
and Whittle, Samuel",
title="Investigating Subjective Experience and the Influence of Weather Among Individuals With Fibromyalgia: A Content Analysis of Twitter",
journal="JMIR Public Health Surveill",
year="2017",
month="Jan",
day="19",
volume="3",
number="1",
pages="e4",
keywords="fibromyalgia",
keywords="Twitter messaging",
keywords="social networks",
keywords="pain",
keywords="weather",
keywords="sentiment analysis",
keywords="infodemiology",
abstract="Background: Little is understood about the determinants of symptom expression in individuals with fibromyalgia syndrome (FMS). While individuals with FMS often report environmental influences, including weather events, on their symptom severity, a consistent effect of specific weather conditions on FMS symptoms has yet to be demonstrated. Content analysis of a large number of messages by individuals with FMS on Twitter can provide valuable insights into variation in the fibromyalgia experience from a first-person perspective. Objective: The objective of our study was to use content analysis of tweets to investigate the association between weather conditions and fibromyalgia symptoms among individuals who tweet about fibromyalgia. Our second objective was to gain insight into how Twitter is used as a form of communication and expression by individuals with fibromyalgia and to explore and uncover thematic clusters and communities related to weather. Methods: Computerized sentiment analysis was performed to measure the association between negative sentiment scores (indicative of severe symptoms such as pain) and coincident environmental variables. Date, time, and location data for each individual tweet were used to identify corresponding climate data (such as temperature). We used graph analysis to investigate the frequency and distribution of domain-related terms exchanged in Twitter and their association strengths. A community detection algorithm was applied to partition the graph and detect different communities. Results: We analyzed 140,432 tweets related to fibromyalgia from 2008 to 2014. There was a very weak positive correlation between humidity and negative sentiment scores (r=.009, P=.001). There was no significant correlation between other environmental variables and negative sentiment scores. The graph analysis showed that ``pain'' and ``chronicpain'' were the most frequently used terms. The Louvain method identified 6 communities. Community 1 was related to feelings and symptoms at the time (subjective experience). It also included a list of weather-related terms such as ``weather,'' ``cold,'' and ``rain.'' Conclusions: According to our results, a uniform causal effect of weather variation on fibromyalgia symptoms at the group level remains unlikely. Any impact of weather on fibromyalgia symptoms may vary geographically or at an individual level. Future work will further explore geographic variation and interactions focusing on individual pain trajectories over time. ",
doi="10.2196/publichealth.6344",
url="http://publichealth.jmir.org/2017/1/e4/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28104577"
}


@Article{info:doi/10.2196/jmir.5816,
author="Pappa, Lobo Gisele
and Cunha, Oliveira Tiago
and Bicalho, Viana Paulo
and Ribeiro, Antonio
and Couto Silva, Paula Ana
and Meira Jr, Wagner
and Beleigoli, Rezende Alline Maria",
title="Factors Associated With Weight Change in Online Weight Management Communities: A Case Study in the LoseIt Reddit Community",
journal="J Med Internet Res",
year="2017",
month="Jan",
day="16",
volume="19",
number="1",
pages="e17",
keywords="obesity",
keywords="online social media",
keywords="weight loss",
keywords="user behavior",
keywords="topic modeling",
abstract="Background: Recent research has shown that of the 72\% of American Internet users who have looked for health information online, 22\% have searched for help to lose or control weight. This demand for information has given rise to many online weight management communities, where users support one another throughout their weight loss process. Whether and how user engagement in online communities relates to weight change is not totally understood. Objective: We investigated the activity behavior and analyze the semantic content of the messages of active users in LoseIt (r/loseit), a weight management community of the online social network Reddit. We then explored whether these features are associated with weight loss in this online social network. Methods: A data collection tool was used to collect English posts, comments, and other public metadata of active users (ie, users with at least one post or comment) on LoseIt from August 2010 to November 2014. Analyses of frequency and intensity of user interaction in the community were performed together with a semantic analysis of the messages, done by a latent Dirichlet allocation method. The association between weight loss and online user activity patterns, the semantics of the messages, and real-world variables was found by a linear regression model using 30-day weight change as the dependent variable. Results: We collected posts and comments of 107,886 unique users. Among these, 101,003 (93.62\%) wrote at least one comment and 38,981 (36.13\%) wrote at least one post. Median percentage of days online was 3.81 (IQR 9.51). The 10 most-discussed semantic topics on posts were related to healthy food, clothing, calorie counting, workouts, looks, habits, support, and unhealthy food. In the subset of 754 users who had gender, age, and 30-day weight change data available, women were predominant and 92.9\% (701/754) lost weight. Female gender, body mass index (BMI) at baseline, high levels of online activity, the number of upvotes received per post, and topics discussed within the community were independently associated with weight change. Conclusions: Our findings suggest that among active users of a weight management community, self-declaration of higher BMI levels (which may represent greater dissatisfaction with excess weight), high online activity, and engagement in discussions that might provide social support are associated with greater weight loss. These findings have the potential to aid health professionals to assist patients in online interventions by focusing efforts on increasing engagement and/or starting discussions on topics of higher impact on weight change. ",
doi="10.2196/jmir.5816",
url="http://www.jmir.org/2017/1/e17/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28093378"
}


@Article{info:doi/10.2196/mental.5626,
author="Liu, Sam
and Zhu, Miaoqi
and Yu, Jin Dong
and Rasin, Alexander
and Young, D. Sean",
title="Using Real-Time Social Media Technologies to Monitor Levels of Perceived Stress and Emotional State in College Students: A Web-Based Questionnaire Study",
journal="JMIR Ment Health",
year="2017",
month="Jan",
day="10",
volume="4",
number="1",
pages="e2",
keywords="social media",
keywords="twitter messaging, stress",
keywords="monitoring",
abstract="Background: College can be stressful for many freshmen as they cope with a variety of stressors. Excess stress can negatively affect both psychological and physical health. Thus, there is a need to find innovative and cost-effective strategies to help identify students experiencing high levels of stress to receive appropriate treatment. Social media use has been rapidly growing, and recent studies have reported that data from these technologies can be used for public health surveillance. Currently, no studies have examined whether Twitter data can be used to monitor stress level and emotional state among college students. Objective: The primary objective of our study was to investigate whether students' perceived levels of stress were associated with the sentiment and emotions of their tweets. The secondary objective was to explore whether students' emotional state was associated with the sentiment and emotions of their tweets. Methods: We recruited 181 first-year freshman students aged 18-20 years at University of California, Los Angeles. All participants were asked to complete a questionnaire that assessed their demographic characteristics, levels of stress, and emotional state for the last 7 days. All questionnaires were completed within a 48-hour period. All tweets posted by the participants from that week (November 2 to 8, 2015) were mined and manually categorized based on their sentiment (positive, negative, neutral) and emotion (anger, fear, love, happiness) expressed. Ordinal regressions were used to assess whether weekly levels of stress and emotional states were associated with the percentage of positive, neutral, negative, anger, fear, love, or happiness tweets. Results: A total of 121 participants completed the survey and were included in our analysis. A total of 1879 tweets were analyzed. A higher level of weekly stress was significantly associated with a greater percentage of negative sentiment tweets (beta=1.7, SE 0.7; P=.02) and tweets containing emotions of fear (beta=2.4, SE 0.9; P=.01) and love (beta=3.6, SE 1.4; P=.01). A greater level of anger was negatively associated with the percentage of positive sentiment (beta=--1.6, SE 0.8; P=.05) and tweets related to the emotions of happiness (beta=--2.2, SE 0.9; P=.02). A greater level of fear was positively associated with the percentage of negative sentiment (beta=1.67, SE 0.7; P=.01), particularly a greater proportion of tweets related to the emotion of fear (beta=2.4, SE 0.8; P=.01). Participants who reported a greater level of love showed a smaller percentage of negative sentiment tweets (beta=--1.3, SE 0.7; P=0.05). Emotions of happiness were positively associated with the percentage of tweets related to the emotion of happiness (beta=--1.8, SE 0.8; P=.02) and negatively associated with percentage of negative sentiment tweets (beta=--1.7, SE 0.7; P=.02) and tweets related to the emotion of fear (beta=--2.8, SE 0.8; P=.01). Conclusions: Sentiment and emotions expressed in the tweets have the potential to provide real-time monitoring of stress level and emotional well-being in college students. ",
doi="10.2196/mental.5626",
url="http://mental.jmir.org/2017/1/e2/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28073737"
}


@Article{info:doi/10.2196/jmir.6486,
author="Smith, J. Robert
and Crutchley, Patrick
and Schwartz, Andrew H.
and Ungar, Lyle
and Shofer, Frances
and Padrez, A. Kevin
and Merchant, M. Raina",
title="Variations in Facebook Posting Patterns Across Validated Patient Health Conditions: A Prospective Cohort Study",
journal="J Med Internet Res",
year="2017",
month="Jan",
day="6",
volume="19",
number="1",
pages="e7",
keywords="Facebook",
keywords="depression",
keywords="natural language processing",
keywords="social media",
abstract="Background: Social media is emerging as an insightful platform for studying health. To develop targeted health interventions involving social media, we sought to identify the patient demographic and disease predictors of frequency of posting on Facebook. Objective: The aims were to explore the language topics correlated with frequency of social media use across a cohort of social media users within a health care setting, evaluate the differences in the quantity of social media postings across individuals with different disease diagnoses, and determine if patients could accurately predict their own levels of social media engagement. Methods: Patients seeking care at a single, academic, urban, tertiary care emergency department from March to October 2014 were queried on their willingness to share data from their Facebook accounts and electronic medical records (EMRs). For each participant, the total content of Facebook posts was extracted. Using the latent Dirichlet allocation natural language processing technique, Facebook language topics were correlated with frequency of Facebook use. The mean number of Facebook posts over 6 months prior to enrollment was then compared across validated health outcomes in the sample. Results: A total of 695 patients consented to provide access to their EMR and social media data. Significantly correlated language topics among participants with the highest quartile of posts contained health terms, such as ``cough,'' ``headaches,'' and ``insomnia.'' When adjusted for demographics, individuals with a history of depression had significantly higher posts (mean 38, 95\% CI 28-50) than individuals without a history of depression (mean 22, 95\% CI 19-26, P=.001). Except for depression, across prevalent health outcomes in the sample (hypertension, diabetes, asthma), there were no significant posting differences between individuals with or without each condition. Conclusions: High-frequency posters in our sample were more likely to post about health and to have a diagnosis of depression. The direction of causality between depression and social media use requires further evaluation. Our findings suggest that patients with depression may be appropriate targets for health-related interventions on social media. ",
doi="10.2196/jmir.6486",
url="http://www.jmir.org/2017/1/e7/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28062392"
}


@Article{info:doi/10.2196/mededu.6304,
author="O'Sullivan, Elizabeth
and Cutts, Emily
and Kavikondala, Sushma
and Salcedo, Alejandra
and D'Souza, Karan
and Hernandez-Torre, Martin
and Anderson, Claire
and Tiwari, Agnes
and Ho, Kendall
and Last, Jason",
title="Social Media in Health Science Education: An International Survey",
journal="JMIR Med Educ",
year="2017",
month="Jan",
day="04",
volume="3",
number="1",
pages="e1",
keywords="health education",
keywords="health surveys",
keywords="interdisciplinary studies",
keywords="learning",
keywords="professionalism",
keywords="self report",
keywords="social media",
keywords="students",
keywords="surveys and questionnaires",
keywords="universities",
abstract="Background: Social media is an asset that higher education students can use for an array of purposes. Studies have shown the merits of social media use in educational settings; however, its adoption in health science education has been slow, and the contributing reasons remain unclear. Objective: This multidisciplinary study aimed to examine health science students' opinions on the use of social media in health science education and identify factors that may discourage its use. Methods: Data were collected from the Universitas 21 ``Use of social media in health education'' survey, distributed electronically among the health science staff and students from 8 universities in 7 countries. The 1640 student respondents were grouped as users or nonusers based on their reported frequency of social media use in their education. Results: Of the 1640 respondents, 1343 (81.89\%) use social media in their education. Only 462 of the 1320 (35.00\%) respondents have received specific social media training, and of those who have not, the majority (64.9\%, 608/936) would like the opportunity. Users and nonusers reported the same 3 factors as the top barriers to their use of social media: uncertainty on policies, concerns about professionalism, and lack of support from the department. Nonusers reported all the barriers more frequently and almost half of nonusers reported not knowing how to incorporate social media into their learning. Among users, more than one fifth (20.5\%, 50/243) of students who use social media ``almost always'' reported sharing clinical images without explicit permission. Conclusions: Our global, interdisciplinary study demonstrates that a significant number of students across all health science disciplines self-reported sharing clinical images inappropriately, and thus request the need for policies and training specific to social media use in health science education. ",
doi="10.2196/mededu.6304",
url="http://mededu.jmir.org/2017/1/e1/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28052842"
}


@Article{info:doi/10.2196/jmir.6722,
author="DeHoff, A. Beth
and Staten, K. Lisa
and Rodgers, Christine Rylin
and Denne, C. Scott",
title="The Role of Online Social Support in Supporting and Educating Parents of Young Children With Special Health Care Needs in the United States: A Scoping Review",
journal="J Med Internet Res",
year="2016",
month="Dec",
day="22",
volume="18",
number="12",
pages="e333",
keywords="health communication",
keywords="child",
keywords="social media",
keywords="health education",
keywords="health resources",
keywords="early childhood",
keywords="disability",
keywords="neonatal intensive care unit",
keywords="family",
keywords="maternal-child health services",
abstract="Background: When parents of young children with special health care needs (CSHCN) receive their child's diagnosis, they encounter information they may not understand, emotions they may not know how to cope with, and questions about their child's immediate and long-term future that frequently lack answers. The challenge of health care providers is how to prepare parents for caring for their CSHCN, for coping with any resulting challenges, and for accessing the systems and services that can assist them. Objective: The purpose of this work was to review evidence of the information and support needs of parents of young CSHCN and to determine whether online social support can serve as an avenue for learning and empowerment for these parents. Methods: A scoping review identified the challenges, coping mechanisms, and support needs among parents of CSHCN, and the reach and effectiveness of digital technologies with these families and health care providers. We also conducted interviews with professionals serving parents of CSHCN. Results: The literature review and interviews suggested that parents best learn the information they need, and cope with the emotional challenges of raising a CSHCN, with support from other parents of CSHCN, and that young parents in recent years have most often been finding this parent-to-parent support through digital media, particularly social media, consistent with the theory of online social support. Evidence also shows that social media, particularly Facebook, is used by nearly all women aged 18-29 years across racial and socioeconomic lines in the United States. Conclusions: Parents of young CSHCN experience significant stress but gain understanding, receive support, and develop the ability to care for and be advocates for their child through parent-to-parent emotional and informational social support. Online social support is most effective with young adults of childbearing age, with social media and apps being the most useful within the theoretical framework of social support. This opens new opportunities to effectively educate and support parents of young CSHCN. Providers seeking to inform, educate, and support families of CSHCN should develop strategies to help parents find and use social support through digital resources to facilitate their emotional adjustment and practical abilities to care for and access services for their child. ",
doi="10.2196/jmir.6722",
url="http://www.jmir.org/2016/12/e333/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28007689"
}


@Article{info:doi/10.2196/jmir.6176,
author="Kazley, Swanson Abby
and Hamidi, Bashir
and Balliet, Wendy
and Baliga, Prabhakar",
title="Social Media Use Among Living Kidney Donors and Recipients: Survey on Current Practice and Potential",
journal="J Med Internet Res",
year="2016",
month="Dec",
day="20",
volume="18",
number="12",
pages="e328",
keywords="living kidney donation",
keywords="kidney transplant",
keywords="social media",
abstract="Background: In the United States, there is a national shortage of organs donated for transplant. Among the solid organs, most often kidneys are donated by living donors, but the lack of information and complicated processes limit the number of individuals who serve as living kidney donors. Social media can be a tool for advocacy, educating the public about the need, process, and outcomes of live kidney donors, yet little is known about social media use by kidney transplant patients. Objective: The purpose of this study was to examine the social media use of potential kidney transplant patients and their willingness to use social media and their networks to advocate and educate about living kidney donation. Methods: Using a validated survey, we modified the instrument to apply to the patient population of interest attending the Medical University of South Carolina, Charleston, SC, USA. The questions on the survey inquired about current social media use, sites visited, frequency and duration of social media use, and willingness to use social media to share the need for living kidney donors. We asked patients who had received a transplant and those awaiting a transplant to complete the survey during an office visit. Participation was voluntary. Results: A total of 199 patients completed the survey. Approximately half of all kidney transplant patients surveyed used social media (104/199, 52.3\%), and approximately one-third (66/199, 33.2\%) had more than 100 friends in their social media network. Facebook was the most popular site, and 51\% (102/199) reported that they would be willing to post information about living kidney donation on their social networks. More than a quarter of the sample (75/199, 37.7\%) had posted about their health status in the past. Conclusions: Social media holds great promise for health-related education and awareness. Our study shows the current social media use of kidney transplant patients. In turn, such information can be used to design interventions to ensure appropriate decision making about live kidney donation. Transplant programs can help increase the number of living donors by providing guidance to kidney transplant patients in how to use social media, to be advocates, and to provide information about living kidney donation to their social network. ",
doi="10.2196/jmir.6176",
url="http://www.jmir.org/2016/12/e328/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27998880"
}


@Article{info:doi/10.2196/mhealth.6367,
author="Wilkinson, L. Jessica
and Strickling, Kate
and Payne, E. Hannah
and Jensen, C. Kayla
and West, H. Joshua",
title="Evaluation of Diet-Related Infographics on Pinterest for Use of Behavior Change Theories: A Content Analysis",
journal="JMIR Mhealth Uhealth",
year="2016",
month="Dec",
day="08",
volume="4",
number="4",
pages="e133",
keywords="behavioral health",
keywords="content analysis",
keywords="nutrition",
keywords="social media",
keywords="Internet",
keywords="healthy eating",
keywords="theory",
abstract="Background: There is increasing interest in Pinterest as a method of disseminating health information. However, it is unclear whether the health information promoted on Pinterest is evidence-based or incorporates behavior change theory. Objectives: The objective of the study was to determine the presence of health behavior theory (HBT) constructs in pins found on Pinterest and assess the relationship between various pin characteristics and the likelihood of inclusion of HBT. Methods: A content analysis was conducted on pins collected from Pinterest identified with the search terms ``nutrition infographic'' and ``healthy eating infographic.'' The coding rubric included HBT constructs, pin characteristics, and visual communication tools. Each HBT construct was coded as present or not present (yes=1, no=0). A total theory score was calculated by summing the values for each of the 9 constructs (range 0-9). Adjusted regression analysis was used to identify factors associated with the inclusion of health behavior change theory in pins (P<.05). Results: The mean total theory score was 2.03 (SD 1.2).?Perceived benefits were present most often (170/236, 72\%), followed by behavioral capability (123/238, 51.7\%) and perceived severity (79/236, 33.5\%). The construct that appeared the least was self-regulation/self-control (2/237, 0.8\%). Pin characteristics associated with the inclusion of HBT included a large amount of text (P=.01), photographs of real people (P=.001), cartoon pictures of food (P=.01), and the presence of references (P=.001). The number of repins (P=.04), likes (P=.01), and comments (P=.01) were positively associated with the inclusion of HBT. Conclusions: These findings suggest that current Pinterest infographics targeting healthy eating contain few HBT elements. Health professionals and organizations should create and disseminate infographics that contain more elements of HBT to better influence healthy eating behavior. This may be accomplished by creating pins that use both text and images of people and food in order to portray elements of HBT and convey nutritional information. ",
doi="10.2196/mhealth.6367",
url="http://mhealth.jmir.org/2016/4/e133/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27932316"
}


@Article{info:doi/10.2196/jmir.6670,
author="Massey, M. Philip
and Leader, Amy
and Yom-Tov, Elad
and Budenz, Alexandra
and Fisher, Kara
and Klassen, C. Ann",
title="Applying Multiple Data Collection Tools to Quantify Human Papillomavirus Vaccine Communication on Twitter",
journal="J Med Internet Res",
year="2016",
month="Dec",
day="05",
volume="18",
number="12",
pages="e318",
keywords="HPV vaccine",
keywords="Twitter",
keywords="communication methods",
keywords="content analysis",
keywords="data mining",
abstract="Background: Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States. There are several vaccines that protect against strains of HPV most associated with cervical and other cancers. Thus, HPV vaccination has become an important component of adolescent preventive health care. As media evolves, more information about HPV vaccination is shifting to social media platforms such as Twitter. Health information consumed on social media may be especially influential for segments of society such as younger populations, as well as ethnic and racial minorities. Objective: The objectives of our study were to quantify HPV vaccine communication on Twitter, and to develop a novel methodology to improve the collection and analysis of Twitter data. Methods: We collected Twitter data using 10 keywords related to HPV vaccination from August 1, 2014 to July 31, 2015. Prospective data collection used the Twitter Search API and retrospective data collection used Twitter Firehose. Using a codebook to characterize tweet sentiment and content, we coded a subsample of tweets by hand to develop classification models to code the entire sample using machine learning procedures. We also documented the words in the 140-character tweet text most associated with each keyword. We used chi-square tests, analysis of variance, and nonparametric equality of medians to test for significant differences in tweet characteristic by sentiment. Results: A total of 193,379 English-language tweets were collected, classified, and analyzed. Associated words varied with each keyword, with more positive and preventive words associated with ``HPV vaccine'' and more negative words associated with name-brand vaccines. Positive sentiment was the largest type of sentiment in the sample, with 75,393 positive tweets (38.99\% of the sample), followed by negative sentiment with 48,940 tweets (25.31\% of the sample). Positive and neutral tweets constituted the largest percentage of tweets mentioning prevention or protection (20,425/75,393, 27.09\% and 6477/25,110, 25.79\%, respectively), compared with only 11.5\% of negative tweets (5647/48,940; P<.001). Nearly one-half (22,726/48,940, 46.44\%) of negative tweets mentioned side effects, compared with only 17.14\% (12,921/75,393) of positive tweets and 15.08\% of neutral tweets (3787/25,110; P<.001). Conclusions: Examining social media to detect health trends, as well as to communicate important health information, is a growing area of research in public health. Understanding the content and implications of conversations that form around HPV vaccination on social media can aid health organizations and health-focused Twitter users in creating a meaningful exchange of ideas and in having a significant impact on vaccine uptake. This area of research is inherently interdisciplinary, and this study supports this movement by applying public health, health communication, and data science approaches to extend methodologies across fields. ",
doi="10.2196/jmir.6670",
url="http://www.jmir.org/2016/12/e318/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27919863"
}


@Article{info:doi/10.2196/resprot.6624,
author="Pagoto, L. Sherry
and Baker, Katie
and Griffith, Julia
and Oleski, L. Jessica
and Palumbo, Ashley
and Walkosz, J. Barbara
and Hillhouse, Joel
and Henry, L. Kimberly
and Buller, B. David",
title="Engaging Moms on Teen Indoor Tanning Through Social Media: Protocol of a Randomized Controlled Trial",
journal="JMIR Res Protoc",
year="2016",
month="Nov",
day="29",
volume="5",
number="4",
pages="e228",
keywords="skin cancer",
keywords="indoor tanning",
keywords="melanoma",
keywords="Facebook",
keywords="social media",
keywords="health communication",
abstract="Background: Indoor tanning elevates the risk for melanoma, which is now the most common cancer in US women aged 25-29. Public policies restricting access to indoor tanning by minors to reduce melanoma morbidity and mortality in teens are emerging. In the United States, the most common policy restricting indoor tanning in minors involves parents providing either written or in person consent for the minor to purchase a tanning visit. The effectiveness of this policy relies on parents being properly educated about the harms of indoor tanning to their children. Objective: This randomized controlled trial will test the efficacy of a Facebook-delivered health communication intervention targeting mothers of teenage girls. The intervention will use health communication and behavioral modification strategies to reduce mothers' permissiveness regarding their teenage daughters' use of indoor tanning relative to an attention-control condition with the ultimate goal of reducing indoor tanning in both daughters and mothers. Methods: The study is a 12-month randomized controlled trial comparing 2 conditions: an attention control Facebook private group where content will be relevant to teen health with 25\% focused on prescription drug abuse, a topic unrelated to tanning; and the intervention condition will enter participants into a Facebook private group where 25\% of the teen health content will be focused on indoor tanning. A cohort of 2000 mother-teen daughter dyads will be recruited to participate in this study. Only mothers will participate in the Facebook groups. Both mothers and daughters will complete measures at baseline, end of intervention (1-year) and 6 months post-intervention. Primary outcomes include mothers' permissiveness regarding their teenage daughters' use of indoor tanning, teenage daughters' perception of their mothers' permissiveness, and indoor tanning by both mothers and daughters. Results: The first dyad was enrolled on March 31, 2016, and we anticipate completing this study by October 2019. Conclusions: This trial will deliver social media content grounded in theory and will test it in a randomized design with state-of-the-art measures. This will contribute much needed insights on how to employ social media for health behavior change and disease prevention both for indoor tanning and other health risk behaviors and inform future social media efforts by public health and health care organizations. ClinicalTrial: Clinicaltrials.gov NCT02835807; https://clinicaltrials.gov/ct2/show/NCT02835807 (Archived by WebCite at http://www.webcitation.org/6mDMICcCE). ",
doi="10.2196/resprot.6624",
url="http://www.researchprotocols.org/2016/4/e228/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27899339"
}


@Article{info:doi/10.2196/publichealth.5384,
author="Nishimoto, Naoki
and Ota, Mizuki
and Yagahara, Ayako
and Ogasawara, Katsuhiko",
title="Estimating the Duration of Public Concern After the Fukushima Dai-ichi Nuclear Power Station Accident From the Occurrence of Radiation Exposure-Related Terms on Twitter: A Retrospective Data Analysis",
journal="JMIR Public Health Surveill",
year="2016",
month="Nov",
day="25",
volume="2",
number="2",
pages="e168",
keywords="Twitter",
keywords="social media",
keywords="public concern",
keywords="nuclear power plants",
keywords="survival analysis",
keywords="Kaplan-Meier estimate",
keywords="infodemiology",
keywords="radiation",
abstract="Background: After the Fukushima Dai-ichi Nuclear Power Station accident in Japan on March 11, 2011, a large number of comments, both positive and negative, were posted on social media. Objective: The objective of this study was to clarify the characteristics of the trend in the number of tweets posted on Twitter, and to estimate how long public concern regarding the accident continued. We surveyed the attenuation period of the first term occurrence related to radiation exposure as a surrogate endpoint for the duration of concern. Methods: We retrieved 18,891,284 tweets from Twitter data between March 11, 2011 and March 10, 2012, containing 143 variables in Japanese. We selected radiation, radioactive, Sievert (Sv), Becquerel (Bq), and gray (Gy) as keywords to estimate the attenuation period of public concern regarding radiation exposure. These data, formatted as comma-separated values, were transferred into a Statistical Analysis System (SAS) dataset for analysis, and survival analysis methodology was followed using the SAS LIFETEST procedure. This study was approved by the institutional review board of Hokkaido University and informed consent was waived. Results: A Kaplan-Meier curve was used to show the rate of Twitter users posting a message after the accident that included one or more of the keywords. The term Sv occurred in tweets up to one year after the first tweet. Among the Twitter users studied, 75.32\% (880,108/1,168,542) tweeted the word radioactive and 9.20\% (107,522/1,168,542) tweeted the term Sv. The first reduction was observed within the first 7 days after March 11, 2011. The means and standard errors (SEs) of the duration from the first tweet on March 11, 2011 were 31.9 days (SE 0.096) for radioactive and 300.6 days (SE 0.181) for Sv. These keywords were still being used at the end of the study period. The mean attenuation period for radioactive was one month, and approximately one year for radiation and radiation units. The difference in mean duration between the keywords was attributed to the effect of mass media. Regularly posted messages, such as daily radiation dose reports, were relatively easy to detect from their time and formatted contents. The survival estimation indicated that public concern about the nuclear power plant accident remained after one year. Conclusions: Although the simple plot of the number of tweets did not show clear results, we estimated the mean attenuation period as approximately one month for the keyword radioactive, and found that the keywords were still being used in posts at the end of the study period. Further research is required to quantify the effect of other phrases in social media data. The results of this exploratory study should advance progress in influencing and quantifying the communication of risk. ",
doi="10.2196/publichealth.5384",
url="http://publichealth.jmir.org/2016/2/e168/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27888168"
}


@Article{info:doi/10.2196/medinform.5748,
author="Park, Sook Min
and He, Zhe
and Chen, Zhiwei
and Oh, Sanghee
and Bian, Jiang",
title="Consumers' Use of UMLS Concepts on Social Media: Diabetes-Related Textual Data Analysis in Blog and Social Q\&A Sites",
journal="JMIR Med Inform",
year="2016",
month="Nov",
day="24",
volume="4",
number="4",
pages="e41",
keywords="controlled vocabulary",
keywords="consumer health vocabulary",
keywords="concept coverage",
abstract="Background: The widely known terminology gap between health professionals and health consumers hinders effective information seeking for consumers. Objective: The aim of this study was to better understand consumers' usage of medical concepts by evaluating the coverage of concepts and semantic types of the Unified Medical Language System (UMLS) on diabetes-related postings in 2 types of social media: blogs and social question and answer (Q\&A). Methods: We collected 2 types of social media data: (1) a total of 3711 blogs tagged with ``diabetes'' on Tumblr posted between February and October 2015; and (2) a total of 58,422 questions and associated answers posted between 2009 and 2014 in the diabetes category of Yahoo! Answers. We analyzed the datasets using a widely adopted biomedical text processing framework Apache cTAKES and its extension YTEX. First, we applied the named entity recognition (NER) method implemented in YTEX to identify UMLS concepts in the datasets. We then analyzed the coverage and the popularity of concepts in the UMLS source vocabularies across the 2 datasets (ie, blogs and social Q\&A). Further, we conducted a concept-level comparative coverage analysis between SNOMED Clinical Terms (SNOMED CT) and Open-Access Collaborative Consumer Health Vocabulary (OAC CHV)---the top 2 UMLS source vocabularies that have the most coverage on our datasets. We also analyzed the UMLS semantic types that were frequently observed in our datasets. Results: We identified 2415 UMLS concepts from blog postings, 6452 UMLS concepts from social Q\&A questions, and 10,378 UMLS concepts from the answers. The medical concepts identified in the blogs can be covered by 56 source vocabularies in the UMLS, while those in questions and answers can be covered by 58 source vocabularies. SNOMED CT was the dominant vocabulary in terms of coverage across all the datasets, ranging from 84.9\% to 95.9\%. It was followed by OAC CHV (between 73.5\% and 80.0\%) and Metathesaurus Names (MTH) (between 55.7\% and 73.5\%). All of the social media datasets shared frequent semantic types such as ``Amino Acid, Peptide, or Protein,'' ``Body Part, Organ, or Organ Component,'' and ``Disease or Syndrome.'' Conclusions: Although the 3 social media datasets vary greatly in size, they exhibited similar conceptual coverage among UMLS source vocabularies and the identified concepts showed similar semantic type distributions. As such, concepts that are both frequently used by consumers and also found in professional vocabularies such as SNOMED CT can be suggested to OAC CHV to improve its coverage. ",
doi="10.2196/medinform.5748",
url="https://medinform.jmir.org/2016/4/e41/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27884812"
}


@Article{info:doi/10.2196/mental.5842,
author="Seabrook, M. Elizabeth
and Kern, L. Margaret
and Rickard, S. Nikki",
title="Social Networking Sites, Depression, and Anxiety: A Systematic Review",
journal="JMIR Ment Health",
year="2016",
month="Nov",
day="23",
volume="3",
number="4",
pages="e50",
keywords="depression",
keywords="anxiety",
keywords="social media",
keywords="social networking",
keywords="review, systematic",
keywords="mental health",
keywords="well-being",
abstract="Background: Social networking sites (SNSs) have become a pervasive part of modern culture, which may also affect mental health. Objective: The aim of this systematic review was to identify and summarize research examining depression and anxiety in the context of SNSs. It also aimed to identify studies that complement the assessment of mental illness with measures of well-being and examine moderators and mediators that add to the complexity of this environment. Methods: A multidatabase search was performed. Papers published between January 2005 and June 2016 relevant to mental illness (depression and anxiety only) were extracted and reviewed. Results: Positive interactions, social support, and social connectedness on SNSs were consistently related to lower levels of depression and anxiety, whereas negative interaction and social comparisons on SNSs were related to higher levels of depression and anxiety. SNS use related to less loneliness and greater self-esteem and life satisfaction. Findings were mixed for frequency of SNS use and number of SNS friends. Different patterns in the way individuals with depression and individuals with social anxiety engage with SNSs are beginning to emerge. Conclusions: The systematic review revealed many mixed findings between depression, anxiety, and SNS use. Methodology has predominantly focused on self-report cross-sectional approaches; future research will benefit from leveraging real-time SNS data over time. The evidence suggests that SNS use correlates with mental illness and well-being; however, whether this effect is beneficial or detrimental depends at least partly on the quality of social factors in the SNS environment. Understanding these relationships will lead to better utilization of SNSs in their potential to positively influence mental health. ",
doi="10.2196/mental.5842",
url="http://mental.jmir.org/2016/4/e50/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27881357"
}


@Article{info:doi/10.2196/jmir.6385,
author="Luger, M. Tana
and Hogan, P. Timothy
and Richardson, M. Lorilei
and Cioffari-Bailiff, Lisa
and Harvey, Kimberly
and Houston, K. Thomas",
title="Older Veteran Digital Disparities: Examining the Potential for Solutions Within Social Networks",
journal="J Med Internet Res",
year="2016",
month="Nov",
day="23",
volume="18",
number="11",
pages="e296",
keywords="Internet",
keywords="digital divide",
keywords="social network",
keywords="Veterans",
abstract="Background: Older adults typically have less access to the Internet than other age groups, and older Veterans may use the Internet even less due to economic and geographic reasons. Objective: To explore solutions to this problem, our study examined older Veterans' reported ability to access technology through their close social ties. Methods: Data were collected via mail survey from a sample of Veterans aged 65 years and older (N=266). Results: Nearly half (44.0\%, 117/266) of the sample reported having no Internet access. Yet, among those without current access, older Veterans reported having a median of 5 (IQR 7) close social ties with home Internet access. These older Veterans also reported that they would feel comfortable asking a median of 2 (IQR 4) social ties for help to access the Internet, and that a median of 2 (IQR 4) social ties would directly access the Internet for the older Veteran to help with health management. Conclusions: Findings suggest that even older Veterans without current Internet access have at least two social ties with home Internet who could be called upon for technology support. Thus, older Veterans may be willing to call upon these ``surrogate seekers'' for technology assistance and support in health management. This has implications for the digital divide, technology design, and health care policy. ",
doi="10.2196/jmir.6385",
url="http://www.jmir.org/2016/11/e296/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27881361"
}


@Article{info:doi/10.2196/publichealth.6586,
author="Tangherlini, R. Timothy
and Roychowdhury, Vwani
and Glenn, Beth
and Crespi, M. Catherine
and Bandari, Roja
and Wadia, Akshay
and Falahi, Misagh
and Ebrahimzadeh, Ehsan
and Bastani, Roshan",
title="``Mommy Blogs'' and the Vaccination Exemption Narrative: Results From A Machine-Learning Approach for Story Aggregation on Parenting Social Media Sites",
journal="JMIR Public Health Surveill",
year="2016",
month="Nov",
day="22",
volume="2",
number="2",
pages="e166",
keywords="vaccination",
keywords="social media",
keywords="machine learning",
keywords="personal narratives",
keywords="Internet",
keywords="health knowledge",
keywords="attitudes",
keywords="practice",
abstract="Background: Social media offer an unprecedented opportunity to explore how people talk about health care at a very large scale. Numerous studies have shown the importance of websites with user forums for people seeking information related to health. Parents turn to some of these sites, colloquially referred to as ``mommy blogs,'' to share concerns about children's health care, including vaccination. Although substantial work has considered the role of social media, particularly Twitter, in discussions of vaccination and other health care--related issues, there has been little work on describing the underlying structure of these discussions and the role of persuasive storytelling, particularly on sites with no limits on post length. Understanding the role of persuasive storytelling at Internet scale provides useful insight into how people discuss vaccinations, including exemption-seeking behavior, which has been tied to a recent diminution of herd immunity in some communities. Objective: To develop an automated and scalable machine-learning method for story aggregation on social media sites dedicated to discussions of parenting. We wanted to discover the aggregate narrative frameworks to which individuals, through their exchange of experiences and commentary, contribute over time in a particular topic domain. We also wanted to characterize temporal trends in these narrative frameworks on the sites over the study period. Methods: To ensure that our data capture long-term discussions and not short-term reactions to recent events, we developed a dataset of 1.99 million posts contributed by 40,056 users and viewed 20.12 million times indexed from 2 parenting sites over a period of 105 months. Using probabilistic methods, we determined the topics of discussion on these parenting sites. We developed a generative statistical-mechanical narrative model to automatically extract the underlying stories and story fragments from millions of posts. We aggregated the stories into an overarching narrative framework graph. In our model, stories were represented as network graphs with actants as nodes and their various relationships as edges. We estimated the latent stories circulating on these sites by modeling the posts as a sampling of the hidden narrative framework graph. Temporal trends were examined based on monthly user-poststatistics. Results: We discovered that discussions of exemption from vaccination requirements are highly represented. We found a strong narrative framework related to exemption seeking and a culture of distrust of government and medical institutions. Various posts reinforced part of the narrative framework graph in which parents, medical professionals, and religious institutions emerged as key nodes, and exemption seeking emerged as an important edge. In the aggregate story, parents used religion or belief to acquire exemptions to protect their children from vaccines that are required by schools or government institutions, but (allegedly) cause adverse reactions such as autism, pain, compromised immunity, and even death. Although parents joined and left the discussion forums over time, discussions and stories about exemptions were persistent and robust to these membership changes. Conclusions: Analyzing parent forums about health care using an automated analytic approach, such as the one presented here, allows the detection of widespread narrative frameworks that structure and inform discussions. In most vaccination stories from the sites we analyzed, it is taken for granted that vaccines and not vaccine preventable diseases (VPDs) pose a threat to children. Because vaccines are seen as a threat, parents focus on sharing successful strategies for avoiding them, with exemption being the foremost among these strategies. When new parents join such sites, they may be exposed to this endemic narrative framework in the threads they read and to which they contribute, which may influence their health care decision making. ",
doi="10.2196/publichealth.6586",
url="http://publichealth.jmir.org/2016/2/e166/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27876690"
}


@Article{info:doi/10.2196/jmir.6326,
author="Guillory, Jamie
and Kim, Annice
and Murphy, Joe
and Bradfield, Brian
and Nonnemaker, James
and Hsieh, Yuli",
title="Comparing Twitter and Online Panels for Survey Recruitment of E-Cigarette Users and Smokers",
journal="J Med Internet Res",
year="2016",
month="Nov",
day="15",
volume="18",
number="11",
pages="e288",
keywords="social media",
keywords="electronic cigarettes",
keywords="tobacco",
keywords="Twitter",
abstract="Background: E-cigarettes have rapidly increased in popularity in recent years, driven, at least in part, by marketing and word-of-mouth discussion on Twitter. Given the rapid proliferation of e-cigarettes, researchers need timely quantitative data from e-cigarette users and smokers who may see e-cigarettes as a cessation tool. Twitter provides an ideal platform for recruiting e-cigarette users and smokers who use Twitter. Online panels offer a second method of accessing this population, but they have been criticized for recruiting too few young adults, among whom e-cigarette use rates are highest. Objective: This study compares effectiveness of recruiting Twitter users who are e-cigarette users and smokers who have never used e-cigarettes via Twitter to online panelists provided by Qualtrics and explores how users recruited differ by demographics, e-cigarette use, and social media use. Methods: Participants were adults who had ever used e-cigarettes (n=278; male: 57.6\%, 160/278; age: mean 34.26, SD 14.16 years) and smokers (n=102; male: 38.2\%, 39/102; age: mean 42.80, SD 14.16 years) with public Twitter profiles. Participants were recruited via online panel (n=190) or promoted tweets using keyword targeting for e-cigarette users (n=190). Predictor variables were demographics (age, gender, education, race/ethnicity), e-cigarette use (eg, past 30-day e-cigarette use, e-cigarette puffs per day), social media use behaviors (eg, Twitter use frequency), and days to final survey completion from survey launch for Twitter versus panel. Recruitment method (Twitter, panel) was the dependent variable. Results: Across the total sample, participants were recruited more quickly via Twitter (incidence rate ratio=1.30, P=.02) than panel. Compared with young adult e-cigarette users (age 18-24 years), e-cigarette users aged 25 to 34 years (OR 0.01, 95\% CI 0.00-0.60, P=.03) and 35 to 44 years (OR 0.01, 95\% CI 0.00-0.51, P=.02) were more likely to be recruited via Twitter than panel. Smokers aged 35 to 44 years were less likely than those aged 18 to 24 years to be recruited via Twitter than panel (35-44: OR 0.03, 95\% CI 0.00-0.49, P=.01). E-cigarette users who reported a greater number of e-cigarette puffs per day were more likely to be recruited via Twitter than panel compared to those who reported fewer puffs per day (OR 1.12, 95\% CI 1.05-1.20, P=.001). With each one-unit increase in Twitter usage, e-cigarette users were 9.55 times (95\% CI 2.28-40.00, P=.002) and smokers were 4.91 times (95\% CI 1.90-12.74, P=.001) as likely to be recruited via Twitter than panel. Conclusions: Twitter ads were more time efficient than an online panel in recruiting e-cigarette users and smokers. In addition, Twitter provided access to younger adults, who were heavier users of e-cigarettes and Twitter. Recruiting via social media and online panel in combination offered access to a more diverse population of participants. ",
doi="10.2196/jmir.6326",
url="http://www.jmir.org/2016/11/e288/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27847353"
}


@Article{info:doi/10.2196/jmir.5811,
author="Hand, K. Rosa
and Kenne, Deric
and Wolfram, M. Taylor
and Abram, K. Jenica
and Fleming, Michael",
title="Assessing the Viability of Social Media for Disseminating Evidence-Based Nutrition Practice Guideline Through Content Analysis of Twitter Messages and Health Professional Interviews: An Observational Study",
journal="J Med Internet Res",
year="2016",
month="Nov",
day="15",
volume="18",
number="11",
pages="e295",
keywords="social media",
keywords="information dissemination",
keywords="medical nutrition therapy",
keywords="evidence-based medicine",
keywords="heart failure",
abstract="Background: Given the high penetration of social media use, social media has been proposed as a method for the dissemination of information to health professionals and patients. This study explored the potential for social media dissemination of the Academy of Nutrition and Dietetics Evidence-Based Nutrition Practice Guideline (EBNPG) for Heart Failure (HF). Objectives: The objectives were to (1) describe the existing social media content on HF, including message content, source, and target audience, and (2) describe the attitude of physicians and registered dietitian nutritionists (RDNs) who care for outpatient HF patients toward the use of social media as a method to obtain information for themselves and to share this information with patients. Methods: The methods were divided into 2 parts. Part 1 involved conducting a content analysis of tweets related to HF, which were downloaded from Twitonomy and assigned codes for message content (19 codes), source (9 codes), and target audience (9 codes); code frequency was described. A comparison in the popularity of tweets (those marked as favorites or retweeted) based on applied codes was made using t tests. Part 2 involved conducting phone interviews with RDNs and physicians to describe health professionals' attitude toward the use of social media to communicate general health information and information specifically related to the HF EBNPG. Interviews were transcribed and coded; exemplar quotes representing frequent themes are presented. Results: The sample included 294 original tweets with the hashtag ``\#heartfailure.'' The most frequent message content codes were ``HF awareness'' (166/294, 56.5\%) and ``patient support'' (97/294, 33.0\%). The most frequent source codes were ``professional, government, patient advocacy organization, or charity'' (112/277, 40.4\%) and ``patient or family'' (105/277, 37.9\%). The most frequent target audience codes were ``unable to identify'' (111/277, 40.1\%) and ``other'' (55/277, 19.9\%). Significant differences were found in the popularity of tweets with (mean 1, SD 1.3 favorites) or without (mean 0.7, SD 1.3 favorites), the content code being ``HF research'' (P=.049). Tweets with the source code ``professional, government, patient advocacy organizations, or charities'' were significantly more likely to be marked as a favorite and retweeted than those without this source code (mean 1.2, SD 1.4 vs mean 0.8, SD 1.2, P=.03) and (mean 1.5, SD 1.8 vs mean 0.9, SD 2.0, P=.03). Interview participants believed that social media was a useful way to gather professional information. They did not believe that social media was useful for communicating with patients due to privacy concerns and the fact that the information had to be kept general rather than be tailored for a specific patient and the belief that their patients did not use social media or technology. Conclusions: Existing Twitter content related to HF comes from a combination of patients and evidence-based organizations; however, there is little nutrition content. That gap may present an opportunity for EBNPG dissemination. Health professionals use social media to gather information for themselves but are skeptical of its value when communicating with patients, particularly due to privacy concerns and misconceptions about the characteristics of social media users. ",
doi="10.2196/jmir.5811",
url="http://www.jmir.org/2016/11/e295/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27847349"
}


@Article{info:doi/10.2196/jmir.5994,
author="Russell, J. Dianne
and Sprung, Jennifer
and McCauley, Dayle
and Kraus de Camargo, Olaf
and Buchanan, Francine
and Gulko, Roman
and Martens, Rachel
and Gorter, Willem Jan",
title="Knowledge Exchange and Discovery in the Age of Social Media: The Journey From Inception to Establishment of a Parent-Led Web-Based Research Advisory Community for Childhood Disability",
journal="J Med Internet Res",
year="2016",
month="Nov",
day="11",
volume="18",
number="11",
pages="e293",
keywords="knowledge exchange",
keywords="research engagement",
keywords="collaborative research",
keywords="scientific collaboration",
keywords="Web-based community",
keywords="social media",
keywords="Facebook",
keywords="childhood disability",
keywords="patient and public involvement(PPI)",
abstract="Background: Efforts to involve parents and families in all aspects of research, from initiating the question through to dissemination and knowledge exchange, are increasing. While social media as a method for health communication has shown numerous benefits, including increasing accessibility, interactions with others, and access to health care information, little work has been published on the use of social media to enhance research partnerships. Objective: Our objective was to describe the development and evaluation of a Web-based research advisory community, hosted on Facebook and connecting a diverse group of parents of special needs children with researchers at CanChild Centre for Childhood Disability Research. The goal of this community is to work together and exchange knowledge in order to improve research and the lives of children and their families. Methods: The Web-based Parents Participating in Research (PPR) advisory community was a secret Facebook group launched in June 2014 and run by 2 parent moderators who worked in consultation with CanChild. We evaluated its success using Facebook statistics of engagement and activity (eg, number of posts, number of comments) between June 2014 and April 2015, and a Web-based survey of members. Results: The PPR community had 96 participants (2 parent moderators, 13 researchers, and 81 family members) as of April 1, 2015. Over 9 months, 432 original posts were made: 155 (35.9\%) by moderators, 197 (45.6\%) by parents, and 80 (18.5\%) by researchers. Posts had a median of 3 likes (range 0-24) and 4 comments (range 0-113). Members, rather than moderators, generated 64\% (277/432) of posts. The survey had a 51\% response rate (49/96 members), with 40 (82\%) being parent members and 9 (18\%) being researchers. The initial purpose of the group was to be an advisory to CanChild, and 76\% (28/37) of parents and all the researchers (9/9) identified having an impact on childhood disability research as their reason for participating. A total of 58\% (23/40) of parents and 56\% (5/9) of researchers indicated they felt safe to share sensitive or personal information. While researchers shared evidence-based resources and consulted with families to get guidance on specific issues, there was an unexpected benefit of gaining an understanding of what issues were important to families in their daily lives. Parents felt a sense of belonging to this community where they could share their stories but also wanted more researcher participation and clarity on the purpose of the group. Conclusions: The PPR community grew from inception to an established community with active engagement and knowledge exchange. Both parents and researchers described valuable experiences. Researchers should consider social media as a means of engaging families in all phases of research to ensure that research and its outcomes are meaningful to those who need it most. ",
doi="10.2196/jmir.5994",
url="http://www.jmir.org/2016/11/e293/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27836818"
}


@Article{info:doi/10.2196/diabetes.6256,
author="Liu, Yang
and Mei, Qiaozhu
and Hanauer, A. David
and Zheng, Kai
and Lee, M. Joyce",
title="Use of Social Media in the Diabetes Community: An Exploratory Analysis of Diabetes-Related Tweets",
journal="JMIR Diabetes",
year="2016",
month="Nov",
day="07",
volume="1",
number="2",
pages="e4",
keywords="social media",
keywords="Twitter, DSMA",
keywords="diabetes community",
keywords="spatiotemporal analysis",
keywords="content analysis",
abstract="Background: Use of social media is becoming ubiquitous, and disease-related communities are forming online, including communities of interest around diabetes. Objective: Our objective was to examine diabetes-related participation on Twitter by describing the frequency and timing of diabetes-related tweets, the geography of tweets, and the types of participants over a 2-year sample of 10\% of all tweets. Methods: We identified tweets with diabetes-related search terms and hashtags in a dataset of 29.6 billion tweets for the years 2013 and 2014 and extracted the text, time, location, retweet, and user information. We assessed the frequencies of tweets used across different search terms and hashtags by month and day of week and, for tweets that provided location information, by country. We also performed these analyses for a subset of tweets that used the hashtag \#dsma, a social media advocacy community focused on diabetes. Random samples of user profiles in the 2 groups were also drawn and reviewed to understand the types of stakeholders participating online. Results: We found 1,368,575 diabetes-related tweets based on diabetes-related terms and hashtags. There was a seasonality to tweets; a higher proportion occurred during the month of November, which is when World Diabetes Day occurs. The subset of tweets with the \#dsma were most frequent on Thursdays (coordinated universal time), which is consistent with the timing of a weekly chat organized by this online community. Approximately 2\% of tweets carried geolocation information and were most prominent in the United States (on the east and west coasts), followed by Indonesia and the United Kingdom. For the user profiles randomly selected among overall tweets, we could not identify a relationship to diabetes for the majority of users; for the profiles using the \#dsma hashtag, we found that patients with type 1 diabetes and their caregivers represented the largest proportion of individuals. Conclusions: Twitter is increasingly becoming a space for online conversations about diabetes. Further qualitative and quantitative content analysis is needed to understand the nature and purpose of these conversations. ",
doi="10.2196/diabetes.6256",
url="http://diabetes.jmir.org/2016/2/e4/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30291053"
}


@Article{info:doi/10.2196/jmir.5698,
author="Topolovec-Vranic, Jane
and Natarajan, Karthik",
title="The Use of Social Media in Recruitment for Medical Research Studies: A Scoping Review",
journal="J Med Internet Res",
year="2016",
month="Nov",
day="7",
volume="18",
number="11",
pages="e286",
keywords="patient selection",
keywords="social media",
keywords="social networking",
keywords="intervention study",
keywords="observational study",
keywords="Internet",
abstract="Background: Recruiting an adequate number of participants into medical research studies is challenging for many researchers. Over the past 10 years, the use of social media websites has increased in the general population. Consequently, social media websites are a new, powerful method for recruiting participants into such studies. Objective: The objective was to answer the following questions: (1) Is the use of social media more effective at research participant recruitment than traditional methods? (2) Does social media recruit a sample of research participants comparable to that recruited via other methods? (3) Is social media more cost-effective at research participant recruitment than traditional methods? Methods: Using the MEDLINE, PsycINFO, and EMBASE databases, all medical research studies that used social media and at least one other method for recruitment were identified. These studies were then categorized as either interventional studies or observational studies. For each study, the effectiveness of recruitment, demographic characteristics of the participants, and cost-effectiveness of recruitment using social media were evaluated and compared with that of the other methods used. The social media sites used in recruitment were identified, and if a study stated that the target population was ``difficult to reach'' as identified by the authors of the study, this was noted. Results: Out of 30 studies, 12 found social media to be the most effective recruitment method, 15 did not, and 3 found social media to be equally effective as another recruitment method. Of the 12 studies that found social media to be the best recruitment method, 8 were observational studies while 4 were interventional studies. Of the 15 studies that did not find social media to be the best recruitment method, 7 were interventional studies while 8 were observational studies. In total, 8 studies stated that the target population was ``hard-to-reach,'' and 6 of these studies found social media to be the most effective recruitment method. Out of 14 studies that reported demographic data for participants, 2 studies found that social media recruited a sample comparable to that recruited via traditional methods and 12 did not. Out of 13 studies that reported cost-effectiveness, 5 studies found social media to be the most cost-effective recruitment method, 7 did not, and 1 study found social media equally cost-effective as compared with other methods. Conclusions: Only 12 studies out of 30 found social media to be the most effective recruitment method. There is evidence that social media can be the best recruitment method for hard-to-reach populations and observational studies. With only 30 studies having compared recruitment through social media with other methods, more studies need to be done that report the effectiveness of recruitment for each strategy, demographics of participants recruited, and cost-effectiveness of each method. ",
doi="10.2196/jmir.5698",
url="http://www.jmir.org/2016/11/e286/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27821383"
}


@Article{info:doi/10.2196/mhealth.5987,
author="Shibasaki, Sanchia
and Gardner, Karen
and Sibthorpe, Beverly",
title="Using Knowledge Translation to Craft ``Sticky'' Social Media Health Messages That Provoke Interest, Raise Awareness, Impart Knowledge, and Inspire Change",
journal="JMIR Mhealth Uhealth",
year="2016",
month="Oct",
day="05",
volume="4",
number="4",
pages="e115",
keywords="knowledge translation",
keywords="social media",
keywords="Indigenous health",
keywords="health promotion",
abstract="Background: In Australia, there is growing use of technology supported knowledge translation (KT) strategies such as social media and mobile apps in health promotion and in Indigenous health. However, little is known about how individuals use technologies and the evidence base for the impact of these health interventions on health behavior change is meager. Objective: The objective of our study was to examine how Facebook is used to promote health messages to Indigenous people and discuss how KT can support planning and implementing health messages to ensure chosen strategies are fit for the purpose and achieve impact. Methods: A desktop audit of health promotion campaigns on smoking prevention and cessation for Australian Indigenous people using Facebook was conducted. Results: Our audit identified 13 out of 21 eligible campaigns that used Facebook. Facebook pages with the highest number of likes (more than 5000) were linked to a website and to other social media applications and demonstrated stickiness characteristics by posting frequently (triggers and unexpected), recruiting sporting or public personalities to promote campaigns (social currency and public), recruiting Indigenous people from the local region (stories and emotion), and sharing stories and experiences based on real-life events (credible and practical value). Conclusions: KT planning may support campaigns to identify and select KT strategies that are best suited and well-aligned to the campaign's goals, messages, and target audiences. KT planning can also help mitigate unforeseen and expected risks, reduce unwarranted costs and expenses, achieve goals, and limit the peer pressure of using strategies that may not be fit for purpose. One of the main challenges in using KT systems and processes involves coming to an adequate conceptualization of the KT process itself. ",
doi="10.2196/mhealth.5987",
url="http://mhealth.jmir.org/2016/4/e115/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27707685"
}


@Article{info:doi/10.2196/jmir.5377,
author="Quinn, Darren
and Chen, Liming
and Mulvenna, D. Maurice
and Bond, Raymond",
title="Exploring the Relationship Between Online Social Network Site Usage and the Impact on Quality of Life for Older and Younger Users: An Interaction Analysis",
journal="J Med Internet Res",
year="2016",
month="Sep",
day="29",
volume="18",
number="9",
pages="e245",
keywords="online social network",
keywords="social networking",
keywords="Facebook",
keywords="quality of life",
keywords="interaction analysis",
keywords="younger users",
keywords="older users",
abstract="Background: Analyzing content generated by users of social network sites has been shown to be beneficial across a number of disciplines. Such analysis has revealed the precise behavior of users that details their distinct patterns of engagement. An issue is evident whereby without direct engagement with end users, the reasoning for anomalies can only be the subject of conjecture. Furthermore, the impact of engaging in social network sites on quality of life is an area which has received little attention. Of particular interest is the impact of online social networking on older users, which is a demographic that is specifically vulnerable to social isolation. A review of the literature reveals a lack of knowledge concerning the impact of these technologies on such users and even less is known regarding how this impact varies across different demographics. Objective: The objective of our study was to analyze user interactions and to survey the attitudes of social network users directly, capturing data in four key areas: (1) functional usage, (2) behavioral patterns, (3) technology, and (4) quality of life. Methods: An online survey was constructed, comprising 32 questions. Each question directly related to a research question. Respondents were recruited through a variety of methods including email campaigns, Facebook advertisements, and promotion from related organizations. Results: In total, data was collected from 919 users containing 446 younger and 473 older users. In comparison to younger users, a greater proportion of older users (289/473, 61.1\% older vs 218/446, 48.9\% younger) (P<.001) stated that Facebook had either a positive or huge impact on their quality of life. Furthermore, a greater percentage of older users strongly agreed that Facebook strengthened their relationship with other people (64/473, 13.5\% older vs 40/446, 9.0\%younger) (P=.02). In comparison to younger users, a greater proportion of older users had more positive emotions---classified as slightly better or very good---during their engagement with Facebook (186/473, 39.3\% older vs 120/446, 26.9\% younger) (P<.001). Conclusions: The results reveal that despite engaging at considerably lower rates with significantly fewer connections, older users gain a greater quality-of-life benefit. Results disclose how both cohorts vary in their use, interactions, and rationale for engaging with Facebook. ",
doi="10.2196/jmir.5377",
url="http://www.jmir.org/2016/9/e245/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27687745"
}


@Article{info:doi/10.2196/publichealth.4885,
author="Dietrich, Janine Janan
and Laher, Fatima
and Hornschuh, Stefanie
and Nkala, Busisiwe
and Chimoyi, Lucy
and Otwombe, Kennedy
and Kaida, Angela
and Gray, Elisabeth Glenda
and Miller, Cari",
title="Investigating Sociodemographic Factors and HIV Risk Behaviors Associated With Social Networking Among Adolescents in Soweto, South Africa: A Cross-Sectional Survey",
journal="JMIR Public Health Surveill",
year="2016",
month="Sep",
day="28",
volume="2",
number="2",
pages="e154",
keywords="mobile phone",
keywords="adolescent health",
keywords="HIV",
keywords="health",
keywords="social networking",
keywords="mhealth",
keywords="South Africa",
abstract="Background: Internet access via mobile phones and computers facilitates interaction and potential health communication among individuals through social networking. Many South African adolescents own mobile phones and can access social networks via apps. Objective: We investigated sociodemographic factors and HIV risk behaviors of adolescent social networking users in Soweto, South Africa. Methods: We conducted an interviewer-administered, cross-sectional survey of adolescents aged 14-19 years. Independent covariates of social networking were assessed by multivariate logistic regression analysis. Results: Of 830 adolescents, 57\% (475/830) were females and the median age was found to be 18 years (interquartile range 17-18). Social networking was used by 60\% of adolescents (494/830); more than half, that is, 87\% (396/494) accessed social networks through mobile phones and 56\% (275/494) spent more than 4 hours per day using their mobile phones. Social networking was independently associated with mobile usage 2-4 hours (adjusted odds ratio [AOR]: 3.06, CI: 1.69-5.51) and more than 4 hours per day (AOR: 6.16, CI: 3.46-10.9) and one (AOR: 3.35, CI: 1.79-6.27) or more sexual partner(s) (AOR: 2.58, CI: 1.05-6.36). Conclusions: Mobile phone--based social networking is prevalent among sexually active adolescents living in Soweto and may be used as an entry point for health promotion and initiation of low-cost adolescent health interventions. ",
doi="10.2196/publichealth.4885",
url="http://publichealth.jmir.org/2016/2/e154/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27683173"
}


@Article{info:doi/10.2196/jmir.5702,
author="Benetoli, Arcelio
and Chen, Frank Timothy
and Schaefer, Marion
and Chaar, B. Betty
and Aslani, Parisa",
title="Professional Use of Social Media by Pharmacists: A Qualitative Study",
journal="J Med Internet Res",
year="2016",
month="Sep",
day="23",
volume="18",
number="9",
pages="e258",
keywords="social media",
keywords="social networks",
keywords="social networking sites",
keywords="YouTube",
keywords="Wikipedia",
keywords="Facebook",
keywords="pharmacists",
keywords="pharmacy",
abstract="Background: Social media is frequently used by consumers and health care professionals; however, our knowledge about its use in a professional capacity by pharmacists is limited. Objective: Our aim was to investigate the professional use of social media by pharmacists. Methods: In-depth semistructured interviews were conducted with practicing pharmacists (N=31) from nine countries. Interviews were recorded, transcribed verbatim, and thematically analyzed. Results: Wikipedia, YouTube, and Facebook were the main social media platforms used. Professional use of social media included networking with peers, discussion of health and professional topics, accessing and sharing health and professional information, job searching, and professional promotion. Wikipedia was the participants' first choice when seeking information about unfamiliar topics, or topics that were difficult to search for. Very few pharmacy-related contributions to Wikipedia were reported. YouTube, a video-sharing platform, was used for self-education. University lectures, ``how-to'' footage, and professionally made videos were commonly watched. No professional contribution was made to YouTube. Facebook, a general social networking site, was used for professional networking, promotion of achievements, and job advertisements. It also afforded engagement in professional discussions and information sharing among peers. Conclusions: Participants used social media in a professional capacity, specifically for accessing and sharing health and professional information among peers. Pharmacists, as medicines experts, should take a leading role in contributing to health information dissemination in these user-friendly virtual environments, to reach not only other health care professionals but also health consumers. ",
doi="10.2196/jmir.5702",
url="http://www.jmir.org/2016/9/e258/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27663570"
}


@Article{info:doi/10.2196/jmir.6404,
author="Adam, M. Laura
and Manca, P. Donna
and Bell, C. Rhonda",
title="Can Facebook Be Used for Research? Experiences Using Facebook to Recruit Pregnant Women for a Randomized Controlled Trial",
journal="J Med Internet Res",
year="2016",
month="Sep",
day="21",
volume="18",
number="9",
pages="e250",
keywords="pregnant women",
keywords="maternal health",
keywords="social media",
keywords="Internet",
abstract="Background: Recruitment is often a difficult and costly part of any human research study. Social media and other emerging means of mass communication hold promise as means to complement traditional strategies used for recruiting participants because they can reach a large number of people in a short amount of time. With the ability to target a specified audience, paid Facebook advertisements have potential to reach future research participants of a specific demographic. This paper describes the experiences of a randomized controlled trial in Edmonton, Alberta, attempting to recruit healthy pregnant women between 8 and 20 weeks' gestation for participation in a prenatal study. Various traditional recruitment approaches, in addition to paid Facebook advertisements were trialed. Objective: To evaluate the effectiveness of paid advertisements on Facebook as a platform for recruiting pregnant women to a randomized controlled trial in comparison with traditional recruitment approaches. Methods: Recruitment using traditional approaches occurred for 7 months, whereas Facebook advertisements ran for a total of 26 days. Interested women were prompted to contact the study staff for a screening call to determine study eligibility. Costs associated with each recruitment approach were recorded and used to calculate the cost to recruit eligible participants. Performance of Facebook advertisements was monitored using Facebook Ads Manager. Results: Of the 115 women included, 39.1\% (n=45) of the women who contacted study staff heard about the study through Facebook, whereas 60.9\% (n=70) of them heard about it through traditional recruitment approaches. During the 215 days ({\textasciitilde}7 months) that the traditional approaches were used, the average rate of interest was 0.3 (0.2) women/day, whereas the 26 days of Facebook advertisements resulted in an average rate of interest of 2.8 (1.7) women/day. Facebook advertisements cost Can \$506.91 with a cost per eligible participant of Cad \$20.28. In comparison, the traditional approaches cost Cad \$1087, with approximately Cad \$24.15 per eligible participant. Demographic characteristics of women were similar between the 2 recruitment methods except that women recruited using Facebook were significantly earlier in their pregnancy than those recruited using traditional approaches (P<.03). Conclusions: Paid Facebook advertisements hold promise as a platform for reaching pregnant women. The relative ease of placing an advertisement, the comparable cost per participant recruited, and the dramatically improved recruitment rates in comparison with traditional approaches highlight the importance of combining novel and traditional recruitment approaches to recruit women for pregnancy-related studies. Trial Registration: ClinicalTrials.gov NCT02711644; https://clinicaltrials.gov/ct2/show/NCT02711644 (Archived by WebCite at http://www.webcitation.org/6kKpagpMk) ",
doi="10.2196/jmir.6404",
url="http://www.jmir.org/2016/9/e250/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27655184"
}


@Article{info:doi/10.2196/jmir.5691,
author="Laws, A. Rachel
and Litterbach, V. Eloise-Kate
and Denney-Wilson, A. Elizabeth
and Russell, G. Catherine
and Taki, Sarah
and Ong, Kok-Leong
and Elliott, M. Rosalind
and Lymer, J. Sharyn
and Campbell, J. Karen",
title="A Comparison of Recruitment Methods for an mHealth Intervention Targeting Mothers: Lessons from the Growing Healthy Program",
journal="J Med Internet Res",
year="2016",
month="Sep",
day="15",
volume="18",
number="9",
pages="e248",
keywords="recruitment",
keywords="mHealth",
keywords="parents",
keywords="social media",
keywords="obesity prevention",
keywords="infant feeding",
keywords="children",
keywords="infants",
keywords="practitioners",
keywords="primary health care",
abstract="Background: Mobile health (mHealth) programs hold great promise for increasing the reach of public health interventions. However, mHealth is a relatively new field of research, presenting unique challenges for researchers. A key challenge is understanding the relative effectiveness and cost of various methods of recruitment to mHealth programs. Objective: The objectives of this study were to (1) compare the effectiveness of various methods of recruitment to an mHealth intervention targeting healthy infant feeding practices, and (2) explore factors influencing practitioner referral to the intervention. Methods: The Growing healthy study used a quasi-experimental design with an mHealth intervention group and a concurrent nonrandomized comparison group. Eligibility criteria included: expectant parents (>30 weeks of gestation) or parents with an infant <3 months old, ability to read and understand English, own a mobile phone, ?18 years old, and living in Australia. Recruitment to the mHealth program consisted of: (1) practitioner-led recruitment through Maternal and Child Health nurses, midwives, and nurses in general practice; (2) face-to-face recruitment by researchers; and (3) online recruitment. Participants' baseline surveys provided information regarding how participants heard about the study, and their sociodemographic details. Costs per participant recruited were calculated by taking into account direct advertising costs and researcher time/travel costs. Practitioner feedback relating to the recruitment process was obtained through a follow-up survey and qualitative interviews. Results: A total of 300 participants were recruited to the mHealth intervention. The cost per participant recruited was lowest for online recruitment (AUD \$14) and highest for practice nurse recruitment (AUD \$586). Just over half of the intervention group (50.3\%, 151/300) were recruited online over a 22-week period compared to practitioner recruitment (29.3\%, 88/300 over 46 weeks) and face-to-face recruitment by researchers (7.3\%, 22/300 over 18 weeks). No significant differences were observed in participant sociodemographic characteristics between recruitment methods, with the exception that practitioner/face-to-face recruitment resulted in a higher proportion of first-time parents (68\% versus 48\%, P=.002). Less than half of the practitioners surveyed reported referring to the program often or most of the time. Key barriers to practitioner referral included lack of time, difficulty remembering to refer, staff changes, lack of parental engagement, and practitioner difficulty in accessing the app. Conclusions: Online recruitment using parenting-related Facebook pages was the most cost effective and timely method of recruitment to an mHealth intervention targeting parents of young infants. Consideration needs to be given to addressing practitioner barriers to referral, to further explore if this can be a viable method of recruitment. ",
doi="10.2196/jmir.5691",
url="http://www.jmir.org/2016/9/e248/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27634633"
}


@Article{info:doi/10.2196/mededu.6232,
author="Alsobayel, Hana",
title="Use of Social Media for Professional Development by Health Care Professionals: A Cross-Sectional Web-Based Survey",
journal="JMIR Med Educ",
year="2016",
month="Sep",
day="12",
volume="2",
number="2",
pages="e15",
keywords="social media",
keywords="education, professional",
keywords="health education",
keywords="professional competence",
abstract="Background: Social media can be used in health care settings to enhance professional networking and education; patient communication, care, and education; public health programs; organizational promotion; and research. Objective: The aim of this study was to explore the use of social media networks for the purpose of professional development among health care professionals in Saudi Arabia using a purpose-designed Web-based survey. Methods: A cross-sectional web-based survey was undertaken. A link to the survey was posted on the investigator's personal social media accounts including Twitter, LinkedIn, and WhatsApp. Results: A total of 231 health care professionals, who are generally social media users, participated in the study. Of these professionals, 70.6\% (163/231) use social media for their professional development. The social media applications most frequently used, in the descending order, for professional development were Twitter, YouTube, Instagram, Facebook, Snapchat, and LinkedIn. The majority of respondents used social media for professional development irrespective of their age group, with the highest proportion seen in those aged 20-30 years. Social media were perceived as being most beneficial for professional development in terms of their impact on the domains of knowledge and problem solving and least helpful for enhancing clinical skills. Twitter was perceived as the most helpful type of social media for all domains listed. Respondents most frequently reported that social media were useful for professional development for the reasons of knowledge exchange and networking. Conclusions: Social media are frequently used by health care professionals in Saudi Arabia for the purposes of professional development, with Twitter most frequently used for this purpose. These findings suggest that social media networks can be powerful tools for engaging health care professionals in their professional development. ",
doi="10.2196/mededu.6232",
url="http://mededu.jmir.org/2016/2/e15/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27731855"
}


@Article{info:doi/10.2196/resprot.4808,
author="Valdez Soto, Miguel
and Balls-Berry, E. Joyce
and Bishop, G. Shawn
and Aase, A. Lee
and Timimi, K. Farris
and Montori, M. Victor
and Patten, A. Christi",
title="Use of Web 2.0 Social Media Platforms to Promote Community-Engaged Research Dialogs: A Preliminary Program Evaluation",
journal="JMIR Res Protoc",
year="2016",
month="Sep",
day="09",
volume="5",
number="3",
pages="e183",
keywords="Web 2.0",
keywords="social media",
keywords="platforms",
keywords="analytics",
keywords="community",
keywords="engagement",
keywords="stakeholders",
keywords="WordPress",
keywords="Twitter",
keywords="Facebook",
abstract="Background: Community-engaged research is defined by the Institute of Medicine as the process of working collaboratively with groups of people affiliated by geographic proximity, special interests, or similar situations with respect to issues affecting their well-being. Traditional face-to-face community-engaged research is limited by geographic location, limited in resources, and/or uses one-way communications. Web 2.0 technologies including social media are novel communication channels for community-engaged research because these tools can reach a broader audience while promoting bidirectional dialogs. Objective: This paper reports on a preliminary program evaluation of the use of social media platforms for promoting engagement of researchers and community representatives in dialogs about community-engaged research. Methods: For this pilot program evaluation, the Clinical and Translational Science Office for Community Engagement in Research partnered with the Social Media Network at our institution to create a WordPress blog and Twitter account. Both social media platforms were facilitated by a social media manager. We used descriptive analytics for measuring engagement with WordPress and Twitter over an 18-month implementation period during 2014-2016. For the blog, we examined type of user (researcher, community representative, other) and used content analysis to generate the major themes from blog postings. For use of Twitter, we examined selected demographics and impressions among followers. Results: There were 76 blog postings observed from researchers (48/76, 64\%), community representatives (23/76, 32\%) and funders (5/76, 8\%). The predominant themes of the blog content were research awareness and dissemination of community-engaged research (35/76, 46\%) and best practices (23/76, 30\%). For Twitter, we obtained 411 followers at the end of the 18-month evaluation period, with an increase of 42\% (from 280 to 411) over the final 6 months. Followers reported varied geographic location (321/411, 78\%, resided in the United States); 99\% (407/411) spoke English; and about half (218/411, 53\%) were female. Followers produced 132,000 Twitter impressions. Conclusions: Researchers and community stakeholders use social medial platforms for dialogs related to community-engaged research. This preliminary work is novel because we used Web 2.0 social media platforms to engage these stakeholders whereas prior work used face-to-face formats. Future research is needed to explore additional social media platforms; expanded reach to other diverse stakeholders including patients, providers, and payers; and additional outcomes related to engagement. ",
doi="10.2196/resprot.4808",
url="http://www.researchprotocols.org/2016/3/e183/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27613231"
}


@Article{info:doi/10.2196/jmir.6045,
author="Surian, Didi
and Nguyen, Quoc Dat
and Kennedy, Georgina
and Johnson, Mark
and Coiera, Enrico
and Dunn, G. Adam",
title="Characterizing Twitter Discussions About HPV Vaccines Using Topic Modeling and Community Detection",
journal="J Med Internet Res",
year="2016",
month="Aug",
day="29",
volume="18",
number="8",
pages="e232",
keywords="topic modelling",
keywords="graph algorithms analysis",
keywords="social media",
keywords="public health surveillance",
abstract="Background: In public health surveillance, measuring how information enters and spreads through online communities may help us understand geographical variation in decision making associated with poor health outcomes. Objective: Our aim was to evaluate the use of community structure and topic modeling methods as a process for characterizing the clustering of opinions about human papillomavirus (HPV) vaccines on Twitter. Methods: The study examined Twitter posts (tweets) collected between October 2013 and October 2015 about HPV vaccines. We tested Latent Dirichlet Allocation and Dirichlet Multinomial Mixture (DMM) models for inferring topics associated with tweets, and community agglomeration (Louvain) and the encoding of random walks (Infomap) methods to detect community structure of the users from their social connections. We examined the alignment between community structure and topics using several common clustering alignment measures and introduced a statistical measure of alignment based on the concentration of specific topics within a small number of communities. Visualizations of the topics and the alignment between topics and communities are presented to support the interpretation of the results in context of public health communication and identification of communities at risk of rejecting the safety and efficacy of HPV vaccines. Results: We analyzed 285,417 Twitter posts (tweets) about HPV vaccines from 101,519 users connected by 4,387,524 social connections. Examining the alignment between the community structure and the topics of tweets, the results indicated that the Louvain community detection algorithm together with DMM produced consistently higher alignment values and that alignments were generally higher when the number of topics was lower. After applying the Louvain method and DMM with 30 topics and grouping semantically similar topics in a hierarchy, we characterized 163,148 (57.16\%) tweets as evidence and advocacy, and 6244 (2.19\%) tweets describing personal experiences. Among the 4548 users who posted experiential tweets, 3449 users (75.84\%) were found in communities where the majority of tweets were about evidence and advocacy. Conclusions: The use of community detection in concert with topic modeling appears to be a useful way to characterize Twitter communities for the purpose of opinion surveillance in public health applications. Our approach may help identify online communities at risk of being influenced by negative opinions about public health interventions such as HPV vaccines. ",
doi="10.2196/jmir.6045",
url="http://www.jmir.org/2016/8/e232/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27573910"
}


@Article{info:doi/10.2196/jmir.5985,
author="Zhao, Kang
and Wang, Xi
and Cha, Sarah
and Cohn, M. Amy
and Papandonatos, D. George
and Amato, S. Michael
and Pearson, L. Jennifer
and Graham, L. Amanda",
title="A Multirelational Social Network Analysis of an Online Health Community for Smoking Cessation",
journal="J Med Internet Res",
year="2016",
month="Aug",
day="25",
volume="18",
number="8",
pages="e233",
keywords="social networks",
keywords="smoking cessation",
keywords="community networks",
abstract="Background: Online health communities (OHCs) provide a convenient and commonly used way for people to connect around shared health experiences, exchange information, and receive social support. Users often interact with peers via multiple communication methods, forming a multirelational social network. Use of OHCs is common among smokers, but to date, there have been no studies on users' online interactions via different means of online communications and how such interactions are related to smoking cessation. Such information can be retrieved in multirelational social networks and could be useful in the design and management of OHCs. Objective: To examine the social network structure of an OHC for smoking cessation using a multirelational approach, and to explore links between subnetwork position (ie, centrality) and smoking abstinence. Methods: We used NetworkX to construct 4 subnetworks based on users' interactions via blogs, group discussions, message boards, and private messages. We illustrated topological properties of each subnetwork, including its degree distribution, density, and connectedness, and compared similarities among these subnetworks by correlating node centrality and measuring edge overlap. We also investigated coevolution dynamics of this multirelational network by analyzing tie formation sequences across subnetworks. In a subset of users who participated in a randomized, smoking cessation treatment trial, we conducted user profiling based on users' centralities in the 4 subnetworks and identified user groups using clustering techniques. We further examined 30-day smoking abstinence at 3 months postenrollment in relation to users' centralities in the 4 subnetworks. Results: The 4 subnetworks have different topological characteristics, with message board having the most nodes (36,536) and group discussion having the highest network density (4.35{\texttimes}10?3). Blog and message board subnetworks had the most similar structures with an in-degree correlation of .45, out-degree correlation of .55, and Jaccard coefficient of .23 for edge overlap. A new tie in the group discussion subnetwork had the lowest probability of triggering subsequent ties among the same two users in other subnetworks: 6.33\% (54,142/855,893) for 2-tie sequences and 2.13\% (18,207/855,893) for 3-tie sequences. Users' centralities varied across the 4 subnetworks. Among a subset of users enrolled in a randomized trial, those with higher centralities across subnetworks generally had higher abstinence rates, although high centrality in the group discussion subnetwork was not associated with higher abstinence rates. Conclusions: A multirelational approach revealed insights that could not be obtained by analyzing the aggregated network alone, such as the ineffectiveness of group discussions in triggering social ties of other types, the advantage of blogs, message boards, and private messages in leading to subsequent social ties of other types, and the weak connection between one's centrality in the group discussion subnetwork and smoking abstinence. These insights have implications for the design and management of online social networks for smoking cessation. ",
doi="10.2196/jmir.5985",
url="http://www.jmir.org/2016/8/e233/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27562640"
}


@Article{info:doi/10.2196/cancer.5367,
author="Ruckenstuhl, Paul
and Schippinger, Michael
and Liebmann, Paul
and Leithner, Andreas
and Bernhardt, Gerwin",
title="Like or Dislike? Impact of Facebook on Ewing Sarcoma Treatment",
journal="JMIR Cancer",
year="2016",
month="Aug",
day="25",
volume="2",
number="2",
pages="e11",
keywords="social media",
keywords="Facebook",
keywords="Ewing sarcoma",
keywords="social media networking",
abstract="Background: An increasing number of patients are raising their voices in online forums to exchange health-related information. Facebook is the leading social media platform with more than 1 billion international daily users recorded in the summer of 2015. Facebook has a dynamic audience and is utilized in a number of ways, discussing medical issues being one of them. Ewing sarcoma mainly affects teenagers and young adults. Additionally, many individuals within this age group are regular users of Facebook. However, little is known about the impact of this modern way of communication via Web-based platforms on patients with Ewing sarcoma and their social environment. Objective: The aim of this study was to analyze and compare Ewing sarcoma patients' and relatives' behavior on Facebook to draw conclusions regarding the impact of Facebook on Ewing sarcoma treatment. Methods: We examined a Facebook group named ``Ewing Sarcoma Awareness'' that is used to exchange information for both patients and relatives regarding Ewing sarcoma. A self-designed questionnaire was used to compare patients' and relatives' answers. Additionally, we analyzed all processes (posts, likes, threads, links) in the group for 6 consecutive months. A total of 65 members of the Facebook group (26 patients, 39 relatives) out of 2227 international group members participated in our study. Results: More than 70\% (46/65) of all participants reported that they use the group Ewing Sarcoma Awareness as a source of information about Ewing sarcoma. Of the participants, 89\% (58/65) agreed on our scale from a little to a lot that being in contact with other affected people through the group makes it easier to handle the diagnosis. In this study, 20\% (13/65) of all participants reported that the group affected their choice of treatment and 15\% (10/65) of participants were influenced in the selection of their specialist. Regarding the recommendation of the Facebook group toward other people, significant differences (P=.003) were found comparing patients' and relatives' results. During the last 6 months most activities in the group concerned sharing destiny and handling the diagnosis. Conclusions: The Facebook group Ewing Sarcoma Awareness has a relevant impact on group members regarding their choice of treatment. Moreover, participants turn toward the group to receive mental and emotional support in everyday life. Statements made within the group are in part questionable from a medical point of view and the impact made by these statements on patients' care requires further evaluation. ",
doi="10.2196/cancer.5367",
url="http://cancer.jmir.org/2016/2/e11/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28410188"
}


@Article{info:doi/10.2196/jmir.5949,
author="Menefee, K. Hannah
and Thompson, J. Morgan
and Guterbock, M. Thomas
and Williams, C. Ishan
and Valdez, S. Rupa",
title="Mechanisms of Communicating Health Information Through Facebook: Implications for Consumer Health Information Technology Design",
journal="J Med Internet Res",
year="2016",
month="Aug",
day="11",
volume="18",
number="8",
pages="e218",
keywords="consumer health information",
keywords="medical informatics",
keywords="Facebook",
keywords="social networks",
keywords="health communication",
abstract="Background: Consumer health information technology (IT) solutions are designed to support patient health management and have the ability to facilitate patients' health information communication with their social networks. However, there is a need for consumer health IT solutions to align with patients' health management preferences for increased adoption of the technology. It may be possible to gain an understanding of patients' needs for consumer health IT supporting their health information communication with social networks by explicating how they have adopted and adapted social networking sites, such as Facebook, for this purpose. Objective: Our aim was to characterize patients' use of all communication mechanisms within Facebook for health information communication to provide insight into how consumer health IT solutions may be better designed to meet patients' communication needs and preferences. Methods: This study analyzed data about Facebook communication mechanisms use from a larger, three-phase, sequential, mixed-methods study. We report here on the results of the study's first phase: qualitative interviews (N=25). Participants were over 18, used Facebook, were residents or citizens of the United States, spoke English, and had a diagnosis consistent with type 2 diabetes. Participants were recruited through Facebook groups and pages. Participant interviews were conducted via Skype or telephone between July and September 2014. Data analysis was grounded in qualitative content analysis and the initial coding framework was informed by the findings of a previous study. Results: Participants' rationales for the use or disuse of a particular Facebook mechanism to communicate health information reflected six broad themes: (1) characteristics and circumstances of the person, (2) characteristics and circumstances of the relationship, (3) structure and composition of the social network, (4) content of the information, (5) communication purpose, and (6) attributes of the technology. Conclusions: The results of this study showed that participants consider multiple factors when choosing a Facebook mechanism for health information communication. Factors included what information they intended to share, what they were trying to accomplish, attributes of technology, and attributes and communication practices of their social networks. There is a need for consumer health IT that allows for a range of choices to suit the intersectionality of participants' rationales. Technology that better meets patients' needs may lead to better self-management of health conditions, and therefore, improve overall health outcomes. ",
doi="10.2196/jmir.5949",
url="http://www.jmir.org/2016/8/e218/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27515151"
}


@Article{info:doi/10.2196/jmir.5832,
author="Grosberg, Dafna
and Grinvald, Haya
and Reuveni, Haim
and Magnezi, Racheli",
title="Frequent Surfing on Social Health Networks is Associated With Increased Knowledge and Patient Health Activation",
journal="J Med Internet Res",
year="2016",
month="Aug",
day="10",
volume="18",
number="8",
pages="e212",
keywords="Internet",
keywords="social networks",
keywords="social media",
keywords="pain",
keywords="Patient Activation Measure (PAM)",
keywords="chronic disease",
keywords="diabetes mellitus",
abstract="Background: The advent of the Internet has driven a technological revolution that has changed our lives. As part of this phenomenon, social networks have attained a prominent role in health care. A variety of medical services is provided over the Internet, including home monitoring, interactive communications between the patient and service providers, and social support, among others. This study emphasizes some of the practical implications of Web-based health social networks for patients and for health care systems. Objective: The objective of this study was to assess how participation in a social network among individuals with a chronic condition contributed to patient activation, based on the Patient Activation Measure (PAM). Methods: A prospective, cross-sectional survey with a retrospective component was conducted. Data were collected from Camoni, a Hebrew-language Web-based social health network, participants in the diabetes mellitus, pain, hypertension, and depression/anxiety forums, during November 2012 to 2013. Experienced users (enrolled at least 6 months) and newly enrolled received similar versions of the same questionnaire including sociodemographics and PAM. Results: Among 686 participants, 154 of 337 experienced and 123 of 349 newly enrolled completed the questionnaire. Positive correlations (P<.05) were found between frequency and duration of site visits and patient activation, social relationships, and chronic disease knowledge. Men surfed longer than women ($\chi${\texttwosuperior}3=10.104, P<.05). Experienced users with diabetes surfed more than those with other illnesses and had significantly higher PAM scores (mean, M=69.3, standard deviation, SD=19.1, PAM level 4; Z=?4.197, P<.001) than new users (M=62.8, SD=18.7, PAM level 3). Disease knowledge directly predicted PAM for all users ($\beta$=.26 and .21, respectively). Frequency and duration of social health network use were correlated with increased knowledge about a chronic disease. Experienced surfers had higher PAM than newly enrolled, suggesting that continued site use may contribute to increased activation. Conclusions: Web-based social health networks offer an opportunity to expand patient knowledge and increase involvement in personal health, thereby increasing patient activation. Further studies are needed to examine these changes on other aspects of chronic illnesses such as quality of life and costs. ",
doi="10.2196/jmir.5832",
url="http://www.jmir.org/2016/8/e212/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27511272"
}


@Article{info:doi/10.2196/jmir.6185,
author="Allem, Jon-Patrick
and Ferrara, Emilio",
title="The Importance of Debiasing Social Media Data to Better Understand E-Cigarette-Related Attitudes and Behaviors",
journal="J Med Internet Res",
year="2016",
month="Aug",
day="09",
volume="18",
number="8",
pages="e219",
keywords="Internet",
keywords="surveillance",
keywords="electronic cigarettes",
keywords="Twitter",
keywords="social media",
doi="10.2196/jmir.6185",
url="http://www.jmir.org/2016/8/e219/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27507563"
}


@Article{info:doi/10.2196/medinform.5984,
author="Choi, Iee
and Kim, Kyu Jin
and Kim, Jun Sun
and Cho, Chul Soo
and Kim, Nyeo Il",
title="Satisfaction Levels and Factors Influencing Satisfaction With Use of a Social App for Neonatal and Pediatric Patient Transfer Information Systems: A Questionnaire Study Among Doctors",
journal="JMIR Med Inform",
year="2016",
month="Aug",
day="04",
volume="4",
number="3",
pages="e26",
keywords="social media",
keywords="personal satisfaction",
keywords="information systems",
keywords="patient transfer",
abstract="Background: The treatment of neonatal and pediatric patients is limited to certain medical institutions depending on treatment difficulty. Effective patient transfers are necessary in situations where there are limited medical resources. In South Korea, the government has made a considerable effort to establish patient transfer systems using various means, such as websites, telephone, and so forth. However, in reality, the effort has not yet been effective. Objective: In this study, we ran a patient transfer information system using a social app for effective patient transfer. We analyzed the results, satisfaction levels, and the factors influencing satisfaction. Methods: Naver Band is a social app and mobile community application which in Korea is more popular than Facebook. It facilitates group communication. Using Naver Band, two systems were created: one by the Neonatal Intensive Care Unit and the other by the Department of Pediatrics at Chonbuk National University Children's Hospital, South Korea. The information necessary for patient transfers was provided to participating obstetricians (n=51) and pediatricians (n=90). We conducted a survey to evaluate the systems and reviewed the results retrospectively. Results: The number of patients transferred was reported to increase by 65\% (26/40) obstetricians and 40\% (23/57) pediatricians. The time taken for transfers was reported to decrease by 72\% (29/40) obstetricians and 59\% (34/57) pediatricians. Satisfaction was indicated by 83\% (33/40) obstetricians and 89\% (51/57) pediatricians. Regarding factors influencing satisfaction, the obstetricians reported communication with doctors in charge (P=.03) and time reduction during transfers (P=.02), whereas the pediatricians indicated review of the diagnosis and treatment of transferred patients (P=.01) and the time reduction during transfers (P=.007). Conclusions: The users were highly satisfied and different users indicated different factors of satisfaction. This finding implies that users' requirements should be accommodated in future developments of patient transfer information systems. ",
doi="10.2196/medinform.5984",
url="http://medinform.jmir.org/2016/3/e26/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27492978"
}


@Article{info:doi/10.2196/jmir.5602,
author="Prescott, L. Tonya
and Phillips II, Gregory
and DuBois, Zachary L.
and Bull, S. Sheana
and Mustanski, Brian
and Ybarra, L. Michele",
title="Reaching Adolescent Gay, Bisexual, and Queer Men Online: Development and Refinement of a National Recruitment Strategy",
journal="J Med Internet Res",
year="2016",
month="Aug",
day="04",
volume="18",
number="8",
pages="e200",
keywords="Facebook",
keywords="mHealth",
keywords="recruitment methods",
keywords="intervention development",
keywords="HIV",
keywords="adolescent",
keywords="AGBM",
keywords="sexual minority",
abstract="Background: Using social networking websites to recruit research participants is increasingly documented in the literature, although few studies have leveraged these sites to reach those younger than 18 years. Objective: To discuss the development and refinement of a recruitment protocol to reach and engage adolescent gay, bisexual, and other teenaged men who have sex with men (AGBM). Participants were recruited for development and evaluation activities related to Guy2Guy, a text messaging--based human immunodeficiency virus infection prevention program. Methods: Eligibility criteria included being between 14 to 18 years old; being a cisgender male; self-identifying as gay, bisexual, and/or queer; being literate in English, exclusively owning a cell phone, enrolled in an unlimited text messaging plan, intending to keep their current phone number over the next 6 months, and having used text messaging for at least the past 6 months. Recruitment experiences and subsequent steps to refine the Internet-based recruitment strategy are discussed for 4 research activities: online focus groups, content advisory team, beta test, and randomized controlled trial (RCT). Recruitment relied primarily on Facebook advertising. To a lesser extent, Google AdWords and promotion through partner organizations working with AGBM youth were also utilized. Results: Facebook advertising strategies were regularly adjusted based on preidentified recruitment targets for race, ethnicity, urban-rural residence, and sexual experience. The result was a diverse sample of participants, of whom 30\% belonged to a racial minority and 20\% were Hispanic. Facebook advertising was the most cost-effective method, and it was also able to reach diverse recruitment goals: recruitment for the first focus group cost an average of US \$2.50 per enrolled participant, and it took 9 days to enroll 40 participants; the second focus group cost an average of US \$6.96 per enrolled participant, and it took 11 days to enroll 40 participants. Recruitment for the first content advisory team cost an average of US \$32.52 per enrolled participant; the second cost US \$29.52 per participant. Both recruitment drives required 10 days to enroll 24 participants. For the beta test, recruitment cost an average of US \$17.19 per enrolled participant, and it took 16 days to complete enrollment of 20 participants. For the RCT, recruitment cost an average of US \$12.54 per enrolled participant, and it took 148 days to enroll 302 participants. Google AdWords campaigns did not result in any enrolled participants of whom the research staff members were aware. Conclusions: Internet-based strategies can be a cost-efficient means to recruit and retain hard-to-reach populations from across the country. With real-time monitoring of participant demographic characteristics, diverse samples can be achieved. Although Facebook advertising was particularly successful in this study, alternative social media strategies can be explored in future research as these media are ever-changing. ",
doi="10.2196/jmir.5602",
url="http://www.jmir.org/2016/8/e200/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27492781"
}


@Article{info:doi/10.2196/jmir.5574,
author="Cole-Lewis, Heather
and Perotte, Adler
and Galica, Kasia
and Dreyer, Lindy
and Griffith, Christopher
and Schwarz, Mary
and Yun, Christopher
and Patrick, Heather
and Coa, Kisha
and Augustson, Erik",
title="Social Network Behavior and Engagement Within a Smoking Cessation Facebook Page",
journal="J Med Internet Res",
year="2016",
month="Aug",
day="02",
volume="18",
number="8",
pages="e205",
keywords="social network analysis",
keywords="smoking cessation",
keywords="Facebook",
keywords="social support",
keywords="Web-based communities",
keywords="social media",
keywords="communication",
abstract="Background: Social media platforms are increasingly being used to support individuals in behavior change attempts, including smoking cessation. Examining the interactions of participants in health-related social media groups can help inform our understanding of how these groups can best be leveraged to facilitate behavior change. Objective: The aim of this study was to analyze patterns of participation, self-reported smoking cessation length, and interactions within the National Cancer Institutes' Facebook community for smoking cessation support. Methods: Our sample consisted of approximately 4243 individuals who interacted (eg, posted, commented) on the public Smokefree Women Facebook page during the time of data collection. In Phase 1, social network visualizations and centrality measures were used to evaluate network structure and engagement. In Phase 2, an inductive, thematic qualitative content analysis was conducted with a subsample of 500 individuals, and correlational analysis was used to determine how participant engagement was associated with self-reported session length. Results: Between February 2013 and March 2014, there were 875 posts and 4088 comments from approximately 4243 participants. Social network visualizations revealed the moderator's role in keeping the community together and distributing the most active participants. Correlation analyses suggest that engagement in the network was significantly inversely associated with cessation status (Spearman correlation coefficient = ?0.14, P=.03, N=243). The content analysis of 1698 posts from 500 randomly selected participants identified the most frequent interactions in the community as providing support (43\%, n=721) and announcing number of days smoke free (41\%, n=689). Conclusions: These findings highlight the importance of the moderator for network engagement and provide helpful insights into the patterns and types of interactions participants are engaging in. This study adds knowledge of how the social network of a smoking cessation community behaves within the confines of a Facebook group. ",
doi="10.2196/jmir.5574",
url="http://www.jmir.org/2016/8/e205/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27485315"
}


@Article{info:doi/10.2196/publichealth.5333,
author="Meaney, Sarah
and Cussen, Leanne
and Greene, A. Richard
and O'Donoghue, Keelin",
title="Reaction on Twitter to a Cluster of Perinatal Deaths: A Mixed Method Study",
journal="JMIR Public Health Surveill",
year="2016",
month="Jul",
day="27",
volume="2",
number="2",
pages="e36",
keywords="social media",
keywords="health care services",
keywords="maternity",
keywords="perinatal death",
keywords="Twitter",
keywords="infodemiology",
keywords="infoveillance",
abstract="Background: Participation in social networking sites is commonplace and the micro-blogging site Twitter can be considered a platform for the rapid broadcasting of news stories. Objective: The aim of this study was to explore the Twitter status updates and subsequent responses relating to a number of perinatal deaths which occurred in a small maternity unit in Ireland. Methods: An analysis of Twitter status updates, over a two month period from January to March 2014, was undertaken to identify the key themes arising in relation to the perinatal deaths. Results: Our search identified 3577 tweets relating to the reported perinatal deaths. At the height of the controversy, Twitter updates generated skepticism in relation to the management of not only of the unit in question, which was branded as unsafe, but also the governance of the entire Irish maternity service. Themes of concern and uncertainty arose whereby the professional motives of the obstetric community and staffing levels in the maternity services were called into question. Conclusions: Twitter activity provides a useful insight into attitudes towards health-related events. The role of the media in influencing opinion is well-documented and this study underscores the challenges that clinicians face in light of an obstetric media scandal. Further study to identify how the obstetric community could develop tools to utilize Twitter to disseminate valid health information could be beneficial. ",
doi="10.2196/publichealth.5333",
url="http://publichealth.jmir.org/2016/2/e36/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27466002"
}


@Article{info:doi/10.2196/jmir.5662,
author="Balestra, Martina
and Shaer, Orit
and Okerlund, Johanna
and Westendorf, Lauren
and Ball, Madeleine
and Nov, Oded",
title="Social Annotation Valence: The Impact on Online Informed Consent Beliefs and Behavior",
journal="J Med Internet Res",
year="2016",
month="Jul",
day="20",
volume="18",
number="7",
pages="e197",
keywords="consent forms",
keywords="decision support systems",
keywords="social tagging systems",
keywords="informed consent",
keywords="ethics",
abstract="Background: Social media, mobile and wearable technology, and connected devices have significantly expanded the opportunities for conducting biomedical research online. Electronic consent to collecting such data, however, poses new challenges when contrasted to traditional consent processes. It reduces the participant-researcher dialogue but provides an opportunity for the consent deliberation process to move from solitary to social settings. In this research, we propose that social annotations, embedded in the consent form, can help prospective participants deliberate on the research and the organization behind it in ways that traditional consent forms cannot. Furthermore, we examine the role of the comments' valence on prospective participants' beliefs and behavior. Objective: This study focuses specifically on the influence of annotations' valence on participants' perceptions and behaviors surrounding online consent for biomedical research. We hope to shed light on how social annotation can be incorporated into digitally mediated consent forms responsibly and effectively. Methods: In this controlled between-subjects experiment, participants were presented with an online consent form for a personal genomics study that contained social annotations embedded in its margins. Individuals were randomly assigned to view the consent form with positive-, negative-, or mixed-valence comments beside the text of the consent form. We compared participants' perceptions of being informed and having understood the material, their trust in the organization seeking the consent, and their actual consent across conditions. Results: We find that comment valence has a marginally significant main effect on participants' perception of being informed (F2=2.40, P=.07); specifically, participants in the positive condition (mean 4.17, SD 0.94) felt less informed than those in the mixed condition (mean 4.50, SD 0.69, P=.09). Comment valence also had a marginal main effect on the extent to which participants reported trusting the organization (F2=2.566, P=.08). Participants in the negative condition (mean 3.59, SD 1.14) were marginally less trusting than participants exposed to the positive condition (mean 4.02, SD 0.90, P=.06). Finally, we found that consent rate did not differ across comment valence conditions; however, participants who spent less time studying the consent form were more likely to consent when they were exposed to positive-valence comments. Conclusions: This work explores the effects of adding a computer-mediated social dimension, which inherently contains human emotions and opinions, to the consent deliberation process. We proposed that augmenting the consent deliberation process to incorporate multiple voices can enable individuals to capitalize on the knowledge of others, which brings to light questions, problems, and concerns they may not have considered on their own. We found that consent forms containing positive valence annotations are likely to lead participants to feel less informed and simultaneously more trusting of the organization seeking consent. In certain cases where participants spent little time considering the content of the consent form, participants exposed to positive valence annotations were even more likely to consent to the study. We suggest that these findings represent important considerations for the design of future electronic informed consent mechanisms. ",
doi="10.2196/jmir.5662",
url="http://www.jmir.org/2016/7/e197/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27439320"
}


@Article{info:doi/10.2196/jmir.5972,
author="DeAndrea, Christopher David
and Vendemia, Ashley Megan",
title="How Affiliation Disclosure and Control Over User-Generated Comments Affects Consumer Health Knowledge and Behavior: A Randomized Controlled Experiment of Pharmaceutical Direct-to-Consumer Advertising on Social Media",
journal="J Med Internet Res",
year="2016",
month="Jul",
day="19",
volume="18",
number="7",
pages="e189",
keywords="direct-to-consumer advertising",
keywords="DTCA",
keywords="social media",
keywords="Facebook",
keywords="pharmaceutical marketing",
keywords="online promotion of prescription drugs",
keywords="health communication",
abstract="Background: More people are seeking health information online than ever before and pharmaceutical companies are increasingly marketing their drugs through social media. Objective: The aim was to examine two major concerns related to online direct-to-consumer pharmaceutical advertising: (1) how disclosing an affiliation with a pharmaceutical company affects how people respond to drug information produced by both health organizations and online commenters, and (2) how knowledge that health organizations control the display of user-generated comments affects consumer health knowledge and behavior. Methods: We conducted a 2{\texttimes}2{\texttimes}2 between-subjects experiment (N=674). All participants viewed an infographic posted to Facebook by a health organization about a prescription allergy drug. Across conditions, the infographic varied in the degree to which the health organization and commenters appeared to be affiliated with a drug manufacturer, and the display of user-generated comments appeared to be controlled. Results: Affiliation disclosure statements on a health organization's Facebook post increased perceptions of an organization-drug manufacturer connection, which reduced trust in the organization (point estimate --0.45, 95\% CI --0.69 to --0.24) and other users who posted comments about the drug (point estimate --0.44, 95\% CI --0.68 to --0.22). Furthermore, increased perceptions of an organization-manufacturer connection reduced the likelihood that people would recommend the drug to important others (point estimate --0.35, 95\% CI --0.59 to --0.15), and share the drug post with others on Facebook (point estimate --0.37, 95\% CI --0.64 to --0.16). An affiliation cue next to the commenters' names increased perceptions that the commenters were affiliated with the drug manufacturer, which reduced trust in the comments (point estimate --0.81, 95\% CI --1.04 to --0.59), the organization that made the post (point estimate --0.68, 95\% CI --0.90 to --0.49), the likelihood of participants recommending the drug (point estimate --0.61, 95\% CI --0.82 to --0.43), and sharing the post with others on Facebook (point estimate --0.63, 95\% CI --0.87 to --0.43). Cues indicating that a health organization removed user-generated comments from a post increased perceptions that the drug manufacturer influenced the display of the comments, which negatively affected trust in the comments (point estimate --0.35, 95\% CI --0.53 to --0.20), the organization (point estimate --0.31, 95\% CI --0.47 to --0.17), the likelihood of recommending the drug (point estimate --0.26, 95\% CI --0.41 to --0.14), and the likelihood of sharing the post with others on Facebook (point estimate --0.28, 95\% CI --0.45 to --0.15). (All estimates are unstandardized indirect effects and 95\% bias-corrected bootstrap confidence intervals.) Conclusions: Concern over pharmaceutical companies hiding their affiliations and strategically controlling user-generated comments is well founded; these practices can greatly affect not only how viewers evaluate drug information online, but also how likely they are to propagate the information throughout their online and offline social networks. ",
doi="10.2196/jmir.5972",
url="http://www.jmir.org/2016/7/e189/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27435883"
}


@Article{info:doi/10.2196/jmir.4480,
author="Winandy, Marcel
and Kostkova, Patty
and de Quincey, Ed
and St Louis, Connie
and Szomszor, Martin",
title="Follow \#eHealth2011: Measuring the Role and Effectiveness of Online and Social Media in Increasing the Outreach of a Scientific Conference",
journal="J Med Internet Res",
year="2016",
month="Jul",
day="19",
volume="18",
number="7",
pages="e191",
keywords="social media",
keywords="social media networks",
keywords="Web conferencing",
keywords="marketing",
abstract="Background: Social media promotion is increasingly adopted by organizers of industry and academic events; however, the success of social media strategies is rarely questioned or the real impact scientifically analyzed. Objective: We propose a framework that defines and analyses the impact, outreach, and effectiveness of social media for event promotion and research dissemination to participants of a scientific event as well as to the virtual audience through the Web. Methods: Online communication channels Twitter, Facebook, Flickr, and a Liveblog were trialed and their impact measured on outreach during five phases of an eHealth conference: the setup, active and last-minute promotion phases before the conference, the actual event, and after the conference. Results: Planned outreach through online channels and social media before and during the event reached an audience several magnitudes larger in size than would have been possible using traditional means. In the particular case of eHealth 2011, the outreach using traditional means would have been 74 attendees plus 23 extra as sold proceedings and the number of downloaded articles from the online proceedings (4107 until October 2013). The audience for the conference reached via online channels and social media was estimated at more than 5300 in total during the event. The role of Twitter for promotion before the event was complemented by an increased usage of the website and Facebook during the event followed by a sharp increase of views of posters on Flickr after the event. Conclusions: Although our case study is focused on a particular audience around eHealth 2011, our framework provides a template for redefining ``audience'' and outreach of events, merging traditional physical and virtual communities and providing an outline on how these could be successfully reached in clearly defined event phases. ",
doi="10.2196/jmir.4480",
url="http://www.jmir.org/2016/7/e191/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27436012"
}


@Article{info:doi/10.2196/publichealth.5579,
author="Hudnut-Beumler, Julia
and Po'e, Eli
and Barkin, Shari",
title="The Use of Social Media for Health Promotion in Hispanic Populations: A Scoping Systematic Review",
journal="JMIR Public Health Surveill",
year="2016",
month="Jul",
day="11",
volume="2",
number="2",
pages="e32",
keywords="social media",
keywords="social networking",
keywords="Hispanic Americans",
keywords="public health",
keywords="health behavior",
abstract="Background: The Internet is an increasingly popular platform for public health interventions due to its distinct ability to communicate with, engage, and educate communities. Given the widespread use of the Internet, these interventions could be a means of equalizing access to information to address health disparities in minority populations, such as Hispanics. Hispanics are disproportionately affected by poor health outcomes, including obesity, diabetes, and human immunodeficiency virus/acquired immune deficiency syndrome. Although underserved and underrepresented, Hispanics are among the leading users of social media in the United States. Previous reviews have examined the use of social media in public health efforts, but, to our knowledge, none have focused on the Hispanic population. Objective: To conduct a scoping systematic review of the published literature to capture the ways social media has been used in health interventions aimed at Hispanic populations and identify gaps in existing knowledge to provide recommendations for future research. Methods: We performed a systematic review of the literature related to social media, public health, and Hispanics using the PubMed, PsycINFO, and EMBASE databases to locate peer-reviewed studies published between January 1, 2010, and December 31, 2015. Each article was reviewed for the following inclusion criteria: social media as a main component of study methodology or content; public health topic; majority Hispanic/Latino study population; English or Spanish language; and original research study. Relevant data were extracted from articles meeting inclusion criteria including publication year, location, study design, social media platform, use of social media, target population, and public health topic. Results: Of the 267 articles retrieved, a total of 27 unique articles met inclusion criteria. All were published in 2012 or later. The most common study design was a cross-sectional survey, which was featured in 10 of the 27 (37\%) articles. All articles used social media for at least one of the following three purposes: recruiting study participants (14 of 27, 52\%), promoting health education (12 of 27, 44\%), and/or describing social media users (12 of 27, 44\%). All but one article used multiple social media platforms, though Facebook was by far the most popular appearing in 24 of the 27 (89\%). A diverse array of Hispanic populations was targeted, and health topics featured. Of these, the most highly represented were articles on sexual health directed toward Latino men who have sex with men (12 of 27, 44\%). Healthy eating and active living received the second greatest focus (4 of 27, 15\%). Conclusions: Social media offers a potential accessible venue for health interventions aimed at Hispanics, a group at disproportionate risk for poor health outcomes. To date, most publications are descriptive in nature, with few indicating specific interventions and associated outcomes to improve health. ",
doi="10.2196/publichealth.5579",
url="http://publichealth.jmir.org/2016/2/e32/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27400979"
}


@Article{info:doi/10.2196/mhealth.5637,
author="Chang, Cherng-Shiow Rebecca
and Lu, Hsi-Peng
and Yang, Peishan
and Luarn, Pin",
title="Reciprocal Reinforcement Between Wearable Activity Trackers and Social Network Services in Influencing Physical Activity Behaviors",
journal="JMIR Mhealth Uhealth",
year="2016",
month="Jul",
day="05",
volume="4",
number="3",
pages="e84",
keywords="Wearable activity trackers",
keywords="wearables",
keywords="physical activity",
keywords="social support",
keywords="social network services",
keywords="behavior change techniques",
abstract="Background: Wearable activity trackers (WATs) are emerging consumer electronic devices designed to support physical activities (PAs), which are based on successful behavior change techniques focusing on goal-setting and frequent behavioral feedbacks. Despite their utility, data from both recent academic and market research have indicated high attrition rates of WAT users. Concurrently, evidence shows that social support (SS), delivered/obtained via social network services or sites (SNS), could increase adherence and engagement of PA intervention programs. To date, relatively few studies have looked at how WATs and SS may interact and affect PAs. Objective: The purpose of this study was to explore how these two Internet and mobile technologies, WATs and SNS, could work together to foster sustainable PA behavior changes and habits among middle-aged adults (40-60 years old) in Taiwan. Methods: We used purposive sampling of Executive MBA Students from National Taiwan University of Science and Technology to participate in our qualitative research. In-depth interviews and focus groups were conducted with a total of 15 participants, including 9 WAT users and 6 nonusers. Analysis of the collected materials was done inductively using the thematic approach with no preset categories. Two authors from different professional backgrounds independently annotated and coded the transcripts, and then discussed and debated until consensus was reached on the final themes. Results: The thematic analysis revealed six themes: (1) WATs provided more awareness than motivation in PA with goal-setting and progress monitoring, (2) SS, delivered/obtained via SNS, increased users' adherence and engagement with WATs and vice versa, (3) a broad spectrum of configurations would be needed to deliver WATs with appropriately integrated SS functions, (4) WAT design, style, and appearance mattered even more than those of smartphones, as they are body-worn devices, (5) the user interfaces of WATs left a great deal to be desired, and (6) privacy concerns must be addressed before more mainstream consumers would consider adopting WATs. Conclusions: Participants perceived WATs as an awareness tool to understand one's PA level. It is evident from our study that SS, derived from SNS and other pertinent vehicles such as the LINE social messaging application (similar to WhatsApp and WeChat), will increase the engagement and adherence of WAT usage. Combining WATs and SNS enables cost-effective, scalable PA intervention programs with end-to-end services and data analytics capabilities, to elevate WATs from one-size-fits-all consumer electronics to personalized PA assistants. ",
doi="10.2196/mhealth.5637",
url="http://mhealth.jmir.org/2016/3/e84/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27380798"
}


@Article{info:doi/10.2196/jmir.4726,
author="Reuter, Katja
and Ukpolo, Francis
and Ward, Edward
and Wilson, L. Melissa
and Angyan, Praveen",
title="Trial Promoter: A Web-Based Tool for Boosting the Promotion of Clinical Research Through Social Media",
journal="J Med Internet Res",
year="2016",
month="Jun",
day="29",
volume="18",
number="6",
pages="e144",
keywords="algorithm",
keywords="automation",
keywords="clinical trial",
keywords="communication",
keywords="Facebook",
keywords="Internet",
keywords="online",
keywords="patient",
keywords="recruitment",
keywords="social network",
keywords="social media",
keywords="Twitter",
abstract="Background: Scarce information about clinical research, in particular clinical trials, is among the top reasons why potential participants do not take part in clinical studies. Without volunteers, on the other hand, clinical research and the development of novel approaches to preventing, diagnosing, and treating disease are impossible. Promising digital options such as social media have the potential to work alongside traditional methods to boost the promotion of clinical research. However, investigators and research institutions are challenged to leverage these innovations while saving time and resources. Objective: To develop and test the efficiency of a Web-based tool that automates the generation and distribution of user-friendly social media messages about clinical trials. Methods: Trial Promoter is developed in Ruby on Rails, HTML, cascading style sheet (CSS), and JavaScript. In order to test the tool and the correctness of the generated messages, clinical trials (n=46) were randomized into social media messages and distributed via the microblogging social media platform Twitter and the social network Facebook. The percent correct was calculated to determine the probability with which Trial Promoter generates accurate messages. Results: During a 10-week testing phase, Trial Promoter automatically generated and published 525 user-friendly social media messages on Twitter and Facebook. On average, Trial Promoter correctly used the message templates and substituted the message parameters (text, URLs, and disease hashtags) 97.7\% of the time (1563/1600).  Conclusions: Trial Promoter may serve as a promising tool to render clinical trial promotion more efficient while requiring limited resources. It supports the distribution of any research or other types of content. The Trial Promoter code and installation instructions are freely available online. ",
doi="10.2196/jmir.4726",
url="http://www.jmir.org/2016/6/e144/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27357424"
}


@Article{info:doi/10.2196/jmir.5312,
author="Rolls, Kaye
and Hansen, Margaret
and Jackson, Debra
and Elliott, Doug",
title="How Health Care Professionals Use Social Media to Create Virtual Communities: An Integrative Review",
journal="J Med Internet Res",
year="2016",
month="Jun",
day="16",
volume="18",
number="6",
pages="e166",
keywords="social media",
keywords="literature review",
keywords="physicians",
keywords="nurses",
keywords="midwives",
keywords="social networking",
keywords="pharmacist",
keywords="social worker",
keywords="allied health personnel",
abstract="Background: Prevailing health care structures and cultures restrict intraprofessional communication, inhibiting knowledge dissemination and impacting the translation of research into practice. Virtual communities may facilitate professional networking and knowledge sharing in and between health care disciplines. Objectives: This study aimed to review the literature on the use of social media by health care professionals in developing virtual communities that facilitate professional networking, knowledge sharing, and evidence-informed practice. Methods: An integrative literature review was conducted to identify research published between 1990 and 2015. Search strategies sourced electronic databases (PubMed, CINAHL), snowball references, and tables of contents of 3 journals. Papers that evaluated social media use by health care professionals (unless within an education framework) using any research design (except for research protocols or narrative reviews) were included. Standardized data extraction and quality assessment tools were used. Results: Overall, 72 studies were included: 44 qualitative (including 2 ethnographies, 26 qualitative descriptive, and 1 Q-sort) and 20 mixed-methods studies, and 8 literature reviews. The most common methods of data collection were Web-based observation (n=39), surveys (n=23), interviews (n=11), focus groups (n=2), and diaries (n=1). Study quality was mixed. Social media studied included Listservs (n=22), Twitter (n=18), general social media (n=17), discussion forums (n=7), Web 2.0 (n=3), virtual community of practice (n=3), wiki (n=1), and Facebook (n=1). A range of health care professionals were sampled in the studies, including physicians (n=24), nurses (n=15), allied health professionals (n=14), followed by health care professionals in general (n=8), a multidisciplinary clinical specialty area (n=9), and midwives (n=2). Of 36 virtual communities, 31 were monodiscipline for a discrete clinical specialty. Population uptake by the target group ranged from 1.6\% to 29\% (n=4). Evaluation using related theories of ``planned behavior'' and the ``technology acceptance model'' (n=3) suggests that social media use is mediated by an individual's positive attitude toward and accessibility of the media, which is reinforced by credible peers. The most common reason to establish a virtual community was to create a forum where relevant specialty knowledge could be shared and professional issues discussed (n=17). Most members demonstrated low posting behaviors but more frequent reading or accessing behaviors. The most common Web-based activity was request for and supply of specialty-specific clinical information. This knowledge sharing is facilitated by a Web-based culture of collectivism, reciprocity, and a respectful noncompetitive environment. Findings suggest that health care professionals view virtual communities as valuable knowledge portals for sourcing clinically relevant and quality information that enables them to make more informed practice decisions. Conclusions: There is emerging evidence that health care professionals use social media to develop virtual communities to share domain knowledge. These virtual communities, however, currently reflect tribal behaviors of clinicians that may continue to limit knowledge sharing. Further research is required to evaluate the effects of social media on knowledge distribution in clinical practice and importantly whether patient outcomes are significantly improved. ",
doi="10.2196/jmir.5312",
url="http://www.jmir.org/2016/6/e166/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27328967"
}


@Article{info:doi/10.2196/resprot.5621,
author="Rastegar-Mojarad, Majid
and Liu, Hongfang
and Nambisan, Priya",
title="Using Social Media Data to Identify Potential Candidates for Drug Repurposing: A Feasibility Study",
journal="JMIR Res Protoc",
year="2016",
month="Jun",
day="16",
volume="5",
number="2",
pages="e121",
keywords="social media",
keywords="drug repurposing",
keywords="natural language processing",
keywords="patient comments",
abstract="Background: Drug repurposing (defined as discovering new indications for existing drugs) could play a significant role in drug development, especially considering the declining success rates of developing novel drugs. Typically, new indications for existing medications are identified by accident. However, new technologies and a large number of available resources enable the development of systematic approaches to identify and validate drug-repurposing candidates. Patients today report their experiences with medications on social media and reveal side effects as well as beneficial effects of those medications. Objective: Our aim was to assess the feasibility of using patient reviews from social media to identify potential candidates for drug repurposing. Methods: We retrieved patient reviews of 180 medications from an online forum, WebMD. Using dictionary-based and machine learning approaches, we identified disease names in the reviews. Several publicly available resources were used to exclude comments containing known indications and adverse drug effects. After manually reviewing some of the remaining comments, we implemented a rule-based system to identify beneficial effects. Results: The dictionary-based system and machine learning system identified 2178 and 6171 disease names respectively in 64,616 patient comments. We provided a list of 10 common patterns that patients used to report any beneficial effects or uses of medication. After manually reviewing the comments tagged by our rule-based system, we identified five potential drug repurposing candidates. Conclusions: To our knowledge, this is the first study to consider using social media data to identify drug-repurposing candidates. We found that even a rule-based system, with a limited number of rules, could identify beneficial effect mentions in patient comments. Our preliminary study shows that social media has the potential to be used in drug repurposing. ",
doi="10.2196/resprot.5621",
url="http://www.researchprotocols.org/2016/2/e121/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27311964"
}


@Article{info:doi/10.2196/jmir.5502,
author="Carter-Harris, Lisa
and Bartlett Ellis, Rebecca
and Warrick, Adam
and Rawl, Susan",
title="Beyond Traditional Newspaper Advertisement: Leveraging Facebook-Targeted Advertisement to Recruit Long-Term Smokers for Research",
journal="J Med Internet Res",
year="2016",
month="Jun",
day="15",
volume="18",
number="6",
pages="e117",
keywords="facebook",
keywords="recruitment methods",
keywords="smokers",
keywords="older",
abstract="Background: Smokers are a stigmatized population, but an important population to reach for the purpose of research. Therefore, innovative recruitment methods are needed that are both cost-effective and efficacious in recruiting this population. Objective: The aim of the present article was to evaluate the feasibility of Facebook-targeted advertisement to recruit long-term smokers eligible for lung cancer screening for a descriptive, cross-sectional survey. Methods: A social media recruitment campaign was launched using Facebook-targeted advertisement to target age and keywords related to tobacco smoking in the Facebook users profile, interests, and likes. A 3-day newspaper advertisement recruitment campaign was used as a comparison. The study that used both recruitment methods aimed to test the psychometric properties of 4 newly developed lung cancer screening health belief scales. Data were collected via cross-sectional survey methodology using an Web-based survey platform. Results: The Facebook-targeted advertisements were viewed 56,621 times over an 18-day campaign in 2015 in the United States. The advertisement campaign yielded 1121 unique clicks to the Web-based survey platform at a cost of \$1.51 per completed survey. Of those who clicked through to the study survey platform, 423 (37.7\%) consented to participate; 92 (8.2\%) dropped out during completion of the survey yielding a final study pool of 331 completed surveys. Recruitment by newspaper advertisement yielded a total of 30 participants in response to a 3-day advertisement campaign; recruitment efficacy resulted in 10 participants/day at \$40.80 per completed survey. Participants represented current (n=182; 51\%) and former smokers (n=178; 49\%) with a mean age of 63.4 years (SD 6.0). Cost of the advertisement campaign was \$500 total for the 18-day campaign. Conclusions: Recruitment by Facebook was more efficacious and cost-effective compared with newspaper advertisement. Facebook offers a new venue for recruitment into research studies that offer the potential for wider reach at a lower cost while providing privacy and flexibility for potential study participants. The study's findings extend recent work of other researchers who have demonstrated Facebook's utility with younger smokers, and Facebook is an effective tool to recruit older smokers. Furthermore, Facebook is a cost-effective alternative to traditional newspaper advertisement offering a new, affordable venue to recruit large numbers of older smokers efficiently. ",
doi="10.2196/jmir.5502",
url="http://www.jmir.org/2016/6/e117/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27306780"
}


@Article{info:doi/10.2196/jmir.5420,
author="Crosier, Sage Benjamin
and Brian, Marie Rachel
and Ben-Zeev, Dror",
title="Using Facebook to Reach People Who Experience Auditory Hallucinations",
journal="J Med Internet Res",
year="2016",
month="Jun",
day="14",
volume="18",
number="6",
pages="e160",
keywords="hearing voices",
keywords="auditory hallucinations",
keywords="social media",
keywords="Facebook",
keywords="survey",
keywords="advertisements",
abstract="Background: Auditory hallucinations (eg, hearing voices) are relatively common and underreported false sensory experiences that may produce distress and impairment. A large proportion of those who experience auditory hallucinations go unidentified and untreated. Traditional engagement methods oftentimes fall short in reaching the diverse population of people who experience auditory hallucinations. Objective: The objective of this proof-of-concept study was to examine the viability of leveraging Web-based social media as a method of engaging people who experience auditory hallucinations and to evaluate their attitudes toward using social media platforms as a resource for Web-based support and technology-based treatment. Methods: We used Facebook advertisements to recruit individuals who experience auditory hallucinations to complete an 18-item Web-based survey focused on issues related to auditory hallucinations and technology use in American adults. We systematically tested multiple elements of the advertisement and survey layout including image selection, survey pagination, question ordering, and advertising targeting strategy. Each element was evaluated sequentially and the most cost-effective strategy was implemented in the subsequent steps, eventually deriving an optimized approach. Three open-ended question responses were analyzed using conventional inductive content analysis. Coded responses were quantified into binary codes, and frequencies were then calculated. Results: Recruitment netted N=264 total sample over a 6-week period. Ninety-seven participants fully completed all measures at a total cost of \$8.14 per participant across testing phases. Systematic adjustments to advertisement design, survey layout, and targeting strategies improved data quality and cost efficiency. People were willing to provide information on what triggered their auditory hallucinations along with strategies they use to cope, as well as provide suggestions to others who experience auditory hallucinations. Women, people who use mobile phones, and those experiencing more distress, were reportedly more open to using Facebook as a support and/or therapeutic tool in the future. Conclusions: Facebook advertisements can be used to recruit research participants who experience auditory hallucinations quickly and in a cost-effective manner. Most (58\%) Web-based respondents are open to Facebook-based support and treatment and are willing to describe their subjective experiences with auditory hallucinations. ",
doi="10.2196/jmir.5420",
url="http://www.jmir.org/2016/6/e160/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27302017"
}


@Article{info:doi/10.2196/jmir.5327,
author="Sadah, A. Shouq
and Shahbazi, Moloud
and Wiley, T. Matthew
and Hristidis, Vagelis",
title="Demographic-Based Content Analysis of Web-Based Health-Related Social Media",
journal="J Med Internet Res",
year="2016",
month="Jun",
day="13",
volume="18",
number="6",
pages="e148",
keywords="Web-based social media",
keywords="demographics",
keywords="content analysis",
keywords="health forums",
keywords="drug reviews",
abstract="Background: An increasing number of patients from diverse demographic groups share and search for health-related information on Web-based social media. However, little is known about the content of the posted information with respect to the users' demographics. Objective: The aims of this study were to analyze the content of Web-based health-related social media based on users' demographics to identify which health topics are discussed in which social media by which demographic groups and to help guide educational and research activities. Methods: We analyze 3 different types of health-related social media: (1) general Web-based social networks Twitter and Google+; (2) drug review websites; and (3) health Web forums, with a total of about 6 million users and 20 million posts. We analyzed the content of these posts based on the demographic group of their authors, in terms of sentiment and emotion, top distinctive terms, and top medical concepts. Results: The results of this study are: (1) Pregnancy is the dominant topic for female users in drug review websites and health Web forums, whereas for male users, it is cardiac problems, HIV, and back pain, but this is not the case for Twitter; (2) younger users (0-17 years) mainly talk about attention-deficit hyperactivity disorder (ADHD) and depression-related drugs, users aged 35-44 years discuss about multiple sclerosis (MS) drugs, and middle-aged users (45-64 years) talk about alcohol and smoking; (3) users from the Northeast United States talk about physical disorders, whereas users from the West United States talk about mental disorders and addictive behaviors; (4) Users with higher writing level express less anger in their posts. Conclusion: We studied the popular topics and the sentiment based on users' demographics in Web-based health-related social media. Our results provide valuable information, which can help create targeted and effective educational campaigns and guide experts to reach the right users on Web-based social chatter. ",
doi="10.2196/jmir.5327",
url="http://www.jmir.org/2016/6/e148/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27296242"
}


@Article{info:doi/10.2196/publichealth.5308,
author="Lyles, Rees Courtney
and Godbehere, Andrew
and Le, Gem
and El Ghaoui, Laurent
and Sarkar, Urmimala",
title="Applying Sparse Machine Learning Methods to Twitter: Analysis of the 2012 Change in Pap Smear Guidelines. A Sequential Mixed-Methods Study",
journal="JMIR Public Health Surveill",
year="2016",
month="Jun",
day="10",
volume="2",
number="1",
pages="e21",
keywords="Twitter",
keywords="machine learning",
keywords="social media",
keywords="cervical cancer",
keywords="qualitative research",
abstract="Background: It is difficult to synthesize the vast amount of textual data available from social media websites. Capturing real-world discussions via social media could provide insights into individuals' opinions and the decision-making process. Objective: We conducted a sequential mixed methods study to determine the utility of sparse machine learning techniques in summarizing Twitter dialogues. We chose a narrowly defined topic for this approach: cervical cancer discussions over a 6-month time period surrounding a change in Pap smear screening guidelines. Methods: We applied statistical methodologies, known as sparse machine learning algorithms, to summarize Twitter messages about cervical cancer before and after the 2012 change in Pap smear screening guidelines by the US Preventive Services Task Force (USPSTF). All messages containing the search terms ``cervical cancer,'' ``Pap smear,'' and ``Pap test'' were analyzed during: (1) January 1--March 13, 2012, and (2) March 14--June 30, 2012. Topic modeling was used to discern the most common topics from each time period, and determine the singular value criterion for each topic. The results were then qualitatively coded from top 10 relevant topics to determine the efficiency of clustering method in grouping distinct ideas, and how the discussion differed before vs. after the change in guidelines . Results: This machine learning method was effective in grouping the relevant discussion topics about cervical cancer during the respective time periods ({\textasciitilde}20\% overall irrelevant content in both time periods). Qualitative analysis determined that a significant portion of the top discussion topics in the second time period directly reflected the USPSTF guideline change (eg, ``New Screening Guidelines for Cervical Cancer''), and many topics in both time periods were addressing basic screening promotion and education (eg, ``It is Cervical Cancer Awareness Month! Click the link to see where you can receive a free or low cost Pap test.'') Conclusions: It was demonstrated that machine learning tools can be useful in cervical cancer prevention and screening discussions on Twitter. This method allowed us to prove that there is publicly available significant information about cervical cancer screening on social media sites. Moreover, we observed a direct impact of the guideline change within the Twitter messages. ",
doi="10.2196/publichealth.5308",
url="http://publichealth.jmir.org/2016/1/e21/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27288093"
}


@Article{info:doi/10.2196/jmir.5612,
author="Lefebvre, Cedric
and Mesner, Jason
and Stopyra, Jason
and O'Neill, James
and Husain, Iltifat
and Geer, Carol
and Gerancher, Karen
and Atkinson, Hal
and Harper, Erin
and Huang, William
and Cline, M. David",
title="Social Media in Professional Medicine: New Resident Perceptions and Practices",
journal="J Med Internet Res",
year="2016",
month="Jun",
day="09",
volume="18",
number="6",
pages="e119",
keywords="social media",
keywords="professionalism",
keywords="physicians",
keywords="education",
abstract="Background: For younger generations, unconstrained online social activity is the norm. Little data are available about perceptions among young medical practitioners who enter the professional clinical arena, while the impact of existing social media policy on these perceptions is unclear. Objective: The objective of this study was to investigate the existing perceptions about social media and professionalism among new physicians entering in professional clinical practice; and to determine the effects of formal social media instruction and policy on young professionals' ability to navigate case-based scenarios about online behavior in the context of professional medicine. Methods: This was a prospective observational study involving the new resident physicians at a large academic medical center. Medical residents from 9 specialties were invited to participate and answer an anonymous questionnaire about social media in clinical medicine. Data were analyzed using SAS 9.4 (Cary, NC), chi-square or Fisher's exact test was used as appropriate, and the correct responses were compared between different groups using the Kruskal--Wallis analysis of variance. Results: Familiarity with current institutional policy was associated with an average of 2.2 more correct responses (P=.01). Instruction on social media use during medical school was related to correct responses for 2 additional questions (P=.03). On dividing the groups into no policy exposure, single policy exposure, or both exposures, the mean differences were found to be statistically significant (3.5, 7.5, and 9.4, respectively) (P=.03). Conclusions: In this study, a number of young physicians demonstrated a casual approach to social media activity in the context of professional medical practice. Several areas of potential educational opportunity and focus were identified: (1) online privacy, (2) maintaining digital professionalism, (3) safeguarding the protected health information of patients, and (4) the impact of existing social media policies. Prior social media instruction and/or familiarity with a social media policy are associated with an improved performance on case-based questions regarding online professionalism. This suggests a correlation between an instruction about online professionalism and more cautious online behavior. Improving the content and delivery of social media policy may assist in preserving institutional priorities, protecting patient information, and safeguarding young professionals from online misadventure. ",
doi="10.2196/jmir.5612",
url="http://www.jmir.org/2016/6/e119/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27283846"
}


@Article{info:doi/10.2196/resprot.4551,
author="Naja, J. Wadih
and Kansoun, H. Alaa
and Haddad, S. Ramzi",
title="Prevalence of Depression in Medical Students at the Lebanese University and Exploring its Correlation With Facebook Relevance: A Questionnaire Study",
journal="JMIR Res Protoc",
year="2016",
month="May",
day="31",
volume="5",
number="2",
pages="e96",
keywords="depression",
keywords="Facebook",
keywords="PHQ-9",
keywords="FbRQ",
keywords="Lebanese University Faculty of Medicine",
abstract="Background: The prevalence of major depression is particularly high in medical students, affecting around one-third of this population. Moreover, online social media, in particular Facebook, is becoming an intrinsic part in the life of a growing proportion of individuals worldwide. Objective: Our primary objective is to identify the prevalence of depression in medical students at the Lebanese University Faculty of Medicine, a unique state university in Lebanon, its correlation with the utilization of the interactive features of Facebook, and the way students may resort to these features. Methods: Students of the Lebanese University Faculty of Medicine were assessed for (1) depression and (2) Facebook activity. To screen for major depression, we used the Patient Health Questionnaire-9 (PHQ-9) scale. To test for Facebook activity, we developed the Facebook Resorting Questionnaire (FbRQ), which measures the degree to which students resort to Facebook. Results: A total of 365 out of 480 students (76.0\%) participated in the survey. A total of 25 students were excluded, hence 340 students were included in the final analysis. Current depression was reported in 117 students out of 340 (34.4\%) and t tests showed female predominance. Moreover, PHQ-9 score multiple regression analysis showed that feeling depressed is explained 63.5\% of the time by specific independent variables studied from the PHQ-9 and the FbRQ. Depression varied significantly among the different academic years (P<.001) and it peaked in the third-year students. One-way analysis of variance (ANOVA) showed that depression and resorting to Facebook had a positive and significant relationship (P=.003) and the different FbRQ categories had significant differences in resorting-to-Facebook power. The like, add friend, and check-in features students used when resorting to Facebook were significantly associated with depression. Conclusions: This study showed that depression was highly prevalent among students of the Faculty of Medicine at the Lebanese University. Moreover, Facebook may be a promising, helpful, psychological tool for optimizing the management of depression. Our study brought to bear further questions that now prompt further observation and scrutiny to know more about the high rates of depression in this student population, more so in the part of the world studied, and to the growing role of social media. ",
doi="10.2196/resprot.4551",
url="http://www.researchprotocols.org/2016/2/e96/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27246394"
}


@Article{info:doi/10.2196/jmir.5713,
author="Hall, William Eric
and Heneine, Walid
and Sanchez, Travis
and Sineath, Craig Robert
and Sullivan, Patrick",
title="Preexposure Prophylaxis Modality Preferences Among Men Who Have Sex With Men and Use Social Media in the United States",
journal="J Med Internet Res",
year="2016",
month="May",
day="19",
volume="18",
number="5",
pages="e111",
keywords="preexposure prophylaxis",
keywords="PrEP",
keywords="men who have sex with men",
keywords="MSM",
keywords="HIV prevention",
keywords="Facebook",
keywords="survey",
abstract="Background: Preexposure prophylaxis (PrEP) is available as a daily pill for preventing infection with the human immunodeficiency virus (HIV). Innovative methods of administering PrEP systemically or topically are being discussed and developed. Objective: The objective of our study was to assess attitudes toward different experimental modalities of PrEP administration. Methods: From April to July 2015, we recruited 1106 HIV-negative men who have sex with men through online social media advertisements and surveyed them about their likelihood of using different PrEP modalities. Participants responded to 5-point Likert-scale items indicating how likely they were to use each of the following PrEP modalities: a daily oral pill, on-demand pills, periodic injection, penile gel (either before or after intercourse), rectal gel (before/after), and rectal suppository (before/after). We used Wilcoxon signed rank tests to determine whether the stated likelihood of using any modality differed from daily oral PrEP. Related items were combined to assess differences in likelihood of use based on tissue or time of administration. Participants also ranked their interest in using each modality, and we used the modified Borda count method to determine consensual rankings. Results: Most participants indicated they would be somewhat likely or very likely to use PrEP as an on-demand pill (685/1105, 61.99\%), daily oral pill (528/1036, 50.97\%), injection (575/1091, 52.70\%), or penile gel (438/755, 58.01\% before intercourse; 408/751, 54.33\% after). The stated likelihoods of using on-demand pills (median score 4) and of using a penile gel before intercourse (median 4) were both higher than that of using a daily oral pill (median 4, P<.001 and P=.001, respectively). Compared with a daily oral pill, participants reported a significantly lower likelihood of using any of the 4 rectal modalities (Wilcoxon signed rank test, all P<.001). On 10-point Likert scales created by combining application methods, the reported likelihood of using a penile gel (median 7) was higher than that of using a rectal gel (median 6, P<.001), which was higher than the likelihood of using a rectal suppository (median 6, P<.001). The modified Borda count ranked on-demand pills as the most preferred modality. There was no difference in likelihood of use of PrEP (gel or suppository) before or after intercourse. Conclusions: Participants typically prefer systemic PrEP and are less likely to use a modality that is administered rectally. Although most of these modalities are seen as favorable or neutral, attitudes may change as information about efficacy and application becomes available. Further data on modality preference across risk groups will better inform PrEP development. ",
doi="10.2196/jmir.5713",
url="http://www.jmir.org/2016/5/e111/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27199100"
}


@Article{info:doi/10.2196/jmir.5360,
author="Bold, W. Krysten
and Hanrahan, H. Tess
and O'Malley, S. Stephanie
and Fucito, M. Lisa",
title="Exploring the Utility of Web-Based Social Media Advertising to Recruit Adult Heavy-Drinking Smokers for Treatment",
journal="J Med Internet Res",
year="2016",
month="May",
day="18",
volume="18",
number="5",
pages="e107",
keywords="smoking",
keywords="alcohol drinking",
keywords="social media",
keywords="research subject recruitment",
abstract="Background: Identifying novel ways to recruit smokers for treatment studies is important. In particular, certain subgroups of adult smokers, such as heavy-drinking smokers, are at increased risk for serious medical problems and are less likely to try quitting smoking, so drawing this hard-to-reach population into treatment is important for improving health outcomes. Objective: This study examined the utility of Facebook advertisements to recruit smokers and heavy-drinking smokers for treatment research and evaluated smoking and alcohol use and current treatment goals among those who responded to the Web-based survey. Methods: Using Facebook's advertising program, 3 separate advertisements ran for 2 months targeting smokers who were thinking about quitting. Advertisements were shown to adult (at least 18 years of age), English-speaking Facebook users in the greater New Haven, Connecticut, area. Participants were invited to complete a Web-based survey to determine initial eligibility for a smoking cessation research study. Results: Advertisements generated 1781 clicks and 272 valid, completed surveys in 2 months, with one advertisement generating the most interest. Facebook advertising was highly cost-effective, averaging \$0.27 per click, \$1.76 per completed survey, and \$4.37 per participant meeting initial screening eligibility. On average, those who completed the Web-based survey were 36.8 (SD 10.4) years old, and 65.8\% (179/272) were female. Advertisements were successful in reaching smokers; all respondents reported daily smoking (mean 16.2 [SD 7.0] cigarettes per day). The majority of smokers (254/272, 93.4\%) were interested in changing their smoking behavior immediately. Many smokers (161/272, 59.2\%) also reported heavy alcohol consumption at least once a month. Among smokers interested in reducing their alcohol use, more were heavy drinkers (45/56, 80.4\%) compared to non-heavy drinkers (11/56, 19.6\%; $\chi$2[1,N=272]=13.0, P<.001). Of those who met initial screening eligibility from the Web-based survey, 12.7\% (14/110) attended an in-person follow-up appointment. Conclusions: Social media advertisements designed to target smokers were cost-effective and successful for reaching adult smokers interested in treatment. Additionally, recruiting for smokers reached those who also drink alcohol heavily, many of whom were interested in changing this behavior as well. However, additional social media strategies may be needed to engage individuals into treatment after completion of Web-based screening surveys. ",
doi="10.2196/jmir.5360",
url="http://www.jmir.org/2016/5/e107/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27194456"
}


@Article{info:doi/10.2196/resprot.4203,
author="Kandadai, Venk
and Yang, Haodong
and Jiang, Ling
and Yang, C. Christopher
and Fleisher, Linda
and Winston, Koplin Flaura",
title="Measuring Health Information Dissemination and Identifying Target Interest Communities on Twitter: Methods Development and Case Study of the @SafetyMD Network",
journal="JMIR Res Protoc",
year="2016",
month="May",
day="05",
volume="5",
number="2",
pages="e50",
keywords="Twitter",
keywords="health information",
keywords="dissemination",
keywords="health communication",
keywords="digital health",
abstract="Background: Little is known about the ability of individual stakeholder groups to achieve health information dissemination goals through Twitter. Objective: This study aimed to develop and apply methods for the systematic evaluation and optimization of health information dissemination by stakeholders through Twitter. Methods: Tweet content from 1790 followers of @SafetyMD (July-November 2012) was examined. User emphasis, a new indicator of Twitter information dissemination, was defined and applied to retweets across two levels of retweeters originating from @SafetyMD. User interest clusters were identified based on principal component analysis (PCA) and hierarchical cluster analysis (HCA) of a random sample of 170 followers. Results: User emphasis of keywords remained across levels but decreased by 9.5 percentage points. PCA and HCA identified 12 statistically unique clusters of followers within the @SafetyMD Twitter network. Conclusions: This study is one of the first to develop methods for use by stakeholders to evaluate and optimize their use of Twitter to disseminate health information. Our new methods provide preliminary evidence that individual stakeholders can evaluate the effectiveness of health information dissemination and create content-specific clusters for more specific targeted messaging. ",
doi="10.2196/resprot.4203",
url="http://www.researchprotocols.org/2016/2/e50/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27151100"
}


@Article{info:doi/10.2196/jmir.5385,
author="V{\"a}lim{\"a}ki, Maritta
and Athanasopoulou, Christina
and Lahti, Mari
and Adams, E. Clive",
title="Effectiveness of Social Media Interventions for People With Schizophrenia: A Systematic Review and Meta-Analysis",
journal="J Med Internet Res",
year="2016",
month="Apr",
day="22",
volume="18",
number="4",
pages="e92",
keywords="social media",
keywords="effectiveness",
keywords="technology",
keywords="Internet",
keywords="Web 2.0",
keywords="schizophrenia",
keywords="mental health",
abstract="Background: Recent studies have shown that people with serious mental disorders spend time online for the purposes of disclosure, information gathering, or gaming. However, coherent information on the effects of social media on treatment for people with schizophrenia is still lacking. Objective: Our aim was to determine the effects of social media interventions for supporting mental health and well-being among people with schizophrenia. Methods: A systematic review and meta-analysis were undertaken to determine the effects of social media interventions for supporting mental health and well-being among people with schizophrenia. Ten databases were searched, while search parameters included English-only manuscripts published prior to June 25, 2015. Study appraisals were made independently by 2 reviewers, and qualitative and quantitative syntheses of data were conducted. Results: Out of 1043 identified records, only two randomized studies of moderate quality (three records, total N=331, duration 12 months) met the inclusion criteria. Participants were people with schizophrenia spectrum or an affective disorder. Social media was used as part of Web-based psychoeducation, or as online peer support (listserv and bulletin board). Outcome measures included perceived stress, social support, and disease-related distress. At 3 months, participants with schizophrenia in the intervention group reported lower perceived stress levels (P=.04) and showed a trend for a higher perceived level of social support (P=.06). However, those who reported more positive experiences with the peer support group also reported higher levels of psychological distress (P=.01). Conclusions: Despite using comprehensive searches from 10 databases, we found only two studies, whereas numerous reports have been published citing the benefits of social media in mental health. Findings suggest the effects of social media interventions are largely unknown. More research is needed to understand the effects of social media, for users with and without mental illness, in order to determine the impact on mental well-being ofsocial media use as well as its risks. ",
doi="10.2196/jmir.5385",
url="http://www.jmir.org/2016/4/e92/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27105939"
}


@Article{info:doi/10.2196/jmir.4265,
author="Huang, Jidong
and Kornfield, Rachel
and Emery, L. Sherry",
title="100 Million Views of Electronic Cigarette YouTube Videos and Counting: Quantification, Content Evaluation, and Engagement Levels of Videos",
journal="J Med Internet Res",
year="2016",
month="Mar",
day="18",
volume="18",
number="3",
pages="e67",
keywords="electronic cigarettes",
keywords="electronic nicotine delivery systems",
keywords="ENDS",
keywords="tobacco products",
keywords="YouTube",
keywords="social media",
abstract="Background: The video-sharing website, YouTube, has become an important avenue for product marketing, including tobacco products. It may also serve as an important medium for promoting electronic cigarettes, which have rapidly increased in popularity and are heavily marketed online. While a few studies have examined a limited subset of tobacco-related videos on YouTube, none has explored e-cigarette videos' overall presence on the platform. Objective: To quantify e-cigarette-related videos on YouTube, assess their content, and characterize levels of engagement with those videos. Understanding promotion and discussion of e-cigarettes on YouTube may help clarify the platform's impact on consumer attitudes and behaviors and inform regulations. Methods: Using an automated crawling procedure and keyword rules, e-cigarette-related videos posted on YouTube and their associated metadata were collected between July 1, 2012, and June 30, 2013. Metadata were analyzed to describe posting and viewing time trends, number of views, comments, and ratings. Metadata were content coded for mentions of health, safety, smoking cessation, promotional offers, Web addresses, product types, top-selling brands, or names of celebrity endorsers. Results: As of June 30, 2013, approximately 28,000 videos related to e-cigarettes were captured. Videos were posted by approximately 10,000 unique YouTube accounts, viewed more than 100 million times, rated over 380,000 times, and commented on more than 280,000 times. More than 2200 new videos were being uploaded every month by June 2013. The top 1\% of most-viewed videos accounted for 44\% of total views. Text fields for the majority of videos mentioned websites (70.11\%); many referenced health (13.63\%), safety (10.12\%), smoking cessation (9.22\%), or top e-cigarette brands (33.39\%). The number of e-cigarette-related YouTube videos was projected to exceed 65,000 by the end of 2014, with approximately 190 million views. Conclusions: YouTube is a major information-sharing platform for electronic cigarettes. YouTube appears to be used unevenly for promotional purposes by e-cigarette brands, and our analyses indicated a high level of user engagement with a small subset of content. There is evidence that YouTube videos promote e-cigarettes as cigarette smoking cessation tools. Presence and reach of e-cigarette videos on YouTube warrants attention from public health professionals and policymakers. ",
doi="10.2196/jmir.4265",
url="http://www.jmir.org/2016/3/e67/",
url="http://www.ncbi.nlm.nih.gov/pubmed/26993213"
}


@Article{info:doi/10.2196/jmir.5409,
author="Risson, Val{\'e}ry
and Saini, Deepanshu
and Bonzani, Ian
and Huisman, Alice
and Olson, Melvin",
title="Patterns of Treatment Switching in Multiple Sclerosis Therapies in US Patients Active on Social Media: Application of Social Media Content Analysis to Health Outcomes Research",
journal="J Med Internet Res",
year="2016",
month="Mar",
day="17",
volume="18",
number="3",
pages="e62",
keywords="Internet",
keywords="multiple sclerosis",
keywords="outcomes assessment",
keywords="drug switching",
abstract="Background: Social media analysis has rarely been applied to the study of specific questions in outcomes research. Objective: The aim was to test the applicability of social media analysis to outcomes research using automated listening combined with filtering and analysis of data by specialists. After validation, the process was applied to the study of patterns of treatment switching in multiple sclerosis (MS). Methods: A comprehensive listening and analysis process was developed that blended automated listening with filtering and analysis of data by life sciences-qualified analysts and physicians. The population was patients with MS from the United States. Data sources were Facebook, Twitter, blogs, and online forums. Sources were searched for mention of specific oral, injectable, and intravenous (IV) infusion treatments. The representativeness of the social media population was validated by comparison with community survey data and with data from three large US administrative claims databases: MarketScan, PharMetrics Plus, and Department of Defense. Results: A total of 10,260 data points were sampled for manual review: 3025 from Twitter, 3771 from Facebook, 2773 from Internet forums, and 691 from blogs. The demographics of the social media population were similar to those reported from community surveys and claims databases. Mean age was 39 (SD 11) years and 14.56\% (326/2239) of the population was older than 50 years. Women, patients aged 30 to 49 years, and those diagnosed for more than 10 years were represented by more data points than other patients were. Women also accounted for a large majority (82.6\%, 819/991) of reported switches. Two-fifths of switching patients had lived with their disease for more than 10 years since diagnosis. Most reported switches (55.05\%, 927/1684) were from injectable to oral drugs with switches from IV therapies to orals the second largest switch (15.38\%, 259/1684). Switches to oral drugs accounted for more than 80\% (927/1114) of the switches away from injectable therapies. Four reasons accounted for more than 90\% of all switches: severe side effects, lack of efficacy, physicians' advice, and greater ease of use. Side effects were the main reason for switches to oral or to injectable therapies and search for greater efficacy was the most important factor in switches to IV therapies. Cost of medication was the reason for switching in less than 0.5\% of patients. Conclusions: Social intelligence can be applied to outcomes research with power to analyze MS patients' personal experiences of treatments and to chart the most common reasons for switching between therapies. ",
doi="10.2196/jmir.5409",
url="http://www.jmir.org/2016/3/e62/",
url="http://www.ncbi.nlm.nih.gov/pubmed/26987964"
}


@Article{info:doi/10.2196/jmir.4193,
author="Song, Hayeon
and Omori, Kikuko
and Kim, Jihyun
and Tenzek, E. Kelly
and Hawkins, Morey Jennifer
and Lin, Wan-Ying
and Kim, Yong-Chan
and Jung, Joo-Young",
title="Trusting Social Media as a Source of Health Information: Online Surveys Comparing the United States, Korea, and Hong Kong",
journal="J Med Internet Res",
year="2016",
month="Mar",
day="14",
volume="18",
number="3",
pages="e25",
keywords="social media",
keywords="medical informatics",
keywords="trust",
keywords="culture",
keywords="consumer behavior",
keywords="consumer health information",
keywords="information sharing",
abstract="Background: The Internet has increasingly become a popular source of health information by connecting individuals with health content, experts, and support. More and more, individuals turn to social media and Internet sites to share health information and experiences. Although online health information seeking occurs worldwide, limited empirical studies exist examining cross-cultural differences in perceptions about user-generated, experience-based information compared to expertise-based information sources. Objective: To investigate if cultural variations exist in patterns of online health information seeking, specifically in perceptions of online health information sources. It was hypothesized that Koreans and Hongkongers, compared to Americans, would be more likely to trust and use experience-based knowledge shared in social Internet sites, such as social media and online support groups. Conversely, Americans, compared to Koreans and Hongkongers, would value expertise-based knowledge prepared and approved by doctors or professional health providers more. Methods: Survey questionnaires were developed in English first and then translated into Korean and Chinese. The back-translation method ensured the standardization of questions. Surveys were administered using a standardized recruitment strategy and data collection methods. Results: A total of 826 participants living in metropolitan areas from the United States (n=301), Korea (n=179), and Hong Kong (n=337) participated in the study. We found significant cultural differences in information processing preferences for online health information. A planned contrast test revealed that Koreans and Hongkongers showed more trust in experience-based health information sources (blogs: t451.50=11.21, P<.001; online support group: t455.71=9.30, P<.001; social networking sites [SNS]: t466.75=11.36, P<.001) and also reported using blogs (t515.31=6.67, P<.001) and SNS (t529.22=4.51, P<.001) more frequently than Americans. Americans showed a stronger preference for using expertise-based information sources (eg, WebMD and CDC) compared to Koreans and Hongkongers (t360.02=3.01, P=.003). Trust in expertise-based information sources was universal, demonstrating no cultural differences (Brown-Forsythe F2,654=1.82, P=.16). Culture also contributed significantly to differences in searching information on behalf of family members (t480.38=5.99, P<.001) as well as to the goals of information searching. Conclusions: This research found significant cultural differences in information processing preferences for online health information. Further discussion is included regarding effective communication strategies in providing quality health information. ",
doi="10.2196/jmir.4193",
url="http://www.jmir.org/2016/3/e25/",
url="http://www.ncbi.nlm.nih.gov/pubmed/26976273"
}


@Article{info:doi/10.2196/jmir.5042,
author="Xu, Ronghua
and Zhang, Qingpeng",
title="Understanding Online Health Groups for Depression: Social Network and Linguistic Perspectives",
journal="J Med Internet Res",
year="2016",
month="Mar",
day="10",
volume="18",
number="3",
pages="e63",
keywords="mental health",
keywords="depression",
keywords="social media",
keywords="information science",
keywords="online health group",
keywords="social network analysis",
abstract="Background: Mental health problems have become increasingly prevalent in the past decade. With the advance of Web 2.0 technologies, social media present a novel platform for Web users to form online health groups. Members of online health groups discuss health-related issues and mutually help one another by anonymously revealing their mental conditions, sharing personal experiences, exchanging health information, and providing suggestions and support. The conversations in online health groups contain valuable information to facilitate the understanding of their mutual help behaviors and their mental health problems. Objective: We aimed to characterize the conversations in a major online health group for major depressive disorder (MDD) patients in a popular Chinese social media platform. In particular, we intended to explain how Web users discuss depression-related issues from the perspective of the social networks and linguistic patterns revealed by the members' conversations. Methods: Social network analysis and linguistic analysis were employed to characterize the social structure and linguistic patterns, respectively. Furthermore, we integrated both perspectives to exploit the hidden relations between them. Results: We found an intensive use of self-focus words and negative affect words. In general, group members used a higher proportion of negative affect words than positive affect words. The social network of the MDD group for depression possessed small-world and scale-free properties, with a much higher reciprocity ratio and clustering coefficient value as compared to the networks of other social media platforms and classic network models. We observed a number of interesting relationships, either strong correlations or convergent trends, between the topological properties and linguistic properties of the MDD group members. Conclusions: (1) The MDD group members have the characteristics of self-preoccupation and negative thought content, according to Beck's cognitive theory of depression; (2) the social structure of the MDD group is much stickier than those of other social media groups, indicating the tendency of mutual communications and efficient spread of information in the MDD group; and (3) the linguistic patterns of MDD members are associated with their topological positions in the social network. ",
doi="10.2196/jmir.5042",
url="http://www.jmir.org/2016/3/e63/",
url="http://www.ncbi.nlm.nih.gov/pubmed/26966078"
}


@Article{info:doi/10.2196/jmir.5391,
author="Hamad, O. Eradah
and Savundranayagam, Y. Marie
and Holmes, D. Jeffrey
and Kinsella, Anne Elizabeth
and Johnson, M. Andrew",
title="Toward a Mixed-Methods Research Approach to Content Analysis in The Digital Age: The Combined Content-Analysis Model and its Applications to Health Care Twitter Feeds",
journal="J Med Internet Res",
year="2016",
month="Mar",
day="08",
volume="18",
number="3",
pages="e60",
keywords="health care social media",
keywords="Twitter feeds",
keywords="health care tweets",
keywords="mixed methods research",
keywords="content analysis",
keywords="coding",
keywords="computer-aided content analysis",
keywords="infodemiology",
keywords="infoveillance",
keywords="digital disease detection",
abstract="Background: Twitter's 140-character microblog posts are increasingly used to access information and facilitate discussions among health care professionals and between patients with chronic conditions and their caregivers. Recently, efforts have emerged to investigate the content of health care-related posts on Twitter. This marks a new area for researchers to investigate and apply content analysis (CA). In current infodemiology, infoveillance and digital disease detection research initiatives, quantitative and qualitative Twitter data are often combined, and there are no clear guidelines for researchers to follow when collecting and evaluating Twitter-driven content. Objective: The aim of this study was to identify studies on health care and social media that used Twitter feeds as a primary data source and CA as an analysis technique. We evaluated the resulting 18 studies based on a narrative review of previous methodological studies and textbooks to determine the criteria and main features of quantitative and qualitative CA. We then used the key features of CA and mixed-methods research designs to propose the combined content-analysis (CCA) model as a solid research framework for designing, conducting, and evaluating investigations of Twitter-driven content. Methods: We conducted a PubMed search to collect studies published between 2010 and 2014 that used CA to analyze health care-related tweets. The PubMed search and reference list checks of selected papers identified 21 papers. We excluded 3 papers and further analyzed 18. Results: Results suggest that the methods used in these studies were not purely quantitative or qualitative, and the mixed-methods design was not explicitly chosen for data collection and analysis. A solid research framework is needed for researchers who intend to analyze Twitter data through the use of CA. Conclusions: We propose the CCA model as a useful framework that provides a straightforward approach to guide Twitter-driven studies and that adds rigor to health care social media investigations. We provide suggestions for the use of the CCA model in elder care-related contexts. ",
doi="10.2196/jmir.5391",
url="http://www.jmir.org/2016/3/e60/",
url="http://www.ncbi.nlm.nih.gov/pubmed/26957477"
}


@Article{info:doi/10.2196/mededu.4715,
author="Hatzipanagos, Stylianos
and John, Bernadette
and Chiu, Tiffany Yuan-Li",
title="The Significance of Kinship for Medical Education: Reflections on the Use of a Bespoke Social Network to Support Learners' Professional Identities",
journal="JMIR Medical Education",
year="2016",
month="Mar",
day="03",
volume="2",
number="1",
pages="e1",
keywords="institutional social networks",
keywords="collaborative software",
keywords="medical education",
keywords="social media",
abstract="Background: Social media can support and sustain communities much better than previous generations of learning technologies, where institutional barriers undermined any initiatives for embedding formal and informal learning. Some of the many types of social media have already had an impact on student learning, based on empirical evidence. One of these, social networking, has the potential to support communication in formal and informal spaces. Objective: In this paper we report on the evaluation of an institutional social network---King's Social Harmonisation Project (KINSHIP)---established to foster an improved sense of community, enhance communication, and serve as a space to model digital professionalism for students at King's College London, United Kingdom. Methods: Our evaluation focused on a study that examined students' needs and perceptions with regard to the provision of a cross-university platform. Data were collected from students, including those in the field of health and social care, in order to recommend a practical way forward to address current needs in this area. Results: The findings indicate that the majority of the respondents were positive about using a social networking platform to develop their professional voice and profiles. Results suggest that timely promotion of the platform, emphasis on interface and learning design, and a clear identity are required in order to gain acceptance as the institutional social networking site. Conclusions: Empirical findings in this study project an advantage of an institutional social network such a KINSHIP over other social networks (eg, Facebook) because access is limited to staff and students and the site is mainly being used for academic purposes. ",
doi="10.2196/mededu.4715",
url="http://mededu.jmir.org/2016/1/e1/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27731848"
}


@Article{info:doi/10.2196/jmir.4738,
author="Kim, Yoonsang
and Huang, Jidong
and Emery, Sherry",
title="Garbage in, Garbage Out: Data Collection, Quality Assessment and Reporting Standards for Social Media Data Use in Health Research, Infodemiology and Digital Disease Detection",
journal="J Med Internet Res",
year="2016",
month="Feb",
day="26",
volume="18",
number="2",
pages="e41",
keywords="social media",
keywords="precision and recall",
keywords="sensitivity and specificity",
keywords="search filter",
keywords="Twitter",
keywords="standard reporting",
keywords="infodemiology",
keywords="infoveillance",
keywords="digital disease detection",
abstract="Background: Social media have transformed the communications landscape. People increasingly obtain news and health information online and via social media. Social media platforms also serve as novel sources of rich observational data for health research (including infodemiology, infoveillance, and digital disease detection detection). While the number of studies using social data is growing rapidly, very few of these studies transparently outline their methods for collecting, filtering, and reporting those data. Keywords and search filters applied to social data form the lens through which researchers may observe what and how people communicate about a given topic. Without a properly focused lens, research conclusions may be biased or misleading. Standards of reporting data sources and quality are needed so that data scientists and consumers of social media research can evaluate and compare methods and findings across studies. Objective: We aimed to develop and apply a framework of social media data collection and quality assessment and to propose a reporting standard, which researchers and reviewers may use to evaluate and compare the quality of social data across studies. Methods: We propose a conceptual framework consisting of three major steps in collecting social media data: develop, apply, and validate search filters. This framework is based on two criteria: retrieval precision (how much of retrieved data is relevant) and retrieval recall (how much of the relevant data is retrieved). We then discuss two conditions that estimation of retrieval precision and recall rely on---accurate human coding and full data collection---and how to calculate these statistics in cases that deviate from the two ideal conditions. We then apply the framework on a real-world example using approximately 4 million tobacco-related tweets collected from the Twitter firehose. Results: We developed and applied a search filter to retrieve e-cigarette--related tweets from the archive based on three keyword categories: devices, brands, and behavior. The search filter retrieved 82,205 e-cigarette--related tweets from the archive and was validated. Retrieval precision was calculated above 95\% in all cases. Retrieval recall was 86\% assuming ideal conditions (no human coding errors and full data collection), 75\% when unretrieved messages could not be archived, 86\% assuming no false negative errors by coders, and 93\% allowing both false negative and false positive errors by human coders. Conclusions: This paper sets forth a conceptual framework for the filtering and quality evaluation of social data that addresses several common challenges and moves toward establishing a standard of reporting social data. Researchers should clearly delineate data sources, how data were accessed and collected, and the search filter building process and how retrieval precision and recall were calculated. The proposed framework can be adapted to other public social media platforms. ",
doi="10.2196/jmir.4738",
url="http://www.jmir.org/2016/2/e41/",
url="http://www.ncbi.nlm.nih.gov/pubmed/26920122"
}


@Article{info:doi/10.2196/publichealth.5032,
author="Hart, Mark
and Stetten, Nichole
and Castaneda, Gail",
title="Considerations for Public Health Organizations Attempting to Implement a Social Media Presence: A Qualitative Study",
journal="JMIR Public Health Surveill",
year="2016",
month="Feb",
day="24",
volume="2",
number="1",
pages="e6",
keywords="public health",
keywords="social networking sites",
keywords="professional development",
keywords="training centers",
keywords="Facebook",
keywords="Twitter",
abstract="Background: In the past decade, social media has become an integral part of our everyday lives, but research on how this tool is used by public health workers and organizations is still developing. Budget cuts and staff reduction in county departments have required employees to take on more responsibilities. These reductions have caused a reduction in the time for training or collaborating with others in the field. To make up for the loss, many employees are seeking collaboration through social media sites but are unable to do so because state departments block these Internet sites. Objective: This study sought to highlight the key considerations and decision-making process for a public health organization deciding whether to implement a social media presence for their organization. Methods: Using 3 structured interviews, 15 stakeholders were questioned on their personal experience with social media, experience within the context of public health, and their thoughts on implementation for their center. Interviews were coded using constant comparative qualitative methods. Results: The following themes emerged from the interviews: (1) personal experience with technology and social networking sites, (2) use of social networking sites in public health, (3) use of social networking sites in work environments, (4) social networking sites access, (5) ways the Rural South Public Health Training Center could use social networking sites, and (6) perceived outcomes of social networking site usage for the Rural South Public Health Training Center (positive and negative). Conclusions: The collective voice of the center showed a positive perceived perception of social media implementation, with the benefits outweighing the risks. Despite the benefits, there is a cautious skepticism of the importance of social networking site use. ",
doi="10.2196/publichealth.5032",
url="http://publichealth.jmir.org/2016/1/e6/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27227160"
}


@Article{info:doi/10.2196/ijmr.4492,
author="Holton, Sara
and Rowe, Heather
and Kirkman, Maggie
and Jordan, Lynne
and McNamee, Kathleen
and Bayly, Christine
and McBain, John
and Sinnott, Vikki
and Fisher, Jane",
title="Barriers to Managing Fertility: Findings From the Understanding Fertility Management in Contemporary Australia Facebook Discussion Group",
journal="Interact J Med Res",
year="2016",
month="Feb",
day="15",
volume="5",
number="1",
pages="e7",
keywords="fertility management",
keywords="Australia",
keywords="Facebook",
keywords="social media",
abstract="Background: As part of research investigating the complexities of managing fertility in Australia, public opinions about how Australians manage their fertility were sought from women and men. Objective: To identify public opinion about sexual and reproductive health in Australia. Methods: To ensure access to a diverse group of people throughout Australia, an online group was advertised and convened on Facebook from October through December 2013. In a closed-group moderated discussion, participants responded to questions about how people in Australia attempt to manage three aspects of fertility: avoiding pregnancy, achieving pregnancy, and difficulties conceiving. Nonidentifiable demographic information was sought; no personal accounts of fertility management were requested. The discussion transcript was analyzed thematically. Results: There were 61 female and 2 male Facebook users aged 18 to 50 years living in Australia participating in the study. Four main themes about fertility management were identified: access, geographical location, knowledge, and cost. Participants reported that young people and people from rural areas face barriers accessing contraception and fertility services. Limited knowledge about sex and reproduction and the cost of fertility services and contraception were also said to impede effective fertility management. Conclusions: Reasons for inequalities in effective fertility management that are amenable to change were identified. Facebook is an effective method for gaining insights into public opinion about sexual and reproductive health. ",
doi="10.2196/ijmr.4492",
url="http://www.i-jmr.org/2016/1/e7/",
url="http://www.ncbi.nlm.nih.gov/pubmed/26878865"
}


@Article{info:doi/10.2196/publichealth.5101,
author="Pan, Sung-Ching
and Sheng, Wang-Huei
and Tien, Kuei-Lien
and Chien, Kuang-Tse
and Chen, Yee-Chun
and Chang, Shawn-Chwen",
title="Promoting a Hand Hygiene Program Using Social Media: An Observational Study",
journal="JMIR Public Health Surveill",
year="2016",
month="Feb",
day="02",
volume="2",
number="1",
pages="e5",
keywords="social media",
keywords="hand hygiene",
keywords="infection control",
abstract="Background: Hand hygiene is an important component in infection control to protect patient safety and reduce health care-associated infection. Objective: Our aim was to evaluate the efficacy of different social media on the promotion of a hand hygiene (HH) program. Methods: The observational study was conducted from May 5 to December 31, 2014, at a 2600-bed tertiary care hospital. A 3-minute video of an HH campaign in 8 languages was posted to YouTube. The Chinese version was promoted through three platforms: the hospital website, the hospital group email, and the Facebook site of a well-known Internet illustrator. The video traffic was analyzed via Google Analytics. HH compliance was measured in November 2013 and 2014. Results: There were 5252 views of the video, mainly of the Chinese-language version (3509/5252, 66.81\%). The NTUH website had 24,000 subscribers, and 151 of them viewed the video (connection rate was 151/24,000, 0.63\%). There were 9967 users of the hospital email group and the connection rate was 0.91\% (91/9967). The connection rate was 6.17\% (807/13,080) from Facebook, significantly higher than the other 2 venues (both P<.001). HH compliance sustained from 83.7\% (473/565) in 2013 to 86.7\% (589/679) in 2014 (P=.13) among all HCWs. Conclusions: Facebook had the highest connection rate in the HH video campaign. The use of novel social media such as Facebook should be considered for future programs that promote hand hygiene and other healthy behaviors. ",
doi="10.2196/publichealth.5101",
url="http://publichealth.jmir.org/2016/1/e5/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27227159"
}


@Article{info:doi/10.2196/jmir.5086,
author="Pagoto, Sherry
and Waring, E. Molly
and May, N. Christine
and Ding, Y. Eric
and Kunz, H. Werner
and Hayes, Rashelle
and Oleski, L. Jessica",
title="Adapting Behavioral Interventions for Social Media Delivery",
journal="J Med Internet Res",
year="2016",
month="Jan",
day="29",
volume="18",
number="1",
pages="e24",
keywords="social media",
keywords="behavioral interventions",
keywords="health behavior",
keywords="online social networks",
doi="10.2196/jmir.5086",
url="http://www.jmir.org/2016/1/e24/",
url="http://www.ncbi.nlm.nih.gov/pubmed/26825969"
}


@Article{info:doi/10.2196/jmir.4887,
author="Meyer, N.D Ashley
and Longhurst, A. Christopher
and Singh, Hardeep",
title="Crowdsourcing Diagnosis for Patients With Undiagnosed Illnesses: An Evaluation of CrowdMed",
journal="J Med Internet Res",
year="2016",
month="Jan",
day="14",
volume="18",
number="1",
pages="e12",
keywords="crowdsourcing",
keywords="diagnosis",
keywords="diagnostic errors",
keywords="patient safety",
keywords="World Wide Web",
abstract="Background: Despite visits to multiple physicians, many patients remain undiagnosed. A new online program, CrowdMed, aims to leverage the ``wisdom of the crowd'' by giving patients an opportunity to submit their cases and interact with case solvers to obtain diagnostic possibilities. Objective: To describe CrowdMed and provide an independent assessment of its impact. Methods: Patients submit their cases online to CrowdMed and case solvers sign up to help diagnose patients. Case solvers attempt to solve patients' diagnostic dilemmas and often have an interactive online discussion with patients, including an exchange of additional diagnostic details. At the end, patients receive detailed reports containing diagnostic suggestions to discuss with their physicians and fill out surveys about their outcomes. We independently analyzed data collected from cases between May 2013 and April 2015 to determine patient and case solver characteristics and case outcomes. Results: During the study period, 397 cases were completed. These patients previously visited a median of 5 physicians, incurred a median of US \$10,000 in medical expenses, spent a median of 50 hours researching their illnesses online, and had symptoms for a median of 2.6 years. During this period, 357 active case solvers participated, of which 37.9\% (132/348) were male and 58.3\% (208/357) worked or studied in the medical industry. About half (50.9\%, 202/397) of patients were likely to recommend CrowdMed to a friend, 59.6\% (233/391) reported that the process gave insights that led them closer to the correct diagnoses, 57\% (52/92) reported estimated decreases in medical expenses, and 38\% (29/77) reported estimated improvement in school or work productivity. Conclusions: Some patients with undiagnosed illnesses reported receiving helpful guidance from crowdsourcing their diagnoses during their difficult diagnostic journeys. However, further development and use of crowdsourcing methods to facilitate diagnosis requires long-term evaluation as well as validation to account for patients' ultimate correct diagnoses. ",
doi="10.2196/jmir.4887",
url="http://www.jmir.org/2016/1/e12/",
url="http://www.ncbi.nlm.nih.gov/pubmed/26769236"
}


@Article{info:doi/10.2196/jmir.5209,
author="Ramo, E. Danielle
and Thrul, Johannes
and Chavez, Kathryn
and Delucchi, L. Kevin
and Prochaska, J. Judith",
title="Feasibility and Quit Rates of the Tobacco Status Project: A Facebook Smoking Cessation Intervention for Young Adults",
journal="J Med Internet Res",
year="2015",
month="Dec",
day="31",
volume="17",
number="12",
pages="e291",
keywords="smoking cessation",
keywords="Facebook",
keywords="social media",
keywords="young adults",
abstract="Background: Young adult smokers are a challenging group to engage in smoking cessation interventions. With wide reach and engagement among users, Facebook offers opportunity to engage young people in socially supportive communities for quitting smoking and sustaining abstinence. Objective: We developed and tested initial efficacy, engagement, and acceptability of the Tobacco Status Project, a smoking cessation intervention for young adults delivered within Facebook. Methods: The intervention was based on the US Public Health Service Clinical Practice Guidelines and the Transtheoretical Model and enrolled participants into study-run 3-month secret Facebook groups matched on readiness to quit smoking. Cigarette smokers (N=79) aged 18-25, who used Facebook on most days, were recruited via Facebook. All participants received the intervention and were randomized to one of three monetary incentive groups tied to engagement (commenting in groups). Assessments were completed at baseline, 3-, 6-, and 12-months follow-up. Analyses examined retention, smoking outcomes over 12 months (7-day point prevalence abstinence, ?50\% reduction in cigarettes smoked, quit attempts and strategies used, readiness to quit), engagement, and satisfaction with the intervention. Results: Retention was 82\% (65/79) at 6 months and 72\% (57/79) at 12 months. From baseline to 12-months follow-up, there was a significant increase in the proportion prepared to quit (10/79, 13\%; 36/79, 46\%, P<.001). Over a third (28/79, 35\%) reduced their cigarette consumption by 50\% or greater, and 66\% (52/79) made at least one 24-hour quit attempt during the study. In an intent-to-treat analysis, 13\% (10/79) self-reported 7-day abstinence (6/79, 8\% verified biochemically) at 12-months follow-up. In their quit attempts, 11\% (9/79) used a nicotine replacement therapy approved by the Food and Drug Administration, while 18\% (14/79) used an electronic nicotine delivery system to quit (eg, electronic cigarette). A majority (48/79, 61\%) commented on at least one Facebook post, with more commenting among those with biochemically verified abstinence at 3 months (P=.036) and those randomized to receive a personal monetary incentive (P=.015). Over a third of participants (28/79, 35\%) reported reading most or all of the Facebook posts. Highest acceptability ratings of the intervention were for post ease (57/79, 72\%) and thinking about what they read (52/79, 66\%); 71\% (56/79) recommended the program to others. Only 5 participants attended the optional cognitive-behavioral counseling sessions, though their attendance was high (6/7 sessions overall) and the sessions were rated as easy to understand, useful, and helpful (all 90-100\% agreed). Conclusions: A Facebook quit smoking intervention is attractive and feasible to deliver, and early efficacy data are encouraging. However, the 1.5-fold greater use of electronic cigarettes over nicotine replacement products for quitting is concerning. ",
doi="10.2196/jmir.5209",
url="http://www.jmir.org/2015/12/e291/",
url="http://www.ncbi.nlm.nih.gov/pubmed/26721211"
}


@Article{info:doi/10.2196/ijmr.4504,
author="Vaala, E. Sarah
and Hood, K. Korey
and Laffel, Lori
and Kumah-Crystal, A. Yaa
and Lybarger, K. Cindy
and Mulvaney, A. Shelagh",
title="Use of Commonly Available Technologies for Diabetes Information and Self-Management Among Adolescents With Type 1 Diabetes and Their Parents: A Web-Based Survey Study",
journal="Interact J Med Res",
year="2015",
month="Dec",
day="29",
volume="4",
number="4",
pages="e24",
keywords="diabetes mellitus, Type 1",
keywords="adolescent",
keywords="technology",
keywords="adoption",
keywords="self-management",
keywords="self-care",
abstract="Background: For individuals with Type 1 diabetes (T1D), following a complicated daily medical regimen is critical to maintaining optimal health. Adolescents in particular struggle with regimen adherence. Commonly available technologies (eg, diabetes websites, apps) can provide diabetes-related support, yet little is known about how many adolescents with T1D use them, why they are used, or relationships between use and self-management. Objective: This study examined adolescent and parent use of 5 commonly available technologies for diabetes, including proportions who use each technology, frequency of use, and number of different technologies used for diabetes. Analyses also investigated the reasons adolescents reported for using or not using technologies for diabetes, and factors correlated with adolescents' technology use. Finally, this study examined relationships between the type and number of technologies adolescents use for diabetes and their self-management and glycemic control. Methods: Adolescents (12-17 years) and their parents (N=174 pairs), recruited from a pediatric diabetes clinic (n=134) and the Children with Diabetes community website (n=40), participated in this Web-based survey study. Glycosylated hemoglobin (A1C) values were obtained from medical records for pediatric clinic patients. Adolescents reported their use of 5 commonly available technologies for diabetes (ie, social networking, diabetes websites, mobile diabetes apps, text messaging, and glucometer/insulin pump software), reasons for use, and self-management behavior (Self-Care Inventory-Revised, SCI-R). Results: Most adolescents and parents used at least one of the 5 technologies for diabetes. Among adolescents, the most commonly used technology for diabetes was text messaging (53\%), and the least commonly used was diabetes websites (25\%). Most adolescents who used diabetes apps, text messaging, or pump/glucometer software did so more frequently (?2 times per week), compared to social networking and website use (?1 time per week). The demographic, clinical, and parent-technology use factors related to adolescents' technology use varied by technology. Adolescents who used social networking, websites, or pump/glucometer software for diabetes had better self-management behavior (SCI-R scores: beta=.18, P=.02; beta=.15, P=.046; beta=.15, P=.04, respectively), as did those who used several technologies for diabetes (beta=.23, P=.003). However, use of diabetes websites was related to poorer glycemic control (A1C: beta=.18, P=.01). Conclusions: Adolescents with T1D may be drawn to different technologies for different purposes, as individual technologies likely offer differing forms of support for diabetes self-management (eg, tracking blood glucose or aiding problem solving). Findings suggest that technologies that are especially useful for adolescents' diabetes problem solving may be particularly beneficial for their self-management. Additional research should examine relationships between the nature of technology use and adolescents' T1D self-management over time. ",
doi="10.2196/ijmr.4504",
url="http://www.i-jmr.org/2015/4/e24/",
url="http://www.ncbi.nlm.nih.gov/pubmed/26715191"
}


@Article{info:doi/10.2196/jmir.5144,
author="Katsuki, Takeo
and Mackey, Ken Tim
and Cuomo, Raphael",
title="Establishing a Link Between Prescription Drug Abuse and Illicit Online Pharmacies: Analysis of Twitter Data",
journal="J Med Internet Res",
year="2015",
month="Dec",
day="16",
volume="17",
number="12",
pages="e280",
keywords="social media",
keywords="surveillance",
keywords="prescription drug abuse",
keywords="twitter",
keywords="eHealth",
keywords="illicit Internet pharmacies",
keywords="cyberpharmacies",
keywords="infodemiology",
keywords="infoveillance",
abstract="Background: Youth and adolescent non-medical use of prescription medications (NUPM) has become a national epidemic. However, little is known about the association between promotion of NUPM behavior and access via the popular social media microblogging site, Twitter, which is currently used by a third of all teens. Objective: In order to better assess NUPM behavior online, this study conducts surveillance and analysis of Twitter data to characterize the frequency of NUPM-related tweets and also identifies illegal access to drugs of abuse via online pharmacies. Methods: Tweets were collected over a 2-week period from April 1-14, 2015, by applying NUPM keyword filters for both generic/chemical and street names associated with drugs of abuse using the Twitter public streaming application programming interface. Tweets were then analyzed for relevance to NUPM and whether they promoted illegal online access to prescription drugs using a protocol of content coding and supervised machine learning. Results: A total of 2,417,662 tweets were collected and analyzed for this study. Tweets filtered for generic drugs names comprised 232,108 tweets, including 22,174 unique associated uniform resource locators (URLs), and 2,185,554 tweets (376,304 unique URLs) filtered for street names. Applying an iterative process of manual content coding and supervised machine learning, 81.72\% of the generic and 12.28\% of the street NUPM datasets were predicted as having content relevant to NUPM respectively. By examining hyperlinks associated with NUPM relevant content for the generic Twitter dataset, we discovered that 75.72\% of the tweets with URLs included a hyperlink to an online marketing affiliate that directly linked to an illicit online pharmacy advertising the sale of Valium without a prescription. Conclusions: This study examined the association between Twitter content, NUPM behavior promotion, and online access to drugs using a broad set of prescription drug keywords. Initial results are concerning, as our study found over 45,000 tweets that directly promoted NUPM by providing a URL that actively marketed the illegal online sale of prescription drugs of abuse. Additional research is needed to further establish the link between Twitter content and NUPM, as well as to help inform future technology-based tools, online health promotion activities, and public policy to combat NUPM online. ",
doi="10.2196/jmir.5144",
url="http://www.jmir.org/2015/12/e280/",
url="http://www.ncbi.nlm.nih.gov/pubmed/26677966"
}


@Article{info:doi/10.2196/jmir.4233,
author="Flaudias, Valentin
and de Chazeron, Ingrid
and Zerhouni, Oulmann
and Boudesseul, Jordane
and Begue, Laurent
and Bouthier, Renaud
and L{\'e}vrier, Christel
and Llorca, Michel Pierre
and Brousse, Georges",
title="Preventing Alcohol Abuse Through Social Networking Sites: A First Assessment of a Two-Year Ecological Approach",
journal="J Med Internet Res",
year="2015",
month="Dec",
day="10",
volume="17",
number="12",
pages="e278",
keywords="social networking",
keywords="primary prevention",
keywords="alcohol consumption",
keywords="students",
abstract="Background: Prevention strategies to reduce alcohol use/consumption among young people are crucial to reducing alcohol-related deaths and preventing disease. This paper focuses on the effectiveness of a social networking site (SNS) alcohol prevention program targeted toward young people. Objective: We hypothesized that the program would diminish the relation made by participants between alcohol and festive moments, and would result in a reduction of their declared consumption of alcohol at festive moments during the program. We also explored the interaction with the prevention program that was the most efficient. Methods: The prevention program took the form of 3 lotteries over 2 years. The participants periodically received prevention messages, particularly on alcohol and festive moments (eg, videos on Facebook and short message service [SMS] text messages on their mobile phones). For the 3 periods, the participants had to answer questions exploring the level of their belief that alcohol consumption and festive moments are highly associated. A control group that did not participate in the prevention program was asked the same questions over the same number of days for the first 2 periods. During the second period, the participants were asked to answer questions about their alcohol consumption during parties. During the third period, we explored the interaction with the prevention program on the reduction of their belief that alcohol consumption and festive moments are associated. Results: A total of 651 participants (age: mean 22.24, SD 4.10 years; women: n=430) during the first period, 301 participants (age: mean 21.27, SD 3.07 years; women n=199) during the second period, and 305 (age: mean 22.41, SD 4.65 years; women: n=190) during the third period correctly completed the survey. For the control group, 69 students completed the survey during the first period (age: mean 18.93, SD 1.14 years; women: n=59) and 50 during the second (age: mean 20.78, SD 1.94 years; women: n=45). We observed a significant reduction in the association of alcohol with festive moments in the participants over the 2 years (period 1: z=--4.80, P<.001; period 2: z=--2.11, P=.04; period 3: z=--2.30; P=.02), but not in the controls. We also observed a reduction in the number of glasses consumed during festive moments for the participants (z=--2.36, P=.02), but not for the controls during the second period. The third period showed that only the number of days since registration in the program had an impact on the reduction of the association of festive moments and alcohol consumption (t21=3.186, P=.005). Conclusions: The findings of this study suggest that the SNS prevention program is promising in preventing the association of alcohol with festive moments and, more generally, in impacting social norms. ",
doi="10.2196/jmir.4233",
url="http://www.jmir.org/2015/12/e278/",
url="http://www.ncbi.nlm.nih.gov/pubmed/26681577"
}


@Article{info:doi/10.2196/mededu.4886,
author="Flickinger, E. Tabor
and O'Hagan, Thomas
and Chisolm, S. Margaret",
title="Developing a Curriculum to Promote Professionalism for Medical Students Using Social Media: Pilot of a Workshop and Blog-Based Intervention",
journal="JMIR Medical Education",
year="2015",
month="Dec",
day="01",
volume="1",
number="2",
pages="e17",
keywords="medical education",
keywords="medical students",
keywords="professionalism",
keywords="social media",
keywords="social networking",
abstract="Background: As the use of social media (SM) tools becomes increasingly widespread, medical trainees need guidance on applying principles of professionalism to their online behavior. Objective: To develop a curriculum to improve knowledge and skills regarding professionalism of SM use by medical students. Methods: This project was conducted in 3 phases: (1) a needs assessment was performed via a survey of medical students regarding SM use, rationale for and frequency of use, and concerns; (2) a workshop-format curriculum was designed and piloted for preclinical students to gain foundational knowledge of online professionalism; and (3) a complementary longitudinal SM-based curriculum was designed and piloted for clinical students to promote both medical humanism and professionalism. Results: A total of 72 medical students completed the survey (response rate 30\%). Among the survey respondents, 71/72 (99\%) reported visiting social networking sites, with 55/72 (76\%) reporting daily visits. Privacy of personal information (62/72, 86\%) and mixing of personal/professional identities (49/72, 68\%) were the students' most commonly endorsed concerns regarding SM use. The workshop-format curriculum was evaluated qualitatively via participant feedback. Of the 120 students who participated in the workshop, 91 completed the post workshop evaluation (response rate 76\%), with 56 positive comments and 54 suggestions for improvement. The workshop was experienced by students as enjoyable, thought provoking, informative, and relevant. Suggestions for improvement included adjustments to timing, format, and content of the workshop. The SM-based curriculum was evaluated by a small-scale pilot of 11 students, randomized to the intervention group (participation in faculty-moderated blog) or the control group. Outcomes were assessed quantitatively and qualitatively via personal growth scales, participant feedback, and analysis of blog themes. There was a trend toward improvement in total personal growth scores among those students in the blog group from 3.65 (0.47) to 4.11 (0.31) (mean [SD]) with no change observed for the students in the control group (3.89 [0.11] before and after evaluation). Themes relevant to humanism and professionalism were observed in the blog discussion. Conclusions: Most medical students surveyed reported using SM and identified privacy and personal-professional boundaries as areas of concern. The workshop format and SM-based curricula were well-received by students whose formative feedback will inform the refinement and further development of efforts to promote professionalism among medical students. ",
doi="10.2196/mededu.4886",
url="http://mededu.jmir.org/2015/2/e17/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27731846"
}


@Article{info:doi/10.2196/publichealth.5014,
author="Albalawi, Yousef
and Sixsmith, Jane",
title="Agenda Setting for Health Promotion: Exploring an Adapted Model for the Social Media Era",
journal="JMIR Public Health Surveill",
year="2015",
month="Nov",
day="25",
volume="1",
number="2",
pages="e21",
keywords="agenda setting, health promotion, social media, Twitter, health communication, Saudi Arabia, road traffic accidents",
abstract="Background: The foundation of best practice in health promotion is a robust theoretical base that informs design, implementation, and evaluation of interventions that promote the public's health. This study provides a novel contribution to health promotion through the adaptation of the agenda-setting approach in response to the contribution of social media. This exploration and proposed adaptation is derived from a study that examined the effectiveness of Twitter in influencing agenda setting among users in relation to road traffic accidents in Saudi Arabia. Objective: The proposed adaptations to the agenda-setting model to be explored reflect two levels of engagement: agenda setting within the social media sphere and the position of social media within classic agenda setting. This exploratory research aims to assess the veracity of the proposed adaptations on the basis of the hypotheses developed to test these two levels of engagement. Methods: To validate the hypotheses, we collected and analyzed data from two primary sources: Twitter activities and Saudi national newspapers. Keyword mentions served as indicators of agenda promotion; for Twitter, interactions were used to measure the process of agenda setting within the platform. The Twitter final dataset comprised 59,046 tweets and 38,066 users who contributed by tweeting, replying, or retweeting. Variables were collected for each tweet and user. In addition, 518 keyword mentions were recorded from six popular Saudi national newspapers. Results: The results showed significant ratification of the study hypotheses at both levels of engagement that framed the proposed adaptions. The results indicate that social media facilitates the contribution of individuals in influencing agendas (individual users accounted for 76.29\%, 67.79\%, and 96.16\% of retweet impressions, total impressions, and amplification multipliers, respectively), a component missing from traditional constructions of agenda-setting models. The influence of organizations on agenda setting is also highlighted (in the data of user interactions, organizational accounts registered 17\% and 14.74\% as source and target of interactions, respectively). In addition, 13 striking similarities showed the relationship between newspapers and Twitter on the mentions trends line. Conclusions: The effective use of social media platforms in health promotion intervention programs requires new strategies that consider the limitations of traditional communication channels. Conducting research is vital to establishing a strong basis for modifying, designing, and developing new health promotion strategies and approaches. ",
doi="10.2196/publichealth.5014",
url="http://publichealth.jmir.org/2015/2/e21/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27227139"
}


@Article{info:doi/10.2196/jmir.4161,
author="Benetoli, Arcelio
and Chen, F. Timothy
and Spagnardi, Sarah
and Beer, Troy
and Aslani, Parisa",
title="Provision of a Medicines Information Service to Consumers on Facebook: An Australian Case Study",
journal="J Med Internet Res",
year="2015",
month="Nov",
day="23",
volume="17",
number="11",
pages="e265",
keywords="medicines information",
keywords="Facebook",
keywords="pharmacists",
keywords="consumers",
keywords="information services",
keywords="drug information services",
keywords="social media",
abstract="Background: Social networking sites (SNSs) have changed the way people communicate. They may also change the way people seek health advice. Objective: This study describes the provision of a medicines information service on Facebook to individual consumers. It aimed to discuss the pros and cons, and inform health and pharmacy stakeholders and researchers about the opportunities and challenges of providing such a service. Methods: We adopted an exploratory approach using a case study method. Results: NPS MedicineWise, an independent, not-for-profit Australian organization, runs a public question-and-answer service on Facebook, dubbed Pharmacist Hour. Consumers following the organization's Facebook page are invited to post medication-related questions often with a suggested health topic. A wide range of questions and comments are posted related to medication usage. The pharmacist answers the queries, providing evidence-based medicines information and using consumer-friendly language, during the specific 1-hour period. The most popular questions in the past 12 months were related to adverse effects, treatment options for conditions, and drug interactions. The service had a mean number of engagements (defined as a like or share of the Pharmacy Hour post) of 38 (SD 19) people and a mean 5 (SD 3) questions per session. Conclusions: The Pharmacist Hour Facebook service addresses the medicines information needs of consumers and indirectly promotes other appropriate and relevant NPS MedicineWise products and services to further assist consumers. The service offers a new medium for a quality use of medicines organization committed to promoting awareness about the correct and safe use of medicines in Australia. ",
doi="10.2196/jmir.4161",
url="http://www.jmir.org/2015/11/e265/",
url="http://www.ncbi.nlm.nih.gov/pubmed/26596328"
}


@Article{info:doi/10.2196/jmir.5007,
author="Oksanen, Atte
and Garcia, David
and Sirola, Anu
and N{\"a}si, Matti
and Kaakinen, Markus
and Keipi, Teo
and R{\"a}s{\"a}nen, Pekka",
title="Pro-Anorexia and Anti-Pro-Anorexia Videos on YouTube: Sentiment Analysis of User Responses",
journal="J Med Internet Res",
year="2015",
month="Nov",
day="12",
volume="17",
number="11",
pages="e256",
keywords="eating disorders",
keywords="anorexia",
keywords="social media",
keywords="emotions",
abstract="Background: Pro-anorexia communities exist online and encourage harmful weight loss and weight control practices, often through emotional content that enforces social ties within these communities. User-generated responses to videos that directly oppose pro-anorexia communities have not yet been researched in depth. Objective: The aim was to study emotional reactions to pro-anorexia and anti-pro-anorexia online content on YouTube using sentiment analysis. Methods: Using the 50 most popular YouTube pro-anorexia and anti-pro-anorexia user channels as a starting point, we gathered data on users, their videos, and their commentators. A total of 395 anorexia videos and 12,161 comments were analyzed using positive and negative sentiments and ratings submitted by the viewers of the videos. The emotional information was automatically extracted with an automatic sentiment detection tool whose reliability was tested with human coders. Ordinary least squares regression models were used to estimate the strength of sentiments. The models controlled for the number of video views and comments, number of months the video had been on YouTube, duration of the video, uploader's activity as a video commentator, and uploader's physical location by country. Results: The 395 videos had more than 6 million views and comments by almost 8000 users. Anti-pro-anorexia video comments expressed more positive sentiments on a scale of 1 to 5 (adjusted prediction [AP] 2.15, 95\% CI 2.11-2.19) than did those of pro-anorexia videos (AP 2.02, 95\% CI 1.98-2.06). Anti-pro-anorexia videos also received more likes (AP 181.02, 95\% CI 155.19-206.85) than pro-anorexia videos (AP 31.22, 95\% CI 31.22-37.81). Negative sentiments and video dislikes were equally distributed in responses to both pro-anorexia and anti-pro-anorexia videos. Conclusions: Despite pro-anorexia content being widespread on YouTube, videos promoting help for anorexia and opposing the pro-anorexia community were more popular, gaining more positive feedback and comments than pro-anorexia videos. Thus, the anti-pro-anorexia content provided a user-generated counterforce against pro-anorexia content on YouTube. Professionals working with young people should be aware of the social media dynamics and versatility of user-generated eating disorder content online. ",
doi="10.2196/jmir.5007",
url="http://www.jmir.org/2015/11/e256/",
url="http://www.ncbi.nlm.nih.gov/pubmed/26563678"
}


@Article{info:doi/10.2196/jmir.4575,
author="Thrul, Johannes
and Klein, B. Alexandra
and Ramo, E. Danielle",
title="Smoking Cessation Intervention on Facebook: Which Content Generates the Best Engagement?",
journal="J Med Internet Res",
year="2015",
month="Nov",
day="11",
volume="17",
number="11",
pages="e244",
keywords="young adults",
keywords="smoking cessation",
keywords="Facebook",
keywords="engagement",
keywords="Transtheoretical Model",
abstract="Background: Social media offer a great opportunity to deliver smoking cessation treatment to young adults, but previous online and social media interventions targeting health behavior change have struggled with low participant engagement. We examined engagement generated by content based on the Transtheoretical Model of Behavior Change (TTM) in a motivationally tailored smoking cessation intervention on Facebook. Objective: This study aimed to identify which intervention content based on the TTM (Decisional Balance and 10 processes of change) generated the highest engagement among participants in pre-action stages of change (Precontemplation, Contemplation, and Preparation). Methods: Participants (N=79, 20\% female, mean age 20.8) were assessed for readiness to quit smoking and assigned to one of 7 secret Facebook groups tailored to their stage of change. Daily postings to the groups based on TTM Decisional Balance and the 10 processes of change were made by research staff over 3 months. Engagement was operationalized as the number of participant comments to each post. TTM content-based predictors of number of comments were analyzed and stratified by baseline stage of change, using negative binomial regression analyses with and without zero inflation. Results: A total of 512 TTM-based posts generated 630 individual comments. In Precontemplation and Contemplation groups, Decisional Balance posts generated above average engagement (P=.01 and P<.001). In Contemplation groups, posts based on the TTM processes Dramatic Relief and Self-Liberation resulted in below average engagement (P=.01 and P=.005). In Preparation groups, posts based on Consciousness Raising generated above average engagement (P=.009). Participant engagement decreased over time and differed between groups within Precontemplation and Contemplation stages, but was independent of day of the week and time of day the content was posted to the groups. No participant baseline characteristics significantly predicted engagement. Conclusions: Participants not ready to quit in the next 30 days (in Precontemplation or Contemplation) engaged most when prompted to think about the pros and cons of behavior change, while those in the Preparation stage engaged most when posts increased awareness about smoking and smoking cessation. Findings support tailoring intervention content to readiness to quit and suggest intervention components that may be most effective in generating high participant engagement on social media. ",
doi="10.2196/jmir.4575",
url="http://www.jmir.org/2015/11/e244/",
url="http://www.ncbi.nlm.nih.gov/pubmed/26561529"
}


@Article{info:doi/10.2196/jmir.4466,
author="Kim, E. Annice
and Hopper, Timothy
and Simpson, Sean
and Nonnemaker, James
and Lieberman, J. Alicea
and Hansen, Heather
and Guillory, Jamie
and Porter, Lauren",
title="Using Twitter Data to Gain Insights into E-cigarette Marketing and Locations of Use: An Infoveillance Study",
journal="J Med Internet Res",
year="2015",
month="Nov",
day="06",
volume="17",
number="11",
pages="e251",
keywords="electronic cigarettes",
keywords="social media",
keywords="tobacco",
keywords="marketing",
keywords="natural language processing",
abstract="Background: Marketing and use of electronic cigarettes (e-cigarettes) and other electronic nicotine delivery devices have increased exponentially in recent years fueled, in part, by marketing and word-of-mouth communications via social media platforms, such as Twitter. Objective: This study examines Twitter posts about e-cigarettes between 2008 and 2013 to gain insights into (1) marketing trends for selling and promoting e-cigarettes and (2) locations where people use e-cigarettes. Methods: We used keywords to gather tweets about e-cigarettes between July 1, 2008 and February 28, 2013. A randomly selected subset of tweets was manually coded as advertising (eg, marketing, advertising, sales, promotion) or nonadvertising (eg, individual users, consumers), and classification algorithms were trained to code the remaining data into these 2 categories. A combination of manual coding and natural language processing methods was used to indicate locations where people used e-cigarettes. Additional metadata were used to generate insights about users who tweeted most frequently about e-cigarettes. Results: We identified approximately 1.7 million tweets about e-cigarettes between 2008 and 2013, with the majority of these tweets being advertising (93.43\%, 1,559,508/1,669,123). Tweets about e-cigarettes increased more than tenfold between 2009 and 2010, suggesting a rapid increase in the popularity of e-cigarettes and marketing efforts. The Twitter handles tweeting most frequently about e-cigarettes were a mixture of e-cigarette brands, affiliate marketers, and resellers of e-cigarette products. Of the 471 e-cigarette tweets mentioning a specific place, most mentioned e-cigarette use in class (39.1\%, 184/471) followed by home/room/bed (12.5\%, 59/471), school (12.1\%, 57/471), in public (8.7\%, 41/471), the bathroom (5.7\%, 27/471), and at work (4.5\%, 21/471). Conclusions: Twitter is being used to promote e-cigarettes by different types of entities and the online marketplace is more diverse than offline product offerings and advertising strategies. E-cigarettes are also being used in public places, such as schools, underscoring the need for education and enforcement of policies banning e-cigarette use in public places. Twitter data can provide new insights on e-cigarettes to help inform future research, regulations, surveillance, and enforcement efforts. ",
doi="10.2196/jmir.4466",
url="http://www.jmir.org/2015/11/e251/",
url="http://www.ncbi.nlm.nih.gov/pubmed/26545927"
}


@Article{info:doi/10.2196/jmir.4387,
author="Taggart, Tamara
and Grewe, Elisabeth Mary
and Conserve, F. Donaldson
and Gliwa, Catherine
and Roman Isler, Malika",
title="Social Media and HIV: A Systematic Review of Uses of Social Media in HIV Communication",
journal="J Med Internet Res",
year="2015",
month="Nov",
day="02",
volume="17",
number="11",
pages="e248",
keywords="HIV",
keywords="social media",
keywords="communication",
abstract="Background: Social media, including mobile technologies and social networking sites, are being used increasingly as part of human immunodeficiency virus (HIV) prevention and treatment efforts. As an important avenue for communication about HIV, social media use may continue to increase and become more widespread. Objective: The objective of this paper is to present a comprehensive systematic review of the current published literature on the design, users, benefits, and limitations of using social media to communicate about HIV prevention and treatment. Methods: This review paper used a systematic approach to survey all literature published before February 2014 using 7 electronic databases and a manual search. The inclusion criteria were (1) primary focus on communication/interaction about HIV/acquired immunodeficiency syndrome (AIDS), (2) discusses the use of social media to facilitate communication, (3) communication on the social media platform is between individuals or a group of individuals rather than the use of preset, automated responses from a platform, (4) published before February 19, 2014, and (5) all study designs. Results: The search identified 35 original research studies. Thirty studies had low or unclear risk of at least one of the bias items in the methodological quality assessment. Among the 8 social media platform types described, short message service text messaging was most commonly used. Platforms served multiple purposes including disseminating health information, conducting health promotion, sharing experiences, providing social support, and promoting medication adherence. Social media users were diverse in geographic location and race/ethnicity; studies commonly reported users aged 18-40 years and users with lower income. Although most studies did not specify whether use was anonymous, studies reported the importance of anonymity in social media use to communicate about HIV largely due to the stigma associated with HIV. The ability to share and receive information about HIV was the most commonly reported benefit of social media use and the most common challenges were related to technology. Measures of frequency of use, satisfaction, and effects of use varied across studies. Conclusions: Using social media to bridge communication among a diverse range of users, in various geographic and social contexts, may be leveraged through pre-existing platforms and with attention to the roles of anonymity and confidentiality in communication about HIV prevention and treatment. More robust research is needed to determine the effects of social media use on various health and social outcomes related to HIV. ",
doi="10.2196/jmir.4387",
url="http://www.jmir.org/2015/11/e248/",
url="http://www.ncbi.nlm.nih.gov/pubmed/26525289"
}


@Article{info:doi/10.2196/jmir.4898,
author="Alnemer, A. Khalid
and Alhuzaim, M. Waleed
and Alnemer, A. Ahmed
and Alharbi, B. Bader
and Bawazir, S. Abdulrahman
and Barayyan, R. Omar
and Balaraj, K. Faisal",
title="Are Health-Related Tweets Evidence Based? Review and Analysis of Health-Related Tweets on Twitter",
journal="J Med Internet Res",
year="2015",
month="Oct",
day="29",
volume="17",
number="10",
pages="e246",
keywords="health",
keywords="diseases",
keywords="daily medical information",
keywords="medical accounts",
keywords="health accounts",
keywords="doctor accounts",
keywords="nutrition accounts",
abstract="Background: Health care professionals are utilizing Twitter to communicate, develop disease surveillance systems, and mine health-related information. The immediate users of this health information is the general public, including patients. This necessitates the validation of health-related tweets by health care professionals to ensure they are evidence based and to avoid the use of noncredible information as a basis for critical decisions. Objective: The aim of this study was to evaluate health-related tweets on Twitter for validity (evidence based) and to create awareness in the community regarding the importance of evidence-based health-related tweets. Methods: All tweets containing health-related information in the Arabic language posted April 1-5, 2015, were mined from Twitter. The tweets were classified based on popularity, activity, interaction, and frequency to obtain 25 Twitter accounts (8 physician accounts, 10 nonofficial health institute accounts, 4 dietitian accounts, and 3 government institute accounts) and 625 tweets. These tweets were evaluated by 3 American Board--certified medical consultants and a score was generated (true/false) and interobserver agreement was calculated. Results: A total of 625 health-related Arabic-language tweets were identified from 8 physician accounts, 10 nonofficial health institute accounts, 4 dietician accounts, and 3 government institute accounts. The reviewers labeled 320 (51.2\%) tweets as false and 305 (48.8\%) tweets as true. Comparative analysis of tweets by account type showed 60 of 75 (80\%) tweets by government institutes, 124 of 201 (61.7\%) tweets by physicians, and 42 of 101 (41.6\%) tweets by dieticians were true. The interobserver agreement was moderate (range 0.78-0.22). More than half of the health-related tweets (169/248, 68.1\%) from nonofficial health institutes and dietician accounts (59/101, 58.4\%) were false. Tweets by the physicians were more likely to be rated ``true'' compared to other groups (P<.001). Conclusions: Approximately half of the medical tweets from professional accounts on Twitter were found to be false based on expert review. Furthermore, most of the evidence-based health-related tweets are posted by government institutes and physicians. ",
doi="10.2196/jmir.4898",
url="http://www.jmir.org/2015/10/e246/",
url="http://www.ncbi.nlm.nih.gov/pubmed/26515535"
}


@Article{info:doi/10.2196/mededu.5063,
author="Pinilla, Severin
and Nicolai, Leo
and Gradel, Maximilian
and Pander, Tanja
and Fischer, R. Martin
and von der Borch, Philip
and Dimitriadis, Konstantinos",
title="Undergraduate Medical Students Using Facebook as a Peer-Mentoring Platform: A Mixed-Methods Study",
journal="JMIR Medical Education",
year="2015",
month="Oct",
day="27",
volume="1",
number="2",
pages="e12",
keywords="medical education",
keywords="peer mentoring",
keywords="social media",
keywords="Facebook",
abstract="Background: Peer mentoring is a powerful pedagogical approach for supporting undergraduate medical students in their learning environment. However, it remains unclear what exactly peer mentoring is and whether and how undergraduate medical students use social media for peer-mentoring activities. Objective: We aimed at describing and exploring the Facebook use of undergraduate medical students during their first 2 years at a German medical school. The data should help medical educators to effectively integrate social media in formal mentoring programs for medical students. Methods: We developed a coding scheme for peer mentoring and conducted a mixed-methods study in order to explore Facebook groups of undergraduate medical students from a peer-mentoring perspective. Results: All major peer-mentoring categories were identified in Facebook groups of medical students. The relevance of these Facebook groups was confirmed through triangulation with focus groups and descriptive statistics. Medical students made extensive use of Facebook and wrote a total of 11,853 posts and comments in the respective Facebook groups (n=2362 total group members). Posting peaks were identified at the beginning of semesters and before exam periods, reflecting the formal curriculum milestones. Conclusions: Peer mentoring is present in Facebook groups formed by undergraduate medical students who extensively use these groups to seek advice from peers on study-related issues and, in particular, exam preparation. These groups also seem to be effective in supporting responsive and large-scale peer-mentoring structures; formal mentoring programs might benefit from integrating social media into their activity portfolio. ",
doi="10.2196/mededu.5063",
url="http://mededu.jmir.org/2015/2/e12/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27731859"
}


@Article{info:doi/10.2196/jmir.4969,
author="Cole-Lewis, Heather
and Pugatch, Jillian
and Sanders, Amy
and Varghese, Arun
and Posada, Susana
and Yun, Christopher
and Schwarz, Mary
and Augustson, Erik",
title="Social Listening: A Content Analysis of E-Cigarette Discussions on Twitter",
journal="J Med Internet Res",
year="2015",
month="Oct",
day="27",
volume="17",
number="10",
pages="e243",
keywords="social media",
keywords="Twitter",
keywords="e-cigarettes",
keywords="content analysis",
abstract="Background: Electronic cigarette (e-cigarette) use has increased in the United States, leading to active debate in the public health sphere regarding e-cigarette use and regulation. To better understand trends in e-cigarette attitudes and behaviors, public health and communication professionals can turn to the dialogue taking place on popular social media platforms such as Twitter. Objective: The objective of this study was to conduct a content analysis to identify key conversation trends and patterns over time using historical Twitter data. Methods: A 5-category content analysis was conducted on a random sample of tweets chosen from all publicly available tweets sent between May 1, 2013, and April 30, 2014, that matched strategic keywords related to e-cigarettes. Relevant tweets were isolated from the random sample of approximately 10,000 tweets and classified according to sentiment, user description, genre, and theme. Descriptive analyses including univariate and bivariate associations, as well as correlation analyses were performed on all categories in order to identify patterns and trends. Results: The analysis revealed an increase in e-cigarette--related tweets from May 2013 through April 2014, with tweets generally being positive; 71\% of the sample tweets were classified as having a positive sentiment. The top two user categories were everyday people (65\%) and individuals who are part of the e-cigarette community movement (16\%). These two user groups were responsible for a majority of informational (79\%) and news tweets (75\%), compared to reputable news sources and foundations or organizations, which combined provided 5\% of informational tweets and 12\% of news tweets. Personal opinion (28\%), marketing (21\%), and first person e-cigarette use or intent (20\%) were the three most common genres of tweets, which tended to have a positive sentiment. Marketing was the most common theme (26\%), and policy and government was the second most common theme (20\%), with 86\% of these tweets coming from everyday people and the e-cigarette community movement combined, compared to 5\% of policy and government tweets coming from government, reputable news sources, and foundations or organizations combined. Conclusions: Everyday people and the e-cigarette community are dominant forces across several genres and themes, warranting continued monitoring to understand trends and their implications regarding public opinion, e-cigarette use, and smoking cessation. Analyzing social media trends is a meaningful way to inform public health practitioners of current sentiments regarding e-cigarettes, and this study contributes a replicable methodology. ",
doi="10.2196/jmir.4969",
url="http://www.jmir.org/2015/10/e243/",
url="http://www.ncbi.nlm.nih.gov/pubmed/26508089"
}


@Article{info:doi/10.2196/jmir.4763,
author="Maloney, Stephen
and Tunnecliff, Jacqueline
and Morgan, Prue
and Gaida, E. Jamie
and Clearihan, Lyn
and Sadasivan, Sivalal
and Davies, David
and Ganesh, Shankar
and Mohanty, Patitapaban
and Weiner, John
and Reynolds, John
and Ilic, Dragan",
title="Translating Evidence Into Practice via Social Media: A Mixed-Methods Study",
journal="J Med Internet Res",
year="2015",
month="Oct",
day="26",
volume="17",
number="10",
pages="e242",
keywords="social media",
keywords="medical informatics",
keywords="evidence-based practice",
keywords="e-learning",
abstract="Background: Approximately 80\% of research evidence relevant to clinical practice never reaches the clinicians delivering patient care. A key barrier for the translation of evidence into practice is the limited time and skills clinicians have to find and appraise emerging evidence.  Social media may provide a bridge between health researchers and health service providers. Objective: The aim of this study was to determine the efficacy of social media as an educational medium to effectively translate emerging research evidence into clinical practice. Methods: The study used a mixed-methods approach. Evidence-based practice points were delivered via social media platforms. The primary outcomes of attitude, knowledge, and behavior change were assessed using a preintervention/postintervention evaluation, with qualitative data gathered to contextualize the findings. Results: Data were obtained from 317 clinicians from multiple health disciplines, predominantly from the United Kingdom, Australia, the United States, India, and Malaysia. The participants reported an overall improvement in attitudes toward social media for professional development (P<.001). The knowledge evaluation demonstrated a significant increase in knowledge after the training (P<.001).  The majority of respondents (136/194, 70.1\%) indicated that the education they had received via social media had changed the way they practice, or intended to practice. Similarly, a large proportion of respondents (135/193, 69.9\%) indicated that the education they had received via social media had increased their use of research evidence within their clinical practice. Conclusions: Social media may be an effective educational medium for improving knowledge of health professionals, fostering their use of research evidence, and changing their clinical behaviors by translating new research evidence into clinical practice. ",
doi="10.2196/jmir.4763",
url="http://www.jmir.org/2015/10/e242/",
url="http://www.ncbi.nlm.nih.gov/pubmed/26503129"
}


@Article{info:doi/10.2196/resprot.4864,
author="Pagoto, L. Sherry
and Waring, E. Molly
and Schneider, L. Kristin
and Oleski, L. Jessica
and Olendzki, Effie
and Hayes, B. Rashelle
and Appelhans, M. Bradley
and Whited, C. Matthew
and Busch, M. Andrew
and Lemon, C. Stephenie",
title="Twitter-Delivered Behavioral Weight-Loss Interventions: A Pilot Series",
journal="JMIR Res Protoc",
year="2015",
month="Oct",
day="23",
volume="4",
number="4",
pages="e123",
keywords="social networks",
keywords="Twitter",
keywords="obesity",
keywords="weight loss",
keywords="online social networking",
keywords="peer-to-peer health care",
keywords="digital health",
abstract="Background: Lifestyle interventions are efficacious at reducing risk for diabetes and cardiovascular disease but have not had a significant public health impact given high cost and patient and provider burden. Objective: Online social networks may reduce the burden of lifestyle interventions to the extent that they displace in-person visits and may enhance opportunities for social support for weight loss. Methods: We conducted an iterative series of pilot studies to evaluate the feasibility and acceptability of using online social networks to deliver a lifestyle intervention. Results: In Study 1 (n=10), obese participants with depression received lifestyle counseling via 12 weekly group visits and a private group formed using the online social network, Twitter. Mean weight loss was 2.3 pounds (SD 7.7; range -19.2 to 8.2) or 1.2\% (SD 3.6) of baseline weight. A total of 67\% (6/9) of participants completing exit interviews found the support of the Twitter group at least somewhat useful. In Study 2 (n=11), participants were not depressed and were required to be regular users of social media. Participants lost, on average, 5.6 pounds (SD 6.3; range -15 to 0) or 3.0\% (SD 3.4) of baseline weight, and 100\% (9/9) completing exit interviews found the support of the Twitter group at least somewhat useful. To explore the feasibility of eliminating in-person visits, in Study 3 (n=12), we delivered a 12-week lifestyle intervention almost entirely via Twitter by limiting the number of group visits to one, while using the same inclusion criteria as that used in Study 2. Participants lost, on average, 5.4 pounds (SD 6.4; range -14.2 to 3.9) or 3.0\% (SD 3.1) of baseline weight, and 90\% (9/10) completing exit interviews found the support of the Twitter group at least somewhat useful. Findings revealed that a private Twitter weight-loss group was both feasible and acceptable for many patients, particularly among regular users of social media. Conclusions: Future research should evaluate the efficacy and cost-effectiveness of online social network-delivered lifestyle interventions relative to traditional modalities. ",
doi="10.2196/resprot.4864",
url="http://www.researchprotocols.org/2015/4/e123/",
url="http://www.ncbi.nlm.nih.gov/pubmed/26500186"
}


@Article{info:doi/10.2196/jmir.4829,
author="Cheung, Derek Yee Tak
and Chan, Helen Ching Han
and Lai, Jonah Chi-Keung
and Chan, Vivian Wai Fung
and Wang, Ping Man
and Li, William Ho Cheung
and Chan, Chee Sophia Siu
and Lam, Tai-Hing",
title="Using WhatsApp and Facebook Online Social Groups for Smoking Relapse Prevention for Recent Quitters: A Pilot Pragmatic Cluster Randomized Controlled Trial",
journal="J Med Internet Res",
year="2015",
month="Oct",
day="22",
volume="17",
number="10",
pages="e238",
keywords="social networking",
keywords="social media",
keywords="smoking cessation",
keywords="relapse prevention",
abstract="Background: Quit attempters often have episodes of smoking relapse before they eventually quit. Interactive text messaging through mobile phones has been shown to increase abstinence. This service can be potentially applied on the platform of a social networking service to help quitters maintain abstinence. Objective: Our aim was to determine if the group discussion and reminders via the WhatsApp or Facebook social group were effective to prevent smoking relapse in quitters who had stopped smoking recently. Methods: This was a single-blinded, parallel, 3-arm pilot cluster randomized controlled trial allocating recent quitters, who had completed an 8-week treatment and reported abstinence for at least 7 days, to WhatsApp (n=42), Facebook (n=40), and a control group (n=54). The 2 intervention groups participated in a 2-month online group discussion with either WhatsApp or Facebook moderated by a trained smoking cessation counselor and received a self-help booklet on smoking cessation. The control group only received the booklet. The primary outcome was the 2- and 6-month relapse rates, defined as the proportion of participants who smoked at least 5 cigarettes in 3 consecutive days. Results: Fewer participants in the WhatsApp group (17\%, 7/42) reported relapse than the control group (42.6\%, 23/54) at 2-month (OR 0.27, 95\% CI 0.10-0.71) and 6-month (40.5\%, 17/42 vs 61.1\%, 33/54; OR 0.43, 95\% CI 0.19-0.99) follow-ups. The Facebook group (30.0\%, 12/40) had an insignificantly lower relapse rate than the control group (42.6\%, 23/54) at 2-month (OR 0.58, 95\% CI 0.24-1.37) and 6-month (52.5\%, 13/40 vs 61.1\%, 33/54; OR 0.70, 95\% CI 0.31-1.61) follow-ups. The WhatsApp social groups had more moderators' posts (median 60, IQR 25 vs median 32, IQR 7; P=.05) and participants' posts (median 35, IQR 50 vs median 6, IQR 9; P=.07) than their Facebook counterparts, but the difference was insignificant. Conclusions: The intervention via the WhatsApp social group was effective in reducing relapse probably because of enhanced discussion and social support. Inactive discussion in the Facebook social group might have attributed to the lower effectiveness. ClinicalTrial: Clinicaltrials.gov NCT02007369; https://clinicaltrials.gov/show/NCT02007369 (Archived by WebCite? at http://www.webcitation.org/6c3RbltQG) ",
doi="10.2196/jmir.4829",
url="http://www.jmir.org/2015/10/e238/",
url="http://www.ncbi.nlm.nih.gov/pubmed/26494159"
}


@Article{info:doi/10.2196/jmir.3891,
author="Zowawi, Mamoon Hosam
and Abedalthagafi, Malak
and Mar, A. Florie
and Almalki, Turki
and Kutbi, H. Abdullah
and Harris-Brown, Tiffany
and Harbarth, Stephan
and Balkhy, H. Hanan
and Paterson, L. David
and Hasanain, Abdalazez Rihab",
title="The Potential Role of Social Media Platforms in Community Awareness of Antibiotic Use in the Gulf Cooperation Council States: Luxury or Necessity?",
journal="J Med Internet Res",
year="2015",
month="Oct",
day="15",
volume="17",
number="10",
pages="e233",
keywords="social media",
keywords="antibiotics",
keywords="awareness",
keywords="health campaigns",
keywords="Gulf States",
doi="10.2196/jmir.3891",
url="http://www.jmir.org/2015/10/e233/",
url="http://www.ncbi.nlm.nih.gov/pubmed/26471079"
}


@Article{info:doi/10.2196/games.4002,
author="Dagan, Noa
and Beskin, Daniel
and Brezis, Mayer
and Reis, Y. Ben",
title="Effects of Social Network Exposure on Nutritional Learning: Development of an Online Educational Platform",
journal="JMIR Serious Games",
year="2015",
month="Oct",
day="05",
volume="3",
number="2",
pages="e7",
keywords="nutrition requirements",
keywords="obesity",
keywords="public health",
keywords="social networking sites",
abstract="Background: Social networking sites (SNSs) such as Facebook have the potential to enhance online public health interventions, in part, as they provide social exposure and reinforcement. Objective: The objective of the study was to evaluate whether social exposure provided by SNSs enhances the effects of online public health interventions. Methods: As a sample intervention, we developed Food Hero, an online platform for nutritional education in which players feed a virtual character according to their own nutritional needs and complete a set of virtual sport challenges. The platform was developed in 2 versions: a ``private version'' in which a user can see only his or her own score, and a ``social version'' in which a user can see other players' scores, including preexisting Facebook friends. We assessed changes in participants' nutritional knowledge using 4 quiz scores and 3 menu-assembly scores. Monitoring feeding and exercising attempts assessed engagement with the platform. Results: The 2 versions of the platform were randomly assigned between a study group (30 members receiving the social version) and a control group (33 members, private version). The study group's performance on the quizzes gradually increased over time, relative to that of the control group, becoming significantly higher by the fourth quiz (P=.02). Furthermore, the study group's menu-assembly scores improved over time compared to the first score, whereas the control group's performance deteriorated. Study group members spent an average of 3:40 minutes assembling each menu compared to 2:50 minutes in the control group, and performed an average of 1.58 daily sport challenges, compared to 1.21 in the control group (P=.03). Conclusions: This work focused on isolating the SNSs' social effects in order to help guide future online interventions. Our results indicate that the social exposure provided by SNSs is associated with increased engagement and learning in an online nutritional educational platform. ",
doi="10.2196/games.4002",
url="http://games.jmir.org/2015/2/e7/",
url="http://www.ncbi.nlm.nih.gov/pubmed/26441466"
}


@Article{info:doi/10.2196/mhealth.4374,
author="Landry, Megan
and Vyas, Amita
and Turner, Monique
and Glick, Sara
and Wood, Susan",
title="Evaluation of Social Media Utilization by Latino Adolescents: Implications for Mobile Health Interventions",
journal="JMIR mHealth uHealth",
year="2015",
month="Sep",
day="29",
volume="3",
number="3",
pages="e89",
keywords="acculturation",
keywords="Latino/a",
keywords="sex",
keywords="short message service",
keywords="social networking",
abstract="Background: Trends in social media use, including sending/receiving short message service (SMS) and social networking, are constantly changing, yet little is known about adolescent's utilization and behaviors. This longitudinal study examines social media utilization among Latino youths, and differences by sex and acculturation. Objectives: The purpose of this study was to examine Latino adolescents' social media utilization and behavior over a 16-month period, and to assess whether changes in use differed by sex and acculturation. Methods: This study included 555 Latino youths aged 13-19 who completed baseline and 16-month follow-up surveys. Prevalence of social media utilization and frequency, by sex and acculturation categories, was examined using generalized estimating equations. Results: Women are more likely to use SMS, but men are significantly more likely to SMS a girl/boyfriend (P=.03). The use of Internet by men and women to research health information increased over time. Facebook use declined over time (P<.001), whereas use of YouTube (P=.03) and Instagram (P<.001) increased, especially among women and more US acculturated youths. Conclusion: Social media is ubiquitous in Latino adolescents' lives and may be a powerful mode for public health intervention delivery. ",
doi="10.2196/mhealth.4374",
url="http://mhealth.jmir.org/2015/3/e89/",
url="http://www.ncbi.nlm.nih.gov/pubmed/26420553"
}


@Article{info:doi/10.2196/jmir.4943,
author="Alber, M. Julia
and Bernhardt, M. Jay
and Stellefson, Michael
and Weiler, M. Robert
and Anderson-Lewis, Charkarra
and Miller, David M.
and MacInnes, Jann",
title="Designing and Testing an Inventory for Measuring Social Media Competency of Certified Health Education Specialists",
journal="J Med Internet Res",
year="2015",
month="Sep",
day="23",
volume="17",
number="9",
pages="e221",
keywords="social media",
keywords="health education",
keywords="professional competence",
abstract="Background: Social media can promote healthy behaviors by facilitating engagement and collaboration among health professionals and the public. Thus, social media is quickly becoming a vital tool for health promotion. While guidelines and trainings exist for public health professionals, there are currently no standardized measures to assess individual social media competency among Certified Health Education Specialists (CHES) and Master Certified Health Education Specialists (MCHES). Objective: The aim of this study was to design, develop, and test the Social Media Competency Inventory (SMCI) for CHES and MCHES. Methods: The SMCI was designed in three sequential phases: (1) Conceptualization and Domain Specifications, (2) Item Development, and (3) Inventory Testing and Finalization. Phase 1 consisted of a literature review, concept operationalization, and expert reviews. Phase 2 involved an expert panel (n=4) review, think-aloud sessions with a small representative sample of CHES/MCHES (n=10), a pilot test (n=36), and classical test theory analyses to develop the initial version of the SMCI. Phase 3 included a field test of the SMCI with a random sample of CHES and MCHES (n=353), factor and Rasch analyses, and development of SMCI administration and interpretation guidelines. Results: Six constructs adapted from the unified theory of acceptance and use of technology and the integrated behavioral model were identified for assessing social media competency: (1) Social Media Self-Efficacy, (2) Social Media Experience, (3) Effort Expectancy, (4) Performance Expectancy, (5) Facilitating Conditions, and (6) Social Influence. The initial item pool included 148 items. After the pilot test, 16 items were removed or revised because of low item discrimination (r<.30), high interitem correlations ($\Rho$>.90), or based on feedback received from pilot participants.  During the psychometric analysis of the field test data, 52 items were removed due to low discrimination, evidence of content redundancy, low R-squared value, or poor item infit or outfit. Psychometric analyses of the data revealed acceptable reliability evidence for the following scales: Social Media Self-Efficacy (alpha=.98, item reliability=.98, item separation=6.76), Social Media Experience (alpha=.98, item reliability=.98, item separation=6.24), Effort Expectancy(alpha =.74, item reliability=.95, item separation=4.15), Performance Expectancy (alpha =.81, item reliability=.99, item separation=10.09), Facilitating Conditions (alpha =.66, item reliability=.99, item separation=16.04), and Social Influence (alpha =.66, item reliability=.93, item separation=3.77). There was some evidence of local dependence among the scales, with several observed residual correlations above |.20|. Conclusions: Through the multistage instrument-development process, sufficient reliability and validity evidence was collected in support of the purpose and intended use of the SMCI. The SMCI can be used to assess the readiness of health education specialists to effectively use social media for health promotion research and practice. Future research should explore associations across constructs within the SMCI and evaluate the ability of SMCI scores to predict social media use and performance among CHES and MCHES. ",
doi="10.2196/jmir.4943",
url="http://www.jmir.org/2015/9/e221/",
url="http://www.ncbi.nlm.nih.gov/pubmed/26399428"
}


@Article{info:doi/10.2196/jmir.4786,
author="Perera, Marlon
and Roberts, Matthew
and Lawrentschuk, Nathan
and Bolton, Damien",
title="Response to ``Twitter-Based Journal Clubs: Some Additional Facts and Clarifications''",
journal="J Med Internet Res",
year="2015",
month="Sep",
day="18",
volume="17",
number="9",
pages="e217",
doi="10.2196/jmir.4786",
url="http://www.jmir.org/2015/9/e217/",
url="http://www.ncbi.nlm.nih.gov/pubmed/26385506"
}


@Article{info:doi/10.2196/jmir.4639,
author="Topf, M. Joel
and Sparks, A. Matthew
and Iannuzzella, Francesco
and Lerma, Edgar
and Oates, Thomas
and Phelan, J. Paul
and Hiremath, Swapnil",
title="Twitter-Based Journal Clubs: Additional Facts and Clarifications",
journal="J Med Internet Res",
year="2015",
month="Sep",
day="16",
volume="17",
number="9",
pages="e216",
doi="10.2196/jmir.4639",
url="http://www.jmir.org/2015/9/e216/",
url="http://www.ncbi.nlm.nih.gov/pubmed/26376668"
}


@Article{info:doi/10.2196/publichealth.4777,
author="Chu, Kar-Hai
and Sidhu, K. Anupreet
and Valente, W. Thomas",
title="Electronic Cigarette Marketing Online: a Multi-Site, Multi-Product Comparison",
journal="JMIR Public Health Surveill",
year="2015",
month="Sep",
day="11",
volume="1",
number="2",
pages="e11",
keywords="electronic cigarettes",
keywords="content analysis",
keywords="social networking sites",
keywords="marketing",
abstract="Background: Electronic cigarette awareness and use has been increasing rapidly. E-cigarette brands have utilized social networking sites to promote their products, as the growth of the e-cigarette industry has paralleled that of Web 2.0. These online platforms are cost-effective and have unique technological features and user demographics that can be attractive for selective marketing. The popularity of multiple sites also poses a risk of exposure to social networks where e-cigarette brands might not have a presence. Objective: To examine the marketing strategies of leading e-cigarette brands on multiple social networking sites, and to identify how affordances of the digital media are used to their advantage. Secondary analyses include determining if any brands are benefitting from site demographics, and exploring cross-site diffusion of marketing content through multi-site users. Methods: We collected data from two e-cigarette brands from four social networking sites over approximately 2.5 years. Content analysis is used to search for themes, population targeting, marketing strategies, and cross-site spread of messages. Results: Twitter appeared to be the most frequently used social networking site for interacting directly with product users. Facebook supported informational broadcasts, such as announcements regarding political legislation. E-cigarette brands also differed in their approaches to their users, from informal conversations to direct product marketing. Conclusions: E-cigarette makers use different strategies to market their product and engage their users. There was no evidence of direct targeting of vulnerable populations, but the affordances of the different sites are exploited to best broadcast context-specific messages. We developed a viable method to study cross-site diffusion, although additional refinement is needed to account for how different types of digital media are used. ",
doi="10.2196/publichealth.4777",
url="http://publichealth.jmir.org/2015/2/e11/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27227129"
}


@Article{info:doi/10.2196/mededu.4908,
author="El Bialy, Safaa
and Jalali, Alireza",
title="Go Where the Students Are: A Comparison of the Use of Social Networking Sites Between Medical Students and Medical Educators",
journal="JMIR Medical Education",
year="2015",
month="Sep",
day="08",
volume="1",
number="2",
pages="e7",
keywords="social media",
keywords="e-learning",
keywords="innovations in medical education",
abstract="Background: Medical education has grown beyond the boundaries of the classroom, and social media is seen as the bridge between informal and formal learning as it keeps students highly engaged with educational content outside the classroom. Objective: The purpose of this study is to explore the perceptions of medical educators and medical students regarding the use of social media for educational purposes. Methods: Both groups (medical educators and students) were invited to take a survey. The surveys consisted of 29 questions, including Likert-style, multiple choice, yes/no, ranking, and short answer questions. The survey forms and statistics were built using Google Drive analytics with the free Spanning Stats module.To compare between professors and students, results were exported to a Microsoft Office Excel spreadsheet (Microsoft Corp, Redmond, WA). The study protocol was approved by The Ottawa Health Science Network Research Ethics Board (OHSN-REB:20140680-01H). Results: The overall response rate to the survey was 40.9\% (63/154) for students, and 36\% (72/200) for medical educators. The majority of educators (79\%, 57/72) and students (100.0\%, 63/63) had presence on social networking sites (SNSs). Only (33\% 19/57) of educators used SNSs with their students, the most used sites were Facebook (52\%, 10/19) and Twitter (47\%, 9/19), followed by LinkedIn (21\%, 4/19), Google+ (16\%, 3/19),YouTube (11\%, 2/19), and blogs (11\%, 2/19). Facebook (100\%, 63/63), YouTube (43\%, 27/63), Twitter (31\%, 20/63), and Instagram (30\%, 19/63) were the sites most commonly used by students. The educators used SNSs mainly to post opinions (86\%, 49/57), share videos (81\%, 46/57), chat (71\%, 41/57), engage in medical education (68\%, 40/57), take surveys (24\%, 14/57), and play games (5\%, 3/57). On the other hand, students used SNSs mainly to chat with friends (94\%, 59/63), for medical education purposes (67\%, 42/63), to share videos (62\%, 39/63), to post opinions (49\%, 31/63), to take surveys (11\%, 7/63), and to play games (6\%, 4/63). Most educators (67\%, 38/57) do not use social media in their education Although most of the educators (89\%, 17/19) and students (73\%, 46/63) found the use of social media time-effective, that it offered an inviting atmosphere (89\%, 17/19 and 70\%, 44/63), and that it enhanced the learning experience (95\%, 18/19 and 70\%, 44/63), both groups stated that they had colleagues who refused to use social media. The detractors' concerns included privacy issues (47\%, 18/38), time-wasting (34\%, 13/38), distraction (21\%, 8/38), and that these media might not be suitable for education (11\%, 4/38). When it came to using SNSs with the students, the educators most often used SNSs to post articles (42\%, 8/19), explanatory comments (31\%, 6/19), and videos (27\%, 5/19).While students preferred the following posts : Quizzes (87\% 55/63), revision files (82\% 52/63) and explanatory comments (29\% 21/63). Conclusions: Although social media continue to grow, some educators find that they do not offer suitable modes of learning. However, it is important to acknowledge that there are persistent differences in technology adoption and use along gender, racial, and socioeconomic lines; this is often referred to as the ``digital divide''. The current study shows that students prefer certain posts like quizzes and revision files, while educators are focused on posting videos, articles, and explanatory comments. Medical educators are encouraged to focus on the students in a way to minimize the gap between learners and educators. It will remain our responsibility as educators to focuson the student, use SNSs at their fullest, and integrate them into traditional Web-based management systems and into existingcurricula to best benefit the students. ",
doi="10.2196/mededu.4908",
url="http://mededu.jmir.org/2015/2/e7/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27731847"
}


@Article{info:doi/10.2196/jmir.4392,
author="Cole-Lewis, Heather
and Varghese, Arun
and Sanders, Amy
and Schwarz, Mary
and Pugatch, Jillian
and Augustson, Erik",
title="Assessing Electronic Cigarette-Related Tweets for Sentiment and Content Using Supervised Machine Learning",
journal="J Med Internet Res",
year="2015",
month="Aug",
day="25",
volume="17",
number="8",
pages="e208",
keywords="social media",
keywords="Twitter",
keywords="e-cigarette",
keywords="machine learning",
abstract="Background: Electronic cigarettes (e-cigarettes) continue to be a growing topic among social media users, especially on Twitter. The ability to analyze conversations about e-cigarettes in real-time can provide important insight into trends in the public's knowledge, attitudes, and beliefs surrounding e-cigarettes, and subsequently guide public health interventions. Objective: Our aim was to establish a supervised machine learning algorithm to build predictive classification models that assess Twitter data for a range of factors related to e-cigarettes. Methods: Manual content analysis was conducted for 17,098 tweets. These tweets were coded for five categories: e-cigarette relevance, sentiment, user description, genre, and theme. Machine learning classification models were then built for each of these five categories, and word groupings (n-grams) were used to define the feature space for each classifier. Results: Predictive performance scores for classification models indicated that the models correctly labeled the tweets with the appropriate variables between 68.40\% and 99.34\% of the time, and the percentage of maximum possible improvement over a random baseline that was achieved by the classification models ranged from 41.59\% to 80.62\%. Classifiers with the highest performance scores that also achieved the highest percentage of the maximum possible improvement over a random baseline were Policy/Government (performance: 0.94; \% improvement: 80.62\%), Relevance (performance: 0.94; \% improvement: 75.26\%), Ad or Promotion (performance: 0.89; \% improvement: 72.69\%), and Marketing (performance: 0.91; \% improvement: 72.56\%). The most appropriate word-grouping unit (n-gram) was 1 for the majority of classifiers. Performance continued to marginally increase with the size of the training dataset of manually annotated data, but eventually leveled off. Even at low dataset sizes of 4000 observations, performance characteristics were fairly sound. Conclusions: Social media outlets like Twitter can uncover real-time snapshots of personal sentiment, knowledge, attitudes, and behavior that are not as accessible, at this scale, through any other offline platform. Using the vast data available through social media presents an opportunity for social science and public health methodologies to utilize computational methodologies to enhance and extend research and practice. This study was successful in automating a complex five-category manual content analysis of e-cigarette-related content on Twitter using machine learning techniques. The study details machine learning model specifications that provided the best accuracy for data related to e-cigarettes, as well as a replicable methodology to allow extension of these methods to additional topics. ",
doi="10.2196/jmir.4392",
url="http://www.jmir.org/2015/8/e208/",
url="http://www.ncbi.nlm.nih.gov/pubmed/26307512"
}


@Article{info:doi/10.2196/jmir.4803,
author="Carrotte, R. Elise
and Vella, M. Alyce
and Lim, SC Megan",
title="Predictors of ``Liking'' Three Types of Health and Fitness-Related Content on Social Media: A Cross-Sectional Study",
journal="J Med Internet Res",
year="2015",
month="Aug",
day="21",
volume="17",
number="8",
pages="e205",
keywords="fitspiration",
keywords="social media",
keywords="blogging",
keywords="adolescent",
keywords="physical fitness",
keywords="eating disorders",
keywords="women's health",
abstract="Background: Adolescence and young adulthood are key periods for developing norms related to health behaviors and body image, and social media can influence these norms. Social media is saturated with content related to dieting, fitness, and health. Health and fitness--related social media content has received significant media attention for often containing objectifying and inaccurate health messages. Limited research has identified problematic features of such content, including stigmatizing language around weight, portraying guilt-related messages regarding food, and praising thinness. However, no research has identified who is ``liking'' or ``following'' (ie, consuming) such content. Objective: This exploratory study aimed to identify demographics, mental health, and substance use--related behaviors that predicted consuming 3 types of health and fitness--related social media content---weight loss/fitness motivation pages (ie, ``fitspiration''), detox/cleanse pages, and diet/fitness plan pages---among young social media users. Methods: Participants (N=1001; age: median 21.06, IQR 17.64-24.64; female: 723/1001, 72.23\%) completed a cross-sectional 112-question online survey aimed at social media users aged between 15-29 years residing in Victoria, Australia. Logistic regression was used to determine which characteristics predicted consuming the 3 types of health and fitness--related social media content. Results: A total of 378 (37.76\%) participants reported consuming at least 1 of the 3 types of health and fitness--related social media content: 308 (30.77\%) fitspiration pages, 145 (14.49\%) detox pages, and 235 (23.48\%) diet/fitness plan pages. Of the health and fitness--related social media content consumers, 85.7\% (324/378) identified as female and 44.8\% (324/723) of all female participants consumed at least 1 type of health and fitness--related social media content. Predictors of consuming at least one type of health and fitness--related social media content in univariable analysis included female gender (OR 3.5, 95\% CI 2.5-4.9, P<.001), being aged 15-17 years (OR 3.0, 95\% CI 2.2-4.0, P<.001), residing outside a major city (OR 2.0, 95\% CI 1.4-2.9, P<.001), having no post--high school education (OR 2.2, 95\% CI 1.7-2.9, P<.001), being born in Australia (OR 2.0, 95\% CI 1.2-3.2, P=.006), having a self-reported eating disorder (OR 2.4, 95\% CI 1.5-3.9, P<.001), being a victim of bullying (OR 1.7, CI 1.3-2.3, P<.001), misusing detox/laxative teas or diet pills (OR 4.6, 95\% CI 2.8-7.6, P<.001), never using illegal drugs (OR 1.6, 95\% CI 1.2-2.0, P=.001), and not engaging in risky single occasion drinking on a weekly basis (OR 2.0, 95\% CI 1.3-3.0, P=.003). Conclusions: Consumers of health and fitness--related social media content were predominantly teenaged girls. There is a need to ensure that this social media content portrays responsible health messages and to research further the role of fitspiration pages, detox pages, and diet/fitness plan pages in influencing body image and health behaviors. ",
doi="10.2196/jmir.4803",
url="http://www.jmir.org/2015/8/e205/",
url="http://www.ncbi.nlm.nih.gov/pubmed/26297689"
}


@Article{info:doi/10.2196/jmir.4414,
author="Narayanaswami, Pushpa
and Gronseth, Gary
and Dubinsky, Richard
and Penfold-Murray, Rebecca
and Cox, Julie
and Bever Jr, Christopher
and Martins, Yolanda
and Rheaume, Carol
and Shouse, Denise
and Getchius, SD Thomas",
title="The Impact of Social Media on Dissemination and Implementation of Clinical Practice Guidelines: A Longitudinal Observational Study",
journal="J Med Internet Res",
year="2015",
month="Aug",
day="13",
volume="17",
number="8",
pages="e193",
keywords="information dissemination",
keywords="social media",
keywords="multiple sclerosis",
keywords="complementary medicine",
keywords="medicine, complementary",
keywords="therapy, complementary",
keywords="alternative medicine",
keywords="alternative therapies",
keywords="clinical practice guidelines",
keywords="dissemination and implementation",
abstract="Background: Evidence-based clinical practice guidelines (CPGs) are statements that provide recommendations to optimize patient care for a specific clinical problem or question. Merely reading a guideline rarely leads to implementation of recommendations. The American Academy of Neurology (AAN) has a formal process of guideline development and dissemination. The last few years have seen a burgeoning of social media such as Facebook, Twitter, and LinkedIn, and newer methods of dissemination such as podcasts and webinars. The role of these media in guideline dissemination has not been studied. Systematic evaluation of dissemination methods and comparison of the effectiveness of newer methods with traditional methods is not available. It is also not known whether specific dissemination methods may be more effectively targeted to specific audiences. Objective: Our aim was to (1) develop an innovative dissemination strategy by adding social media-based dissemination methods to traditional methods for the AAN clinical practice guidelines ``Complementary and alternative medicine in multiple sclerosis'' (``CAM in MS'') and (2) evaluate whether the addition of social media outreach improves awareness of the CPG and knowledge of CPG recommendations, and affects implementation of those recommendations. Methods: Outcomes were measured by four surveys in each of the two target populations: patients and physicians/clinicians (``physicians''). The primary outcome was the difference in participants' intent to discuss use of complementary and alternative medicine (CAM) with their physicians or patients, respectively, after novel dissemination, as compared with that after traditional dissemination. Secondary outcomes were changes in awareness of the CPG, knowledge of CPG content, and behavior regarding CAM use in multiple sclerosis (MS). Results: Response rates were 25.08\% (622/2480) for physicians and 43.5\% (348/800) for patients. Awareness of the CPG increased after traditional dissemination (absolute difference, 95\% confidence interval: physicians 36\%, 95\% CI 25-46, and patients 10\%, 95\% CI 1-11) but did not increase further after novel dissemination (physicians 0\%, 95\% CI -11 to 11, and patients -4\%, 95\% CI -6 to 14). Intent to discuss CAM also increased after traditional dissemination but did not change after novel dissemination (traditional: physicians 12\%, 95\% CI 2-22, and patients 19\%, 95\% CI 3-33; novel: physicians 11\%, 95\% CI -1 to -21, and patients -8\%, 95\% CI -22 to 8). Knowledge of CPG recommendations and behavior regarding CAM use in MS did not change after either traditional dissemination or novel dissemination. Conclusions: Social media-based dissemination methods did not confer additional benefit over print-, email-, and Internet-based methods in increasing CPG awareness and changing intent in physicians or patients. Research on audience selection, message formatting, and message delivery is required to utilize Web 2.0 technologies optimally for dissemination. ",
doi="10.2196/jmir.4414",
url="http://www.jmir.org/2015/8/e193/",
url="http://www.ncbi.nlm.nih.gov/pubmed/26272267"
}


@Article{info:doi/10.2196/resprot.4621,
author="Merolli, Mark
and Gray, Kathleen
and Martin-Sanchez, Fernando
and Mantopoulos, Steven
and Hogg, Malcolm",
title="Using Social Media While Waiting in Pain: A Clinical 12-Week Longitudinal Pilot Study",
journal="JMIR Res Protoc",
year="2015",
month="Aug",
day="07",
volume="4",
number="3",
pages="e101",
keywords="chronic pain",
keywords="chronic disease",
keywords="participatory health",
keywords="patient-reported outcomes",
keywords="self-management",
keywords="social media",
keywords="therapeutic affordances",
keywords="pilot study",
abstract="Background: Chronic pain places an enormous burden on health care systems. Multidisciplinary pain management services are well documented as an effective means to improve patient outcomes. However, waiting lists to access these services are long and outcomes deteriorate. Innovative solutions such as social media are gaining attention as a way to decrease this burden and improve outcomes. It is a challenge to design research that demonstrates whether social media are acceptable to patients and clinically effective. Objective: The aim was to conduct a longitudinal pilot study to understand what aspects of research design are key to the success of running a larger-scale study of social media use in the clinical management of chronic pain. Methods: A 12-week study examined social media use by patients on the waiting list for the Royal Melbourne Hospital Pain Management Service. Selected social media resources were suggested for use by patients waiting for an appointment at the clinic. Patients filled out measures for pain interference and pain self-efficacy before and after the study. Follow-up was conducted at monthly intervals via telephone semistructured interviews to discuss engagement and garner individual perceptions towards social media use. A social media-use instrument was also administered as part of the after-study questionnaire. Results: Targeted recruitment refined 235 patient referrals to 138 (58.7\%) suitable potential participants. Contact was made with 84 out of 138 (60.9\%) patients. After a further exclusion of 54 out of 84 (64\%) patients for various reasons, this left 30 out of 84 (36\%) patients fitting the inclusion criteria and interested in study participation. A final study cohort of 17 out of 30 (57\%) was obtained. Demographics of the 17 patients were mixed. Low back pain was the primary condition reported as leading to chronic pain. Semistructured interviews collected data from 16 out of 17 (94\%) patients who started the trial, and at final follow-up 9 out of 17 (53\%) patients completed questionnaires. Low specificity of the resources to one's condition and time poorness may have been barriers to engagement. Conclusions: Results suggest that with refinements, this study design can be implemented successfully when conducting a larger social media study. At present, comment cannot be made on what effect using social media can have on patients on hospital waiting lists, nor whether those who use social media while waiting in pain achieve better outcomes from eventual participation in a chronic pain program. Long-term follow-up should be included in future studies to answer this. Future research should focus on multicenter randomized controlled trials, involving patients in the intervention design for improved participation and outcomes and for evidence to be sound. ",
doi="10.2196/resprot.4621",
url="http://www.researchprotocols.org/2015/3/e101/",
url="http://www.ncbi.nlm.nih.gov/pubmed/26254245"
}


@Article{info:doi/10.2196/jmir.4308,
author="Sadah, A. Shouq
and Shahbazi, Moloud
and Wiley, T. Matthew
and Hristidis, Vagelis",
title="A Study of the Demographics of Web-Based Health-Related Social Media Users",
journal="J Med Internet Res",
year="2015",
month="Aug",
day="06",
volume="17",
number="8",
pages="e194",
keywords="online social media",
keywords="demographics",
keywords="health forums",
keywords="health care disparity",
keywords="drug reviews",
abstract="Background: The rapid spread of Web-based social media in recent years has impacted how patients share health-related information. However, little work has studied the demographics of these users. Objective: Our aim was to study the demographics of users who participate in health-related Web-based social outlets to identify possible links to health care disparities. Methods: We analyze and compare three different types of health-related social outlets: (1) general Web-based social networks, Twitter and Google+, (2) drug review websites, and (3) health Web forums. We focus on the following demographic attributes: age, gender, ethnicity, location, and writing level. We build and evaluate domain-specific classifiers to infer missing data where possible. The estimated demographic statistics are compared against various baselines, such as Internet and social networks usage of the population. Results: We found that (1) drug review websites and health Web forums are dominated by female users, (2) the participants of health-related social outlets are generally older with the exception of the 65+ years bracket, (3) blacks are underrepresented in health-related social networks, (4) users in areas with better access to health care participate more in Web-based health-related social outlets, and (5) the writing level of users in health-related social outlets is significantly lower than the reading level of the population. Conclusions: We identified interesting and actionable disparities in the participation of various demographic groups to various types of health-related social outlets. These disparities are significantly distinct from the disparities in Internet usage or general social outlets participation. ",
doi="10.2196/jmir.4308",
url="http://www.jmir.org/2015/8/e194/",
url="http://www.ncbi.nlm.nih.gov/pubmed/26250986"
}


@Article{info:doi/10.2196/jmir.4721,
author="Attai, J. Deanna
and Cowher, S. Michael
and Al-Hamadani, Mohammed
and Schoger, M. Jody
and Staley, C. Alicia
and Landercasper, Jeffrey",
title="Twitter Social Media is an Effective Tool for Breast Cancer Patient Education and Support: Patient-Reported Outcomes by Survey",
journal="J Med Internet Res",
year="2015",
month="Jul",
day="30",
volume="17",
number="7",
pages="e188",
keywords="breast cancer",
keywords="education",
keywords="social support",
keywords="social media",
keywords="patient outcome assessment",
abstract="Background: Despite reported benefits, many women do not attend breast cancer support groups. Abundant online resources for support exist, but information regarding the effectiveness of participation is lacking. We report the results of a Twitter breast cancer support community participant survey. Objective: The aim was to determine the effectiveness of social media as a tool for breast cancer patient education and decreasing anxiety. Methods: The Breast Cancer Social Media Twitter support community (\#BCSM) began in July 2011. Institutional review board approval with a waiver of informed consent was obtained for a deidentified survey that was posted for 2 weeks on Twitter and on the \#BCSM blog and Facebook page. Results: There were 206 respondents to the survey. In all, 92.7\% (191/206) were female. Respondents reported increased knowledge about breast cancer in the following domains: overall knowledge (80.9\%, 153/189), survivorship (85.7\%, 162/189), metastatic breast cancer (79.4\%, 150/189), cancer types and biology (70.9\%, 134/189), clinical trials and research (66.1\%, 125/189), treatment options (55.6\%, 105/189), breast imaging (56.6\%, 107/189), genetic testing and risk assessment (53.9\%, 102/189), and radiotherapy (43.4\%, 82/189). Participation led 31.2\% (59/189) to seek a second opinion or bring additional information to the attention of their treatment team and 71.9\% (136/189) reported plans to increase their outreach and advocacy efforts as a result of participation. Levels of reported anxiety before and after participation were analyzed: 29 of 43 (67\%) patients who initially reported ``high or extreme'' anxiety reported ``low or no'' anxiety after participation (P<.001). Also, no patients initially reporting low or no anxiety before participation reported an increase to high or extreme anxiety after participation. Conclusions: This study demonstrates that breast cancer patients' perceived knowledge increases and their anxiety decreases by participation in a Twitter social media support group. ",
doi="10.2196/jmir.4721",
url="http://www.jmir.org/2015/7/e188/",
url="http://www.ncbi.nlm.nih.gov/pubmed/26228234"
}


@Article{info:doi/10.2196/publichealth.4488,
author="Adrover, Cosme
and Bodnar, Todd
and Huang, Zhuojie
and Telenti, Amalio
and Salath{\'e}, Marcel",
title="Identifying Adverse Effects of HIV Drug Treatment and Associated Sentiments Using Twitter",
journal="JMIR Public Health Surveill",
year="2015",
month="Jul",
day="27",
volume="1",
number="2",
pages="e7",
keywords="Twitter",
keywords="HIV",
keywords="AIDS",
keywords="pharmacovigilance",
keywords="mTurk",
keywords="mechanical Turk",
abstract="Background: Social media platforms are increasingly seen as a source of data on a wide range of health issues. Twitter is of particular interest for public health surveillance because of its public nature. However, the very public nature of social media platforms such as Twitter may act as a barrier to public health surveillance, as people may be reluctant to publicly disclose information about their health. This is of particular concern in the context of diseases that are associated with a certain degree of stigma, such as HIV/AIDS. Objective: The objective of the study is to assess whether adverse effects of HIV drug treatment and associated sentiments can be determined using publicly available data from social media. Methods: We describe a combined approach of machine learning and crowdsourced human assessment to identify adverse effects of HIV drug treatment solely on individual reports posted publicly on Twitter. Starting from a large dataset of 40 million tweets collected over three years, we identify a very small subset (1642; 0.004\%) of individual reports describing personal experiences with HIV drug treatment. Results: Despite the small size of the extracted final dataset, the summary representation of adverse effects attributed to specific drugs, or drug combinations, accurately captures well-recognized toxicities. In addition, the data allowed us to discriminate across specific drug compounds, to identify preferred drugs over time, and to capture novel events such as the availability of preexposure prophylaxis. Conclusions: The effect of limited data sharing due to the public nature of the data can be partially offset by the large number of people sharing data in the first place, an observation that may play a key role in digital epidemiology in general. ",
doi="10.2196/publichealth.4488",
url="http://publichealth.jmir.org/2015/2/e7/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27227141"
}


@Article{info:doi/10.2196/jmir.4086,
author="Maher, Carol
and Ferguson, Monika
and Vandelanotte, Corneel
and Plotnikoff, Ron
and De Bourdeaudhuij, Ilse
and Thomas, Samantha
and Nelson-Field, Karen
and Olds, Tim",
title="A Web-Based, Social Networking Physical Activity Intervention for Insufficiently Active Adults Delivered via Facebook App: Randomized Controlled Trial",
journal="J Med Internet Res",
year="2015",
month="Jul",
day="13",
volume="17",
number="7",
pages="e174",
keywords="social network",
keywords="behavior change",
keywords="intervention",
keywords="Internet",
keywords="physical activity",
abstract="Background: Online social networks offer considerable potential for delivery of socially influential health behavior change interventions. Objective: To determine the efficacy, engagement, and feasibility of an online social networking physical activity intervention with pedometers delivered via Facebook app. Methods: A total of 110 adults with a mean age of 35.6 years (SD 12.4) were recruited online in teams of 3 to 8 friends. Teams were randomly allocated to receive access to a 50-day online social networking physical activity intervention which included self-monitoring, social elements, and pedometers (``Active Team'' Facebook app; n=51 individuals, 12 teams) or a wait-listed control condition (n=59 individuals, 13 teams). Assessments were undertaken online at baseline, 8 weeks, and 20 weeks. The primary outcome measure was self-reported weekly moderate-to-vigorous physical activity (MVPA). Secondary outcomes were weekly walking, vigorous physical activity time, moderate physical activity time, overall quality of life, and mental health quality of life. Analyses were undertaken using random-effects mixed modeling, accounting for potential clustering at the team level. Usage statistics were reported descriptively to determine engagement and feasibility. Results: At the 8-week follow-up, the intervention participants had significantly increased their total weekly MVPA by 135 minutes relative to the control group (P=.03), due primarily to increases in walking time (155 min/week increase relative to controls, P<.001). However, statistical differences between groups for total weekly MVPA and walking time were lost at the 20-week follow-up. There were no significant changes in vigorous physical activity, nor overall quality of life or mental health quality of life at either time point. High levels of engagement with the intervention, and particularly the self-monitoring features, were observed. Conclusions: An online, social networking physical activity intervention with pedometers can produce sizable short-term physical activity changes. Future work is needed to determine how to maintain behavior change in the longer term, how to reach at-need populations, and how to disseminate such interventions on a mass scale. Trial Registration: Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12614000488606; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=366239 (Archived by WebCite at http://www.webcitation.org/6ZVtu6TMz). ",
doi="10.2196/jmir.4086",
url="http://www.jmir.org/2015/7/e174/",
url="http://www.ncbi.nlm.nih.gov/pubmed/26169067"
}


@Article{info:doi/10.2196/jmir.3973,
author="Li, Jingquan",
title="A Privacy Preservation Model for Health-Related Social Networking Sites",
journal="J Med Internet Res",
year="2015",
month="Jul",
day="08",
volume="17",
number="7",
pages="e168",
keywords="social networks",
keywords="privacy",
keywords="security",
keywords="threat modeling",
keywords="privacy preservation model",
keywords="electronic health records",
keywords="health care",
doi="10.2196/jmir.3973",
url="http://www.jmir.org/2015/7/e168/",
url="http://www.ncbi.nlm.nih.gov/pubmed/26155953"
}


@Article{info:doi/10.2196/resprot.3433,
author="Rastegar-Mojarad, Majid
and Ye, Zhan
and Wall, Daniel
and Murali, Narayana
and Lin, Simon",
title="Collecting and Analyzing Patient Experiences of Health Care From Social Media",
journal="JMIR Res Protoc",
year="2015",
month="Jul",
day="02",
volume="4",
number="3",
pages="e78",
keywords="patient satisfaction",
keywords="social media",
keywords="health care",
keywords="natural language processing",
keywords="consumer health information",
abstract="Background: Social Media, such as Yelp, provides rich information of consumer experience. Previous studies suggest that Yelp can serve as a new source to study patient experience. However, the lack of a corpus of patient reviews causes a major bottleneck for applying computational techniques. Objective: The objective of this study is to create a corpus of patient experience (COPE) and report descriptive statistics to characterize COPE. Methods: Yelp reviews about health care-related businesses were extracted from the Yelp Academic Dataset. Natural language processing (NLP) tools were used to split reviews into sentences, extract noun phrases and adjectives from each sentence, and generate parse trees and dependency trees for each sentence. Sentiment analysis techniques and Hadoop were used to calculate a sentiment score of each sentence and for parallel processing, respectively. Results: COPE contains 79,173 sentences from 6914 patient reviews of 985 health care facilities near 30 universities in the United States. We found that patients wrote longer reviews when they rated the facility poorly (1 or 2 stars). We demonstrated that the computed sentiment scores correlated well with consumer-generated ratings. A consumer vocabulary to describe their health care experience was constructed by a statistical analysis of word counts and co-occurrences in COPE. Conclusions: A corpus called COPE was built as an initial step to utilize social media to understand patient experiences at health care facilities. The corpus is available to download and COPE can be used in future studies to extract knowledge of patients' experiences from their perspectives. Such information can subsequently inform and provide opportunity to improve the quality of health care. ",
doi="10.2196/resprot.3433",
url="http://www.researchprotocols.org/2015/3/e78/",
url="http://www.ncbi.nlm.nih.gov/pubmed/26137885"
}


@Article{info:doi/10.2196/publichealth.3953,
author="Weeg, Christopher
and Schwartz, Andrew H.
and Hill, Shawndra
and Merchant, M. Raina
and Arango, Catalina
and Ungar, Lyle",
title="Using Twitter to Measure Public Discussion of Diseases: A Case Study",
journal="JMIR Public Health Surveill",
year="2015",
month="Jun",
day="26",
volume="1",
number="1",
pages="e6",
keywords="bias",
keywords="data mining",
keywords="demographics",
keywords="disease",
keywords="epidemiology",
keywords="prevalence",
keywords="public health",
keywords="social media",
abstract="Background: Twitter is increasingly used to estimate disease prevalence, but such measurements can be biased, due to both biased sampling and inherent ambiguity of natural language. Objective: We characterized the extent of these biases and how they vary with disease. Methods: We correlated self-reported prevalence rates for 22 diseases from Experian's Simmons National Consumer Study (n=12,305) with the number of times these diseases were mentioned on Twitter during the same period (2012). We also identified and corrected for two types of bias present in Twitter data: (1) demographic variance between US Twitter users and the general US population; and (2) natural language ambiguity, which creates the possibility that mention of a disease name may not actually refer to the disease (eg, ``heart attack'' on Twitter often does not refer to myocardial infarction). We measured the correlation between disease prevalence and Twitter disease mentions both with and without bias correction. This allowed us to quantify each disease's overrepresentation or underrepresentation on Twitter, relative to its prevalence. Results: Our sample included 80,680,449 tweets. Adjusting disease prevalence to correct for Twitter demographics more than doubles the correlation between Twitter disease mentions and disease prevalence in the general population (from .113 to .258, P <.001). In addition, diseases varied widely in how often mentions of their names on Twitter actually referred to the diseases, from 14.89\% (3827/25,704) of instances (for stroke) to 99.92\% (5044/5048) of instances (for arthritis). Applying ambiguity correction to our Twitter corpus achieves a correlation between disease mentions and prevalence of .208 ( P <.001). Simultaneously applying correction for both demographics and ambiguity more than triples the baseline correlation to .366 ( P <.001). Compared with prevalence rates, cancer appeared most overrepresented in Twitter, whereas high cholesterol appeared most underrepresented. Conclusions: Twitter is a potentially useful tool to measure public interest in and concerns about different diseases, but when comparing diseases, improvements can be made by adjusting for population demographics and word ambiguity. ",
doi="10.2196/publichealth.3953",
url="http://publichealth.jmir.org/2015/1/e6/",
url="http://www.ncbi.nlm.nih.gov/pubmed/26925459"
}


@Article{info:doi/10.2196/jmir.4297,
author="van Mierlo, Trevor
and Hyatt, Douglas
and Ching, T. Andrew",
title="Mapping Power Law Distributions in Digital Health Social Networks: Methods, Interpretations, and Practical Implications",
journal="J Med Internet Res",
year="2015",
month="Jun",
day="25",
volume="17",
number="6",
pages="e160",
keywords="social networks",
keywords="eHealth",
keywords="1\% rule",
keywords="Pareto Principal",
keywords="power law",
keywords="90-9-1 principle",
keywords="moderated support",
keywords="peer-to-peer support",
abstract="Background: Social networks are common in digital health. A new stream of research is beginning to investigate the mechanisms of digital health social networks (DHSNs), how they are structured, how they function, and how their growth can be nurtured and managed. DHSNs increase in value when additional content is added, and the structure of networks may resemble the characteristics of power laws. Power laws are contrary to traditional Gaussian averages in that they demonstrate correlated phenomena. Objectives: The objective of this study is to investigate whether the distribution frequency in four DHSNs can be characterized as following a power law. A second objective is to describe the method used to determine the comparison. Methods: Data from four DHSNs---Alcohol Help Center (AHC), Depression Center (DC), Panic Center (PC), and Stop Smoking Center (SSC)---were compared to power law distributions. To assist future researchers and managers, the 5-step methodology used to analyze and compare datasets is described. Results: All four DHSNs were found to have right-skewed distributions, indicating the data were not normally distributed. When power trend lines were added to each frequency distribution, R2 values indicated that, to a very high degree, the variance in post frequencies can be explained by actor rank (AHC .962, DC .975, PC .969, SSC .95). Spearman correlations provided further indication of the strength and statistical significance of the relationship (AHC .987. DC .967, PC .983, SSC .993, P<.001). Conclusions: This is the first study to investigate power distributions across multiple DHSNs, each addressing a unique condition. Results indicate that despite vast differences in theme, content, and length of existence, DHSNs follow properties of power laws. The structure of DHSNs is important as it gives insight to researchers and managers into the nature and mechanisms of network functionality. The 5-step process undertaken to compare actor contribution patterns can be replicated in networks that are managed by other organizations, and we conjecture that patterns observed in this study could be found in other DHSNs. Future research should analyze network growth over time and examine the characteristics and survival rates of superusers. ",
doi="10.2196/jmir.4297",
url="http://www.jmir.org/2015/6/e160/",
url="http://www.ncbi.nlm.nih.gov/pubmed/26111790"
}


@Article{info:doi/10.2196/jmir.3662,
author="Balatsoukas, Panos
and Kennedy, M. Catriona
and Buchan, Iain
and Powell, John
and Ainsworth, John",
title="The Role of Social Network Technologies in Online Health Promotion: A Narrative Review of Theoretical and Empirical Factors Influencing Intervention Effectiveness",
journal="J Med Internet Res",
year="2015",
month="Jun",
day="11",
volume="17",
number="6",
pages="e141",
keywords="health behaviors",
keywords="health promotion",
keywords="health behavior change",
keywords="health education",
keywords="social media",
keywords="social technology",
keywords="social networking",
keywords="content analysis",
keywords="theoretical grounding",
abstract="Background: Social network technologies have become part of health education and wider health promotion---either by design or happenstance. Social support, peer pressure, and information sharing in online communities may affect health behaviors. If there are positive and sustained effects, then social network technologies could increase the effectiveness and efficiency of many public health campaigns. Social media alone, however, may be insufficient to promote health. Furthermore, there may be unintended and potentially harmful consequences of inaccurate or misleading health information. Given these uncertainties, there is a need to understand and synthesize the evidence base for the use of online social networking as part of health promoting interventions to inform future research and practice. Objective: Our aim was to review the research on the integration of expert-led health promotion interventions with online social networking in order to determine the extent to which the complementary benefits of each are understood and used. We asked, in particular, (1) How is effectiveness being measured and what are the specific problems in effecting health behavior change?, and (2) To what extent is the designated role of social networking grounded in theory? Methods: The narrative synthesis approach to literature review was used to analyze the existing evidence. We searched the indexed scientific literature using keywords associated with health promotion and social networking. The papers included were only those making substantial study of both social networking and health promotion---either reporting the results of the intervention or detailing evidence-based plans. General papers about social networking and health were not included. Results: The search identified 162 potentially relevant documents after review of titles and abstracts. Of these, 42 satisfied the inclusion criteria after full-text review. Six studies described randomized controlled trials (RCTs) evaluating the effectiveness of online social networking within health promotion interventions. Most of the trials investigated the value of a ``social networking condition'' in general and did not identify specific features that might play a role in effectiveness. Issues about the usability and level of uptake of interventions were more common among pilot studies, while observational studies showed positive evidence about the role of social support. A total of 20 papers showed the use of theory in the design of interventions, but authors evaluated effectiveness in only 10 papers. Conclusions: More research is needed in this area to understand the actual effect of social network technologies on health promotion. More RCTs of greater length need to be conducted taking into account contextual factors such as patient characteristics and types of a social network technology. Also, more evidence is needed regarding the actual usability of online social networking and how different interface design elements may help or hinder behavior change and engagement. Moreover, it is crucial to investigate further the effect of theory on the effectiveness of this type of technology for health promotion. Research is needed linking theoretical grounding with observation and analysis of health promotion in online networks. ",
doi="10.2196/jmir.3662",
url="http://www.jmir.org/2015/6/e141/",
url="http://www.ncbi.nlm.nih.gov/pubmed/26068087"
}


@Article{info:doi/10.2196/jmir.4343,
author="Dunn, G. Adam
and Leask, Julie
and Zhou, Xujuan
and Mandl, D. Kenneth
and Coiera, Enrico",
title="Associations Between Exposure to and Expression of Negative Opinions About Human Papillomavirus Vaccines on Social Media: An Observational Study",
journal="J Med Internet Res",
year="2015",
month="Jun",
day="10",
volume="17",
number="6",
pages="e144",
keywords="HPV vaccines",
keywords="Twitter messaging",
keywords="social media",
keywords="public health surveillance",
keywords="social networks",
abstract="Background: Groups and individuals that seek to negatively influence public opinion about the safety and value of vaccination are active in online and social media and may influence decision making within some communities. Objective: We sought to measure whether exposure to negative opinions about human papillomavirus (HPV) vaccines in Twitter communities is associated with the subsequent expression of negative opinions by explicitly measuring potential information exposure over the social structure of Twitter communities. Methods: We hypothesized that prior exposure to opinions rejecting the safety or value of HPV vaccines would be associated with an increased risk of posting similar opinions and tested this hypothesis by analyzing temporal sequences of messages posted on Twitter (tweets). The study design was a retrospective analysis of tweets related to HPV vaccines and the social connections between users. Between October 2013 and April 2014, we collected 83,551 English-language tweets that included terms related to HPV vaccines and the 957,865 social connections among 30,621 users posting or reposting the tweets. Tweets were classified as expressing negative or neutral/positive opinions using a machine learning classifier previously trained on a manually labeled sample. Results: During the 6-month period, 25.13\% (20,994/83,551) of tweets were classified as negative; among the 30,621 users that tweeted about HPV vaccines, 9046 (29.54\%) were exposed to a majority of negative tweets. The likelihood of a user posting a negative tweet after exposure to a majority of negative opinions was 37.78\% (2780/7361) compared to 10.92\% (1234/11,296) for users who were exposed to a majority of positive and neutral tweets corresponding to a relative risk of 3.46 (95\% CI 3.25-3.67, P<.001). Conclusions: The heterogeneous community structure on Twitter appears to skew the information to which users are exposed in relation to HPV vaccines. We found that among users that tweeted about HPV vaccines, those who were more often exposed to negative opinions were more likely to subsequently post negative opinions. Although this research may be useful for identifying individuals and groups currently at risk of disproportionate exposure to misinformation about HPV vaccines, there is a clear need for studies capable of determining the factors that affect the formation and adoption of beliefs about public health interventions. ",
doi="10.2196/jmir.4343",
url="http://www.jmir.org/2015/6/e144/",
url="http://www.ncbi.nlm.nih.gov/pubmed/26063290"
}


@Article{info:doi/10.2196/jmir.4305,
author="Yin, Zhijun
and Fabbri, Daniel
and Rosenbloom, Trent S.
and Malin, Bradley",
title="A Scalable Framework to Detect Personal Health Mentions on Twitter",
journal="J Med Internet Res",
year="2015",
month="Jun",
day="05",
volume="17",
number="6",
pages="e138",
keywords="consumer health",
keywords="information retrieval",
keywords="machine learning",
keywords="social media",
keywords="twitter",
keywords="infodemiology",
abstract="Background: Biomedical research has traditionally been conducted via surveys and the analysis of medical records. However, these resources are limited in their content, such that non-traditional domains (eg, online forums and social media) have an opportunity to supplement the view of an individual's health. Objective: The objective of this study was to develop a scalable framework to detect personal health status mentions on Twitter and assess the extent to which such information is disclosed. Methods: We collected more than 250 million tweets via the Twitter streaming API over a 2-month period in 2014. The corpus was filtered down to approximately 250,000 tweets, stratified across 34 high-impact health issues, based on guidance from the Medical Expenditure Panel Survey. We created a labeled corpus of several thousand tweets via a survey, administered over Amazon Mechanical Turk, that documents when terms correspond to mentions of personal health issues or an alternative (eg, a metaphor). We engineered a scalable classifier for personal health mentions via feature selection and assessed its potential over the health issues. We further investigated the utility of the tweets by determining the extent to which Twitter users disclose personal health status. Results: Our investigation yielded several notable findings. First, we find that tweets from a small subset of the health issues can train a scalable classifier to detect health mentions. Specifically, training on 2000 tweets from four health issues (cancer, depression, hypertension, and leukemia) yielded a classifier with precision of 0.77 on all 34 health issues. Second, Twitter users disclosed personal health status for all health issues. Notably, personal health status was disclosed over 50\% of the time for 11 out of 34 (33\%) investigated health issues. Third, the disclosure rate was dependent on the health issue in a statistically significant manner (P<.001). For instance, more than 80\% of the tweets about migraines (83/100) and allergies (85/100) communicated personal health status, while only around 10\% of the tweets about obesity (13/100) and heart attack (12/100) did so. Fourth, the likelihood that people disclose their own versus other people's health status was dependent on health issue in a statistically significant manner as well (P<.001). For example, 69\% (69/100) of the insomnia tweets disclosed the author's status, while only 1\% (1/100) disclosed another person's status. By contrast, 1\% (1/100) of the Down syndrome tweets disclosed the author's status, while 21\% (21/100) disclosed another person's status. Conclusions: It is possible to automatically detect personal health status mentions on Twitter in a scalable manner. These mentions correspond to the health issues of the Twitter users themselves, but also other individuals. Though this study did not investigate the veracity of such statements, we anticipate such information may be useful in supplementing traditional health-related sources for research purposes. ",
doi="10.2196/jmir.4305",
url="http://www.jmir.org/2015/6/e138/",
url="http://www.ncbi.nlm.nih.gov/pubmed/26048075"
}


@Article{info:doi/10.2196/jmir.4365,
author="Hao, Haijing",
title="The Development of Online Doctor Reviews in China: An Analysis of the Largest Online Doctor Review Website in China",
journal="J Med Internet Res",
year="2015",
month="Jun",
day="01",
volume="17",
number="6",
pages="e134",
keywords="online doctor reviews",
keywords="China health system",
keywords="quantitative review",
keywords="qualitative review",
keywords="patient empowerment",
keywords="physician quality",
abstract="Background: Since the time of Web 2.0, more and more consumers have used online doctor reviews to rate their doctors or to look for a doctor.  This phenomenon has received health care researchers' attention worldwide, and many studies have been conducted on online doctor reviews in the United States and Europe. But no study has yet been done in China.  Also, in China, without a mature primary care physician recommendation system, more and more Chinese consumers seek online doctor reviews to look for a good doctor for their health care concerns. Objective: This study sought to examine the online doctor review practice in China, including addressing the following questions: (1) How many doctors and specialty areas are available for online review? (2) How many online reviews are there on those doctors? (3) What specialty area doctors are more likely to be reviewed or receive more reviews? (4) Are those reviews positive or negative? Methods: This study explores an empirical dataset from Good Doctor website, haodf.com---the earliest and  largest online doctor review and online health care community website in China---from 2006 to 2014, to examine the stated research questions by using descriptive statistics, binary logistic regression, and multivariate linear regression. Results: The dataset from the Good Doctor website contained 314,624 doctors across China and among them, 112,873 doctors received 731,543 quantitative reviews and 772,979 qualitative reviews as of April 11, 2014.  On average, 37\% of the doctors had been reviewed on the Good Doctor website.  Gynecology-obstetrics-pediatrics doctors were most likely to be reviewed, with an odds ratio (OR) of 1.497 (95\% CI 1.461-1.535), and internal medicine doctors were less likely to be reviewed, with an OR of 0.94 (95\% CI 0.921-0.960), relative to the combined small specialty areas. Both traditional Chinese medicine doctors and surgeons were more likely to be reviewed than the combined small specialty areas, with an OR of 1.483 (95\% CI 1.442-1.525) and an OR of 1.366 (95\% CI 1.337-1.395), respectively.  Quantitatively, traditional Chinese medicine doctors (P<.001) and gynecology-obstetrics-pediatrics doctors (P<.001) received more reviews than the combined small specialty areas.  But internal medicine doctors received fewer reviews than the combined small specialty areas (P<.001). Also, the majority of quantitative reviews were positive---about 88\% were positive for the doctors' treatment effect measure and 91\% were positive for the bedside manner measure. This was the case for the four major specialty areas, which had the most number of doctors---internal medicine, gynecology-obstetrics-pediatrics, surgery, and traditional Chinese medicine. Conclusions: Like consumers in the United States and Europe, Chinese consumers have started to use online doctor reviews. Similar to previous research on other countries' online doctor reviews, the online reviews in China covered almost every medical specialty, and most of the reviews were positive even though all of the reviewing procedures and the final available information were anonymous. The average number of reviews per rated doctor received in this dataset was 6, which was higher than that for doctors in the United States or Germany, probably because this dataset covered a longer time period than did the US or German dataset. But this number is still very small compared to any doctor's real patient population, and it cannot represent the reality of that population. Also, since all the data used for analysis were from one single website, the data might be biased and might not be a representative national sample of China. ",
doi="10.2196/jmir.4365",
url="http://www.jmir.org/2015/6/e134/",
url="http://www.ncbi.nlm.nih.gov/pubmed/26032933"
}


@Article{info:doi/10.2196/jmir.4357,
author="Tyrawski, Jennifer
and DeAndrea, C. David",
title="Pharmaceutical Companies and Their Drugs on Social Media: A Content Analysis of Drug Information on Popular Social Media Sites",
journal="J Med Internet Res",
year="2015",
month="Jun",
day="01",
volume="17",
number="6",
pages="e130",
keywords="social media",
keywords="eHealth",
keywords="direct-to-consumer advertising",
keywords="eDTCA",
keywords="pharmaceutical drugs",
keywords="online pharmaceutical services",
keywords="illegal online pharmacies",
keywords="Facebook",
keywords="Twitter",
keywords="YouTube",
abstract="Background: Many concerns have been raised about pharmaceutical companies marketing their drugs directly to consumers on social media. This form of direct-to-consumer advertising (DTCA) can be interactive and, because it is largely unmonitored, the benefits of pharmaceutical treatment could easily be overemphasized compared to the risks. Additionally, nonexpert consumers can share their own drug product testimonials on social media and illegal online pharmacies can market their services on popular social media sites. There is great potential for the public to be exposed to misleading or dangerous information about pharmaceutical drugs on social media. Objective: Our central aim was to examine how pharmaceutical companies use social media to interact with the general public and market their drugs. We also sought to analyze the nature of information that appears in search results for widely used pharmaceutical drugs in the United States on Facebook, Twitter, and YouTube with a particular emphasis on the presence of illegal pharmacies. Methods: Content analyses were performed on (1) social media content on the Facebook, Twitter, and YouTube accounts of the top 15 pharmaceutical companies in the world and (2) the content that appears when searching on Facebook, Twitter, and YouTube for the top 20 pharmaceutical drugs purchased in the United States. Notably, for the company-specific analysis, we examined the presence of information similar to various forms of DTCA, the audience reach of company postings, and the quantity and quality of company-consumer interaction. For the drug-specific analysis, we documented the presence of illegal pharmacies, personal testimonials, and drug efficacy claims. Results: From the company-specific analysis, we found information similar to help-seeking DTCA in 40.7\% (301/740) of pharmaceutical companies' social media posts. Drug product claims were present in only 1.6\% (12/740) of posts. Overall, there was a substantial amount of consumers who interacted with pharmaceutical companies through commenting (23.9\%, 177/740). For the drug-specific analysis, we found that the majority of search results contained drug product claims (69.4\%, 482/695); more claims mentioned only benefits (44.8\%, 216/482) relative to only risks (27.2\%, 131/482). Additionally, approximately 25\% (150/603) of posts on Twitter and YouTube were presented as personal testimonials. A considerable percentage of content on Facebook contained advertisements for illegal online pharmacies (17\%, 16/92). Conclusions: Pharmaceutical companies avoid making drug product claims on their social media accounts but frequently post content that is consistent with FDA definitions for help-seeking DTCA. Thousands of people often view content posted by pharmaceutical companies on social media; users also share company postings making both direct and indirect influence possible. Finally, people are likely to be exposed to drug product claims and information about illegal pharmacies when searching for information about popular pharmaceutical drugs on social media. ",
doi="10.2196/jmir.4357",
url="http://www.jmir.org/2015/6/e130/",
url="http://www.ncbi.nlm.nih.gov/pubmed/26032738"
}


@Article{info:doi/10.2196/jmir.3863,
author="Mollema, Liesbeth
and Harmsen, Anhai Irene
and Broekhuizen, Emma
and Clijnk, Rutger
and De Melker, Hester
and Paulussen, Theo
and Kok, Gerjo
and Ruiter, Robert
and Das, Enny",
title="Disease Detection or Public Opinion Reflection? Content Analysis of Tweets, Other Social Media, and Online Newspapers During the Measles Outbreak in the Netherlands in 2013",
journal="J Med Internet Res",
year="2015",
month="May",
day="26",
volume="17",
number="5",
pages="e128",
keywords="Internet",
keywords="Web 2.0",
keywords="measles",
keywords="infectious disease outbreak",
keywords="Netherlands",
keywords="vaccination",
abstract="Background: In May 2013, a measles outbreak began in the Netherlands among Orthodox Protestants who often refuse vaccination for religious reasons. Objective: Our aim was to compare the number of messages expressed on Twitter and other social media during the measles outbreak with the number of online news articles and the number of reported measles cases to answer the question if and when social media reflect public opinion patterns versus disease patterns. Methods: We analyzed measles-related tweets, other social media messages, and online newspaper articles over a 7-month period (April 15 to November 11, 2013) with regard to topic and sentiment. Thematic analysis was used to structure and analyze the topics. Results: There was a stronger correlation between the weekly number of social media messages and the weekly number of online news articles (P<.001 for both tweets and other social media messages) than between the weekly number of social media messages and the weekly number of reported measles cases (P=.003 and P=.048 for tweets and other social media messages, respectively), especially after the summer break. All data sources showed 3 large peaks, possibly triggered by announcements about the measles outbreak by the Dutch National Institute for Public Health and the Environment and statements made by well-known politicians. Most messages informed the public about the measles outbreak (ie, about the number of measles cases) (93/165, 56.4\%) followed by messages about preventive measures taken to control the measles spread (47/132, 35.6\%). The leading opinion expressed was frustration regarding people who do not vaccinate because of religious reasons (42/88, 48\%). Conclusions: The monitoring of online (social) media might be useful for improving communication policies aiming to preserve vaccination acceptability among the general public. Data extracted from online (social) media provide insight into the opinions that are at a certain moment salient among the public, which enables public health institutes to respond immediately and appropriately to those public concerns. More research is required to develop an automatic coding system that captures content and user's characteristics that are most relevant to the diseases within the National Immunization Program and related public health events and can inform official responses. ",
doi="10.2196/jmir.3863",
url="http://www.jmir.org/2015/5/e128/",
url="http://www.ncbi.nlm.nih.gov/pubmed/26013683"
}


@Article{info:doi/10.2196/jmir.4347,
author="Tunnecliff, Jacqueline
and Ilic, Dragan
and Morgan, Prue
and Keating, Jennifer
and Gaida, E. James
and Clearihan, Lynette
and Sadasivan, Sivalal
and Davies, David
and Ganesh, Shankar
and Mohanty, Patitapaban
and Weiner, John
and Reynolds, John
and Maloney, Stephen",
title="The Acceptability Among Health Researchers and Clinicians of Social Media to Translate Research Evidence to Clinical Practice: Mixed-Methods Survey and Interview Study",
journal="J Med Internet Res",
year="2015",
month="May",
day="20",
volume="17",
number="5",
pages="e119",
keywords="social media",
keywords="evidence-based medicine",
keywords="communication",
keywords="eLearning",
abstract="Background: Establishing and promoting connections between health researchers and health professional clinicians may help translate research evidence to clinical practice. Social media may have the capacity to enhance these connections. Objective: The aim of this study was to explore health researchers' and clinicians' current use of social media and their beliefs and attitudes towards the use of social media for communicating research evidence. Methods: This study used a mixed-methods approach to obtain qualitative and quantitative data. Participation was open to health researchers and clinicians. Data regarding demographic details, current use of social media, and beliefs and attitudes towards the use of social media for professional purposes were obtained through an anonymous Web-based survey. The survey was distributed via email to research centers, educational and clinical institutions, and health professional associations in Australia, India, and Malaysia. Consenting participants were stratified by country and role and selected at random for semistructured telephone interviews to explore themes arising from the survey. Results: A total of 856 participants completed the questionnaire with 125 participants declining to participate, resulting in a response rate of 87.3\%. 69 interviews were conducted with participants from Australia, India, and Malaysia. Social media was used for recreation by 89.2\% (749/840) of participants and for professional purposes by 80.0\% (682/852) of participants. Significant associations were found between frequency of professional social media use and age, gender, country of residence, and graduate status. Over a quarter (26.9\%, 229/852) of participants used social media for obtaining research evidence, and 15.0\% (128/852) of participants used social media for disseminating research evidence. Most participants (95.9\%, 810/845) felt there was a role for social media in disseminating or obtaining research evidence. Over half of the participants (449/842, 53.3\%) felt they had a need for training in the use of social media for professional development. A key barrier to the professional use of social media was concerns regarding trustworthiness of information. Conclusions: A large majority of health researchers and clinicians use social media in recreational and professional contexts. Social media is less frequently used for communication of research evidence. Training in the use of social media for professional development and methods to improve the trustworthiness of information obtained via social media may enhance the utility of social media for communicating research evidence. Future studies should investigate the efficacy of social media in translating research evidence to clinical practice. ",
doi="10.2196/jmir.4347",
url="http://www.jmir.org/2015/5/e119/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25995192"
}


@Article{info:doi/10.2196/cancer.3883,
author="Sato, Akira
and Aramaki, Eiji
and Shimamoto, Yumiko
and Tanaka, Shiro
and Kawakami, Koji",
title="Blog Posting After Lung Cancer Notification: Content Analysis of Blogs Written by Patients or Their Families",
journal="JMIR Cancer",
year="2015",
month="May",
day="18",
volume="1",
number="1",
pages="e5",
keywords="blog",
keywords="lung cancer",
keywords="notification",
keywords="content analysis",
keywords="communication",
keywords="Internet",
abstract="Background: The advent and spread of the Internet has changed the way societies communicate. A portion of information on the Internet may constitute an important source of information concerning the experiences and thoughts of patients and their families. Patients and their families use blogs to obtain updated information, search for alternative treatments, facilitate communication with other patients, and receive emotional support. However, much of this information has yet to be actively utilized by health care professionals. Objective: We analyzed health-related information in blogs from Japan, focusing on the feelings and satisfaction levels of lung cancer patients or their family members after being notified of their disease. Methods: We collected 100 blogs written in Japanese by patients (or their families) who had been diagnosed with lung cancer by a physician. These 100 blogs posts were searchable between June 1 and June 30, 2013. We focused on blog posts that addressed the lung cancer notification event. We analyzed the data using two different approaches (Analysis A and Analysis B). Analysis A was blog content analysis in which we analyzed the content addressing the disease notification event in each blog. Analysis B was patient's dissatisfaction and anxiety analysis. Detailed blog content regarding patient's dissatisfaction and anxiety at the individual sentence level was coded and analyzed. Results: The 100 blog posts were written by 48 men, 46 women, and 6 persons whose sex was undisclosed. The average age of the blog authors was 52.4 years. With regard to cancer staging, there were 5 patients at Stage I, 3 patients at Stage II, 14 patients at Stage III, 21 patients at Stage IV, and 57 patients without a disclosed cancer stage. The results of Analysis A showed that the proportion of patients who were dissatisfied with the level of health care exceeded that of satisfied patients (22\% vs 8\%). From the 2499 sentences in the 100 blog posts analyzed, we identified expressions of dissatisfaction and anxiety in 495 sentences. Our results showed that there were substantially more posts concerning ``Way of living, reasons for living, set of values'' and ``Relationships with medical staff (own hospital)'' than in previous studies (Analysis B). Conclusions: This study provides insight into the feelings of dissatisfaction and anxieties held by lung cancer patients and their families, including those regarding the ``Way of living, reasons for living, set of values'' and ``Relationship with medical staff (own hospital),'' which were inaccessible in previous survey analyses. When comparing information obtained from patients' voluntary records and those from previous surveys conducted by health care institutions, it is likely that the former would be more indicative of patients' actual opinions and feelings. Therefore, it is important to utilize such records as an information resource. ",
doi="10.2196/cancer.3883",
url="https://cancer.jmir.org/2015/1/e5/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28410169"
}


@Article{info:doi/10.2196/mental.4113,
author="Krueger, A. Evan
and Young, D. Sean",
title="Twitter: A Novel Tool for Studying the Health and Social Needs of Transgender Communities",
journal="JMIR Mental Health",
year="2015",
month="May",
day="07",
volume="2",
number="2",
pages="e16",
keywords="Twitter",
keywords="social media",
keywords="transgender",
keywords="health",
abstract="Background: Limited research has examined the health and social needs of transgender and gender nonconforming populations. Due to high levels of stigma, transgender individuals may avoid disclosing their identities to researchers, hindering this type of work. Further, researchers have traditionally relied on clinic-based sampling methods, which may mask the true heterogeneity of transgender and gender nonconforming communities. Online social networking websites present a novel platform for studying this diverse, difficult-to-reach population. Objective: The objective of this study was to attempt to examine the perceived health and social needs of transgender and gender nonconforming communities by examining messages posted to the popular microblogging platform, Twitter. Methods: Tweets were collected from 13 transgender-related hashtags on July 11, 2014. They were read and coded according to general themes addressed, and a content analysis was performed. Qualitative and descriptive statistics are presented. Results: There were 1135 tweets that were collected in total. Both ``positive'' and ``negative'' events were discussed, in both personal and social contexts.  Violence, discrimination, suicide, and sexual risk behavior were discussed. There were 34.36\% (390/1135) of tweets that addressed transgender-relevant current events, and 60.79\% (690/1135) provided a link to a relevant news article or resource. Conclusions: This study found that transgender individuals and allies use Twitter to discuss health and social needs relevant to the population. Real-time social media sites like Twitter can be used to study issues relevant to transgender communities. ",
doi="10.2196/mental.4113",
url="http://mental.jmir.org/2015/2/e16/",
url="http://www.ncbi.nlm.nih.gov/pubmed/26082941"
}


@Article{info:doi/10.2196/jmir.4194,
author="Roberts, John Matthew
and Perera, Marlon
and Lawrentschuk, Nathan
and Romanic, Diana
and Papa, Nathan
and Bolton, Damien",
title="Globalization of Continuing Professional Development by Journal Clubs via Microblogging: A Systematic Review",
journal="J Med Internet Res",
year="2015",
month="Apr",
day="23",
volume="17",
number="4",
pages="e103",
keywords="journal club",
keywords="social media",
keywords="continuing medical education",
keywords="continuing professional development",
keywords="systematic review",
abstract="Background: Journal clubs are an essential tool in promoting clinical evidence-based medical education to all medical and allied health professionals. Twitter represents a public, microblogging forum that can facilitate traditional journal club requirements, while also reaching a global audience, and participation for discussion with study authors and colleagues. Objective: The aim of the current study was to evaluate the current state of social media--facilitated journal clubs, specifically Twitter, as an example of continuing professional development. Methods: A systematic review of literature databases (Medline, Embase, CINAHL, Web of Science, ERIC via ProQuest) was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A systematic search of Twitter, the followers of identified journal clubs, and Symplur was also performed. Demographic and monthly tweet data were extracted from Twitter and Symplur. All manuscripts related to Twitter-based journal clubs were included. Statistical analyses were performed in MS Excel and STATA. Results: From a total of 469 citations, 11 manuscripts were included and referred to five Twitter-based journal clubs (\#ALiEMJC, \#BlueJC, \#ebnjc, \#urojc, \#meded). A Twitter-based journal club search yielded 34 potential hashtags/accounts, of which 24 were included in the final analysis. The median duration of activity was 11.75 (interquartile range [IQR] 19.9, SD 10.9) months, with 7 now inactive. The median number of followers and participants was 374 (IQR 574) and 157 (IQR 272), respectively. An overall increasing establishment of active Twitter-based journal clubs was observed, resulting in an exponential increase in total cumulative tweets (R2=.98), and tweets per month (R2=.72). Cumulative tweets for specific journal clubs increased linearly, with @ADC\_JC, @EBNursingBMJ, @igsjc, @iurojc, and @NephJC, and showing greatest rate of change, as well as total impressions per month since establishment. An average of two tweets per month was estimated for the majority of participants, while the ``Top 10'' tweeters for @iurojc showed a significantly lower contribution to overall tweets for each month (P<.005). A linearly increasing impression:tweet ratio was observed for the top five journal clubs. Conclusions: Twitter-based journal clubs are free, time-efficient, and publicly accessible means to facilitate international discussions regarding clinically important evidence-based research. ",
doi="10.2196/jmir.4194",
url="http://www.jmir.org/2015/4/e103/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25908092"
}


@Article{info:doi/10.2196/jmir.3504,
author="Bissonnette-Maheux, V{\'e}ronique
and Provencher, Veronique
and Lapointe, Annie
and Dugrenier, Marilyn
and Dumas, Audr{\'e}e-Anne
and Pluye, Pierre
and Straus, Sharon
and Gagnon, Marie-Pierre
and Desroches, Sophie",
title="Exploring Women's Beliefs and Perceptions About Healthy Eating Blogs: A Qualitative Study",
journal="J Med Internet Res",
year="2015",
month="Apr",
day="08",
volume="17",
number="4",
pages="e87",
keywords="blog",
keywords="health behavior",
keywords="nutrition",
keywords="qualitative research",
keywords="social media",
keywords="knowledge translation",
abstract="Background: Chronic diseases are the leading cause of death (63\%) worldwide. A key behavioral risk factor is unhealthy eating. New strategies must be identified and evaluated to improve dietary habits. Social media, such as blogs, represent a unique opportunity for improving knowledge translation in health care through interactive communication between health consumers and health professionals. Despite the proliferation of food and lifestyle blogs, no research has been devoted to understanding potential blog readers' perceptions of healthy eating blogs written by dietitians. Objective: To identify women's salient beliefs and perceptions regarding the use of healthy eating blogs written by dietitians promoting the improvement of their dietary habits. Methods: We conducted a qualitative study with female Internet users living in the Quebec City, QC, area with suboptimal dietary habits. First, the women explored 4 existing healthy eating blogs written in French by qualified dietitians. At a focus group 2-4 weeks later, they were asked to discuss their experience and perceptions. Focus group participants were grouped by age (18-34, 35-54, and 55-75 years) and by their use of social media (users/nonusers). Using a questionnaire based on the Theory of Planned Behavior, participants were asked to identify salient beliefs underlying their attitudes (advantages/disadvantages), subjective norms (what people important to them would think), and perceptions of control (facilitators/barriers) regarding the use of a healthy eating blog written by a dietitian to improve dietary habits. Discussion groups were audiotaped, transcribed verbatim, coded, and a deductive content analysis was performed independently by 2 individuals using the NVivo software (version 10). Results: All participants (N=33) were Caucasian women aged between 22 to 73 year. Main advantages perceived of using healthy eating blogs written by a dietitian were that they provided useful recipe ideas, improved lifestyle, were a credible source of information, and allowed interaction with a dietitian. Disadvantages included increased time spent on the Internet and guilt if recommendations were not followed. Important people who would approve were family, colleagues, and friends. Important people who could disapprove were family and doctors. Main facilitators were visually attractive blogs, receiving an email notification about new posts, and finding new information on the blog. Main barriers were too much text, advertising on the blog, and lack of time. Conclusions: The women in this study valued the credibility of healthy eating blogs written by dietitians and the contact with dietitians they provided. Identifying salient beliefs underlying women's perceptions of using such blogs provides an empirically supported basis for the design of knowledge translation interventions to help prevent chronic diseases. ",
doi="10.2196/jmir.3504",
url="http://www.jmir.org/2015/4/e87/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25858777"
}


@Article{info:doi/10.2196/jmir.3646,
author="Jung, Yuchul
and Hur, Cinyoung
and Jung, Dain
and Kim, Minki",
title="Identifying Key Hospital Service Quality Factors in Online Health Communities",
journal="J Med Internet Res",
year="2015",
month="Apr",
day="07",
volume="17",
number="4",
pages="e90",
keywords="hospital service factors",
keywords="online health communities",
keywords="social media-based key quality factors for hospitals",
keywords="recommendation type classification",
keywords="quality factor analysis",
keywords="healthcare policy",
abstract="Background: The volume of health-related user-created content, especially hospital-related questions and answers in online health communities, has rapidly increased. Patients and caregivers participate in online community activities to share their experiences, exchange information, and ask about recommended or discredited hospitals. However, there is little research on how to identify hospital service quality automatically from the online communities. In the past, in-depth analysis of hospitals has used random sampling surveys. However, such surveys are becoming impractical owing to the rapidly increasing volume of online data and the diverse analysis requirements of related stakeholders. Objective: As a solution for utilizing large-scale health-related information, we propose a novel approach to identify hospital service quality factors and overtime trends automatically from online health communities, especially hospital-related questions and answers. Methods: We defined social media--based key quality factors for hospitals. In addition, we developed text mining techniques to detect such factors that frequently occur in online health communities. After detecting these factors that represent qualitative aspects of hospitals, we applied a sentiment analysis to recognize the types of recommendations in messages posted within online health communities. Korea's two biggest online portals were used to test the effectiveness of detection of social media--based key quality factors for hospitals. Results: To evaluate the proposed text mining techniques, we performed manual evaluations on the extraction and classification results, such as hospital name, service quality factors, and recommendation types using a random sample of messages (ie, 5.44\% (9450/173,748) of the total messages). Service quality factor detection and hospital name extraction achieved average F1 scores of 91\% and 78\%, respectively. In terms of recommendation classification, performance (ie, precision) is 78\% on average. Extraction and classification performance still has room for improvement, but the extraction results are applicable to more detailed analysis. Further analysis of the extracted information reveals that there are differences in the details of social media--based key quality factors for hospitals according to the regions in Korea, and the patterns of change seem to accurately reflect social events (eg, influenza epidemics). Conclusions: These findings could be used to provide timely information to caregivers, hospital officials, and medical officials for health care policies. ",
doi="10.2196/jmir.3646",
url="http://www.jmir.org/2015/4/e90/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25855612"
}


@Article{info:doi/10.2196/jmir.3769,
author="Tighe, J. Patrick
and Goldsmith, C. Ryan
and Gravenstein, Michael
and Bernard, Russell H.
and Fillingim, B. Roger",
title="The Painful Tweet: Text, Sentiment, and Community Structure Analyses of Tweets Pertaining to Pain",
journal="J Med Internet Res",
year="2015",
month="Apr",
day="02",
volume="17",
number="4",
pages="e84",
keywords="Twitter messaging",
keywords="emotions",
keywords="text mining",
keywords="social networks",
abstract="Background: Despite the widespread popularity of social media, little is known about the extent or context of pain-related posts by users of those media. Objective: The aim was to examine the type, context, and dissemination of pain-related tweets. Methods: We used content analysis of pain-related tweets from 50 cities to unobtrusively explore the meanings and patterns of communications about pain. Content was examined by location and time of day, as well as within the context of online social networks. Results: The most common terms published in conjunction with the term ``pain'' included feel (n=1504), don't (n=702), and love (n=649). The proportion of tweets with positive sentiment ranged from 13\% in Manila to 56\% in Los Angeles, CA, with a median of 29\% across cities. Temporally, the proportion of tweets with positive sentiment ranged from 24\% at 1600 to 38\% at 2400, with a median of 32\%. The Twitter-based social networks pertaining to pain exhibited greater sparsity and lower connectedness than did those social networks pertaining to common terms such as apple, Manchester United, and Obama. The number of word clusters in proportion to node count was greater for emotion terms such as tired (0.45), happy (0.43), and sad (0.4) when compared with objective terms such as apple (0.26), Manchester United (0.14), and Obama (0.25). Conclusions: Taken together, our results suggest that pain-related tweets carry special characteristics reflecting unique content and their communication among tweeters. Further work will explore how geopolitical events and seasonal changes affect tweeters' perceptions of pain and how such perceptions may affect therapies for pain. ",
doi="10.2196/jmir.3769",
url="http://www.jmir.org/2015/4/e84/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25843553"
}


@Article{info:doi/10.2196/med20.3628,
author="Boudry, Christophe",
title="Web 2.0 Applications in Medicine: Trends and Topics in the Literature",
journal="Med 2.0",
year="2015",
month="Apr",
day="01",
volume="4",
number="1",
pages="e2",
keywords="Social media",
keywords="Internet",
keywords="Health information management",
keywords="bibliometrics",
keywords="Medline",
keywords="Blogging",
keywords="Medical Informatics",
abstract="Background: The World Wide Web has changed research habits, and these changes were further expanded when ``Web 2.0'' became popular in 2005. Bibliometrics is a helpful tool used for describing patterns of publication, for interpreting progression over time, and the geographical distribution of research in a given field. Few studies employing bibliometrics, however, have been carried out on the correlative nature of scientific literature and Web 2.0. Objective: The aim of this bibliometric analysis was to provide an overview of Web 2.0 implications in the biomedical literature. The objectives were to assess the growth rate of literature, key journals, authors, and country contributions, and to evaluate whether the various Web 2.0 applications were expressed within this biomedical literature, and if so, how. Methods: A specific query with keywords chosen to be representative of Web 2.0 applications was built for the PubMed database. Articles related to Web 2.0 were downloaded in Extensible Markup Language (XML) and were processed through developed hypertext preprocessor (PHP) scripts, then imported to Microsoft Excel 2010 for data processing. Results: A total of 1347 articles were included in this study. The number of articles related to Web 2.0 has been increasing from 2002 to 2012 (average annual growth rate was 106.3\% with a maximum of 333\% in 2005). The United States was by far the predominant country for authors, with 514 articles (54.0\%; 514/952). The second and third most productive countries were the United Kingdom and Australia, with 87 (9.1\%; 87/952) and 44 articles (4.6\%; 44/952), respectively. Distribution of number of articles per author showed that the core population of researchers working on Web 2.0 in the medical field could be estimated at approximately 75. In total, 614 journals were identified during this analysis. Using Bradford's law, 27 core journals were identified, among which three (Studies in Health Technology and Informatics, Journal of Medical Internet Research, and Nucleic Acids Research) produced more than 35 articles related to Web 2.0 over the period studied. A total of 274 words in the field of Web 2.0 were found after manual sorting of the 15,878 words appearing in title and abstract fields for articles. Word frequency analysis reveals ``blog'' as the most recurrent, followed by ``wiki'', ``Web 2.0'', ''social media'', ``Facebook'', ``social networks'', ``blogger'', ``cloud computing'', ``Twitter'', and ``blogging''. All categories of Web 2.0 applications were found, indicating the successful integration of Web 2.0 into the biomedical field. Conclusions: This study shows that the biomedical community is engaged in the use of Web 2.0 and confirms its high level of interest in these tools. Therefore, changes in the ways researchers use information seem to be far from over. ",
doi="10.2196/med20.3628",
url="http://www.medicine20.com/2015/1/e2/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25842175"
}


@Article{info:doi/10.2196/jmir.4167,
author="Morris, R. Robert
and Schueller, M. Stephen
and Picard, W. Rosalind",
title="Efficacy of a Web-Based, Crowdsourced Peer-To-Peer Cognitive Reappraisal Platform for Depression: Randomized Controlled Trial",
journal="J Med Internet Res",
year="2015",
month="Mar",
day="30",
volume="17",
number="3",
pages="e72",
keywords="Web-based intervention",
keywords="crowdsourcing",
keywords="randomized controlled trial",
keywords="depression",
keywords="cognitive behavioral therapy",
keywords="mental health",
keywords="social networks",
abstract="Background: Self-guided, Web-based interventions for depression show promising results but suffer from high attrition and low user engagement. Online peer support networks can be highly engaging, but they show mixed results and lack evidence-based content. Objective: Our aim was to introduce and evaluate a novel Web-based, peer-to-peer cognitive reappraisal platform designed to promote evidence-based techniques, with the hypotheses that (1) repeated use of the platform increases reappraisal and reduces depression and (2) that the social, crowdsourced interactions enhance engagement. Methods: Participants aged 18-35 were recruited online and were randomly assigned to the treatment group, ``Panoply'' (n=84), or an active control group, online expressive writing (n=82). Both are fully automated Web-based platforms. Participants were asked to use their assigned platform for a minimum of 25 minutes per week for 3 weeks. Both platforms involved posting descriptions of stressful thoughts and situations. Participants on the Panoply platform additionally received crowdsourced reappraisal support immediately after submitting a post (median response time=9 minutes). Panoply participants could also practice reappraising stressful situations submitted by other users. Online questionnaires administered at baseline and 3 weeks assessed depression symptoms, reappraisal, and perseverative thinking. Engagement was assessed through self-report measures, session data, and activity levels. Results: The Panoply platform produced significant improvements from pre to post for depression (P=.001), reappraisal (P<.001), and perseverative thinking (P<.001). The expressive writing platform yielded significant pre to post improvements for depression (P=.02) and perseverative thinking (P<.001), but not reappraisal (P=.45). The two groups did not diverge significantly at post-test on measures of depression or perseverative thinking, though Panoply users had significantly higher reappraisal scores (P=.02) than expressive writing. We also found significant group by treatment interactions. Individuals with elevated depression symptoms showed greater comparative benefit from Panoply for depression (P=.02) and perseverative thinking (P=.008). Individuals with baseline reappraisal deficits showed greater comparative benefit from Panoply for depression (P=.002) and perseverative thinking (P=.002). Changes in reappraisal mediated the effects of Panoply, but not the expressive writing platform, for both outcomes of depression (ab=-1.04, SE 0.58, 95\% CI -2.67 to -.12) and perseverative thinking (ab=-1.02, SE 0.61, 95\% CI -2.88 to -.20). Dropout rates were similar for the two platforms; however, Panoply yielded significantly more usage activity (P<.001) and significantly greater user experience scores (P<.001). Conclusions: Panoply engaged its users and was especially helpful for depressed individuals and for those who might ordinarily underutilize reappraisal techniques. Further investigation is needed to examine the long-term effects of such a platform and whether the benefits generalize to a more diverse population of users. Trial Registration: ClinicalTrials.gov NCT02302248; https://clinicaltrials.gov/ct2/show/NCT02302248 (Archived by WebCite at http://www.webcitation.org/6Wtkj6CXU). ",
doi="10.2196/jmir.4167",
url="http://www.jmir.org/2015/3/e72/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25835472"
}


@Article{info:doi/10.2196/jmir.3875,
author="Wang, Shiliang
and Paul, J. Michael
and Dredze, Mark",
title="Social Media as a Sensor of Air Quality and Public Response in China",
journal="J Med Internet Res",
year="2015",
month="Mar",
day="26",
volume="17",
number="3",
pages="e22",
keywords="air pollution",
keywords="public health surveillance",
keywords="social media",
keywords="data mining",
keywords="text mining",
keywords="natural language processing",
abstract="Background: Recent studies have demonstrated the utility of social media data sources for a wide range of public health goals, including disease surveillance, mental health trends, and health perceptions and sentiment. Most such research has focused on English-language social media for the task of disease surveillance. Objective: We investigated the value of Chinese social media for monitoring air quality trends and related public perceptions and response. The goal was to determine if this data is suitable for learning actionable information about pollution levels and public response. Methods: We mined a collection of 93 million messages from Sina Weibo, China's largest microblogging service. We experimented with different filters to identify messages relevant to air quality, based on keyword matching and topic modeling. We evaluated the reliability of the data filters by comparing message volume per city to air particle pollution rates obtained from the Chinese government for 74 cities. Additionally, we performed a qualitative study of the content of pollution-related messages by coding a sample of 170 messages for relevance to air quality, and whether the message included details such as a reactive behavior or a health concern. Results: The volume of pollution-related messages is highly correlated with particle pollution levels, with Pearson correlation values up to .718 (n=74, P<.001). Our qualitative results found that 67.1\% (114/170) of messages were relevant to air quality and of those, 78.9\% (90/114) were a firsthand report. Of firsthand reports, 28\% (32/90) indicated a reactive behavior and 19\% (17/90) expressed a health concern. Additionally, 3 messages of 170 requested that action be taken to improve quality. Conclusions: We have found quantitatively that message volume in Sina Weibo is indicative of true particle pollution levels, and we have found qualitatively that messages contain rich details including perceptions, behaviors, and self-reported health effects. Social media data can augment existing air pollution surveillance data, especially perception and health-related data that traditionally requires expensive surveys or interviews. ",
doi="10.2196/jmir.3875",
url="http://www.jmir.org/2015/3/e22/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25831020"
}


@Article{info:doi/10.2196/jmir.3082,
author="Tillmann, Taavi
and Gibson, R. Alexander
and Scott, Gregory
and Harrison, Oliver
and Dominiczak, Anna
and Hanlon, Phil",
title="Systems Medicine 2.0: Potential Benefits of Combining Electronic Health Care Records With Systems Science Models",
journal="J Med Internet Res",
year="2015",
month="Mar",
day="23",
volume="17",
number="3",
pages="e64",
keywords="gene-environment interaction",
keywords="systems theory",
keywords="electronic health records",
keywords="epidemiology",
keywords="online social networks",
keywords="crowd-sourcing",
keywords="Web 2.0",
abstract="Background: The global burden of disease is increasingly dominated by non-communicable diseases.These diseases are less amenable to curative and preventative interventions than communicable disease. This presents a challenge to medical practice and medical research, both of which are experiencing diminishing returns from increasing investment. Objective: Our aim was to (1) review how medical knowledge is generated, and its limitations, (2) assess the potential for emerging technologies and ideas to improve medical research, and (3) suggest solutions and recommendations to increase medical research efficiency on non-communicable diseases. Methods: We undertook an unsystematic review of peer-reviewed literature and technology websites. Results: Our review generated the following conclusions and recommendations. (1) Medical knowledge continues to be generated in a reductionist paradigm. This oversimplifies our models of disease, rendering them ineffective to sufficiently understand the complex nature of non-communicable diseases. (2) Some of these failings may be overcome by adopting a ``Systems Medicine'' paradigm, where the human body is modeled as a complex adaptive system. That is, a system with multiple components and levels interacting in complex ways, wherein disease emerges from slow changes to the system set-up. Pursuing systems medicine research will require larger datasets. (3) Increased data sharing between researchers, patients, and clinicians could provide this unmet need for data. The recent emergence of electronic health care records (EHR) could potentially facilitate this in real-time and at a global level. (4) Efforts should continue to aggregate anonymous EHR data into large interoperable data silos and release this to researchers. However, international collaboration, data linkage, and obtaining additional information from patients will remain challenging. (5) Efforts should also continue towards ``Medicine 2.0''. Patients should be given access to their personal EHR data. Subsequently, online communities can give researchers the opportunity to ask patients for direct access to the patient's EHR data and request additional study-specific information. However, selection bias towards patients who use Web 2.0 technology may be difficult to overcome. Conclusions: Systems medicine, when combined with large-scale data sharing, has the potential to raise our understanding of non-communicable diseases, foster personalized medicine, and make substantial progress towards halting, curing, and preventing non-communicable diseases. Large-scale data amalgamation remains a core challenge and needs to be supported. A synthesis of ``Medicine 2.0'' and ``Systems Science'' concepts into ``Systems Medicine 2.0'' could take decades to materialize but holds much promise. ",
doi="10.2196/jmir.3082",
url="http://www.jmir.org/2015/3/e64/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25831125"
}


@Article{info:doi/10.2196/jmir.3962,
author="Gottlieb, Assaf
and Hoehndorf, Robert
and Dumontier, Michel
and Altman, B. Russ",
title="Ranking Adverse Drug Reactions With Crowdsourcing",
journal="J Med Internet Res",
year="2015",
month="Mar",
day="23",
volume="17",
number="3",
pages="e80",
keywords="pharmacovigilance",
keywords="adverse drug reactions",
keywords="drug side effects",
keywords="crowdsourcing",
keywords="patient-centered care",
keywords="alert fatigue",
abstract="Background: There is no publicly available resource that provides the relative severity of adverse drug reactions (ADRs). Such a resource would be useful for several applications, including assessment of the risks and benefits of drugs and improvement of patient-centered care. It could also be used to triage predictions of drug adverse events. Objective: The intent of the study was to rank ADRs according to severity. Methods: We used Internet-based crowdsourcing to rank ADRs according to severity. We assigned 126,512 pairwise comparisons of ADRs to 2589 Amazon Mechanical Turk workers and used these comparisons to rank order 2929 ADRs. Results: There is good correlation (rho=.53) between the mortality rates associated with ADRs and their rank. Our ranking highlights severe drug-ADR predictions, such as cardiovascular ADRs for raloxifene and celecoxib. It also triages genes associated with severe ADRs such as epidermal growth-factor receptor (EGFR), associated with glioblastoma multiforme, and SCN1A, associated with epilepsy. Conclusions: ADR ranking lays a first stepping stone in personalized drug risk assessment. Ranking of ADRs using crowdsourcing may have useful clinical and financial implications, and should be further investigated in the context of health care decision making. ",
doi="10.2196/jmir.3962",
url="http://www.jmir.org/2015/3/e80/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25800813"
}


@Article{info:doi/10.2196/resprot.3285,
author="Tse, KW Carrie
and Bridges, M. Susan
and Srinivasan, Parthasarathy Divya
and Cheng, SS Brenda",
title="Social Media in Adolescent Health Literacy Education: A Pilot Study",
journal="JMIR Res Protoc",
year="2015",
month="Mar",
day="09",
volume="4",
number="1",
pages="e18",
keywords="social media",
keywords="health literacy",
keywords="oral health literacy",
keywords="dentistry",
keywords="adolescents",
keywords="oral health",
keywords="health informatics",
abstract="Background: While health literacy has gained notice on a global stage, the initial focus on seeking associations with medical conditions may have overlooked its impact across generations. Adolescent health literacy, specifically in dentistry, is an underexplored area despite the significance of this formative stage on an individual's approach to healthy lifestyles and behaviors. Objective: The aim is to conduct a pilot study to evaluate the efficacy of three major social media outlets - Twitter, Facebook, and YouTube - in supporting adolescents' oral health literacy (OHL) education. Methods: A random sample of 22 adolescents (aged 14-16 years) from an English-medium international school in Hong Kong provided informed consent. Sociodemographic information, including English language background, social media usage, and dental experience were collected via a questionnaire. A pre- and post-test of OHL (REALD-30) was administered by two trained, calibrated examiners. Following pre-test, participants were randomly assigned to one of three social media outlets: Twitter, Facebook, or YouTube. Participants received alerts posted daily for 5 consecutive days requiring online accessing of modified and original OHL education materials. One-way ANOVA ( analysis of variance) was used to compare the mean difference between the  pre- and the post-test results among the three social media. Results: No associations were found between the social media allocated and participants' sociodemographics, including English language background, social media usage, and dental experience. Of the three social media, significant differences in literacy assessment scores were evident for participants who received oral health education messages via Facebook (P=.02) and YouTube (P=.005). Conclusions: Based on the results of the pilot study, Facebook and YouTube may be more efficient media outlets for OHL promotion and education among adolescent school children when compared to Twitter. Further analyses with a larger study group is warranted. ",
doi="10.2196/resprot.3285",
url="http://www.researchprotocols.org/2015/1/e18/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25757670"
}


@Article{info:doi/10.2196/jmir.3608,
author="Prescott, Julie
and Gray, J. Nicola
and Smith, J. Felicity
and McDonagh, E. Janet",
title="Blogging as a Viable Research Methodology for Young People With Arthritis: A Qualitative Study",
journal="J Med Internet Res",
year="2015",
month="Mar",
day="05",
volume="17",
number="3",
pages="e61",
keywords="young people",
keywords="blogging",
keywords="qualitative research",
keywords="arthritis",
abstract="Background: The development of services that are responsive to the needs of users is a health policy priority. Finding ways of engaging young people in research to gain insights into their particular experiences, perspectives, and needs is vital but challenging. These data are critical to improving services in ways that meet the needs of young people. Objective: Our aim was to evaluate Web-based blogging as a viable method for understanding the daily experiences and condition management strategies of young people with juvenile arthritis. Methods: To meet the objectives of the study, a qualitative approach was required to gather information on the experiences and perspectives of young people regarding the management of their condition and its daily impact. In collaboration with a group of young people with arthritis, a custom website was developed. This website provided the opportunity for young people (aged 11-19) with arthritis from a United Kingdom pediatric hospital to contribute blogs. It was designed so that young people were free to write about whatever was important to them, but the site also included some structure and prompts to facilitate the writing of blogs. Qualitative analytical procedures were employed, supported by NVivo software. Results: Engagement in the study by young people was variable in terms of their participation rates, frequency of website visits, and the length of their blogs. Young people used the site in different ways, some responding to the website categories and prompts that the team created, while others used it as a diary to record their experiences and thoughts. In line with principles of qualitative inquiry, the data collection was participant-led. Young people were in control of what, how much, and how often they wrote. However, some young people expressed difficulty regarding knowing what they should blog about. For a number of reasons, discussed here, the blogs may also not be fully reflective of experiences and perspectives of the participants. However, the data obtained provided insights into young people's experiences of living with arthritis and their use of medicines in the context of their daily lives. Conclusions: Web-based research with young people presents opportunities and challenges for researchers. Web-based blogging methodology has the potential to give young people and parents the space and empowerment to express their own ideas and concerns. However, this project suggests that it might not be the best way to engage a large diverse group of young people and might most effectively be combined with other approaches. Despite these limitations, the study provided valuable data about the experience and impact of living with a long-term condition from the perspectives of young people with arthritis. ",
doi="10.2196/jmir.3608",
url="http://www.jmir.org/2015/3/e61/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25749691"
}


@Article{info:doi/10.2196/jmir.4069,
author="Heilman, M. James
and West, G. Andrew",
title="Wikipedia and Medicine: Quantifying Readership, Editors, and the Significance of Natural Language",
journal="J Med Internet Res",
year="2015",
month="Mar",
day="04",
volume="17",
number="3",
pages="e62",
keywords="health information systems",
keywords="consumer health information",
keywords="information sharing",
keywords="information networks",
keywords="information science",
keywords="Internet",
keywords="Web 2.0",
keywords="cooperative behavior",
abstract="Background: Wikipedia is a collaboratively edited encyclopedia. One of the most popular websites on the Internet, it is known to be a frequently used source of health care information by both professionals and the lay public. Objective: This paper quantifies the production and consumption of Wikipedia's medical content along 4 dimensions. First, we measured the amount of medical content in both articles and bytes and, second, the citations that supported that content. Third, we analyzed the medical readership against that of other health care websites between Wikipedia's natural language editions and its relationship with disease prevalence. Fourth, we surveyed the quantity/characteristics of Wikipedia's medical contributors, including year-over-year participation trends and editor demographics. Methods: Using a well-defined categorization infrastructure, we identified medically pertinent English-language Wikipedia articles and links to their foreign language equivalents. With these, Wikipedia can be queried to produce metadata and full texts for entire article histories. Wikipedia also makes available hourly reports that aggregate reader traffic at per-article granularity. An online survey was used to determine the background of contributors. Standard mining and visualization techniques (eg, aggregation queries, cumulative distribution functions, and/or correlation metrics) were applied to each of these datasets. Analysis focused on year-end 2013, but historical data permitted some longitudinal analysis. Results: Wikipedia's medical content (at the end of 2013) was made up of more than 155,000 articles and 1 billion bytes of text across more than 255 languages. This content was supported by more than 950,000 references. Content was viewed more than 4.88 billion times in 2013. This makes it one of if not the most viewed medical resource(s) globally. The core editor community numbered less than 300 and declined over the past 5 years. The members of this community were half health care providers and 85.5\% (100/117) had a university education. Conclusions: Although Wikipedia has a considerable volume of multilingual medical content that is extensively read and well-referenced, the core group of editors that contribute and maintain that content is small and shrinking in size. ",
doi="10.2196/jmir.4069",
url="http://www.jmir.org/2015/3/e62/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25739399"
}


@Article{info:doi/10.2196/jmir.3812,
author="Wong, A. Charlene
and Sap, Maarten
and Schwartz, Andrew
and Town, Robert
and Baker, Tom
and Ungar, Lyle
and Merchant, M. Raina",
title="Twitter Sentiment Predicts Affordable Care Act Marketplace Enrollment",
journal="J Med Internet Res",
year="2015",
month="Feb",
day="23",
volume="17",
number="2",
pages="e51",
keywords="affordable care act",
keywords="social media",
keywords="health insurance marketplace",
abstract="Background: Traditional metrics of the impact of the Affordable Care Act (ACA) and health insurance marketplaces in the United States include public opinion polls and marketplace enrollment, which are published with a lag of weeks to months. In this rapidly changing environment, a real-time barometer of public opinion with a mechanism to identify emerging issues would be valuable. Objective: We sought to evaluate Twitter's role as a real-time barometer of public sentiment on the ACA and to determine if Twitter sentiment (the positivity or negativity of tweets) could be predictive of state-level marketplace enrollment. Methods: We retrospectively collected 977,303 ACA-related tweets in March 2014 and then tested a correlation of Twitter sentiment with marketplace enrollment by state. Results: A 0.10 increase in the sentiment score was associated with an 8.7\% increase in enrollment at the state level (95\% CI 1.32-16.13; P=.02), a correlation that remained significant when adjusting for state Medicaid expansion (P=.02) or use of a state-based marketplace (P=.03). Conclusions: This correlation indicates Twitter's potential as a real-time monitoring strategy for future marketplace enrollment periods; marketplaces could systematically track Twitter sentiment to more rapidly identify enrollment changes and potentially emerging issues. As a repository of free and accessible consumer-generated opinions, this study reveals a novel role for Twitter in the health policy landscape. ",
doi="10.2196/jmir.3812",
url="http://www.jmir.org/2015/2/e51/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25707038"
}


@Article{info:doi/10.2196/jmir.3772,
author="Pechmann, Cornelia
and Pan, Li
and Delucchi, Kevin
and Lakon, M. Cynthia
and Prochaska, J. Judith",
title="Development of a Twitter-Based Intervention for Smoking Cessation that Encourages High-Quality Social Media Interactions via Automessages",
journal="J Med Internet Res",
year="2015",
month="Feb",
day="23",
volume="17",
number="2",
pages="e50",
keywords="smoking cessation",
keywords="social media",
keywords="text messaging",
abstract="Background: The medical field seeks to use social media to deliver health interventions, for example, to provide low-cost, self-directed, online self-help groups. However, engagement in online groups is often low and the informational content may be poor. Objective: The specific study aims were to explore if sending automessages to online self-help groups encouraged engagement and to see if overall or specific types of engagement related to abstinence. Methods: We conducted a Stage I Early Therapy Development Trial of a novel social media intervention for smoking cessation called Tweet2Quit that was delivered online over closed, 20-person quit-smoking groups on Twitter in 100 days. Social media such as Twitter traditionally involves non-directed peer-to-peer exchanges, but our hybrid social media intervention sought to increase and direct such exchanges by sending out two types of autocommunications daily: (1) an ``automessage'' that encouraged group discussion on an evidence-based cessation-related or community-building topic, and (2) individualized ``autofeedback'' to each participant on their past 24-hour tweeting. The intervention was purposefully designed without an expert group facilitator and with full automation to ensure low cost, easy implementation, and broad scalability. This purely Web-based trial examined two online quit-smoking groups with 20 members each. Participants were adult smokers who were interested in quitting and were recruited using Google AdWords. Participants' tweets were counted and content coded, distinguishing between responses to the intervention's automessages and spontaneous tweets. In addition, smoking abstinence was assessed at 7 days, 30 days, and 60 days post quit date. Statistical models assessed how tweeting related to abstinence. Results: Combining the two groups, 78\% (31/40) of the members sent at least one tweet; and on average, each member sent 72 tweets during the 100-day period. The automessage-suggested discussion topics and participants' responses to those daily automessages were related in terms of their content (r=.75, P=.012). Responses to automessages contributed 22.78\% (653/2867) of the total tweets; 77.22\% (2214/2867) were spontaneous. Overall tweeting related only marginally to abstinence (OR 1.03, P=.086). However, specific tweet content related to abstinence including tweets about setting of a quit date or use of nicotine patches (OR 1.52, P=.024), countering of roadblocks to quitting (OR 1.76, P=.008) and expressions of confidence about quitting (OR 1.71, SE 0.42, P=.032). Questionable, that is, non-evidence-based, information about quitting did not relate to abstinence (OR 1.12, P=.278). Conclusions: A hybrid social media intervention that combines traditional online social support with daily automessages appears to hold promise for smoking cessation. This hybrid approach capitalizes on social media's spontaneous real-time peer-to-peer exchanges but supplements this with daily automessages that group members respond to, bolstering and sustaining the social network and directing the information content. Highly engaging, this approach should be studied further. Trial Registration: Clinicaltrials.gov NCT01602536; https://clinicaltrials.gov/ct2/show/NCT01602536 (Archived by WebCite at http://www.webcitation.org/6WGbt0o1K) ",
doi="10.2196/jmir.3772",
url="http://www.jmir.org/2015/2/e50/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25707037"
}


@Article{info:doi/10.2196/jmir.3574,
author="Brulet, Alexandre
and Llorca, Guy
and Letrilliart, Laurent",
title="Medical Wikis Dedicated to Clinical Practice: A Systematic Review",
year="2015",
month="Feb",
day="19",
volume="17",
number="2",
pages="e48",
keywords="wikis",
keywords="clinical medicine",
keywords="review",
abstract="Background: Wikis may give clinician communities the opportunity to build knowledge relevant to their practice. The only previous study reviewing a set of health-related wikis, without specification of purpose or audience, globally showed a poor reliability. Objective: Our aim was to review medical wiki websites dedicated to clinical practices. Methods: We used Google in ten languages, PubMed, Embase, Lilacs, and Web of Science to identify websites. The review included wiki sites, accessible and operating, having a topic relevant for clinical medicine, targeting physicians or medical students. Wikis were described according to their purposes, platform, management, information framework, contributions, content, and activity. Purposes were classified as ``encyclopedic'' or ``non-encyclopedic''. The information framework quality was assessed based on the Health On the Net (HONcode) principles for collaborative websites, with additional criteria related to users' transparency and editorial policy. From a sample of five articles per wikis, we assessed the readability using the Flesch test and compared articles according to the wikis' main purpose. Annual editorial activities were estimated using the Google engine. Results: Among 25 wikis included, 11 aimed at building an encyclopedia, five a textbook, three lessons, two oncology protocols, one a single article, and three at reporting clinical cases. Sixteen wikis were specialized with specific themes or disciplines. Fifteen wikis were using MediaWiki software as-is, three were hosted by online wiki farms, and seven were purpose-built. Except for one MediaWiki-based site, only purpose-built platforms managed detailed user disclosures. The owners were ten organizations, six individuals, four private companies, two universities, two scientific societies, and one unknown. Among 21 open communities, 10 required users' credentials to give editing rights. The median information framework quality score was 6 out of 16 (range 0-15). Beyond this score, only one wiki had standardized peer-reviews. Physicians contributed to 22 wikis, medical learners to nine, and lay persons to four. Among 116 sampled articles, those from encyclopedic wikis had more videos, pictures, and external resources, whereas others had more posology details and better readability. The median creation year was 2007 (1997-2011), the median number of content pages was 620.5 (3-98,039), the median of revisions per article was 17.7 (3.6-180.5) and 0.015 of talk pages per article (0-0.42). Five wikis were particularly active, whereas six were declining. Two wikis have been discontinued after the completion of the study. Conclusions: The 25 medical wikis we studied present various limitations in their format, management, and collaborative features. Professional medical wikis may be improved by using clinical cases, developing more detailed transparency and editorial policies, and involving postgraduate and continuing medical education learners. ",
doi="10.2196/jmir.3574",
url="http://www.jmir.org/16/2/e48/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25700482"
}


@Article{info:doi/10.2196/jmir.4061,
author="Haines-Saah, J. Rebecca
and Kelly, T. Mary
and Oliffe, L. John
and Bottorff, L. Joan",
title="Picture Me Smokefree: A Qualitative Study Using Social Media and Digital Photography to Engage Young Adults in Tobacco Reduction and Cessation",
journal="J Med Internet Res",
year="2015",
month="Jan",
day="26",
volume="17",
number="1",
pages="e27",
keywords="smoking cessation",
keywords="tobacco use",
keywords="young adults",
keywords="Facebook",
keywords="participatory visual methods",
abstract="Background: Young adults have high rates of tobacco use compared to other subpopulations, yet there are relatively few tobacco interventions specifically targeted to this group. Picture Me Smokefree is an online tobacco reduction and cessation intervention for young adults that uses digital photography and social networking. Objective: The main goal of the project was to determine the feasibility of engaging young adults in participating in user-driven, online forums intended to provide peer support and motivate critical reflection about tobacco use and cessation among this high-use, hard-to-reach population. A related aim was to explore the influence of gender-related factors on participation, in order to determine the need for online interventions to be tailored to the specific gender preferences reflecting young men and women's participation styles. Methods: A total of 60 young adults ages 19-24 years who self-identified as current cigarette smokers or who had quit within the last year were recruited from across British Columbia, Canada, and participated in an online photo group on Facebook over a period of 12 consecutive weeks. A variety of data collection methods were used including tracking online activity, a brief online follow-up survey, and qualitative interviews with study participants. Data analysis involved descriptive statistics on recruitment, retention, and participation and qualitative (eg, narrative analysis, synthesis of feedback) feedback about participant engagement. Results: Findings from this study suggest good potential for Facebook as an accessible, low-cost platform for engaging young adults to reflect on the reasons for their tobacco use, the benefits of quitting or reducing, and the best strategies for tobacco reduction. Young adults' frequent use of mobile phones and other mobile devices to access social networking permitted ease of access and facilitated real-time peer-to-peer support across a diverse group of participants. However, our experience of conducting the study suggests that working with young tobacco users can be accompanied by considerable recruitment, participation, and retention challenges. Our findings also pointed to differences in how young women and men engaged the photo-group intervention that should be considered, bearing in mind that in follow-up interviews participants indicated their preference for a mixed gender and ``gender neutral'' group format. Conclusions: Tobacco interventions for youth and young adults should be embedded within the existing social networking platforms they access most frequently, rather than designing a stand-alone online prevention or intervention resource. This subpopulation would likely benefit from tobacco reduction interventions that are gender-sensitive rather than gender-specific. ",
doi="10.2196/jmir.4061",
url="http://www.jmir.org/2015/1/e27/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25624064"
}


@Article{info:doi/10.2196/jmir.3915,
author="Merolli, Mark
and Gray, Kathleen
and Martin-Sanchez, Fernando
and Lopez-Campos, Guillermo",
title="Patient-Reported Outcomes and Therapeutic Affordances of Social Media: Findings From a Global Online Survey of People With Chronic Pain",
journal="J Med Internet Res",
year="2015",
month="Jan",
day="22",
volume="17",
number="1",
pages="e20",
keywords="social media",
keywords="chronic disease",
keywords="chronic pain",
keywords="therapeutic affordances",
keywords="patient-reported outcomes",
abstract="Background: Patient-reported outcomes (PROs) from social media use in chronic disease management continue to emerge. While many published articles suggest the potential for social media is positive, there is a lack of robust examination into mediating mechanisms that might help explain social media's therapeutic value. This study presents findings from a global online survey of people with chronic pain (PWCP) to better understand how they use social media as part of self-management. Objective: Our aim is to improve understanding of the various health outcomes reported by PWCP by paying close attention to therapeutic affordances of social media. We wish to examine if demographics of participants underpin health outcomes and whether the concept of therapeutic affordances explains links between social media use and PROs. The goal is for this to help tailor future recommendations for use of social media to meet individuals' health needs and improve clinical practice of social media use. Methods: A total of 231 PWCP took part in a global online survey investigating PROs from social media use. Recruited through various chronic disease entities and social networks, participants provided information on demographics, health/pain status, social media use, therapeutic affordances, and PROs from use. Quantitative analysis was performed on the data using descriptive statistics, cross-tabulation, and cluster analysis. Results: The total dataset represented 218 completed surveys. The majority of participants were university educated (67.0\%, 146/218) and female (83.9\%, 183/218). More than half (58.7\%, 128/218) were married/partnered and not working for pay (75.9\%, 88/116 of these due to ill health). Fibromyalgia (46.6\%, 55/118) and arthritis (27.1\%, 32/118) were the most commonly reported conditions causing pain. Participants showed a clear affinity for social network site use (90.0\%, 189/210), followed by discussion forums and blogs. PROs were consistent, suggesting that social media positively impact psychological, social, and cognitive health. Analysis also highlighted two strong correlations linking platform used and health outcomes (particularly psychological, social, and cognitive) to (1) the narrative affordance of social media and (2) frequency of use of the platforms. Conclusions: Results did not uncover definitive demographics or characteristics of PWCP for which health outcomes are impacted. However, findings corroborate literature within this domain suggesting that there is a typical profile of people who use social media for health and that social media are more suited to particular health outcomes. Exploration of the relationship between social media's therapeutic affordances and health outcomes, in particular the narration affordance, warrants further attention by patients and clinicians. ",
doi="10.2196/jmir.3915",
url="http://www.jmir.org/2015/1/e20/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25616273"
}


@Article{info:doi/10.2196/jmir.3665,
author="Liang, Yunji
and Zheng, Xiaolong
and Zeng, Dajun Daniel
and Zhou, Xingshe
and Leischow, James Scott
and Chung, Wingyan",
title="Exploring How the Tobacco Industry Presents and Promotes Itself in Social Media",
journal="J Med Internet Res",
year="2015",
month="Jan",
day="21",
volume="17",
number="1",
pages="e24",
keywords="cigarette brands",
keywords="promotional strategy",
keywords="social media",
keywords="tobacco control",
keywords="tobacco promotion",
abstract="Background: The commercial potential of social media is utilized by tobacco manufacturers and vendors for tobacco promotion online. However, the prevalence and promotional strategies of pro-tobacco content in social media are still not widely understood. Objective: The goal of this study was to reveal what is presented by the tobacco industry, and how it promotes itself, on social media sites. Methods: The top 70 popular cigarette brands are divided into two groups according to their retail prices: group H (brands with high retail prices) and group L (brands with low retail prices). Three comprehensive searches were conducted on Facebook, Wikipedia, and YouTube respectively using the top 70 popular cigarette brands as keywords. We identified tobacco-related content including history and culture, product features, health warnings, home page of cigarette brands, and Web-based tobacco shops. Furthermore, we examined the promotional strategies utilized in social media. Results: According to the data collected from March 3, 2014 to March 10, 2014, 43 of the 70 representative cigarette brands had created 238 Facebook fan pages, 46 cigarette brands were identified in Wikipedia, and there were over 120,000 pro-tobacco videos on YouTube, associated with 61 cigarette brands. The main content presented on the three social media websites differs significantly. Wikipedia focuses on history and culture (67\%, 32/48; P<.001). Facebook mainly covers history and culture (37\%, 16/43; P<.001) and major products (35\%, 15/43), while YouTube focuses on the features of major tobacco products (79\%, 48/61; P=.04) and information about Web-based shops (49\%, 30/61; P=.004). Concerning the content presented by groups H and L, there is no significant difference between the two groups. With regard to the promotional strategies used, sales promotions exist extensively in social media. Sales promotion is more prevalent on YouTube than on the other two sites (64\%, 39/61 vs 35\%, 15/43; P=.004). Generally, the sale promotions of higher-cost brands in social media are more prevalent than those of lower-cost brands (55\%, 16/29 vs 7\%, 1/14; P<.001 for Facebook; 78\%, 28/36 vs 44\%, 11/25; P=.005 for YouTube). Conclusions: The prevalence of cigarette brands in social media allows more pro-tobacco information to be accessed by online users. This dilemma indicates that corresponding regulations should be established to prevent tobacco promotion in social media. ",
doi="10.2196/jmir.3665",
url="http://www.jmir.org/2015/1/e24/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25608524"
}


@Article{info:doi/10.2196/ijmr.3835,
author="Knight, Emily
and Intzandt, Brittany
and MacDougall, Alicia
and Saunders, J. Travis",
title="Information Seeking in Social Media: A Review of YouTube for Sedentary Behavior Content",
journal="Interact J Med Res",
year="2015",
month="Jan",
day="20",
volume="4",
number="1",
pages="e3",
keywords="sedentary lifestyle",
keywords="translational medical research",
keywords="social media",
abstract="Background: The global prevalence of sedentary lifestyles is of grave concern for public health around the world. Moreover, the health risk of sedentary behaviors is of growing interest for researchers, clinicians, and the general public as evidence demonstrates that prolonged amounts of sedentary time increases risk for lifestyle-related diseases. There is a growing trend in the literature that reports how social media can facilitate knowledge sharing and collaboration. Social sites like YouTube facilitate the sharing of media content between users. Objective: The purpose of this project was to identify sedentary behavior content on YouTube and describe features of this content that may impact the effectiveness of YouTube for knowledge translation. Methods: YouTube was searched on a single day by 3 independent reviewers for evidence-based sedentary behavior content. Subjective data (eg, video purpose, source, and activity type portrayed) and objective data (eg, number of views, comments, shares, and length of the video) were collected from video. Results: In total, 106 videos met inclusion criteria. Videos were uploaded from 13 countries around the globe (ie, Australia, Barbados, Belgium, Canada, Colombia, Kenya, New Zealand, Russia, South Africa, Spain, Ukraine, United Kingdom, United States). The median video length was 3:00 minutes: interquartile range (IQR) 1:44-5:40. On average, videos had been on YouTube for 15.0 months (IQR 6.0-27.5) and had been viewed 239.0 times (IQR 44.5-917.5). Videos had remarkably low numbers of shares (median 0) and comments (median 1). Only 37.7\% (40/106) of videos portrayed content on sedentary behaviors, while the remaining 66 videos portrayed physical activity or a mix of behaviors. Academic/health organizations (39.6\%, 42/106) and individuals (38.7\%, 41/106) were the most prevalent source of videos, and most videos (67.0\%, 71/106) aimed to educate viewers about the topic. Conclusions: This study explored sedentary behavior content available on YouTube. Findings demonstrate that there is confusion between physical activity and sedentary behaviors, that content is being uploaded to the site from around the globe, that content is primarily from health organizations and individuals with the purpose of educating fellow users, but that low views, comments, and shares suggest that sedentary behavior content is relatively underutilized on YouTube. Future research may wish to leverage social platforms, such as YouTube, to facilitate implementation and sharing of evidence-based sedentary behavior content. ",
doi="10.2196/ijmr.3835",
url="http://www.i-jmr.org/2015/1/e3/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25604433"
}


@Article{info:doi/10.2196/jmir.3645,
author="Kornfield, Rachel
and Smith, Clegg Katherine
and Szczypka, Glen
and Vera, Lisa
and Emery, Sherry",
title="Earned Media and Public Engagement With CDC's ``Tips From Former Smokers'' Campaign: An Analysis of Online News and Blog Coverage",
journal="J Med Internet Res",
year="2015",
month="Jan",
day="20",
volume="17",
number="1",
pages="e12",
keywords="mass media",
keywords="tobacco",
keywords="health communication",
abstract="Background: In March 2012, the US Centers for Disease Control and Prevention (CDC) launched the first-ever paid national tobacco education campaign. At a cost of US \$54 million, ``Tips from Former Smokers'' (Tips) ran for 3 months across multiple media, depicting the suffering experienced by smokers and their families in graphic detail. The potential impact and reach of the Tips campaign was not limited to that achieved through paid media placements. It was also potentially extended through ``earned media'', including news and blog coverage of the campaign. Such coverage can shape public understanding of and facilitate public engagement with key health issues. Objective: To better understand the contribution of earned media to the public's engagement with health issues in the current news media environment, we examined the online ``earned media'' and public engagement generated by one national public health campaign. Methods: We constructed a purposive sample of online media coverage of the CDC's 2012 Tips from Former Smokers television campaign, focusing on 14 influential and politically diverse US news outlets and policy-focused blogs. We identified relevant content by combining campaign and website-specific keywords for 4 months around the campaign release. Each story was coded for content, inclusion of multimedia, and measures of audience engagement. Results: The search yielded 36 stories mentioning Tips, of which 27 were focused on the campaign. Story content between pieces was strikingly similar, with most stories highlighting the same points about the campaign's content, cost, and potential impact. We saw notable evidence of audience engagement; stories focused on Tips generated 9547 comments, 8891 Facebook ``likes'', 1027 tweets, and 505 story URL shares on Facebook. Audience engagement varied by story and site, as did the valence and relevance of associated audience comments. Comments were most oppositional on CNN and most supportive on Yahoo. Comment coding revealed approximately equal levels of opposition and support overall. We identified four common arguments among oppositional comments: government intrusion on personal behaviors, problematic allocation of governmental spending, questionable science, and challenges regarding campaign efficacy. Supportive comments tended to convey personal stories and emotions. Conclusions: The Tips campaign received limited coverage on either online news or blog sources, but the limited number of stories generated engagement among online audiences. In addition to the content and volume of blog and news coverage, audience comments and websites' mechanisms for sharing stories via social media are likely to determine the influence of online earned media. In order to facilitate meaningful evaluation of public health campaigns within the rapidly advancing media environment, there is a need for the public health community to build consensus regarding collection and assessment of engagement data. ",
doi="10.2196/jmir.3645",
url="http://www.jmir.org/2015/1/e12/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25604520"
}


@Article{info:doi/10.2196/jmir.3906,
author="van de Belt, H. Tom
and Engelen, JLPG Lucien
and Verhoef, M. Lise
and van der Weide, JA Marian
and Schoonhoven, Lisette
and Kool, B. Rudolf",
title="Using Patient Experiences on Dutch Social Media to Supervise Health Care Services: Exploratory Study",
journal="J Med Internet Res",
year="2015",
month="Jan",
day="15",
volume="17",
number="1",
pages="e7",
keywords="social media",
keywords="rating sites",
keywords="patient safety",
keywords="supervision",
abstract="Background: Social media has become mainstream and a growing number of people use it to share health care-related experiences, for example on health care rating sites. These users' experiences and ratings on social media seem to be associated with quality of care. Therefore, information shared by citizens on social media could be of additional value for supervising the quality and safety of health care services by regulatory bodies, thereby stimulating participation by consumers. Objective: The objective of the study was to identify the added value of social media for two types of supervision by the Dutch Healthcare Inspectorate (DHI), which is the regulatory body charged with supervising the quality and safety of health care services in the Netherlands. These were (1) supervision in response to incidents reported by individuals, and (2) risk-based supervision. Methods: We performed an exploratory study in cooperation with the DHI and searched different social media sources such as Twitter, Facebook, and healthcare rating sites to find additional information for these incidents and topics, from five different sectors. Supervision experts determined the added value for each individual result found, making use of pre-developed scales. Results: Searches in social media resulted in relevant information for six of 40 incidents studied and provided relevant additional information in 72 of 116 cases in risk-based supervision of long-term elderly care. Conclusions: The results showed that social media could be used to include the patient's perspective in supervision. However, it appeared that the rating site ZorgkaartNederland was the only source that provided information that was of additional value for the DHI, while other sources such as forums and social networks like Twitter and Facebook did not result in additional information. This information could be of importance for health care inspectorates, particularly for its enforcement by risk-based supervision in care of the elderly. Further research is needed to determine the added value for other health care sectors. ",
doi="10.2196/jmir.3906",
url="http://www.jmir.org/2015/1/e7/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25592481"
}


@Article{info:doi/10.2196/jmir.3768,
author="Rocheleau, Mary
and Sadasivam, Shankar Rajani
and Baquis, Kate
and Stahl, Hannah
and Kinney, L. Rebecca
and Pagoto, L. Sherry
and Houston, K. Thomas",
title="An Observational Study of Social and Emotional Support in Smoking Cessation Twitter Accounts: Content Analysis of Tweets",
journal="J Med Internet Res",
year="2015",
month="Jan",
day="14",
volume="17",
number="1",
pages="e18",
keywords="smoking cessation",
keywords="Twitter",
keywords="Internet",
keywords="social network",
abstract="Background: Smoking continues to be the number one preventable cause of premature death in the United States. While evidence for the effectiveness of smoking cessation interventions has increased rapidly, questions remain on how to effectively disseminate these findings. Twitter, the second largest online social network, provides a natural way of disseminating information. Health communicators can use Twitter to inform smokers, provide social support, and attract them to other interventions. A key challenge for health researchers is how to frame their communications to maximize the engagement of smokers. Objective: Our aim was to examine current Twitter activity for smoking cessation. Methods: Active smoking cessation related Twitter accounts (N=18) were identified. Their 50 most recent tweets were content coded using a schema adapted from the Roter Interaction Analysis System (RIAS), a theory-based, validated coding method. Using negative binomial regression, the association of number of followers and frequency of individual tweet content at baseline was assessed. The difference in followership at 6 months (compared to baseline) to the frequency of tweet content was compared using linear regression. Both analyses were adjusted by account type (organizational or not organizational). Results: The 18 accounts had 60,609 followers at baseline and 68,167 at 6 months. A total of 24\% of tweets were socioemotional support (mean 11.8, SD 9.8), 14\% (mean 7, SD 8.4) were encouraging/engagement, and 62\% (mean 31.2, SD 15.2) were informational. At baseline, higher frequency of socioemotional support and encouraging/engaging tweets was significantly associated with higher number of followers (socioemotional: incident rate ratio [IRR] 1.09, 95\% CI 1.02-1.20; encouraging/engaging: IRR 1.06, 95\% CI 1.00-1.12). Conversely, higher frequency of informational tweets was significantly associated with lower number of followers (IRR 0.95, 95\% CI 0.92-0.98). At 6 months, for every increase by 1 in socioemotional tweets, the change in followership significantly increased by 43.94 (P=.027); the association was slightly attenuated after adjusting by account type and was not significant (P=.064). Conclusions: Smoking cessation activity does exist on Twitter. Preliminary findings suggest that certain content strategies can be used to encourage followership, and this needs to be further investigated. ",
doi="10.2196/jmir.3768",
url="http://www.jmir.org/2015/1/e18/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25589009"
}


@Article{info:doi/10.2196/jmir.3692,
author="Yonker, M. Lael
and Zan, Shiyi
and Scirica, V. Christina
and Jethwani, Kamal
and Kinane, Bernard T.",
title="``Friending'' Teens: Systematic Review of Social Media in Adolescent and Young Adult Health Care",
journal="J Med Internet Res",
year="2015",
month="Jan",
day="05",
volume="17",
number="1",
pages="e4",
keywords="social media",
keywords="social networking sites",
keywords="adolescents",
keywords="young adults",
keywords="health",
abstract="Background: Social media has emerged as a potentially powerful medium for communication with adolescents and young adults around their health choices. Objective: The goal of this systematic review is to identify research on the use of social media for interacting with adolescents and young adults in order to achieve positive health outcomes. Methods: A MEDLINE/PubMed electronic database search was performed between January 1, 2002 and October 1, 2013, using terms to identify peer-reviewed research in which social media and other Web 2.0 technologies were an important feature. We used a systematic approach to retrieve papers and extract relevant data. Results: We identified 288 studies involving social media, of which 87 met criteria for inclusion; 75 studies were purely observational and 12 were interventional. The ways in which social media was leveraged by these studies included (1) observing adolescent and young adult behavior (n=77), (2) providing health information (n=13), (3) engaging the adolescent and young adult community (n=17), and (4) recruiting research participants (n=23). Common health topics addressed included high-risk sexual behaviors (n=23), alcohol, tobacco, and other drug use (n=19), Internet safety (n=8), mental health issues (n=18), medical conditions (n=11), or other specified issues (n=12). Several studies used more than one social media platform and addressed more than one health-related topic. Conclusions: Social media technologies offer an exciting new means for engaging and communicating with adolescents and young adults; it has been successfully used to engage this age group, identify behaviors, and provide appropriate intervention and education. Nevertheless, the majority of studies to date have been preliminary and limited in their methodologies, and mostly center around evaluating how adolescents and young adults use social media and the resulting implications on their health. Although these explorations are essential, further exploration and development of these strategies into building effective interventions is necessary. ",
doi="10.2196/jmir.3692",
url="http://www.jmir.org/2015/1/e4/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25560751"
}


@Article{info:doi/10.2196/jmir.3494,
author="Merolli, Mark
and Gray, Kathleen
and Martin-Sanchez, Fernando",
title="Therapeutic Affordances of Social Media: Emergent Themes From a Global Online Survey of People With Chronic Pain",
journal="J Med Internet Res",
year="2014",
month="Dec",
day="22",
volume="16",
number="12",
pages="e284",
keywords="social media",
keywords="chronic disease",
keywords="chronic pain",
keywords="therapeutic affordances",
keywords="thematic content analysis",
keywords="patient-reported outcomes",
keywords="model",
abstract="Background: Research continues to present tenuous suggestions that social media is well suited to enhance management of chronic disease and improve health outcomes. Various studies have presented qualitative reports of health outcomes from social media use and have examined discourse and communication themes occurring through different social media. However, there is an absence of published studies examining and unpacking the underlying therapeutic mechanisms driving social media's effects. Objective: This paper presents a qualitative analysis thoroughly describing what social media therapeutically affords people living with chronic pain who are self-managing their condition. From this therapeutic affordance perspective, we aim to formulate a preliminary conceptual model aimed at better understanding ``how'' social media can influence patient outcomes. Methods: In total, 218 people with chronic pain (PWCP) completed an online survey, investigating patient-reported outcomes (PROs) from social media use. Supplementary to quantitative data collected, participants were also given the opportunity to provide further open commentary regarding their use of social media as part of chronic pain management; 68/218 unique users (31.2\%) chose to provide these free-text responses. Through thematic content analysis, 117 free-text responses regarding 10 types of social media were coded. Quotes were extracted and tabulated based on therapeutic affordances that we had previously identified. Inductive analysis was then performed to code defining language and emergent themes central to describing each affordance. Three investigators examined the responses, developed the coding scheme, and applied the coding to the data. Results: We extracted 155 quotes from 117 free-text responses. The largest source of quotes came from social network site users (78/155, 50.3\%). Analysis of component language used to describe the aforementioned affordances and emergent themes resulted in a final revision and renaming of therapeutic affordances: ``exploration'' (52/155, 33.5\% of quotes), ``connection'' (50/155, 32.3\% of quotes), ``narration'' (33/155, 21.3\% of quotes), ``adaptation'' (13/155, 8.4\% of quotes), and ``self-presentation'' (7/155, 4.5\% of quotes). Of the most described affordances, ``exploration'' was based on a propensity for participants to explain their social media use for information seeking purposes. ``Connection'' placed greater emphasis on interaction, highlighting themes of ``exchanging information'' and ``mitigating isolation''. Responses regarding ``narration'' highlighted the value of shared experiences and the emotionally cathartic role this plays. Conclusions: Much of the efficacy of social media may be explicable via a closer examination of therapeutic affordances. Particular areas that warrant attention include social media's ability to filter and guide people to useful information, connect individuals, and share experiences. Further research into a variety of chronic conditions is warranted. Coupled with the results of the present study, a greater theoretical basis detailing how social media may foster health outcomes may lead to an improved evidence base for conducting research and may inform recommendations for social media use in chronic disease management. ",
doi="10.2196/jmir.3494",
url="http://www.jmir.org/2014/12/e284/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25533453"
}


@Article{info:doi/10.2196/jmir.3617,
author="Conway, Mike",
title="Ethical Issues in Using Twitter for Public Health Surveillance and Research: Developing a Taxonomy of Ethical Concepts From the Research Literature",
journal="J Med Internet Res",
year="2014",
month="Dec",
day="22",
volume="16",
number="12",
pages="e290",
keywords="social media",
keywords="twitter messaging",
keywords="ethics",
abstract="Background: The rise of social media and microblogging platforms in recent years, in conjunction with the development of techniques for the processing and analysis of ``big data'', has provided significant opportunities for public health surveillance using user-generated content. However, relatively little attention has been focused on developing ethically appropriate approaches to working with these new data sources. Objective: Based on a review of the literature, this study seeks to develop a taxonomy of public health surveillance-related ethical concepts that emerge when using Twitter data, with a view to: (1) explicitly identifying a set of potential ethical issues and concerns that may arise when researchers work with Twitter data, and (2) providing a starting point for the formation of a set of best practices for public health surveillance through the development of an empirically derived taxonomy of ethical concepts. Methods: We searched Medline, Compendex, PsycINFO, and the Philosopher's Index using a set of keywords selected to identify Twitter-related research papers that reference ethical concepts. Our initial set of queries identified 342 references across the four bibliographic databases. We screened titles and abstracts of these references using our inclusion/exclusion criteria, eliminating duplicates and unavailable papers, until 49 references remained. We then read the full text of these 49 articles and discarded 36, resulting in a final inclusion set of 13 articles. Ethical concepts were then identified in each of these 13 articles. Finally, based on a close reading of the text, a taxonomy of ethical concepts was constructed based on ethical concepts discovered in the papers. Results: From these 13 articles, we iteratively generated a taxonomy of ethical concepts consisting of 10 top level categories: privacy, informed consent, ethical theory, institutional review board (IRB)/regulation, traditional research vs Twitter research, geographical information, researcher lurking, economic value of personal information, medical exceptionalism, and benefit of identifying socially harmful medical conditions. Conclusions: In summary, based on a review of the literature, we present a provisional taxonomy of public health surveillance-related ethical concepts that emerge when using Twitter data. ",
doi="10.2196/jmir.3617",
url="http://www.jmir.org/2014/12/e290/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25533619"
}


@Article{info:doi/10.2196/jmir.3200,
author="Wittmeier, Kristy
and Holland, Cindy
and Hobbs-Murison, Kendall
and Crawford, Elizabeth
and Beauchamp, Chad
and Milne, Brodie
and Morris, Melanie
and Keijzer, Richard",
title="Analysis of a Parent-Initiated Social Media Campaign for Hirschsprung's Disease",
journal="J Med Internet Res",
year="2014",
month="Dec",
day="11",
volume="16",
number="12",
pages="e288",
keywords="Hirschsprung's Disease",
keywords="social media",
keywords="patient oriented research",
keywords="knowledge translation",
abstract="Background: Social media can be particularly useful for patients or families affected by rare conditions by allowing individuals to form online communities across the world. Objective: Our aim in this study was to conduct a descriptive and quantitative analysis of the use of a social media community for Hirschsprung's Disease (HD). Methods: In July 2011, a mother of a child with HD launched the ``Shit Happens'' campaign. The campaign uses social media (blogs, Twitter, and Facebook) to engage other families affected by HD. Internet analytics including Google Analytics and Facebook Insights were used to evaluate the reach and responsiveness of this campaign. Results: On the day the HD campaign was launched, 387 people viewed the blog ``Roo's Journey''. Blog views have now exceeded 5400 views from 37 countries. The Facebook page extends to 46 countries, has an average post reach of 298 users, 1414 ``likes'', and an overall reach of 131,032 users. The campaign has 135 Twitter followers and 344 tweets at the time of writing. The most common question posted on the Facebook page is related to treatment for extreme diaper rash. Responsiveness assessment demonstrated that within 2 hours of posting, a question could receive 143 views and 20 responses, increasing to 30 responses after 5 hours. Conclusions: Social media networks are well suited to discussion, support, and advocacy for health-related conditions and can be especially important in connecting families affected by rare conditions. The HD campaign demonstrates the reach and responsiveness of a community that primarily relies on social media to connect families affected by HD. Although responsive, this community is currently lacking consistent access to evidence-based guidance for their common concerns. We will explore innovative consumer-researcher partnerships to offer a solution in future research. ",
doi="10.2196/jmir.3200",
url="http://www.jmir.org/2014/12/e288/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25499427"
}


@Article{info:doi/10.2196/jmir.3614,
author="Brusse, Carl
and Gardner, Karen
and McAullay, Daniel
and Dowden, Michelle",
title="Social Media and Mobile Apps for Health Promotion in Australian Indigenous Populations: Scoping Review",
journal="J Med Internet Res",
year="2014",
month="Dec",
day="10",
volume="16",
number="12",
pages="e280",
keywords="health promotion",
keywords="indigenous health",
keywords="eHealth",
abstract="Background: Health promotion organizations are increasingly embracing social media technologies to engage end users in a more interactive way and to widely disseminate their messages with the aim of improving health outcomes. However, such technologies are still in their early stages of development and, thus, evidence of their efficacy is limited. Objective: The study aimed to provide a current overview of the evidence surrounding consumer-use social media and mobile software apps for health promotion interventions, with a particular focus on the Australian context and on health promotion targeted toward an Indigenous audience. Specifically, our research questions were: (1) What is the peer-reviewed evidence of benefit for social media and mobile technologies used in health promotion, intervention, self-management, and health service delivery, with regard to smoking cessation, sexual health, and otitis media? and (2) What social media and mobile software have been used in Indigenous-focused health promotion interventions in Australia with respect to smoking cessation, sexual health, or otitis media, and what is the evidence of their effectiveness and benefit? Methods: We conducted a scoping study of peer-reviewed evidence for the effectiveness of social media and mobile technologies in health promotion (globally) with respect to smoking cessation, sexual health, and otitis media. A scoping review was also conducted for Australian uses of social media to reach Indigenous Australians and mobile apps produced by Australian health bodies, again with respect to these three areas. Results: The review identified 17 intervention studies and seven systematic reviews that met inclusion criteria, which showed limited evidence of benefit from these interventions. We also found five Australian projects with significant social media health components targeting the Indigenous Australian population for health promotion purposes, and four mobile software apps that met inclusion criteria. No evidence of benefit was found for these projects. Conclusions: Although social media technologies have the unique capacity to reach Indigenous Australians as well as other underserved populations because of their wide and instant disseminability, evidence of their capacity to do so is limited. Current interventions are neither evidence-based nor widely adopted. Health promotion organizations need to gain a more thorough understanding of their technologies, who engages with them, why they engage with them, and how, in order to be able to create successful social media projects. ",
doi="10.2196/jmir.3614",
url="http://www.jmir.org/2014/12/e280/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25498835"
}


@Article{info:doi/10.2196/jmir.3569,
author="Fari{\v c}, Nu{\vs}a
and Potts, WW Henry",
title="Motivations for Contributing to Health-Related Articles on Wikipedia: An Interview Study",
journal="J Med Internet Res",
year="2014",
month="Dec",
day="03",
volume="16",
number="12",
pages="e260",
keywords="motivation",
keywords="writing",
keywords="social media",
keywords="wikis",
keywords="Wikipedia",
keywords="consumer health information",
abstract="Background: Wikipedia is one of the most accessed sources of health information online. The current English-language Wikipedia contains more than 28,000 articles pertaining to health. Objective: The aim was to characterize individuals' motivations for contributing to health content on the English-language Wikipedia. Methods: A set of health-related articles were randomly selected and recent contributors invited to complete an online questionnaire and follow-up interview (by Skype, by email, or face-to-face). Interviews were transcribed and analyzed using thematic analysis and a realist grounded theory approach. Results: A total of 32 Wikipedians (31 men) completed the questionnaire and 17 were interviewed. Those completing the questionnaire had a mean age of 39 (range 12-59) years; 16 had a postgraduate qualification, 10 had or were currently studying for an undergraduate qualification, 3 had no more than secondary education, and 3 were still in secondary education. In all, 15 were currently working in a health-related field (primarily clinicians). The median period for which they have been an active editing Wikipedia was 3-5 years. Of this group, 12 were in the United States, 6 were in the United Kingdom, 4 were in Canada, and the remainder from another 8 countries. Two-thirds spoke more than 1 language and 90\% (29/32) were also active contributors in domains other than health. Wikipedians in this study were identified as health professionals, professionals with specific health interests, students, and individuals with health problems. Based on the interviews, their motivations for editing health-related content were summarized in 5 strongly interrelated categories: education (learning about subjects by editing articles), help (wanting to improve and maintain Wikipedia), responsibility (responsibility, often a professional responsibility, to provide good quality health information to readers), fulfillment (editing Wikipedia as a fun, relaxing, engaging, and rewarding activity), and positive attitude to Wikipedia (belief in the value of Wikipedia). An additional factor, hostility (from other contributors), was identified that negatively affected Wikipedians' motivations. Conclusions: Contributions to Wikipedia's health-related content in this study were made by both health specialists and laypeople of varying editorial skills. Their motivations for contributing stem from an inherent drive based on values, standards, and beliefs. It became apparent that the community who most actively monitor and edit health-related articles is very small. Although some contributors correspond to a model of ``knowledge philanthropists,'' others were focused on maintaining articles (improving spelling and grammar, organization, and handling vandalism). There is a need for more people to be involved in Wikipedia's health-related content. ",
doi="10.2196/jmir.3569",
url="http://www.jmir.org/2014/12/e260/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25498308"
}


@Article{info:doi/10.2196/jmir.3589,
author="Brown, James
and Ryan, Christopher
and Harris, Anthony",
title="How Doctors View and Use Social Media: A National Survey",
journal="J Med Internet Res",
year="2014",
month="Dec",
day="02",
volume="16",
number="12",
pages="e267",
keywords="social media",
keywords="Internet",
keywords="professional practice",
keywords="health communication",
keywords="ethics",
keywords="health policy",
keywords="patient-physician relations",
abstract="Background: Doctors are uncertain of their ethical and legal obligations when communicating with patients online. Professional guidelines for patient-doctor interaction online have been written with limited quantitative data about doctors' current usage and attitudes toward the medium. Further research into these trends will help to inform more focused policy and guidelines for doctors communicating with patients online. Objective: The intent of the study was to provide the first national profile of Australian doctors' attitudes toward and use of online social media. Methods: The study involved a quantitative, cross-sectional online survey of Australian doctors using a random sample from a large representative database. Results: Of the 1500 doctors approached, 187 participated (12.47\%). Most participants used social media privately, with only one-quarter not using any social media websites at all (48/187, 25.7\%). One in five participants (30/155, 19.4\%) had received a ``friend request'' from a patient. There was limited use of online communication in clinical practice: only 30.5\% (57/187) had communicated with a patient through email and fewer than half (89/185, 48.1\%) could offer their patients electronic forms of information if that were the patients' preference. Three in five participants (110/181, 60.8\%) reported not being uncomfortable about interacting with patients who had accessed personal information about them online, prior to the consultation. Most of the participants (119/181, 65.8\%) were hesitant to immerse themselves more fully in social media and online communication due to worries about public access and legal concerns. Conclusions: Doctors have different practices and views regarding whether or how to communicate appropriately with patients on the Internet, despite online and social media becoming an increasingly common feature of clinical practice. Additional training would assist doctors in protecting their personal information online, integrating online communication in patient care, and guidance on the best approach in ethically difficult online situations. ",
doi="10.2196/jmir.3589",
url="http://www.jmir.org/2014/12/e267/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25470407"
}


@Article{info:doi/10.2196/jmir.3758,
author="Griffis, M. Heather
and Kilaru, S. Austin
and Werner, M. Rachel
and Asch, A. David
and Hershey, C. John
and Hill, Shawndra
and Ha, P. Yoonhee
and Sellers, Allison
and Mahoney, Kevin
and Merchant, M. Raina",
title="Use of Social Media Across US Hospitals: Descriptive Analysis of Adoption and Utilization",
journal="J Med Internet Res",
year="2014",
month="Nov",
day="27",
volume="16",
number="11",
pages="e264",
keywords="social media",
keywords="Internet",
keywords="health information",
abstract="Background: Use of social media has become widespread across the United States. Although businesses have invested in social media to engage consumers and promote products, less is known about the extent to which hospitals are using social media to interact with patients and promote health. Objective: The aim was to investigate the relationship between hospital social media extent of adoption and utilization relative to hospital characteristics. Methods: We conducted a cross-sectional review of hospital-related activity on 4 social media platforms: Facebook, Twitter, Yelp, and Foursquare. All US hospitals were included that reported complete data for the Centers for Medicare and Medicaid Services Hospital Consumer Assessment of Healthcare Providers and Systems survey and the American Hospital Association Annual Survey. We reviewed hospital social media webpages to determine the extent of adoption relative to hospital characteristics, including geographic region, urban designation, bed size, ownership type, and teaching status. Social media utilization was estimated from user activity specific to each social media platform, including number of Facebook likes, Twitter followers, Foursquare check-ins, and Yelp reviews. Results: Adoption of social media varied across hospitals with 94.41\% (3351/3371) having a Facebook page and 50.82\% (1713/3371) having a Twitter account. A majority of hospitals had a Yelp page (99.14\%, 3342/3371) and almost all hospitals had check-ins on Foursquare (99.41\%, 3351/3371). Large, urban, private nonprofit, and teaching hospitals were more likely to have higher utilization of these accounts. Conclusions: Although most hospitals adopted at least one social media platform, utilization of social media varied according to several hospital characteristics. This preliminary investigation of social media adoption and utilization among US hospitals provides the framework for future studies investigating the effect of social media on patient outcomes, including links between social media use and the quality of hospital care and services. ",
doi="10.2196/jmir.3758",
url="http://www.jmir.org/2014/11/e264/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25431831"
}


@Article{info:doi/10.2196/mhealth.2543,
author="Oliveira, Jonice
and Souza, Silva Diego Da
and de Lima, Zudio Patr{\'i}cia
and da Silveira, C. Pedro
and de Souza, Moreira Jano",
title="Enhancing Knowledge Flow in a Health Care Context: A Mobile Computing Approach",
journal="JMIR mHealth uHealth",
year="2014",
month="Nov",
day="26",
volume="2",
number="4",
pages="e17",
keywords="knowledge sharing",
keywords="health care",
keywords="mobile computing",
keywords="Medicine 2.0",
keywords="collaborative interaction",
keywords="social computing",
abstract="Background: Advances in mobile computing and wireless communication have allowed people to interact and exchange knowledge almost anywhere. These technologies support Medicine 2.0, where the health knowledge flows among all involved people (eg, patients, caregivers, doctors, and patients' relatives). Objective: Our paper proposes a knowledge-sharing environment that takes advantage of mobile computing and contextual information to support knowledge sharing among participants within a health care community (ie, from patients to health professionals). This software environment enables knowledge exchange using peer-to-peer (P2P) mobile networks based on users' profiles, and it facilitates face-to-face interactions among people with similar health interests, needs, or goals. Methods: First, we reviewed and analyzed relevant scientific articles and software apps to determine the current state of knowledge flow within health care. Although no proposal was capable of addressing every aspect in the Medicine 2.0 paradigm, a list of requirements was compiled. Using this requirement list and our previous works, a knowledge-sharing environment was created integrating Mobile Exchange of Knowledge (MEK) and the Easy to Deploy Indoor Positioning System (EDIPS), and a twofold qualitative evaluation was performed. Second, we analyzed the efficiency and reliability of the knowledge that the integrated MEK-EDIPS tool provided to users according to their interest topics, and then performed a proof of concept with health professionals to determine the feasibility and usefulness of using this solution in a real-world scenario. Results: . Using MEK, we reached 100\% precision and 80\% recall in the exchange of files within the peer-to-peer network. The mechanism that facilitated face-to-face interactions was evaluated by the difference between the location indicated by the EDIPS tool and the actual location of the people involved in the knowledge exchange. The average distance error was <6.28 m for an indoor environment. The usability and usefulness of this tool was assessed by questioning a sample of 18 health professionals: 94\% (17/18) agreed the integrated MEK-EDIPS tool provides greater interaction among all the participants (eg, patients, caregivers, doctors, and patients' relatives), most considered it extremely important in the health scenario, 72\% (13/18) believed it could increase the knowledge flow in a health environment, and 67\% (12/18) recommend it or would like to recommend its use. Conclusions: The integrated MEK-EDIPS tool can provide more services than any other software tool analyzed in this paper. The proposed integrated MEK-EDIPS tool seems to be the best alternative for supporting health knowledge flow within the Medicine 2.0 paradigm. ",
doi="10.2196/mhealth.2543",
url="http://mhealth.jmir.org/2014/4/e17/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25427923"
}


@Article{info:doi/10.2196/jmir.3373,
author="Hanson, L. Carl
and West, Josh
and Thackeray, Rosemary
and Barnes, D. Michael
and Downey, Jordan",
title="Understanding and Predicting Social Media Use Among Community Health Center Patients: A Cross-Sectional Survey",
journal="J Med Internet Res",
year="2014",
month="Nov",
day="26",
volume="16",
number="11",
pages="e270",
keywords="social media",
keywords="community health centers",
keywords="medically underserved area",
abstract="Background: The use of social media by health care organizations is growing and provides Web-based tools to connect patients, caregivers, and providers. Objective: The aim was to determine the use and factors predicting the use of social media for health care--related purposes among medically underserved primary care patients. Methods: A cross-sectional survey was administered to 444 patients of a federally qualified community health center. Results: Community health center patients preferred that their providers use email, cell phones for texting, and Facebook and cell phone apps for sharing health information. Significantly more Hispanic than white patients believed their providers should use Facebook (P=.001), YouTube (P=.01), and Twitter (P=.04) for sharing health information. Use and intentions to use social media for health-related purposes were significantly higher for those patients with higher subjective norm scores. Conclusions: Understanding use and factors predicting use can increase adoption and utilization of social media for health care--related purposes among underserved patients in community health centers. ",
doi="10.2196/jmir.3373",
url="http://www.jmir.org/2014/11/e270/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25427823"
}


@Article{info:doi/10.2196/jmir.3338,
author="Meylakhs, Peter
and Rykov, Yuri
and Koltsova, Olessia
and Koltsov, Sergey",
title="An AIDS-Denialist Online Community on a Russian Social Networking Service: Patterns of Interactions With Newcomers and Rhetorical Strategies of Persuasion",
journal="J Med Internet Res",
year="2014",
month="Nov",
day="17",
volume="16",
number="11",
pages="e261",
keywords="consumer health information",
keywords="Internet",
keywords="online communities",
keywords="AIDS denialists",
keywords="quality of health information on the Internet",
keywords="netnography",
keywords="qualitative research",
abstract="Background: The rise of social media proved to be a fertile ground for the expansion of the acquired immune deficiency syndrome (AIDS)-denialist movement (in the form of online communities). While there is substantial literature devoted to disproving AIDS-denialist views, there is a lack of studies exploring AIDS-denialists online communities that interact with an external environment. Objective: We explored three research areas: (1) reasons for newcomers to come to an AIDS-denialist community, (2) the patterns of interactions of the community with the newcomers, and (3) rhetorical strategies that denialists use for persuasion in the veracity of their views. Methods: We studied the largest AIDS-denialist community on one of the most popular social networking services in Russia. We used netnography as a method for collecting data for qualitative analysis and observed the community for 9 months (at least 2-3 times a week). While doing netnography, we periodically downloaded community discussions. In total, we downloaded 4821 posts and comments for analysis. Grounded theory approach was used for data analysis. Results: Most users came to the community for the following reasons: their stories did not fit the unitary picture of AIDS disease progression translated by popular medical discourse, health problems, concern about HIV-positive tests, and desire to dissuade community members from false AIDS beliefs. On the basis of strength in AIDS-denialist beliefs, we constructed a typology of the newcomers consisting of three ideal-typical groups: (1) convinced: those who already had become denialists before coming to the group, (2) doubters: those who were undecided about the truth of either human immunodeficiency virus (HIV) science theory or AIDS-denialist theory, and (3) orthodox: those who openly held HIV science views. Reception of a newcomer mainly depended on the newcomer's belief status. Reception was very warm for the convinced, cold or slightly hostile for the doubters, and extremely hostile or derisive for the orthodox. We identified seven main rhetorical strategies of persuasion used by the denialists on the ``undecided''. Conclusions: Contrary to the widespread public health depiction of AIDS denialists as totally irrational, our study suggests that some of those who become AIDS denialists have sufficiently reasonable grounds to suspect that ``something is wrong'' with scientific theory, because their personal experience contradicts the unitary picture of AIDS disease progression. Odd and inexplicable practices of some AIDS centers only fuel these people's suspicions. We can conclude that public health practitioners' practices may play a role in generating AIDS-denialist sentiments. In interactions with the newcomers, the experienced community members highlighted the importance of personal autonomy and freedom of choice in decision making consistent with the consumerist ideology of health care. The study findings suggest that health care workers should change a one-size-fits-all mode of counseling for a more complex and patient-tailored approach, allowing for diversity of disease progression scenarios and scientific uncertainty. ",
doi="10.2196/jmir.3338",
url="http://www.jmir.org/2014/11/e261/"
}


@Article{info:doi/10.2196/resprot.3546,
author="Lambert, N. Danielle
and Bishop, E. Lauren
and Guetig, Stephanie
and Frew, M. Paula",
title="A Formative Evaluation of a Social Media Campaign to Reduce Adolescent Dating Violence",
journal="JMIR Res Protoc",
year="2014",
month="Nov",
day="12",
volume="3",
number="4",
pages="e64",
keywords="adolescents",
keywords="dating violence",
keywords="social media",
keywords="formative evaluation",
abstract="Background: The Emory Jane Fonda Center implemented the Start Strong Atlanta social marketing campaign, ``Keep It Strong ATL'', in 2007 to promote the development of healthy adolescent relationships and to foster the prevention of adolescent dating abuse among 11-14 year olds. Objective: A formative evaluation was conducted to understand whether messages directed at the target audience were relevant to the program's relationship promotion and violence prevention goals, and whether the ``Web 2.0'' social media channels of communication (Facebook, Twitter, YouTube, Flickr, Tumblr, and Pinterest) were reaching the intended audience. Methods: Mixed methodologies included qualitative interviews and a key informant focus group, a cross-sectional survey, and web analytics. Qualitative data were analyzed using constant comparative methodology informed by grounded theory. Descriptive statistics were generated from survey data, and web analytics provided user information and traffic patterns. Results: Results indicated that the Keep It Strong ATL social marketing campaign was a valuable community resource that had potential for broader scope and greater reach. The evaluation team learned the importance of reaching adolescents through Web 2.0 platforms, and the need for message dissemination via peers. Survey results indicated that Facebook (ranked 6.5 out of 8) was the highest rated social media outlet overall, and exhibited greatest appeal and most frequent visits, yet analytics revealed that only 3.5\% of ``likes'' were from the target audience. These results indicate that the social media campaign is reaching predominantly women (76.5\% of viewership) who are outside of the target age range of 11-14 years. Conclusions: While the social media campaign was successfully launched, the findings indicate the need for a more focused selection of communication channels, timing of media updates to maximize visibility, balancing message tone and delivery, and incorporating differentiated messaging for the target audiences. Collaboration with parents and community partners is also emphasized in order to expand the campaign's reach and create more channels to disseminate relationship promotion and dating violence prevention messaging to the intended audience. ",
doi="10.2196/resprot.3546",
url="http://www.researchprotocols.org/2014/4/e64/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25405494"
}


@Article{info:doi/10.2196/jmir.3871,
author="Moseley, T. Edward
and Hsu, J. Douglas
and Stone, J. David
and Celi, Anthony Leo",
title="Beyond Open Big Data: Addressing Unreliable Research",
journal="J Med Internet Res",
year="2014",
month="Nov",
day="11",
volume="16",
number="11",
pages="e259",
keywords="open data",
keywords="unreliable research",
keywords="collaborative learning",
keywords="knowledge discovery",
keywords="peer review",
keywords="research culture",
doi="10.2196/jmir.3871",
url="http://www.jmir.org/2014/11/e259/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25405277"
}


@Article{info:doi/10.2196/jmir.3444,
author="Borromeo, D. Charles
and Schleyer, K. Titus
and Becich, J. Michael
and Hochheiser, Harry",
title="Finding Collaborators: Toward Interactive Discovery Tools for Research Network Systems",
journal="J Med Internet Res",
year="2014",
month="Nov",
day="04",
volume="16",
number="11",
pages="e244",
keywords="translational medical research",
keywords="cooperative behavior",
keywords="interprofessional relations",
keywords="interdisciplinary studies",
keywords="information systems",
keywords="information services",
abstract="Background: Research networking systems hold great promise for helping biomedical scientists identify collaborators with the expertise needed to build interdisciplinary teams. Although efforts to date have focused primarily on collecting and aggregating information, less attention has been paid to the design of end-user tools for using these collections to identify collaborators. To be effective, collaborator search tools must provide researchers with easy access to information relevant to their collaboration needs. Objective: The aim was to study user requirements and preferences for research networking system collaborator search tools and to design and evaluate a functional prototype. Methods: Paper prototypes exploring possible interface designs were presented to 18 participants in semistructured interviews aimed at eliciting collaborator search needs. Interview data were coded and analyzed to identify recurrent themes and related software requirements. Analysis results and elements from paper prototypes were used to design a Web-based prototype using the D3 JavaScript library and VIVO data. Preliminary usability studies asked 20 participants to use the tool and to provide feedback through semistructured interviews and completion of the System Usability Scale (SUS). Results: Initial interviews identified consensus regarding several novel requirements for collaborator search tools, including chronological display of publication and research funding information, the need for conjunctive keyword searches, and tools for tracking candidate collaborators. Participant responses were positive (SUS score: mean 76.4\%, SD 13.9). Opportunities for improving the interface design were identified. Conclusions: Interactive, timeline-based displays that support comparison of researcher productivity in funding and publication have the potential to effectively support searching for collaborators. Further refinement and longitudinal studies may be needed to better understand the implications of collaborator search tools for researcher workflows. ",
doi="10.2196/jmir.3444",
url="http://www.jmir.org/2014/11/e244/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25370463"
}


@Article{info:doi/10.2196/jmir.3807,
author="Brady, J. Christopher
and Villanti, C. Andrea
and Pearson, L. Jennifer
and Kirchner, R. Thomas
and Gupta, P. Omesh
and Shah, P. Chirag",
title="Rapid Grading of Fundus Photographs for Diabetic Retinopathy Using Crowdsourcing",
journal="J Med Internet Res",
year="2014",
month="Oct",
day="30",
volume="16",
number="10",
pages="e233",
keywords="diabetic retinopathy",
keywords="telemedicine",
keywords="fundus photography",
keywords="crowdsourcing",
keywords="Amazon Mechanical Turk",
abstract="Background: Screening for diabetic retinopathy is both effective and cost-effective, but rates of screening compliance remain suboptimal. As screening improves, new methods to deal with screening data may help reduce the human resource needs. Crowdsourcing has been used in many contexts to harness distributed human intelligence for the completion of small tasks including image categorization. Objective: Our goal was to develop and validate a novel method for fundus photograph grading. Methods: An interface for fundus photo classification was developed for the Amazon Mechanical Turk crowdsourcing platform. We posted 19 expert-graded images for grading by Turkers, with 10 repetitions per photo for an initial proof-of-concept (Phase I). Turkers were paid US \$0.10 per image. In Phase II, one prototypical image from each of the four grading categories received 500 unique Turker interpretations. Fifty draws of 1-50 Turkers were then used to estimate the variance in accuracy derived from randomly drawn samples of increasing crowd size to determine the minimum number of Turkers needed to produce valid results. In Phase III, the interface was modified to attempt to improve Turker grading. Results: Across 230 grading instances in the normal versus abnormal arm of Phase I, 187 images (81.3\%) were correctly classified by Turkers. Average time to grade each image was 25 seconds, including time to review training images. With the addition of grading categories, time to grade each image increased and percentage of images graded correctly decreased. In Phase II, area under the curve (AUC) of the receiver-operator characteristic (ROC) indicated that sensitivity and specificity were maximized after 7 graders for ratings of normal versus abnormal (AUC=0.98) but was significantly reduced (AUC=0.63) when Turkers were asked to specify the level of severity. With improvements to the interface in Phase III, correctly classified images by the mean Turker grade in four-category grading increased to a maximum of 52.6\% (10/19 images) from 26.3\% (5/19 images). Throughout all trials, 100\% sensitivity for normal versus abnormal was maintained. Conclusions: With minimal training, the Amazon Mechanical Turk workforce can rapidly and correctly categorize fundus photos of diabetic patients as normal or abnormal, though further refinement of the methodology is needed to improve Turker ratings of the degree of retinopathy. Images were interpreted for a total cost of US \$1.10 per eye. Crowdsourcing may offer a novel and inexpensive means to reduce the skilled grader burden and increase screening for diabetic retinopathy. ",
doi="10.2196/jmir.3807",
url="http://www.jmir.org/2014/10/e233/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25356929"
}


@Article{info:doi/10.2196/jmir.3786,
author="Valdez, S. Rupa
and Guterbock, M. Thomas
and Thompson, J. Morgan
and Reilly, D. Jeremiah
and Menefee, K. Hannah
and Bennici, S. Maria
and Williams, C. Ishan
and Rexrode, L. Deborah",
title="Beyond Traditional Advertisements: Leveraging Facebook's Social Structures for Research Recruitment",
journal="J Med Internet Res",
year="2014",
month="Oct",
day="27",
volume="16",
number="10",
pages="e243",
keywords="participant recruitment",
keywords="Facebook",
keywords="social media",
keywords="consumer health IT",
keywords="ethnicity",
keywords="advertising",
abstract="Background: Obtaining access to a demographically and geographically diverse sample for health-related research can be costly and time consuming. Previous studies have reported mixed results regarding the potential of using social media-based advertisements to overcome these challenges. Objective: Our aim was to develop and assess the feasibility, benefits, and challenges of recruiting for research studies related to consumer health information technology (IT) by leveraging the social structures embedded in the social networking platform, Facebook. Methods: Two recruitment strategies that involved direct communication with existing Facebook groups and pages were developed and implemented in two distinct populations. The first recruitment strategy involved posting a survey link directly to consenting groups and pages and was used to recruit Filipino-Americans to a study assessing the perceptions, use of, and preferences for consumer health IT. This study took place between August and December 2013. The second recruitment strategy targeted individuals with type 2 diabetes and involved creating a study-related Facebook group and asking administrators of other groups and pages to publicize our group to their members. Group members were then directly invited to participate in an online pre-study survey. This portion of a larger study to understand existing health management practices as a foundation for consumer health IT design took place between May and June 2014. In executing both recruitment strategies, efforts were made to establish trust and transparency. Recruitment rate, cost, content of interaction, and characteristics of the sample obtained were used to assess the recruitment methods. Results: The two recruitment methods yielded 87 and 79 complete responses, respectively. The first recruitment method yielded a rate of study completion proportionate to that of the rate of posts made, whereas recruitment successes of the second recruitment method seemed to follow directly from the actions of a subset of administrators. Excluding personnel time, the first recruitment method resulted in no direct costs, and the second recruitment method resulted in a total direct cost of US \$118.17. Messages, posts, and comments received using both recruitment strategies reflected ten themes, including appreciation, assistance, clarification, concerns, encouragement, health information, interest, promotion, solicitations, and support. Both recruitment methods produced mixed results regarding sample representativeness with respect to characteristics such as gender, race, and ethnicity. Conclusions: The results of the study demonstrate that leveraging the social structures of Facebook for health-related research was feasible for obtaining small samples appropriate for qualitative research but not for obtaining large samples needed for quantitative research. The content of interactions with members of the target population prompted ethical deliberations concerning suitable target communities and appropriate boundaries between researchers and participants. Widespread replication of this method would benefit from a broad discussion among researchers, social media users, social media companies, and experts in research ethics to address appropriate protocols for such interactions. ",
doi="10.2196/jmir.3786",
url="http://www.jmir.org/2014/10/e243/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25348050"
}


@Article{info:doi/10.2196/jmir.3416,
author="Nagar, Ruchit
and Yuan, Qingyu
and Freifeld, C. Clark
and Santillana, Mauricio
and Nojima, Aaron
and Chunara, Rumi
and Brownstein, S. John",
title="A Case Study of the New York City 2012-2013 Influenza Season With Daily Geocoded Twitter Data From Temporal and Spatiotemporal Perspectives",
journal="J Med Internet Res",
year="2014",
month="Oct",
day="20",
volume="16",
number="10",
pages="e236",
keywords="influenza",
keywords="Twitter",
keywords="New York City",
keywords="spatiotemporal",
keywords="Google Flu Trends",
keywords="infodemiology",
keywords="mHealth",
keywords="social media, natural language processing",
keywords="medical informatics",
abstract="Background: Twitter has shown some usefulness in predicting influenza cases on a weekly basis in multiple countries and on different geographic scales. Recently, Broniatowski and colleagues suggested Twitter's relevance at the city-level for New York City. Here, we look to dive deeper into the case of New York City by analyzing daily Twitter data from temporal and spatiotemporal perspectives. Also, through manual coding of all tweets, we look to gain qualitative insights that can help direct future automated searches. Objective: The intent of the study was first to validate the temporal predictive strength of daily Twitter data for influenza-like illness emergency department (ILI-ED) visits during the New York City 2012-2013 influenza season against other available and established datasets (Google search query, or GSQ), and second, to examine the spatial distribution and the spread of geocoded tweets as proxies for potential cases. Methods: From the Twitter Streaming API, 2972 tweets were collected in the New York City region matching the keywords ``flu'', ``influenza'', ``gripe'', and ``high fever''. The tweets were categorized according to the scheme developed by Lamb et al. A new fourth category was added as an evaluator guess for the probability of the subject(s) being sick to account for strength of confidence in the validity of the statement. Temporal correlations were made for tweets against daily ILI-ED visits and daily GSQ volume. The best models were used for linear regression for forecasting ILI visits. A weighted, retrospective Poisson model with SaTScan software (n=1484), and vector map were used for spatiotemporal analysis. Results: Infection-related tweets (R=.763) correlated better than GSQ time series (R=.683) for the same keywords and had a lower mean average percent error (8.4 vs 11.8) for ILI-ED visit prediction in January, the most volatile month of flu. SaTScan identified primary outbreak cluster of high-probability infection tweets with a 2.74 relative risk ratio compared to medium-probability infection tweets at P=.001 in Northern Brooklyn, in a radius that includes Barclay's Center and the Atlantic Avenue Terminal. Conclusions: While others have looked at weekly regional tweets, this study is the first to stress test Twitter for daily city-level data for New York City. Extraction of personal testimonies of infection-related tweets suggests Twitter's strength both qualitatively and quantitatively for ILI-ED prediction compared to alternative daily datasets mixed with awareness-based data such as GSQ. Additionally, granular Twitter data provide important spatiotemporal insights. A tweet vector-map may be useful for visualization of city-level spread when local gold standard data are otherwise unavailable. ",
doi="10.2196/jmir.3416",
url="http://www.jmir.org/2014/10/e236/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25331122"
}


@Article{info:doi/10.2196/jmir.3622,
author="Harris, K. Jenine
and Moreland-Russell, Sarah
and Choucair, Bechara
and Mansour, Raed
and Staub, Mackenzie
and Simmons, Kendall",
title="Tweeting for and Against Public Health Policy: Response to the Chicago Department of Public Health's Electronic Cigarette Twitter Campaign",
journal="J Med Internet Res",
year="2014",
month="Oct",
day="16",
volume="16",
number="10",
pages="e238",
keywords="Twitter",
keywords="health departments",
keywords="e-cigarette",
abstract="Background: In January 2014, the Chicago City Council scheduled a vote on local regulation of electronic cigarettes as tobacco products. One week prior to the vote, the Chicago Department of Public Health (CDPH) released a series of messages about electronic cigarettes (e-cigarettes) through its Twitter account. Shortly after the messages, or tweets, were released, the department's Twitter account became the target of a ``Twitter bomb'' by Twitter users sending more than 600 tweets in one week against the proposed regulation. Objective: The purpose of our study was to examine the messages and tweet patterns in the social media response to the CDPH e-cigarette campaign. Methods: We collected all tweets mentioning the CDPH in the week between the e-cigarette campaign and the vote on the new local e-cigarette policy. We conducted a content analysis of the tweets, used descriptive statistics to examine characteristics of involved Twitter users, and used network visualization and descriptive statistics to identify Twitter users prominent in the conversation. Results: Of the 683 tweets mentioning CDPH during the week, 609 (89.2\%) were anti-policy. More than half of anti-policy tweets were about use of electronic cigarettes for cessation as a healthier alternative to combustible cigarettes (358/609, 58.8\%). Just over one-third of anti-policy tweets asserted that the health department was lying or disseminating propaganda (224/609, 36.8\%). Approximately 14\% (96/683, 14.1\%) of the tweets used an account or included elements consistent with ``astroturfing''---a strategy employed to promote a false sense of consensus around an idea. Few Twitter users were from the Chicago area; Twitter users from Chicago were significantly more likely than expected to tweet in support of the policy. Conclusions: Our findings may assist public health organizations to anticipate, recognize, and respond to coordinated social media campaigns. ",
doi="10.2196/jmir.3622",
url="http://www.jmir.org/2014/10/e238/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25320863"
}


@Article{info:doi/10.2196/jmir.3765,
author="Lee, L. Joy
and DeCamp, Matthew
and Dredze, Mark
and Chisolm, S. Margaret
and Berger, D. Zackary",
title="What Are Health-Related Users Tweeting? A Qualitative Content Analysis of Health-Related Users and Their Messages on Twitter",
journal="J Med Internet Res",
year="2014",
month="Oct",
day="15",
volume="16",
number="10",
pages="e237",
keywords="communication",
keywords="consumer health informatics",
keywords="health information technology",
keywords="social media",
abstract="Background: Twitter is home to many health professionals who send messages about a variety of health-related topics. Amid concerns about physicians posting inappropriate content online, more in-depth knowledge about these messages is needed to understand health professionals' behavior on Twitter. Objective: Our goal was to characterize the content of Twitter messages, specifically focusing on health professionals and their tweets relating to health. Methods: We performed an in-depth content analysis of 700 tweets. Qualitative content analysis was conducted on tweets by health users on Twitter. The primary objective was to describe the general type of content (ie, health-related versus non-health related) on Twitter authored by health professionals and further to describe health-related tweets on the basis of the type of statement made. Specific attention was given to whether a tweet was personal (as opposed to professional) or made a claim that users would expect to be supported by some level of medical evidence (ie, a ``testable'' claim). A secondary objective was to compare content types among different users, including patients, physicians, nurses, health care organizations, and others. Results: Health-related users are posting a wide range of content on Twitter. Among health-related tweets, 53.2\% (184/346) contained a testable claim. Of health-related tweets by providers, 17.6\% (61/346) were personal in nature; 61\% (59/96) made testable statements. While organizations and businesses use Twitter to promote their services and products, patient advocates are using this tool to share their personal experiences with health. Conclusions: Twitter users in health-related fields tweet about both testable claims and personal experiences. Future work should assess the relationship between testable tweets and the actual level of evidence supporting them, including how Twitter users---especially patients---interpret the content of tweets posted by health providers. ",
doi="10.2196/jmir.3765",
url="http://www.jmir.org/2014/10/e237/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25591063"
}


@Article{info:doi/10.2196/jmir.3259,
author="Gabarron, Elia
and Serrano, Artur J.
and Wynn, Rolf
and Lau, YS Annie",
title="Tweet Content Related to Sexually Transmitted Diseases: No Joking Matter",
journal="J Med Internet Res",
year="2014",
month="Oct",
day="06",
volume="16",
number="10",
pages="e228",
keywords="Internet",
keywords="chlamydia",
keywords="HIV",
keywords="Twitter messaging",
abstract="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. ",
doi="10.2196/jmir.3259",
url="http://www.jmir.org/2014/10/e228/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25289463"
}


@Article{info:doi/10.2196/jmir.3761,
author="Celi, Anthony Leo
and Ippolito, Andrea
and Montgomery, A. Robert
and Moses, Christopher
and Stone, J. David",
title="Crowdsourcing Knowledge Discovery and Innovations in Medicine",
journal="J Med Internet Res",
year="2014",
month="Sep",
day="19",
volume="16",
number="9",
pages="e216",
keywords="knowledge discovery",
keywords="crowdsourcing",
keywords="innovation",
keywords="hackathon",
doi="10.2196/jmir.3761",
url="http://www.jmir.org/2014/9/e216/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25239002"
}


@Article{info:doi/10.2196/jmir.3304,
author="Rice, M. Simon
and Goodall, Joanne
and Hetrick, E. Sarah
and Parker, G. Alexandra
and Gilbertson, Tamsyn
and Amminger, Paul G.
and Davey, G. Christopher
and McGorry, D. Patrick
and Gleeson, John
and Alvarez-Jimenez, Mario",
title="Online and Social Networking Interventions for the Treatment of Depression in Young People: A Systematic Review",
journal="J Med Internet Res",
year="2014",
month="Sep",
day="16",
volume="16",
number="9",
pages="e206",
keywords="Internet",
keywords="depression",
keywords="young adult",
keywords="adolescent",
keywords="social networking",
keywords="support groups",
keywords="review",
abstract="Background: Major depression accounts for the greatest burden of all diseases globally. The peak onset of depression occurs between adolescence and young adulthood, and for many individuals, depression displays a relapse-remitting and increasingly severe course. Given this, the development of cost-effective, acceptable, and population-focused interventions for depression is critical. A number of online interventions (both prevention and acute phase) have been tested in young people with promising results. As these interventions differ in content, clinician input, and modality, it is important to identify key features (or unhelpful functions) associated with treatment outcomes. Objective: A systematic review of the research literature was undertaken. The review was designed to focus on two aspects of online intervention: (1) standard approaches evaluating online intervention content in randomized controlled designs (Section 1), and (2) second-generation online interventions and services using social networking (eg, social networking sites and online support groups) in any type of research design (Section 2). Methods: Two specific literature searches were undertaken. There was no date range specified. The Section 1 search, which focused on randomized controlled trials, included only young people (12-25 years) and yielded 101 study abstracts, of which 15 met the review inclusion criteria. The Section 2 search, which included all study design types and was not restricted in terms of age, yielded 358 abstracts, of which 22 studies met the inclusion criteria. Information about the studies and their findings were extracted and tabulated for review. Results: The 15 studies identified in Section 1 described 10 trials testing eight different online interventions, all of which were based on a cognitive behavioral framework. All but one of the eight identified studies reported positive results; however, only five of the 15 studies used blinded interviewer administered outcomes with most trials using self-report data. Studies varied significantly in presentation of intervention content, treatment dose, and dropout. Only two studies included moderator or clinician input. Results for Section 2 were less consistent. None of the Section 2 studies reported controlled or randomized designs. With the exception of four studies, all included participants were younger than 25 years of age. Eight of the 16 social networking studies reported positive results for depression-related outcomes. The remaining studies were either mixed or negative. Findings for online support groups tended to be more positive; however, noteworthy risks were identified. Conclusions: Online interventions with a broad cognitive behavioral focus appear to be promising in reducing depression symptomology in young people. Further research is required into the effectiveness of online interventions delivering cognitive behavioral subcomponents, such as problem-solving therapy. Evidence for the use of social networking is less compelling, although limited by a lack of well-designed studies and social networking interventions. A range of future social networking therapeutic opportunities are highlighted. ",
doi="10.2196/jmir.3304",
url="http://www.jmir.org/2014/9/e206/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25226790"
}


@Article{info:doi/10.2196/jmir.3275,
author="Hale, M. Timothy
and Pathipati, S. Akhilesh
and Zan, Shiyi
and Jethwani, Kamal",
title="Representation of Health Conditions on Facebook: Content Analysis and Evaluation of User Engagement",
journal="J Med Internet Res",
year="2014",
month="Aug",
day="04",
volume="16",
number="8",
pages="e182",
keywords="Internet",
keywords="Facebook",
keywords="social media",
keywords="social networking sites",
keywords="social support",
keywords="health communication",
keywords="information seeking behavior",
abstract="Background: A sizable majority of adult Internet users report looking for health information online. Social networking sites (SNS) like Facebook represent a common place to seek information, but very little is known about the representation and use of health content on SNS. Objective: Our goal in this study was to understand the role of SNS in health information seeking. More specifically, we aimed to describe how health conditions are represented on Facebook Pages and how users interact with these different conditions. Methods: We used Google Insights to identify the 20 most searched for health conditions on Google and then searched each of the resulting terms on Facebook. We compiled a list of the first 50 Facebook ``Pages'' results for each health condition. After filtering results to identify pages relevant to our research, we categorized pages into one of seven categories based on the page's primary purpose. We then measured user engagement by evaluating the number of ``Likes'' for different conditions and types of pages. Results: The search returned 50 pages for 18 of the health conditions, but only 48 pages were found for ``anemia'' and 5 pages were found for ``flu symptoms'', yielding a total of 953 pages. A large number of pages (29.4\%, 280/953) were irrelevant to the health condition searched. Of the 673 relevant pages, 151 were not in English or originated outside the United States, leaving 522 pages to be coded for content. The most common type of page was marketing/promotion (32.2\%, 168/522) followed by information/awareness (20.7\%, 108/522), Wikipedia-type pages (15.5\%, 81/522), patient support (9.4\%, 49/522), and general support (3.6\%, 19/522). Health conditions varied greatly by the primary page type. All health conditions had some marketing/promotion pages and this made up 76\% (29/38) of pages on acquired immunodeficiency syndrome (AIDS). The largest percentage of general support pages were cancer (19\%, 6/32) and stomach (16\%, 4/25). For patient support, stroke (67\%, 4/6), lupus (33\%, 10/30), breast cancer (19\%, 6/31), arthritis (16\%, 6/36), and diabetes (16\%, 6/37) ranked the highest. Six health conditions were not represented by any type of support pages (ie, human papillomavirus, diarrhea, flu symptoms, pneumonia, spine, human immunodeficiency virus). Marketing/promotion pages accounted for 46.73\% (10,371,169/22,191,633) of all Likes, followed by support pages (40.66\%, 9,023,234/22,191,633). Cancer and breast cancer accounted for 86.90\% (19,284,066/22,191,633) of all page Likes. Conclusions: This research represents the first attempts to comprehensively describe publicly available health content and user engagement with health conditions on Facebook pages. Public health interventions using Facebook will need to be designed to ensure relevant information is easy to find and with an understanding that stigma associated with some health conditions may limit the users' engagement with Facebook pages. This line of research merits further investigation as Facebook and other SNS continue to evolve over the coming years. ",
doi="10.2196/jmir.3275",
url="http://www.jmir.org/2014/8/e182/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25092386"
}


@Article{info:doi/10.2196/games.3350,
author="Good, M. Benjamin
and Loguercio, Salvatore
and Griffith, L. Obi
and Nanis, Max
and Wu, Chunlei
and Su, I. Andrew",
title="The Cure: Design and Evaluation of a Crowdsourcing Game for Gene Selection for Breast Cancer Survival Prediction",
journal="JMIR Serious Games",
year="2014",
month="Jul",
day="29",
volume="2",
number="2",
pages="e7",
keywords="breast neoplasms",
keywords="gene expression",
keywords="artificial intelligence",
keywords="survival analysis",
keywords="crowdsourcing",
keywords="Web applications",
keywords="computer games",
keywords="collaborative and social computing systems and tools",
keywords="supervised learning",
keywords="feature selection",
abstract="Background: Molecular signatures for predicting breast cancer prognosis could greatly improve care through personalization of treatment.  Computational analyses of genome-wide expression datasets have identified such signatures, but these signatures leave much to be desired in terms of accuracy, reproducibility, and biological interpretability.  Methods that take advantage of structured prior knowledge (eg, protein interaction networks) show promise in helping to define better signatures, but most knowledge remains unstructured.  Crowdsourcing via scientific discovery games is an emerging methodology that has the potential to tap into human intelligence at scales and in modes unheard of before. Objective: The main objective of this study was to test the hypothesis that knowledge linking expression patterns of specific genes to breast cancer outcomes could be captured from players of an open, Web-based game.  We envisioned capturing knowledge both from the player's prior experience and from their ability to interpret text related to candidate genes presented to them in the context of the game. Methods: We developed and evaluated an online game called The Cure that captured information from players regarding genes for use as predictors of breast cancer survival.  Information gathered from game play was aggregated using a voting approach, and used to create rankings of genes.  The top genes from these rankings were evaluated using annotation enrichment analysis, comparison to prior predictor gene sets, and by using them to train and test machine learning systems for predicting 10 year survival. Results: Between its launch in September 2012 and September 2013, The Cure attracted more than 1000 registered players, who collectively played nearly 10,000 games.  Gene sets assembled through aggregation of the collected data showed significant enrichment for genes known to be related to key concepts such as cancer, disease progression, and recurrence.  In terms of the predictive accuracy of models trained using this information, these gene sets provided comparable performance to gene sets generated using other methods, including those used in commercial tests. The Cure is available on the Internet. Conclusions: The principal contribution of this work is to show that crowdsourcing games can be developed as a means to address problems involving domain knowledge.  While most prior work on scientific discovery games and crowdsourcing in general takes as a premise that contributors have little or no expertise, here we demonstrated a crowdsourcing system that succeeded in capturing expert knowledge. ",
doi="10.2196/games.3350",
url="http://games.jmir.org/2014/2/e7/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25654473"
}


@Article{info:doi/10.2196/jmir.3050,
author="Alshaikh, Fahdah
and Ramzan, Farzan
and Rawaf, Salman
and Majeed, Azeem",
title="Social Network Sites as a Mode to Collect Health Data: A Systematic Review",
journal="J Med Internet Res",
year="2014",
month="Jul",
day="14",
volume="16",
number="7",
pages="e171",
keywords="social network",
keywords="social media",
keywords="Internet",
keywords="systematic review",
keywords="young people",
keywords="health education",
keywords="health behaviors",
abstract="Background: To date, health research literature has focused on social network sites (SNS) either as tools to deliver health care, to study the effect of these networks on behavior, or to analyze Web health content. Less is known about the effectiveness of these sites as a method for collecting data for health research and the means to use such powerful tools in health research. Objective: The objective of this study was to systematically review the available literature and explore the use of SNS as a mode of collecting data for health research. The review aims to answer four questions: Does health research employ SNS as method for collecting data? Is data quality affected by the mode of data collection? What types of participants were reached by SNS? What are the strengths and limitations of SNS? Methods: The literature was reviewed systematically in March 2013 by searching the databases MEDLINE, Embase, and PsycINFO, using the Ovid and PubMed interface from 1996 to the third week of March 2013. The search results were examined by 2 reviewers, and exclusion, inclusion, and quality assessment were carried out based on a pre-set protocol. Results: The inclusion criteria were met by 10 studies and results were analyzed descriptively to answer the review questions. There were four main results. (1) SNS have been used as a data collection tool by health researchers; all but 1 of the included studies were cross-sectional and quantitative. (2) Data quality indicators that were reported include response rate, cost, timeliness, missing data/completion rate, and validity. However, comparison was carried out only for response rate and cost as it was unclear how other reported indicators were measured. (3) The most targeted population were females and younger people. (4) All studies stated that SNS is an effective recruitment method but that it may introduce a sampling bias. Conclusions: SNS has a role in health research, but we need to ascertain how to use it effectively without affecting the quality of research. The field of SNS is growing rapidly, and it is necessary to take advantage of the strengths of this tool and to avoid its limitations by effective research design. This review provides an important insight for scholars who plan to conduct research using SNS. ",
doi="10.2196/jmir.3050",
url="http://www.jmir.org/2014/7/e171/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25048247"
}


@Article{info:doi/10.2196/jmir.3189,
author="Struik, Louise Laura
and Baskerville, Bruce Neill",
title="The Role of Facebook in Crush the Crave, a Mobile- and Social Media-Based Smoking Cessation Intervention: Qualitative Framework Analysis of Posts",
journal="J Med Internet Res",
year="2014",
month="Jul",
day="11",
volume="16",
number="7",
pages="e170",
keywords="qualitative research",
keywords="young adult",
keywords="smoking cessation",
keywords="Internet",
keywords="social media",
abstract="Background: Social networking sites, particularly Facebook, are increasingly included in contemporary smoking cessation interventions directed toward young adults. Little is known about the role of Facebook in smoking cessation interventions directed toward this age demographic. Objective: The aim of this study was to characterize the content of posts on the Facebook page of Crush the Crave, an evidence-informed smoking cessation intervention directed toward young adults aged 19 to 29 years. Methods: Crush the Crave Facebook posts between October 10, 2012 and June 12, 2013 were collected for analysis, representing page activity during the pilot phase of Crush the Crave. Of the 399 posts included for analysis, 121 were original posts, whereas the remaining 278 were reply posts. Posts were coded according to themes using framework analysis. Results: We found that the original Crush the Crave Facebook posts served two main purposes: to support smoking cessation and to market Crush the Crave. Most of the original posts (86/121, 71.1\%) conveyed support of smoking cessation through the following 7 subthemes: encouraging cessation, group stimulation, management of cravings, promoting social support, denormalizing smoking, providing health information, and exposing tobacco industry tactics. The remaining original posts (35/121, 28.9\%) aimed to market Crush the Crave through 2 subthemes: Crush the Crave promotion and iPhone 5 contest promotion. Most of the reply posts (214/278, 77.0\%) were in response to the supporting smoking cessation posts and the remaining 64 (23.0\%) were in response to the marketing Crush the Crave posts. The most common response to both the supporting smoking cessation and marketing Crush the Crave posts was user engagement with the images associated with each post at 40.2\% (86/214) and 45\% (29/64), respectively. The second most common response consisted of users sharing their smoking-related experiences. More users shared their smoking-related experiences in response to the supporting smoking cessation posts (81/214, 37.9\%) compared to the marketing Crush the Crave posts (11/64, 17\%). With the exception of 4 posts, a moderator posted all the original posts. In addition, although 56.00\% (18,937/33,815) of Crush the Crave Facebook page users were men, only 19.8\% (55/278) of the reply posts were made by men. Finally, men were found to be more likely to express sarcasm or make strong assertions about quitting smoking and Crush the Crave than women. Conclusions: The CTC Facebook page presents as a unique platform for supporting young adult smoking cessation at all stages of the cessation process. The findings of this study indicate that social networking sites, especially Facebook, warrant inclusion in tobacco control efforts directed towards young adults. Research on effectiveness of the Facebook page for quitting smoking is needed. ",
doi="10.2196/jmir.3189",
url="http://www.jmir.org/2014/7/e170/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25016998"
}


@Article{info:doi/10.2196/jmir.3430,
author="Duke, C. Jennifer
and Hansen, Heather
and Kim, E. Annice
and Curry, Laurel
and Allen, Jane",
title="The Use of Social Media by State Tobacco Control Programs to Promote Smoking Cessation: A Cross-Sectional Study",
journal="J Med Internet Res",
year="2014",
month="Jul",
day="10",
volume="16",
number="7",
pages="e169",
keywords="social media",
keywords="tobacco",
keywords="smoking",
keywords="public health",
keywords="mass media",
abstract="Background: The promotion of evidence-based cessation services through social media sites may increase their utilization by smokers. Data on social media adoption and use within tobacco control programs (TCPs) have not been reported. Objective: This study examines TCP use of and activity levels on social media, the reach of TCP sites, and the level of engagement with the content on sites. Methods: A cross-sectional descriptive study of state TCP social media sites and their content was conducted. Results: In 2013, 60\% (30/50) of TCPs were using social media. Approximately one-quarter (26\%, 13/50) of all TCPs used 3 or more social media sites, 24\% (12/50) used 2, and 10\% (5/50) used 1 site. Overall, 60\% (30/50) had a Facebook page, 36\% (18/50) had a Twitter page, and 40\% (20/50) had a YouTube channel. The reach of social media was different across each site and varied widely by state. Among TCPs with a Facebook page, 73\% (22/30) had less than 100 likes per 100,000 adults in the state, and 13\% (4/30) had more than 400 likes per 100,000 adults. Among TCPs with a Twitter page, 61\% (11/18) had less than 10 followers per 100,000 adults, and just 1 state had more than 100 followers per 100,000 adults. Seven states (23\%, 7/30) updated their social media sites daily. The most frequent social media activities focused on the dissemination of information rather than interaction with site users. Social media resources from a national cessation media campaign were promoted infrequently. Conclusions: The current reach of state TCP social media sites is low and most TCPs are not promoting existing cessation services or capitalizing on social media's interactive potential. TCPs should create an online environment that increases participation and 2-way communication with smokers to promote free cessation services. ",
doi="10.2196/jmir.3430",
url="http://www.jmir.org/2014/7/e169/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25014311"
}


@Article{info:doi/10.2196/jmir.3156,
author="Yom-Tov, Elad
and Borsa, Diana
and Cox, J. Ingemar
and McKendry, A. Rachel",
title="Detecting Disease Outbreaks in Mass Gatherings Using Internet Data",
journal="J Med Internet Res",
year="2014",
month="Jun",
day="18",
volume="16",
number="6",
pages="e154",
keywords="mass gatherings",
keywords="infodemiology",
keywords="infectious disease",
keywords="information retrieval",
keywords="data mining",
abstract="Background: Mass gatherings, such as music festivals and religious events, pose a health care challenge because of the risk of transmission of communicable diseases. This is exacerbated by the fact that participants disperse soon after the gathering, potentially spreading disease within their communities. The dispersion of participants also poses a challenge for traditional surveillance methods. The ubiquitous use of the Internet may enable the detection of disease outbreaks through analysis of data generated by users during events and shortly thereafter. Objective: The intent of the study was to develop algorithms that can alert to possible outbreaks of communicable diseases from Internet data, specifically Twitter and search engine queries. Methods: We extracted all Twitter postings and queries made to the Bing search engine by users who repeatedly mentioned one of nine major music festivals held in the United Kingdom and one religious event (the Hajj in Mecca) during 2012, for a period of 30 days and after each festival. We analyzed these data using three methods, two of which compared words associated with disease symptoms before and after the time of the festival, and one that compared the frequency of these words with those of other users in the United Kingdom in the days following the festivals. Results: The data comprised, on average, 7.5 million tweets made by 12,163 users, and 32,143 queries made by 1756 users from each festival. Our methods indicated the statistically significant appearance of a disease symptom in two of the nine festivals. For example, cough was detected at higher than expected levels following the Wakestock festival. Statistically significant agreement (chi-square test, P<.01) between methods and across data sources was found where a statistically significant symptom was detected. Anecdotal evidence suggests that symptoms detected are indeed indicative of a disease that some users attributed to being at the festival. Conclusions: Our work shows the feasibility of creating a public health surveillance system for mass gatherings based on Internet data. The use of multiple data sources and analysis methods was found to be advantageous for rejecting false positives. Further studies are required in order to validate our findings with data from public health authorities. ",
doi="10.2196/jmir.3156",
url="http://www.jmir.org/2014/6/e154/",
url="http://www.ncbi.nlm.nih.gov/pubmed/24943128"
}


@Article{info:doi/10.2196/jmir.2674,
author="Nakhasi, Atul
and Shen, Xiaotian Album
and Passarella, Joseph Ralph
and Appel, J. Lawrence
and Anderson, AM Cheryl",
title="Online Social Networks That Connect Users to Physical Activity Partners: A Review and Descriptive Analysis",
journal="J Med Internet Res",
year="2014",
month="Jun",
day="16",
volume="16",
number="6",
pages="e153",
keywords="behavior",
keywords="behavior control",
keywords="behavioral research",
keywords="exercise",
keywords="health",
keywords="health behavior",
keywords="information services",
keywords="Internet",
keywords="intervention studies",
keywords="online systems",
keywords="physical fitness",
keywords="social media",
keywords="social medicine",
keywords="social networking",
keywords="social support",
keywords="telemedicine",
keywords="Web",
abstract="Background: The US Centers for Disease Control and Prevention have identified a lack of encouragement, support, or companionship from family and friends as a major barrier to physical activity. To overcome this barrier, online social networks are now actively leveraging principles of companion social support in novel ways. Objective: The aim was to evaluate the functionality, features, and usability of existing online social networks which seek to increase physical activity and fitness among users by connecting them to physical activity partners, not just online, but also face-to-face. Methods: In September 2012, we used 3 major databases to identify the website addresses for relevant online social networks. We conducted a Google search using 8 unique keyword combinations: the common keyword ``find'' coupled with 1 of 4 prefix terms ``health,'' ``fitness,'' ``workout,'' or ``physical'' coupled with 1 of 2 stem terms ``activity partners'' or ``activity buddies.'' We also searched 2 prominent technology start-up news sites, TechCrunch and Y Combinator, using 2 unique keyword combinations: the common keyword ``find'' coupled with 1 of 2 stem terms ``activity partners'' and ``activity buddies.'' Sites were defined as online social health activity networks if they had the ability to (1) actively find physical activity partners or activities for the user, (2) offer dynamic, real-time tracking or sharing of social activities, and (3) provide virtual profiles to users. We excluded from our analysis sites that were not Web-based, publicly available, in English, or free. Results: Of the 360 initial search results, we identified 13 websites that met our complete criteria of an online social health activity network. Features such as physical activity creation (13/13, 100\%) and private messaging (12/13, 92\%) appeared almost universally among these websites. However, integration with Web 2.0 technologies such as Facebook and Twitter (9/13, 69\%) and the option of direct event joining (8/13, 62\%) were not as universally present. Largely absent were more sophisticated features that would enable greater usability, such as interactive engagement prompts (3/13, 23\%) and system-created best fit activities (3/13, 23\%). Conclusions: Several major online social networks that connect users to physical activity partners currently exist and use standardized features to achieve their goals. Future research is needed to better understand how users utilize these features and how helpful they truly are. ",
doi="10.2196/jmir.2674",
url="http://www.jmir.org/2014/6/e153/",
url="http://www.ncbi.nlm.nih.gov/pubmed/24936569"
}


@Article{info:doi/10.2196/jmir.3122,
author="Bidmon, Sonja
and Terlutter, Ralf
and R{\"o}ttl, Johanna",
title="What Explains Usage of Mobile Physician-Rating Apps? Results From a Web-Based Questionnaire",
journal="J Med Internet Res",
year="2014",
month="Jun",
day="11",
volume="16",
number="6",
pages="e148",
keywords="physician-rating apps",
keywords="physician-rating websites",
keywords="sociodemographic variables",
keywords="psychographic variables",
keywords="digital literacy",
keywords="TAM",
abstract="Background: Consumers are increasingly accessing health-related information via mobile devices. Recently, several apps to rate and locate physicians have been released in the United States and Germany. However, knowledge about what kinds of variables explain usage of mobile physician-rating apps is still lacking. Objective: This study analyzes factors influencing the adoption of and willingness to pay for mobile physician-rating apps. A structural equation model was developed based on the Technology Acceptance Model and the literature on health-related information searches and usage of mobile apps. Relationships in the model were analyzed for moderating effects of physician-rating website (PRW) usage. Methods: A total of 1006 randomly selected German patients who had visited a general practitioner at least once in the 3 months before the beginning of the survey were randomly selected and surveyed. A total of 958 usable questionnaires were analyzed by partial least squares path modeling and moderator analyses. Results: The suggested model yielded a high model fit. We found that perceived ease of use (PEOU) of the Internet to gain health-related information, the sociodemographic variables age and gender, and the psychographic variables digital literacy, feelings about the Internet and other Web-based applications in general, patients' value of health-related knowledgeability, as well as the information-seeking behavior variables regarding the amount of daily private Internet use for health-related information, frequency of using apps for health-related information in the past, and attitude toward PRWs significantly affected the adoption of mobile physician-rating apps. The sociodemographic variable age, but not gender, and the psychographic variables feelings about the Internet and other Web-based applications in general and patients' value of health-related knowledgeability, but not digital literacy, were significant predictors of willingness to pay. Frequency of using apps for health-related information in the past and attitude toward PRWs, but not the amount of daily Internet use for health-related information, were significant predictors of willingness to pay. The perceived usefulness of the Internet to gain health-related information and the amount of daily Internet use in general did not have any significant effect on both of the endogenous variables. The moderation analysis with the group comparisons for users and nonusers of PRWs revealed that the attitude toward PRWs had significantly more impact on the adoption and willingness to pay for mobile physician-rating apps in the nonuser group. Conclusions: Important variables that contribute to the adoption of a mobile physician-rating app and the willingness to pay for it were identified. The results of this study are important for researchers because they can provide important insights about the variables that influence the acceptance of apps that allow for ratings of physicians. They are also useful for creators of mobile physician-rating apps because they can help tailor mobile physician-rating apps to the consumers' characteristics and needs. ",
doi="10.2196/jmir.3122",
url="http://www.jmir.org/2014/6/e148/",
url="http://www.ncbi.nlm.nih.gov/pubmed/24918859"
}


@Article{info:doi/10.2196/jmir.3298,
author="Tsuya, Atsushi
and Sugawara, Yuya
and Tanaka, Atsushi
and Narimatsu, Hiroto",
title="Do Cancer Patients Tweet? Examining the Twitter Use of Cancer Patients in Japan",
journal="J Med Internet Res",
year="2014",
month="May",
day="27",
volume="16",
number="5",
pages="e137",
keywords="communication",
keywords="co-occurrence",
keywords="Internet",
keywords="leukemia",
keywords="Web 2.0",
abstract="Background: Twitter is an interactive, real-time media that could prove useful in health care. Tweets from cancer patients could offer insight into the needs of cancer patients. Objective: The objective of this study was to understand cancer patients' social media usage and gain insight into patient needs. Methods: A search was conducted of every publicly available user profile on Twitter in Japan for references to the following: breast cancer, leukemia, colon cancer, rectal cancer, colorectal cancer, uterine cancer, cervical cancer, stomach cancer, lung cancer, and ovarian cancer. We then used an application programming interface and a data mining method to conduct a detailed analysis of the tweets from cancer patients. Results: Twitter user profiles included references to breast cancer (n=313), leukemia (n=158), uterine or cervical cancer (n=134), lung cancer (n=87), colon cancer (n=64), and stomach cancer (n=44). A co-occurrence network is seen for all of these cancers, and each cancer has a unique network conformation. Keywords included words about diagnosis, symptoms, and treatments for almost all cancers. Words related to social activities were extracted for breast cancer. Words related to vaccination and support from public insurance were extracted for uterine or cervical cancer. Conclusions: This study demonstrates that cancer patients share information about their underlying disease, including diagnosis, symptoms, and treatments, via Twitter. This information could prove useful to health care providers. ",
doi="10.2196/jmir.3298",
url="http://www.jmir.org/2014/5/e137/",
url="http://www.ncbi.nlm.nih.gov/pubmed/24867458"
}


@Article{info:doi/10.2196/jmir.2684,
author="Frost, Jeana
and Vermeulen, E. Ivar
and Beekers, Nienke",
title="Anonymity Versus Privacy: Selective Information Sharing in Online Cancer Communities",
journal="J Med Internet Res",
year="2014",
month="May",
day="14",
volume="16",
number="5",
pages="e126",
keywords="online systems",
keywords="cancer",
keywords="privacy",
keywords="confidentiality",
keywords="Health 2.0",
keywords="anonymity",
abstract="Background: Active sharing in online cancer communities benefits patients. However, many patients refrain from sharing health information online due to privacy concerns. Existing research on privacy emphasizes data security and confidentiality, largely focusing on electronic medical records. Patient preferences around information sharing in online communities remain poorly understood. Consistent with the privacy calculus perspective adopted from e-commerce research, we suggest that patients approach online information sharing instrumentally, weighing privacy costs against participation benefits when deciding whether to share certain information. Consequently, we argue that patients prefer sharing clinical information over daily life and identity information that potentially compromises anonymity. Furthermore, we explore whether patients' prior experiences, age, health, and gender affect perceived privacy costs and thus willingness to share information. Objective: The goal of the present study is to document patient preferences for sharing information within online health platforms. Methods: A total of 115 cancer patients reported sharing intentions for 15 different types of information, demographics, health status, prior privacy experiences, expected community utility, and privacy concerns. Results: Factor analysis on the 15 information types revealed 3 factors coinciding with 3 proposed information categories: clinical, daily life, and identity information. A within-subject ANOVA showed a strong preference for sharing clinical information compared to daily life and identity information (F1,114=135.59, P=.001, $\eta$2=.93). Also, adverse online privacy experiences, age, and health status negatively affected information-sharing intentions. Female patients shared information less willingly. Conclusions: Respondents' information-sharing intentions depend on dispositional and situational factors. Patients share medical details more willingly than daily life or identity information. The results suggest the need to focus on anonymity rather than privacy in online communities. ",
doi="10.2196/jmir.2684",
url="http://www.jmir.org/2014/5/e126/",
url="http://www.ncbi.nlm.nih.gov/pubmed/24828114"
}


@Article{info:doi/10.2196/jmir.3229,
author="Yuan, Patrick
and Bare, G. Michael
and Johnson, O. Mallory
and Saberi, Parya",
title="Using Online Social Media for Recruitment of Human Immunodeficiency Virus-Positive Participants: A Cross-Sectional Survey",
journal="J Med Internet Res",
year="2014",
month="May",
day="01",
volume="16",
number="5",
pages="e117",
keywords="HIV",
keywords="AIDS",
keywords="online social media",
keywords="Facebook",
keywords="Twitter",
keywords="recruitment",
keywords="Internet research",
keywords="survey retention",
keywords="online data collection software",
keywords="non-financial incentives",
abstract="Background: There are many challenges in recruiting and engaging participants when conducting research, especially with HIV-positive individuals. Some of these challenges include geographical barriers, insufficient time and financial resources, and perceived HIV-related stigma. Objective: This paper describes the methodology of a recruitment approach that capitalized on existing online social media venues and other Internet resources in an attempt to overcome some of these barriers to research recruitment and retention. Methods: From May through August 2013, a campaign approach using a combination of online social media, non-financial incentives, and Web-based survey software was implemented to advertise, recruit, and retain participants, and collect data for a survey study with a limited budget. Results: Approximately US \$5,000 was spent with a research staff designated at 20\% of full-time effort, yielding 2034 survey clicks, 1404 of which met the inclusion criteria and initiated the survey, for an average cost of US \$3.56 per survey initiation. A total of 1221 individuals completed the survey, yielding 86.97\% retention. Conclusions: These data indicate that online recruitment is a feasible and efficient tool that can be further enhanced by sophisticated online data collection software and the addition of non-financial incentives. ",
doi="10.2196/jmir.3229",
url="http://www.jmir.org/2014/5/e117/",
url="http://www.ncbi.nlm.nih.gov/pubmed/24784982"
}


@Article{info:doi/10.2196/jmir.3311,
author="Martinez, Omar
and Wu, Elwin
and Shultz, Z. Andrew
and Capote, Jonathan
and L{\'o}pez Rios, Javier
and Sandfort, Theo
and Manusov, Justin
and Ovejero, Hugo
and Carballo-Dieguez, Alex
and Chavez Baray, Silvia
and Moya, Eva
and L{\'o}pez Matos, Jonathan
and DelaCruz, J. Juan
and Remien, H. Robert
and Rhodes, D. Scott",
title="Still a Hard-to-Reach Population? Using Social Media to Recruit Latino Gay Couples for an HIV Intervention Adaptation Study",
journal="J Med Internet Res",
year="2014",
month="Apr",
day="24",
volume="16",
number="4",
pages="e113",
keywords="social media",
keywords="online recruitment strategies",
keywords="Spanish-speaking Latino men who have sex with men (MSM)",
keywords="Latino gay couples",
keywords="Latino MSM",
keywords="HIV prevention",
abstract="Background: Online social networking use has increased rapidly among African American and Latino men who have sex with men (MSM), making it important to understand how these technologies can be used to reach, retain, and maintain individuals in care and promote health wellness. In particular, the Internet is increasingly recognized as a platform for health communication and education. However, little is known about how primarily Spanish-speaking populations use and engage with each other through social media platforms. Objective: We aimed to recruit eligible couples for a study to adapt ``Connect `n Unite'' (an HIV prevention intervention initially created for black gay couples) for Spanish-speaking Latino gay couples living in New York City. Methods: In order to successfully design and implement an effective social media recruitment campaign to reach Spanish-speaking Latino gay couples for our ongoing ``Latinos en Pareja'' study, our community stakeholders and research team used McGuire's communication/persuasion matrix. The matrix guided our research, specifically each marketing ``channel'', targeted ``message'', and target population or ``receiver''. We developed a social media recruitment protocol and trained our research staff and stakeholders to conduct social media recruitment. Results: As a result, in just 1 month, we recruited all of our subjects (N=14 couples, that is, N=28 participants) and reached more than 35,658 participants through different channels. One of the major successes of our social media recruitment campaign was to build a strong stakeholder base that became involved early on in all aspects of the research process---from pilot study writing and development to recruitment and retention. In addition, the variety of ``messages'' used across different social media platforms (including Facebook, the ``Latinos en Pareja'' study website, Craigslist, and various smartphone applications such as Grindr, SCRUFF, and Jack'd) helped recruit Latino gay couples. We also relied on a wide range of community-based organizations across New York City to promote the study and build in the social media components. Conclusions: Our findings highlight the importance of incorporating communication technologies into the recruitment and engagement of participants in HIV interventions. Particularly, the success of our social media recruitment strategy with Spanish-speaking Latino MSM shows that this population is not particularly ``hard to reach'', as it is often characterized within public health literature. ",
doi="10.2196/jmir.3311",
url="http://www.jmir.org/2014/4/e113/",
url="http://www.ncbi.nlm.nih.gov/pubmed/24763130"
}


@Article{info:doi/10.2196/jmir.3006,
author="Mishori, Ranit
and Singh, Oberoi Lisa
and Levy, Brendan
and Newport, Calvin",
title="Mapping Physician Twitter Networks: Describing How They Work as a First Step in Understanding Connectivity, Information Flow, and Message Diffusion",
journal="J Med Internet Res",
year="2014",
month="Apr",
day="14",
volume="16",
number="4",
pages="e107",
keywords="social networking",
keywords="network analysis",
keywords="information science",
keywords="dissemination science",
keywords="infodemiology",
keywords="physician communication",
keywords="physician networks",
keywords="Twitter",
abstract="Background: Twitter is becoming an important tool in medicine, but there is little information on Twitter metrics. In order to recommend best practices for information dissemination and diffusion, it is important to first study and analyze the networks. Objective: This study describes the characteristics of four medical networks, analyzes their theoretical dissemination potential, their actual dissemination, and the propagation and distribution of tweets. Methods: Open Twitter data was used to characterize four networks: the American Medical Association (AMA), the American Academy of Family Physicians (AAFP), the American Academy of Pediatrics (AAP), and the American College of Physicians (ACP). Data were collected between July 2012 and September 2012. Visualization was used to understand the follower overlap between the groups. Actual flow of the tweets for each group was assessed. Tweets were examined using Topsy, a Twitter data aggregator. Results: The theoretical information dissemination potential for the groups is large. A collective community is emerging, where large percentages of individuals are following more than one of the groups. The overlap across groups is small, indicating a limited amount of community cohesion and cross-fertilization. The AMA followers' network is not as active as the other networks. The AMA posted the largest number of tweets while the AAP posted the fewest. The number of retweets for each organization was low indicating dissemination that is far below its potential. Conclusions: To increase the dissemination potential, medical groups should develop a more cohesive community of shared followers. Tweet content must be engaging to provide a hook for retweeting and reaching potential audience. Next steps call for content analysis, assessment of the behavior and actions of the messengers and the recipients, and a larger-scale study that considers other medical groups using Twitter. ",
doi="10.2196/jmir.3006",
url="http://www.jmir.org/2014/4/e107/",
url="http://www.ncbi.nlm.nih.gov/pubmed/24733146"
}


@Article{info:doi/10.2196/jmir.3231,
author="Syred, Jonathan
and Naidoo, Carla
and Woodhall, C. Sarah
and Baraitser, Paula",
title="Would You Tell Everyone This? Facebook Conversations as Health Promotion Interventions",
journal="J Med Internet Res",
year="2014",
month="Apr",
day="11",
volume="16",
number="4",
pages="e108",
keywords="social media",
keywords="chlamydia",
keywords="health promotion",
abstract="Background: Health promotion interventions on social networking sites can communicate individually tailored content to a large audience. User-generated content helps to maximize engagement, but health promotion websites have had variable success in supporting user engagement. Objective: The aim of our study was to examine which elements of moderator and participant behavior stimulated and maintained interaction with a sexual health promotion site on Facebook. Methods: We examined the pattern and content of posts on a Facebook page. Google analytics was used to describe the number of people using the page and viewing patterns. A qualitative, thematic approach was used to analyze content. Results: During the study period (January 18, 2010, to June 27, 2010), 576 users interacted 888 times with the site through 508 posts and 380 comments with 93\% of content generated by users. The user-generated conversation continued while new participants were driven to the site by advertising, but interaction with the site ceased rapidly after the advertising stopped. Conversations covered key issues on chlamydia and chlamydia testing. Users endorsed testing, celebrated their negative results, and modified and questioned key messages. There was variation in user approach to the site from sharing of personal experience and requesting help to joking about sexually transmitted infection. The moderator voice was reactive, unengaged, tolerant, simplistic, and was professional in tone. There was no change in the moderator approach throughout the period studied. Conclusions: Our findings suggest this health promotion site provided a space for single user posts but not a self-sustaining conversation. Possible explanations for this include little new content from the moderator, a definition of content too narrow to hold the interest of participants, and limited responsiveness to user needs. Implications for health promotion practice include the need to consider a life cycle approach to online community development for health promotion and the need for a developing moderator strategy to reflect this. This strategy should reflect two facets of moderation for online health promotion interventions: (1) unengaged and professional oversight to provide a safe space for discussion and to maintain information quality, and (2) a more engaged and interactive presence designed to maintain interest that generates new material for discussion and is responsive to user requests. ",
doi="10.2196/jmir.3231",
url="http://www.jmir.org/2014/4/e108/",
url="http://www.ncbi.nlm.nih.gov/pubmed/24727742"
}


@Article{info:doi/10.2196/resprot.3277,
author="Ilakkuvan, Vinu
and Tacelosky, Michael
and Ivey, C. Keith
and Pearson, L. Jennifer
and Cantrell, Jennifer
and Vallone, M. Donna
and Abrams, B. David
and Kirchner, R. Thomas",
title="Cameras for Public Health Surveillance: A Methods Protocol for Crowdsourced Annotation of Point-of-Sale Photographs",
journal="JMIR Res Protoc",
year="2014",
month="Apr",
day="09",
volume="3",
number="2",
pages="e22",
keywords="image processing",
keywords="crowdsourcing",
keywords="annotation",
keywords="public health",
keywords="surveillance",
abstract="Background: Photographs are an effective way to collect detailed and objective information about the environment, particularly for public health surveillance. However, accurately and reliably annotating (ie, extracting information from) photographs remains difficult, a critical bottleneck inhibiting the use of photographs for systematic surveillance. The advent of distributed human computation (ie, crowdsourcing) platforms represents a veritable breakthrough, making it possible for the first time to accurately, quickly, and repeatedly annotate photos at relatively low cost. Objective: This paper describes a methods protocol, using photographs from point-of-sale surveillance studies in the field of tobacco control to demonstrate the development and testing of custom-built tools that can greatly enhance the quality of crowdsourced annotation. Methods: Enhancing the quality of crowdsourced photo annotation requires a number of approaches and tools. The crowdsourced photo annotation process is greatly simplified by decomposing the overall process into smaller tasks, which improves accuracy and speed and enables adaptive processing, in which irrelevant data is filtered out and more difficult targets receive increased scrutiny. Additionally, zoom tools enable users to see details within photographs and crop tools highlight where within an image a specific object of interest is found, generating a set of photographs that answer specific questions. Beyond such tools, optimizing the number of raters (ie, crowd size) for accuracy and reliability is an important facet of crowdsourced photo annotation. This can be determined in a systematic manner based on the difficulty of the task and the desired level of accuracy, using receiver operating characteristic (ROC) analyses. Usability tests of the zoom and crop tool suggest that these tools significantly improve annotation accuracy. The tests asked raters to extract data from photographs, not for the purposes of assessing the quality of that data, but rather to assess the usefulness of the tool. The proportion of individuals accurately identifying the presence of a specific advertisement was higher when provided with pictures of the product's logo and an example of the ad, and even higher when also provided the zoom tool ($\chi$22=155.7, P<.001). Similarly, when provided cropped images, a significantly greater proportion of respondents accurately identified the presence of cigarette product ads ($\chi$21=75.14, P<.001), as well as reported being able to read prices ($\chi$22=227.6, P<.001). Comparing the results of crowdsourced photo-only assessments to traditional field survey data, an excellent level of correspondence was found, with area under the ROC curves produced by sensitivity analyses averaging over 0.95, requiring on average 10 to 15 crowdsourced raters to achieve values of over 0.90. Results: Further testing and improvement of these tools and processes is currently underway. This includes conducting systematic evaluations thatcrowdsource photograph annotation and methodically assess the quality of raters' work. Conclusions: Overall, the combination of crowdsourcing technologies with tiered data flow and tools that enhance annotation quality represents a breakthrough solution to the problem of photograph annotation, vastly expanding opportunities for the use of photographs rich in public health and other data on a scale previously unimaginable. ",
doi="10.2196/resprot.3277",
url="http://www.researchprotocols.org/2014/2/e22/",
url="http://www.ncbi.nlm.nih.gov/pubmed/24717168"
}


@Article{info:doi/10.2196/jmir.2496,
author="Shaikh, R. Abdul
and Butte, J. Atul
and Schully, D. Sheri
and Dalton, S. William
and Khoury, J. Muin
and Hesse, W. Bradford",
title="Collaborative Biomedicine in the Age of Big Data: The Case of Cancer",
journal="J Med Internet Res",
year="2014",
month="Apr",
day="07",
volume="16",
number="4",
pages="e101",
keywords="biomedical research",
keywords="crowdsourcing",
keywords="health information technology",
keywords="innovation",
keywords="precision medicine",
doi="10.2196/jmir.2496",
url="http://www.jmir.org/2014/4/e101/",
url="http://www.ncbi.nlm.nih.gov/pubmed/24711045"
}


@Article{info:doi/10.2196/jmir.3265,
author="Nascimento, D. Thiago
and DosSantos, F. Marcos
and Danciu, Theodora
and DeBoer, Misty
and van Holsbeeck, Hendrik
and Lucas, R. Sarah
and Aiello, Christine
and Khatib, Leen
and Bender, A. MaryCatherine
and 
and Zubieta, Jon-Kar
and DaSilva, F. Alexandre",
title="Real-Time Sharing and Expression of Migraine Headache Suffering on Twitter: A Cross-Sectional Infodemiology Study",
journal="J Med Internet Res",
year="2014",
month="Apr",
day="03",
volume="16",
number="4",
pages="e96",
keywords="migraine",
keywords="headache",
keywords="epidemiology",
keywords="social media",
keywords="Twitter",
abstract="Background: Although population studies have greatly improved our understanding of migraine, they have relied on retrospective self-reports that are subject to memory error and experimenter-induced bias. Furthermore, these studies also lack specifics from the actual time that attacks were occurring, and how patients express and share their ongoing suffering. Objective: As technology and language constantly evolve, so does the way we share our suffering. We sought to evaluate the infodemiology of self-reported migraine headache suffering on Twitter. Methods: Trained observers in an academic setting categorized the meaning of every single ``migraine'' tweet posted during seven consecutive days. The main outcome measures were prevalence, life-style impact, linguistic, and timeline of actual self-reported migraine headache suffering on Twitter. Results: From a total of 21,741 migraine tweets collected, only 64.52\% (14,028/21,741 collected tweets) were from users reporting their migraine headache attacks in real-time. The remainder of the posts were commercial, re-tweets, general discussion or third person's migraine, and metaphor. The gender distribution available for the actual migraine posts was 73.47\% female (10,306/14,028), 17.40\% males (2441/14,028), and 0.01\% transgendered (2/14,028). The personal impact of migraine headache was immediate on mood (43.91\%, 6159/14,028), productivity at work (3.46\%, 486/14,028), social life (3.45\%, 484/14,028), and school (2.78\%, 390/14,028). The most common migraine descriptor was ``Worst'' (14.59\%, 201/1378) and profanity, the ``F-word'' (5.3\%, 73/1378). The majority of postings occurred in the United States (58.28\%, 3413/5856), peaking on weekdays at 10:00h and then gradually again at 22:00h; the weekend had a later morning peak. Conclusions: Twitter proved to be a powerful source of knowledge for migraine research. The data in this study overlap large-scale epidemiological studies, avoiding memory bias and experimenter-induced error. Furthermore, linguistics of ongoing migraine reports on social media proved to be highly heterogeneous and colloquial in our study, suggesting that current pain questionnaires should undergo constant reformulations to keep up with modernization in the expression of pain suffering in our society. In summary, this study reveals the modern characteristics and broad impact of migraine headache suffering on patients' lives as it is spontaneously shared via social media. ",
doi="10.2196/jmir.3265",
url="http://www.jmir.org/2014/4/e96/",
url="http://www.ncbi.nlm.nih.gov/pubmed/24698747"
}


@Article{info:doi/10.2196/jmir.3145,
author="Terlutter, Ralf
and Bidmon, Sonja
and R{\"o}ttl, Johanna",
title="Who Uses Physician-Rating Websites? Differences in Sociodemographic Variables, Psychographic Variables, and Health Status of Users and Nonusers of Physician-Rating Websites",
journal="J Med Internet Res",
year="2014",
month="Mar",
day="31",
volume="16",
number="3",
pages="e97",
keywords="physician-rating websites",
keywords="sociodemographic variables",
keywords="psychographic variables",
keywords="digital literacy",
abstract="Background: The number of physician-rating websites (PRWs) is rising rapidly, but usage is still poor. So far, there has been little discussion about what kind of variables influence usage of PRWs. Objective: We focused on sociodemographic variables, psychographic variables, and health status of PRW users and nonusers. Methods: An online survey of 1006 randomly selected German patients was conducted in September 2012. We analyzed the patients' knowledge and use of online PRWs. We also analyzed the impact of sociodemographic variables (gender, age, and education), psychographic variables (eg, feelings toward the Internet, digital literacy), and health status on use or nonuse as well as the judgment of and behavior intentions toward PRWs. The survey instrument was based on existing literature and was guided by several research questions. Results: A total of 29.3\% (289/986) of the sample knew of a PRW and 26.1\% (257/986) had already used a PRW. Younger people were more prone than older ones to use PRWs (t967=2.27, P=.02). Women used them more than men ($\chi$21=9.4, P=.002), the more highly educated more than less educated people ($\chi$24=19.7, P=.001), and people with chronic diseases more than people without ($\chi$21=5.6, P=.02). No differences were found between users and nonusers in their daily private Internet use and in their use of the Internet for health-related information. Users had more positive feelings about the Internet and other Web-based applications in general (t489=3.07, P=.002) than nonusers, and they had higher digital literacy (t520=4.20, P<.001). Users ascribed higher usefulness to PRWs than nonusers (t612=11.61, P<.001) and users trusted information on PRWs to a greater degree than nonusers (t559=11.48, P<.001). Users were also more likely to rate a physician on a PRW in the future (t367=7.63, P<.001) and to use a PRW in the future (t619=15.01, P<.001). The results of 2 binary logistic regression analyses demonstrated that sociodemographic variables (gender, age, education) and health status alone did not predict whether persons were prone to use PRWs or not. Adding psychographic variables and information-seeking behavior variables to the binary logistic regression analyses led to a satisfying fit of the model and revealed that higher education, poorer health status, higher digital literacy (at the 10\% level of significance), lower importance of family and pharmacist for health-related information, higher trust in information on PRWs, and higher appraisal of usefulness of PRWs served as significant predictors for usage of PRWs. Conclusions: Sociodemographic variables alone do not sufficiently predict use or nonuse of PRWs; specific psychographic variables and health status need to be taken into account. The results can help designers of PRWs to better tailor their product to specific target groups, which may increase use of PRWs in the future. ",
doi="10.2196/jmir.3145",
url="http://www.jmir.org/2014/3/e97/",
url="http://www.ncbi.nlm.nih.gov/pubmed/24686918"
}


@Article{info:doi/10.2196/med20.3128,
author="McHattie, Lynn-Sayers
and Cumming, Grant
and French, Tara",
title="Transforming Patient Experience: Health Web Science Meets Medicine 2.0",
journal="Med 2.0",
year="2014",
month="Mar",
day="20",
volume="3",
number="1",
pages="e2",
keywords="patient-centered medicine",
keywords="co-creation",
keywords="co-design",
keywords="Health Web Science",
keywords="Medicine 2.0",
keywords="P4 medicine",
doi="10.2196/med20.3128",
url="http://www.medicine20.com/2014/1/e2/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25075246"
}


@Article{info:doi/10.2196/med20.3237,
author="Genes, Nicholas
and Chary, Michael
and Chason, Kevin",
title="Analysis of Twitter Users' Sharing of Official New York Storm Response Messages",
journal="Med 2.0",
year="2014",
month="Mar",
day="20",
volume="3",
number="1",
pages="e1",
keywords="social media",
keywords="disaster response",
keywords="emergencies",
keywords="public health",
keywords="emergency management",
abstract="Background: Twitter is a social network where users read, send, and share snippets of text (``tweets''). Tweets can be disseminated through multiple means; on desktop computers, laptops, and mobile devices, over ethernet, Wi-Fi or cellular networks. This redundancy positions Twitter as a useful tool for disseminating information to the public during emergencies or disasters.Previous research on dissemination of information using Twitter has mostly investigated the characteristics of tweets that are most effective in raising consumer awareness about a new product or event. In particular, they describe characteristics that increase the chance the messages will be shared (``retweeted'') by users. In comparison, little has been published on how information from municipal or state government agencies spreads on Twitter during emergency situations. Retweeting these messages is a way to enhance public awareness of potentially important instructions from public officials in a disaster. Objective: The aim of this study is to (1) describe the tweets of select New York State and New York City agencies by public officials surrounding two notable recent winter storms that required a large-scale emergency response, and (2) identify the characteristics of the tweets of public officials that were most disseminated (retweeted). Methods: For one week surrounding Superstorm Sandy (October 2012) and the winter blizzard Nemo (February 2013), we collected (1) tweets from the official accounts for six New York governmental agencies, and (2) all tweets containing the hashtags \#sandy (or \#nemo) and \#nyc. From these data we calculated how many times a tweet was retweeted, controlling for differences in baseline activity in each account.  We observed how many hashtags and links each tweet contained. We also calculated the lexical diversity of each tweet, a measure of the range of vocabulary used. Results: During the Sandy storm, 3242 shared (retweeted) messages from public officials were collected. The lexical diversity of official tweets was similar (2.25-2.49) and well below the average for non-official tweets mentioning \#sandy and \#nyc (3.82). Most official tweets were with substantial retweets including a link for further reading. Of the 448 tweets analyzed from six official city and state Twitter accounts from the Nemo blizzard, 271 were related to the storm, and 174 had actionable information for the public. Actionable storm messages were retweeted approximately 24x per message, compared to 31x per message for general storm information. Conclusions: During two weather emergencies, New York public officials were able to convey storm-related information that was shared widely beyond existing follower bases, potentially improving situational awareness and disaster response. Official Sandy tweets, characterized by a lower lexical diversity score than other city- and Sandy-related tweets, were likely easier to understand, and often linked to further information and resources. Actionable information in the Nemo blizzard, such as specific instructions and cancellation notices, was not shared as often as more general warnings and ``fun facts,'' suggesting agencies mix important instructions with more general news and trivia, as a way of reaching the broadest audience during a disaster. ",
doi="10.2196/med20.3237",
url="http://www.medicine20.com/2014/1/e1/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25075245"
}


@Article{info:doi/10.2196/jmir.2838,
author="Koh, Sukjin
and Gordon, S. Andrew
and Wienberg, Christopher
and Sood, O. Sara
and Morley, Stephanie
and Burke, M. Deborah",
title="Stroke Experiences in Weblogs: A Feasibility Study of Sex Differences",
journal="J Med Internet Res",
year="2014",
month="Mar",
day="19",
volume="16",
number="3",
pages="e84",
keywords="cerebral stroke",
keywords="signs and symptoms",
keywords="sex differences",
keywords="Internet",
keywords="blogging",
abstract="Background: Research on cerebral stroke symptoms using hospital records has reported that women experience more nontraditional symptoms of stroke (eg, mental status change, pain) than men do. This is an important issue because nontraditional symptoms may delay the decision to get medical assistance and increase the difficulty of correct diagnosis. In the present study, we investigate sex differences in the stroke experience as described in stories on weblogs. Objective: The goal of this study was to investigate the feasibility of using the Internet as a source of data for basic research on stroke experiences. Methods: Stroke experiences described in blogs were identified by using StoryUpgrade, a program that searches blog posts using a fictional prototype story. In this study, the prototype story was a description of a stroke experience. Retrieved stories coded by the researchers as relevant were used to update the search query and retrieve more stories using relevance feedback. Stories were coded for first- or third-person narrator, traditional and nontraditional patient symptoms, type of stroke, patient sex and age, delay before seeking medical assistance, and delay at hospital and in treatment. Results: There were 191 relevant stroke stories of which 174 stories reported symptoms (52.3\% female and 47.7\% male patients). There were no sex differences for each traditional or nontraditional stroke symptom by chi-square analysis (all Ps>.05). Type of narrator, however, affected report of traditional and nontraditional symptoms. Female first-person narrators (ie, the patient) were more likely to report mental status change (56.3\%, 27/48) than male first-person narrators (36.4\%, 16/44), a marginally significant effect by logistic regression (P=.056), whereas reports of third-person narrators did not differ for women (27.9\%, 12/43) and men (28.2\%, 11/39) patients. There were more reports of at least 1 nontraditional symptom in the 92 first-person reports (44.6\%, 41/92) than in the 82 third-person reports (25.6\%, 21/82, P=.006). Ischemic or hemorrhagic stroke was reported in 67 and 29 stories, respectively. Nontraditional symptoms varied with stroke type with 1 or more nontraditional symptoms reported for 79.3\% (23/29) of hemorrhagic stroke patients and 53.7\% (36/67) of ischemic stroke patients (P=.001). Conclusions: The results replicate previous findings based on hospital interview data supporting the reliability of findings from weblogs. New findings include the effect of first- versus third-person narrator on sex differences in the report of nontraditional symptoms. This result suggests that narrator is an important variable to be examined in future studies. A fragmentary data problem limits some conclusions because important information, such as age, was not consistently reported. Age trends strengthen the feasibility of using the Internet for stroke research because older adults have significantly increased their Internet use in recent years. ",
doi="10.2196/jmir.2838",
url="http://www.jmir.org/2014/3/e84/",
url="http://www.ncbi.nlm.nih.gov/pubmed/24647327"
}


@Article{info:doi/10.2196/jmir.2679,
author="Capurro, Daniel
and Cole, Kate
and Echavarr{\'i}a, I. Maria
and Joe, Jonathan
and Neogi, Tina
and Turner, M. Anne",
title="The Use of Social Networking Sites for Public Health Practice and Research: A Systematic Review",
journal="J Med Internet Res",
year="2014",
month="Mar",
day="14",
volume="16",
number="3",
pages="e79",
keywords="public health informatics",
keywords="public health",
keywords="social network",
keywords="health communication",
abstract="Background: Social networking sites (SNSs) have the potential to increase the reach and efficiency of essential public health services, such as surveillance, research, and communication. Objective: The objective of this study was to conduct a systematic literature review to identify the use of SNSs for public health research and practice and to identify existing knowledge gaps. Methods: We performed a systematic literature review of articles related to public health and SNSs using PubMed, EMBASE, and CINAHL to search for peer-reviewed publications describing the use of SNSs for public health research and practice. We also conducted manual searches of relevant publications. Each publication was independently reviewed by 2 researchers for inclusion and extracted relevant study data. Results: A total of 73 articles met our inclusion criteria. Most articles (n=50) were published in the final 2 years covered by our search. In all, 58 articles were in the domain of public health research and 15 were in public health practice. Only 1 study was conducted in a low-income country. Most articles (63/73, 86\%) described observational studies involving users or usages of SNSs; only 5 studies involved randomized controlled trials. A large proportion (43/73, 59\%) of the identified studies included populations considered hard to reach, such as young individuals, adolescents, and individuals at risk of sexually transmitted diseases or alcohol and substance abuse. Few articles (2/73, 3\%) described using the multidirectional communication potential of SNSs to engage study populations. Conclusions: The number of publications about public health uses for SNSs has been steadily increasing in the past 5 years. With few exceptions, the literature largely consists of observational studies describing users and usages of SNSs regarding topics of public health interest. More studies that fully exploit the communication tools embedded in SNSs and study their potential to produce significant effects in the overall population's health are needed. ",
doi="10.2196/jmir.2679",
url="http://www.jmir.org/2014/3/e79/",
url="http://www.ncbi.nlm.nih.gov/pubmed/24642014"
}


@Article{info:doi/10.2196/jmir.2972,
author="Harris, K. Jenine
and Choucair, Bechara
and Maier, C. Ryan
and Jolani, Nina
and Bernhardt, M. Jay",
title="Are Public Health Organizations Tweeting to the Choir? Understanding Local Health Department Twitter Followership",
journal="J Med Internet Res",
year="2014",
month="Feb",
day="26",
volume="16",
number="2",
pages="e31",
keywords="local health department",
keywords="Twitter",
keywords="social media",
abstract="Background: One of the essential services provided by the US local health departments is informing and educating constituents about health. Communication with constituents about public health issues and health risks is among the standards required of local health departments for accreditation. Past research found that only 61\% of local health departments met standards for informing and educating constituents, suggesting a considerable gap between current practices and best practice. Objective: Social media platforms, such as Twitter, may aid local health departments in informing and educating their constituents by reaching large numbers of people with real-time messages at relatively low cost. Little is known about the followers of local health departments on Twitter. The aim of this study was to examine characteristics of local health department Twitter followers and the relationship between local health department characteristics and follower characteristics. Methods: In 2013, we collected (using NodeXL) and analyzed a sample of 4779 Twitter followers from 59 randomly selected local health departments in the United States with Twitter accounts. We coded each Twitter follower for type (individual, organization), location, health focus, and industry (eg, media, government). Local health department characteristics were adopted from the 2010 National Association of City and County Health Officials Profile Study data. Results: Local health department Twitter accounts were followed by more organizations than individual users. Organizations tended to be health-focused, located outside the state from the local health department being followed, and from the education, government, and non-profit sectors. Individuals were likely to be local and not health-focused. Having a public information officer on staff, serving a larger population, and ``tweeting'' more frequently were associated with having a higher percentage of local followers. Conclusions: Social media has the potential to reach a wide and diverse audience. Understanding audience characteristics can help public health organizations use this new tool more effectively by tailoring tweet content and dissemination strategies for their audience. ",
doi="10.2196/jmir.2972",
url="http://www.jmir.org/2014/2/e31/",
url="http://www.ncbi.nlm.nih.gov/pubmed/24571914"
}


@Article{info:doi/10.2196/jmir.3054,
author="Huerta, R. Timothy
and Hefner, L. Jennifer
and Ford, W. Eric
and McAlearney, Scheck Ann
and Menachemi, Nir",
title="Hospital Website Rankings in the United States: Expanding Benchmarks and Standards for Effective Consumer Engagement",
journal="J Med Internet Res",
year="2014",
month="Feb",
day="25",
volume="16",
number="2",
pages="e64",
keywords="social media",
keywords="hospitals",
keywords="information services",
keywords="communication",
keywords="access",
keywords="consumer health information",
abstract="Background: Passage of the Patient Protection and Affordable Care Act (ACA) increased the roles hospitals and health systems play in care delivery and led to a wave of consolidation of medical groups and hospitals. As such, the traditional patient interaction with an independent medical provider is becoming far less common, replaced by frequent interactions with integrated medical groups and health systems. It is thus increasingly important for these organizations to have an effective social media presence. Moreover, in the age of the informed consumer, patients desire a readily accessible, electronic interface to initiate contact, making a well-designed website and social media strategy critical features of the modern health care organization. Objective: The purpose of this study was to assess the Web presence of hospitals and their health systems on five dimensions: accessibility, content, marketing, technology, and usability. In addition, an overall ranking was calculated to identify the top 100 hospital and health system websites. Methods: A total of 2407 unique Web domains covering 2785 hospital facilities or their parent organizations were identified and matched against the 2009 American Hospital Association (AHA) Annual Survey. This is a four-fold improvement in prior research and represents what the authors believe to be a census assessment of the online presence of US hospitals and their health systems. Each of the five dimensions was investigated with an automated content analysis using a suite of tools. Scores on the dimensions are reported on a range from 0 to 10, with a higher score on any given dimension representing better comparative performance. Rankings on each dimension and an average ranking are provided for the top 100 hospitals. Results: The mean score on the usability dimension, meant to rate overall website quality, was 5.16 (SD 1.43), with the highest score of 8 shared by only 5 hospitals. Mean scores on other dimensions were between 4.43 (SD 2.19) and 6.49 (SD 0.96). Based on these scores, rank order calculations for the top 100 websites are presented. Additionally, a link to raw data, including AHA ID, is provided to enable researchers and practitioners the ability to further explore relationships to other dynamics in health care. Conclusions: This census assessment of US hospitals and their health systems provides a clear indication of the state of the sector. While stakeholder engagement is core to most discussions of the role that hospitals must play in relation to communities, management of an online presence has not been recognized as a core competency fundamental to care delivery. Yet, social media management and network engagement are skills that exist at the confluence of marketing and technical prowess. This paper presents performance guidelines evaluated against best-demonstrated practice or independent standards to facilitate improvement of the sector's use of websites and social media. ",
doi="10.2196/jmir.3054",
url="http://www.jmir.org/2014/2/e64/",
url="http://www.ncbi.nlm.nih.gov/pubmed/24568892"
}


@Article{info:doi/10.2196/jmir.3018,
author="Frisch, Noreen
and Atherton, Pat
and Borycki, Elizabeth
and Mickelson, Grace
and Cordeiro, Jennifer
and Novak Lauscher, Helen
and Black, Agnes",
title="Growing a Professional Network to Over 3000 Members in Less Than 4 Years: Evaluation of InspireNet, British Columbia's Virtual Nursing Health Services Research Network",
journal="J Med Internet Res",
year="2014",
month="Feb",
day="21",
volume="16",
number="2",
pages="e49",
keywords="social networking",
keywords="social media",
keywords="nursing",
keywords="health services",
keywords="research",
keywords="education",
abstract="Background: Use of Web 2.0 and social media technologies has become a new area of research among health professionals. Much of this work has focused on the use of technologies for health self-management and the ways technologies support communication between care providers and consumers. This paper addresses a new use of technology in providing a platform for health professionals to support professional development, increase knowledge utilization, and promote formal/informal professional communication. Specifically, we report on factors necessary to attract and sustain health professionals' use of a network designed to increase nurses' interest in and use of health services research and to support knowledge utilization activities in British Columbia, Canada. Objective: ``InspireNet'', a virtual professional network for health professionals, is a living laboratory permitting documentation of when and how professionals take up Web 2.0 and social media. Ongoing evaluation documents our experiences in establishing, operating, and evaluating this network. Methods: Overall evaluation methods included (1) tracking website use, (2) conducting two member surveys, and (3) soliciting member feedback through focus groups and interviews with those who participated in electronic communities of practice (eCoPs) and other stakeholders. These data have been used to learn about the types of support that seem relevant to network growth. Results: Network growth exceeded all expectations. Members engaged with varying aspects of the network's virtual technologies, such as teams of professionals sharing a common interest, research teams conducting their work, and instructional webinars open to network members. Members used wikis, blogs, and discussion groups to support professional work, as well as a members' database with contact information and areas of interest. The database is accessed approximately 10 times per day. InspireNet public blog posts are accessed roughly 500 times each. At the time of writing, 21 research teams conduct their work virtually using the InspireNet platform; 10 topic-based Action Teams meet to address issues of mutual concern. Nursing and other health professionals, even those who rated themselves as computer literate, required significant mentoring and support in their efforts to adopt their practice to a virtual environment. There was a steep learning curve for professionals to learn to work in a virtual environment and to benefit from the available technologies. Conclusions: Virtual professional networks can be positioned to make a significant contribution to ongoing professional practice and to creating environments supportive of information sharing, mentoring, and learning across geographical boundaries. Nonetheless, creation of a Web 2.0 and social media platform is not sufficient, in and of itself, to attract or sustain a vibrant community of professionals interested in improving their practice. Essential support includes instruction in the use of Web-based activities and time management, a biweekly e-Newsletter, regular communication from leaders, and an annual face-to-face conference. ",
doi="10.2196/jmir.3018",
url="http://www.jmir.org/2014/2/e49/",
url="http://www.ncbi.nlm.nih.gov/pubmed/24566806"
}


@Article{info:doi/10.2196/jmir.3024,
author="Verhoef, M. Lise
and Van de Belt, H. Tom
and Engelen, JLPG Lucien
and Schoonhoven, Lisette
and Kool, B. Rudolf",
title="Social Media and Rating Sites as Tools to Understanding Quality of Care: A Scoping Review",
journal="J Med Internet Res",
year="2014",
month="Feb",
day="20",
volume="16",
number="2",
pages="e56",
keywords="social media",
keywords="rating sites",
keywords="patient experiences",
keywords="patient satisfaction",
keywords="quality of health care",
abstract="Background: Insight into the quality of health care is important for any stakeholder including patients, professionals, and governments. In light of a patient-centered approach, it is essential to assess the quality of health care from a patient's perspective, which is commonly done with surveys or focus groups. Unfortunately, these ``traditional'' methods have significant limitations that include social desirability bias, a time lag between experience and measurement, and difficulty reaching large groups of people. Information on social media could be of value to overcoming these limitations, since these new media are easy to use and are used by the majority of the population. Furthermore, an increasing number of people share health care experiences online or rate the quality of their health care provider on physician rating sites. The question is whether this information is relevant to determining or predicting the quality of health care. Objective: The goal of our research was to systematically analyze the relation between information shared on social media and quality of care. Methods: We performed a scoping review with the following goals: (1) to map the literature on the association between social media and quality of care, (2) to identify different mechanisms of this relationship, and (3) to determine a more detailed agenda for this relatively new research area. A recognized scoping review methodology was used. We developed a search strategy based on four themes: social media, patient experience, quality, and health care. Four online scientific databases were searched, articles were screened, and data extracted. Results related to the research question were described and categorized according to type of social media. Furthermore, national and international stakeholders were consulted throughout the study, to discuss and interpret results. Results: Twenty-nine articles were included, of which 21 were concerned with health care rating sites. Several studies indicate a relationship between information on social media and quality of health care. However, some drawbacks exist, especially regarding the use of rating sites. For example, since rating is anonymous, rating values are not risk adjusted and therefore vulnerable to fraud. Also, ratings are often based on only a few reviews and are predominantly positive. Furthermore, people providing feedback on health care via social media are presumably not always representative for the patient population. Conclusions: Social media and particularly rating sites are an interesting new source of information about quality of care from the patient's perspective. This new source should be used to complement traditional methods, since measuring quality of care via social media has other, but not less serious, limitations. Future research should explore whether social media are suitable in practice for patients, health insurers, and governments to help them judge the quality performance of professionals and organizations. ",
doi="10.2196/jmir.3024",
url="http://www.jmir.org/2014/2/e56/",
url="http://www.ncbi.nlm.nih.gov/pubmed/24566844"
}


@Article{info:doi/10.2196/jmir.2952,
author="Maher, A. Carol
and Lewis, K. Lucy
and Ferrar, Katia
and Marshall, Simon
and De Bourdeaudhuij, Ilse
and Vandelanotte, Corneel",
title="Are Health Behavior Change Interventions That Use Online Social Networks Effective? A Systematic Review",
journal="J Med Internet Res",
year="2014",
month="Feb",
day="14",
volume="16",
number="2",
pages="e40",
keywords="systematic review",
keywords="social network",
keywords="behavior change",
keywords="intervention",
keywords="Internet",
keywords="physical activity",
keywords="weight loss",
abstract="Background: The dramatic growth of Web 2.0 technologies and online social networks offers immense potential for the delivery of health behavior change campaigns. However, it is currently unclear how online social networks may best be harnessed to achieve health behavior change. Objective: The intent of the study was to systematically review the current level of evidence regarding the effectiveness of online social network health behavior interventions. Methods: Eight databases (Scopus, CINAHL, Medline, ProQuest, EMBASE, PsycINFO, Cochrane, Web of Science and Communication \& Mass Media Complete) were searched from 2000 to present using a comprehensive search strategy. Study eligibility criteria were based on the PICOS format, where ``population'' included child or adult populations, including healthy and disease populations; ``intervention'' involved behavior change interventions targeting key modifiable health behaviors (tobacco and alcohol consumption, dietary intake, physical activity, and sedentary behavior) delivered either wholly or in part using online social networks; ``comparator'' was either a control group or within subject in the case of pre-post study designs; ``outcomes'' included health behavior change and closely related variables (such as theorized mediators of health behavior change, eg, self-efficacy); and ``study design'' included experimental studies reported in full-length peer-reviewed sources. Reports of intervention effectiveness were summarized and effect sizes (Cohen's d and 95\% confidence intervals) were calculated wherever possible. Attrition (percentage of people who completed the study), engagement (actual usage), and fidelity (actual usage/intended usage) with the social networking component of the interventions were scrutinized. Results: A total of 2040 studies were identified from the database searches following removal of duplicates, of which 10 met inclusion criteria. The studies involved a total of 113,988 participants (ranging from  n=10 to n=107,907). Interventions included commercial online health social network websites (n=2), research health social network websites (n=3), and multi-component interventions delivered in part via pre-existing popular online social network websites (Facebook n=4 and Twitter n=1). Nine of the 10 included studies reported significant improvements in some aspect of health behavior change or outcomes related to behavior change. Effect sizes for behavior change ranged widely from ?0.05 (95\% CI 0.45-0.35) to 0.84 (95\% CI 0.49-1.19), but in general were small in magnitude and statistically non-significant. Participant attrition ranged from 0-84\%. Engagement and fidelity were relatively low, with most studies achieving 5-15\% fidelity (with one exception, which achieved 105\% fidelity). Conclusions: To date there is very modest evidence that interventions incorporating online social networks may be effective; however, this field of research is in its infancy. Further research is needed to determine how to maximize retention and engagement, whether behavior change can be sustained in the longer term, and to determine how to exploit online social networks to achieve mass dissemination. Specific recommendations for future research are provided. ",
doi="10.2196/jmir.2952",
url="http://www.jmir.org/2014/2/e40/",
url="http://www.ncbi.nlm.nih.gov/pubmed/24550083"
}


@Article{info:doi/10.2196/jmir.2797,
author="Davis, A. Matthew
and Haney, Sue Carol
and Weeks, B. William
and Sirovich, E. Brenda
and Anthony, L. Denise",
title="Did You Hear the One About the Doctor? An Examination of Doctor Jokes Posted on Facebook",
journal="J Med Internet Res",
year="2014",
month="Feb",
day="13",
volume="16",
number="2",
pages="e41",
keywords="physicians",
keywords="physician-patient relations",
keywords="social networking",
keywords="humor",
abstract="Background: Social networking sites such as Facebook have become immensely popular in recent years and present a unique opportunity for researchers to eavesdrop on the collective conversation of current societal issues. Objective: We sought to explore doctor-related humor by examining doctor jokes posted on Facebook. Methods: We performed a cross-sectional study of 33,326 monitored Facebook users, 263 (0.79\%) of whom posted a joke that referenced doctors on their Facebook wall during a 6-month observation period (December 15, 2010 to June 16, 2011). We compared characteristics of so-called jokers to nonjokers and identified the characteristics of jokes that predicted joke success measured by having elicited at least one electronic laugh (eg, an LOL or ``laughing out loud'') as well as the total number of Facebook ``likes'' the joke received. Results: Jokers told 156 unique doctor jokes and were the same age as nonjokers but had larger social networks (median Facebook friends 227 vs 132, P<.001) and were more likely to be divorced, separated, or widowed (P<.01). In 39.7\% (62/156) of unique jokes, the joke was at the expense of doctors. Jokes at the expense of doctors compared to jokes not at the expense of doctors tended to be more successful in eliciting an electronic laugh (46.5\% vs 37.3\%), although the association was statistically insignificant. In our adjusted models, jokes that were based on current events received considerably more Facebook likes (rate ratio [RR] 2.36, 95\% CI 0.97-5.74). Conclusions: This study provides insight into the use of social networking sites for research pertaining to health and medicine, including the world of doctor-related humor. ",
doi="10.2196/jmir.2797",
url="http://www.jmir.org/2014/2/e41/",
url="http://www.ncbi.nlm.nih.gov/pubmed/24550095"
}


@Article{info:doi/10.2196/jmir.2969,
author="Ho, Kendall
and ",
title="Harnessing the Social Web for Health and Wellness: Issues for Research and Knowledge Translation",
journal="J Med Internet Res",
year="2014",
month="Feb",
day="11",
volume="16",
number="2",
pages="e34",
keywords="social media",
keywords="research",
keywords="interdisciplinary",
doi="10.2196/jmir.2969",
url="http://www.jmir.org/2014/2/e34/",
url="http://www.ncbi.nlm.nih.gov/pubmed/24518432"
}


@Article{info:doi/10.2196/jmir.2912,
author="Grajales III, Jose Francisco
and Sheps, Samuel
and Ho, Kendall
and Novak-Lauscher, Helen
and Eysenbach, Gunther",
title="Social Media: A Review and Tutorial of Applications in Medicine and Health Care",
journal="J Med Internet Res",
year="2014",
month="Feb",
day="11",
volume="16",
number="2",
pages="e13",
keywords="social media",
keywords="blogging",
keywords="social network",
abstract="Background: Social media are dynamic and interactive computer-mediated communication tools that have high penetration rates in the general population in high-income and middle-income countries. However, in medicine and health care, a large number of stakeholders (eg, clinicians, administrators, professional colleges, academic institutions, ministries of health, among others) are unaware of social media's relevance, potential applications in their day-to-day activities, as well as the inherent risks and how these may be attenuated and mitigated. Objective: We conducted a narrative review with the aim to present case studies that illustrate how, where, and why social media are being used in the medical and health care sectors. Methods: Using a critical-interpretivist framework, we used qualitative methods to synthesize the impact and illustrate, explain, and provide contextual knowledge of the applications and potential implementations of social media in medicine and health care. Both traditional (eg, peer-reviewed) and nontraditional (eg, policies, case studies, and social media content) sources were used, in addition to an environmental scan (using Google and Bing Web searches) of resources. Results: We reviewed, evaluated, and synthesized 76 articles, 44 websites, and 11 policies/reports. Results and case studies are presented according to 10 different categories of social media: (1) blogs (eg, WordPress), (2) microblogs (eg, Twitter), (3) social networking sites (eg, Facebook), (4) professional networking sites (eg, LinkedIn, Sermo), (5) thematic networking sites (eg, 23andMe), (6) wikis (eg, Wikipedia), (7) mashups (eg, HealthMap), (8) collaborative filtering sites (eg, Digg), (9) media sharing sites (eg, YouTube, Slideshare), and others (eg, SecondLife). Four recommendations are provided and explained for stakeholders wishing to engage with social media while attenuating risk: (1) maintain professionalism at all times, (2) be authentic, have fun, and do not be afraid, (3) ask for help, and (4) focus, grab attention, and engage. Conclusions: The role of social media in the medical and health care sectors is far reaching, and many questions in terms of governance, ethics, professionalism, privacy, confidentiality, and information quality remain unanswered. By following the guidelines presented, professionals have a starting point to engage with social media in a safe and ethical manner. Future research will be required to understand the synergies between social media and evidence-based practice, as well as develop institutional policies that benefit patients, clinicians, public health practitioners, and industry alike. ",
doi="10.2196/jmir.2912",
url="http://www.jmir.org/2014/2/e13/",
url="http://www.ncbi.nlm.nih.gov/pubmed/24518354"
}


@Article{info:doi/10.2196/jmir.3111,
author="Cui, Licong
and Carter, Rebecca
and Zhang, Guo-Qiang",
title="Evaluation of a Novel Conjunctive Exploratory Navigation Interface for Consumer Health Information: A Crowdsourced Comparative Study",
journal="J Med Internet Res",
year="2014",
month="Feb",
day="10",
volume="16",
number="2",
pages="e45",
keywords="crowdsourcing",
keywords="consumer health information",
keywords="human computer interaction",
keywords="information retrieval",
keywords="search interfaces",
keywords="comparative user evaluation",
abstract="Background: Numerous consumer health information websites have been developed to provide consumers access to health information. However, lookup search is insufficient for consumers to take full advantage of these rich public information resources. Exploratory search is considered a promising complementary mechanism, but its efficacy has never before been rigorously evaluated for consumer health information retrieval interfaces. Objective: This study aims to (1) introduce a novel Conjunctive Exploratory Navigation Interface (CENI) for supporting effective consumer health information retrieval and navigation, and (2) evaluate the effectiveness of CENI through a search-interface comparative evaluation using crowdsourcing with Amazon Mechanical Turk (AMT). Methods: We collected over 60,000 consumer health questions from NetWellness, one of the first consumer health websites to provide high-quality health information. We designed and developed a novel conjunctive exploratory navigation interface to explore NetWellness health questions with health topics as dynamic and searchable menus. To investigate the effectiveness of CENI, we developed a second interface with keyword-based search only. A crowdsourcing comparative study was carefully designed to compare three search modes of interest: (A) the topic-navigation-based CENI, (B) the keyword-based lookup interface, and (C) either the most commonly available lookup search interface with Google, or the resident advanced search offered by NetWellness. To compare the effectiveness of the three search modes, 9 search tasks were designed with relevant health questions from NetWellness. Each task included a rating of difficulty level and questions for validating the quality of answers. Ninety anonymous and unique AMT workers were recruited as participants. Results: Repeated-measures ANOVA analysis of the data showed the search modes A, B, and C had statistically significant differences among their levels of difficulty (P<.001). Wilcoxon signed-rank test (one-tailed) between A and B showed that A was significantly easier than B (P<.001). Paired t tests (one-tailed) between A and C showed A was significantly easier than C (P<.001). Participant responses on the preferred search modes showed that 47.8\% (43/90) participants preferred A, 25.6\% (23/90) preferred B, 24.4\% (22/90) preferred C. Participant comments on the preferred search modes indicated that CENI was easy to use, provided better organization of health questions by topics, allowed users to narrow down to the most relevant contents quickly, and supported the exploratory navigation by non-experts or those unsure how to initiate their search. Conclusions: We presented a novel conjunctive exploratory navigation interface for consumer health information retrieval and navigation. Crowdsourcing permitted a carefully designed comparative search-interface evaluation to be completed in a timely and cost-effective manner with a relatively large number of participants recruited anonymously. Accounting for possible biases, our study has shown for the first time with crowdsourcing that the combination of exploratory navigation and lookup search is more effective than lookup search alone. ",
doi="10.2196/jmir.3111",
url="http://www.jmir.org/2014/2/e45/",
url="http://www.ncbi.nlm.nih.gov/pubmed/24513593"
}


@Article{info:doi/10.2196/jmir.3137,
author="Kahlon, Maninder
and Yuan, Leslie
and Daigre, John
and Meeks, Eric
and Nelson, Katie
and Piontkowski, Cynthia
and Reuter, Katja
and Sak, Rachael
and Turner, Brian
and Weber, M. Griffin
and Chatterjee, Anirvan",
title="The Use and Significance of a Research Networking System",
journal="J Med Internet Res",
year="2014",
month="Feb",
day="07",
volume="16",
number="2",
pages="e46",
keywords="social networking",
keywords="search engine",
keywords="information seeking behavior",
keywords="interprofessional relations",
keywords="multidisciplinary communication",
abstract="Background: Universities have begun deploying public Internet systems that allow for easy search of their experts, expertise, and intellectual networks. Deployed first in biomedical schools but now being implemented more broadly, the initial motivator of these research networking systems was to enable easier identification of collaborators and enable the development of teams for research. Objective: The intent of the study was to provide the first description of the usage of an institutional research ``social networking'' system or research networking system (RNS). Methods: Number of visits, visitor location and type, referral source, depth of visit, search terms, and click paths were derived from 2.5 years of Web analytics data. Feedback from a pop-up survey presented to users over 15 months was summarized. Results: RNSs automatically generate and display profiles and networks of researchers. Within 2.5 years, the RNS at the University of California, San Francisco (UCSF) achieved one-seventh of the monthly visit rate of the main longstanding university website, with an increasing trend. Visitors came from diverse locations beyond the institution. Close to 75\% (74.78\%, 208,304/278,570) came via a public search engine and 84.0\% (210 out of a sample of 250) of these queried an individual's name that took them directly to the relevant profile page. In addition, 20.90\% (214 of 1024) visits went beyond the page related to a person of interest to explore related researchers and topics through the novel and networked information provided by the tool. At the end of the period analyzed, more than 2000 visits per month traversed 5 or more links into related people and topics. One-third of visits came from returning visitors who were significantly more likely to continue to explore networked people and topics (P<.001). Responses to an online survey suggest a broad range of benefits of using the RNS in supporting the research and clinical mission. Conclusions: Returning visitors in an ever-increasing pool of visitors to an RNS are among those that display behavior consistent with using the tool to identify new collaborators or research topics. Through direct user feedback we know that some visits do result in research-enhancing outcomes, although we cannot address the scale of impact. With the rapid pace of acquiring visitors searching for individual names, the RNS is evolving into a new kind of gateway for the university. ",
doi="10.2196/jmir.3137",
url="http://www.jmir.org/2014/2/e46/",
url="http://www.ncbi.nlm.nih.gov/pubmed/24509520"
}


@Article{info:doi/10.2196/jmir.2966,
author="van Mierlo, Trevor",
title="The 1\% Rule in Four Digital Health Social Networks: An Observational Study",
journal="J Med Internet Res",
year="2014",
month="Feb",
day="04",
volume="16",
number="2",
pages="e33",
keywords="social networks",
keywords="Superusers",
keywords="eHealth",
keywords="1\% rule",
keywords="Pareto Principal",
keywords="90-9-1 principle",
keywords="moderated support",
abstract="Background: In recent years, cyberculture has informally reported a phenomenon named the 1\% rule, or 90-9-1 principle, which seeks to explain participatory patterns and network effects within Internet communities. The rule states that 90\% of actors observe and do not participate, 9\% contribute sparingly, and 1\% of actors create the vast majority of new content. This 90\%, 9\%, and 1\% are also known as Lurkers, Contributors, and Superusers, respectively. To date, very little empirical research has been conducted to verify the 1\% rule. Objective: The 1\% rule is widely accepted in digital marketing. Our goal was to determine if the 1\% rule applies to moderated Digital Health Social Networks (DHSNs) designed to facilitate behavior change. Methods: To help gain insight into participatory patterns, descriptive data were extracted from four long-standing DHSNs: the AlcoholHelpCenter, DepressionCenter, PanicCenter, and StopSmokingCenter sites. Results: During the study period, 63,990 actors created 578,349 posts. Less than 25\% of actors made one or more posts. The applicability of the 1\% rule was confirmed as Lurkers, Contributors, and Superusers accounted for a weighted average of 1.3\% (n=4668), 24.0\% (n=88,732), and 74.7\% (n=276,034) of content. Conclusions: The 1\% rule was consistent across the four DHSNs. As social network sustainability requires fresh content and timely interactions, these results are important for organizations actively promoting and managing Internet communities. Superusers generate the vast majority of traffic and create value, so their recruitment and retention is imperative for long-term success. Although Lurkers may benefit from observing interactions between Superusers and Contributors, they generate limited or no network value. The results of this study indicate that DHSNs may be optimized to produce network effects, positive externalities, and bandwagon effects. Further research in the development and expansion of DHSNs is required. ",
doi="10.2196/jmir.2966",
url="http://www.jmir.org/2014/2/e33/",
url="http://www.ncbi.nlm.nih.gov/pubmed/24496109"
}


@Article{info:doi/10.2196/jmir.3078,
author="Kim, Minki
and Jung, Yuchul
and Jung, Dain
and Hur, Cinyoung",
title="Investigating the Congruence of Crowdsourced Information With Official Government Data: The Case of Pediatric Clinics",
journal="J Med Internet Res",
year="2014",
month="Feb",
day="03",
volume="16",
number="2",
pages="e29",
keywords="online health community",
keywords="crowdsourcing",
keywords="risk of misinformation",
keywords="public health",
abstract="Background: Health 2.0 is a benefit to society by helping patients acquire knowledge about health care by harnessing collective intelligence. However, any misleading information can directly affect patients' choices of hospitals and drugs, and potentially exacerbate their health condition. Objective: This study investigates the congruence between crowdsourced information and official government data in the health care domain and identifies the determinants of low congruence where it exists. In-line with infodemiology, we suggest measures to help the patients in the regions vulnerable to inaccurate health information. Methods: We text-mined multiple online health communities in South Korea to construct the data for crowdsourced information on public health services (173,748 messages). Kendall tau and Spearman rank order correlation coefficients were used to compute the differences in 2 ranking systems of health care quality: actual government evaluations of 779 hospitals and mining results of geospecific online health communities. Then we estimated the effect of sociodemographic characteristics on the level of congruence by using an ordinary least squares regression. Results: The regression results indicated that the standard deviation of married women's education (P=.046), population density (P=.01), number of doctors per pediatric clinic (P=.048), and birthrate (P=.002) have a significant effect on the congruence of crowdsourced data (adjusted R2=.33). Specifically, (1) the higher the birthrate in a given region, (2) the larger the variance in educational attainment, (3) the higher the population density, and (4) the greater the number of doctors per clinic, the more likely that crowdsourced information from online communities is congruent with official government data. Conclusions: To investigate the cause of the spread of misleading health information in the online world, we adopted a unique approach by associating mining results on hospitals from geospecific online health communities with the sociodemographic characteristics of corresponding regions. We found that the congruence of crowdsourced information on health care services varied across regions and that these variations could be explained by geospecific demographic factors. This finding can be helpful to governments in reducing the potential risk of misleading online information and the accompanying safety issues. ",
doi="10.2196/jmir.3078",
url="http://www.jmir.org/2014/2/e29/",
url="http://www.ncbi.nlm.nih.gov/pubmed/24496094"
}


@Article{info:doi/10.2196/jmir.3001,
author="Mathew, Deepa
and McKibbon, Ann K.
and Lokker, Cynthia
and Colquhoun, Heather",
title="Engaging With a Wiki Related to Knowledge Translation: A Survey of WhatisKT Wiki Users",
journal="J Med Internet Res",
year="2014",
month="Jan",
day="21",
volume="16",
number="1",
pages="e21",
keywords="knowledge translation",
keywords="wiki",
keywords="usability",
abstract="Background: In 2008, WhatisKT wiki was launched as a collaborative platform for knowledge translation (KT) researchers and stakeholders to debate the use and definitions of KT-related terms. The wiki has definitions for over 110 terms from disciplines including health care, information technology, education, accounting, and business. WhatisKT wiki has over 115 registered users. Approximately 73,000 unique visitors have visited the wiki since 2008. Despite annual increases in visitors and regular maintenance of the wiki, no visitors have contributed content or started a discussion. Objective: We surveyed wiki users to gain an understanding of the perceived value of the website, reasons for not engaging in the wiki, and suggestions to facilitate collaboration and improve the usability of the wiki. Methods: We surveyed three cohorts: KT Canada members who were previously invited to join the wiki, registered wiki members, and unregistered visitors. The first two cohorts completed a Web-based survey that included the System Usability Scale (SUS) questionnaire to assess usability; additionally 3 participants were interviewed. Unregistered wiki visitors were surveyed with polls posted on the wiki. The study received ethics approval from the McMaster University Faculty of Health Sciences Research Ethics Board. Results: Twenty-three participants completed the Web-based and SUS surveys; 15 participants indicated that they would collaborate on the wiki. The mean SUS score of 67 (95\% CI 56-77) indicated that the wiki could be considered for design improvements. Study participants indicated that the wiki could be improved by email notification regarding new terms, better grouping of terms, user friendly interface, and training for users interested in editing content. Conclusions: The findings from this survey will be used to enhance the design and content of WhatisKT wiki. Further feedback from participants will be used to make the wiki an ideal collaboration platform for KT researchers interested in terminology. ",
doi="10.2196/jmir.3001",
url="http://www.jmir.org/2014/1/e21/",
url="http://www.ncbi.nlm.nih.gov/pubmed/24449712"
}


@Article{info:doi/10.2196/jmir.3000,
author="de Jong, Carolina Catharina
and Ros, JG Wynand
and Schrijvers, Guus",
title="The Effects on Health Behavior and Health Outcomes of Internet-Based Asynchronous Communication Between Health Providers and Patients With a Chronic Condition: A Systematic Review",
journal="J Med Internet Res",
year="2014",
month="Jan",
day="16",
volume="16",
number="1",
pages="e19",
keywords="chronic disease",
keywords="telecommunications",
keywords="Internet",
keywords="telemedicine",
keywords="health services",
keywords="delivery of health care",
keywords="medical informatics",
keywords="electronic mail",
keywords="self-care",
keywords="self-efficacy",
abstract="Background: In support of professional practice, asynchronous communication between the patient and the provider is implemented separately or in combination with Internet-based self-management interventions. This interaction occurs primarily through electronic messaging or discussion boards. There is little evidence as to whether it is a useful tool for chronically ill patients to support their self-management and increase the effectiveness of interventions. Objective: The aim of our study was to review the use and usability of patient-provider asynchronous communication for chronically ill patients and the effects of such communication on health behavior, health outcomes, and patient satisfaction. Methods: A literature search was performed using PubMed and Embase. The quality of the articles was appraised according to the National Institute for Health and Clinical Excellence (NICE) criteria. The use and usability of the asynchronous communication was analyzed by examining the frequency of use and the number of users of the interventions with asynchronous communication, as well as of separate electronic messaging. The effectiveness of asynchronous communication  was analyzed by examining effects on health behavior, health outcomes, and patient satisfaction. Results: Patients' knowledge concerning their chronic condition increased and they seemed to appreciate being able to communicate asynchronously with their providers. They not only had specific questions but also wanted to communicate about feeling ill. A decrease in visits to the physician was shown in two studies (P=.07, P=.07). Increases in self-management/self-efficacy for patients with back pain, dyspnea, and heart failure were found. Positive health outcomes were shown in 12 studies, where the clinical outcomes for diabetic patients (HbA1c level) and for asthmatic patients (forced expiratory volume [FEV]) improved. Physical symptoms improved in five studies. Five studies generated a variety of positive psychosocial outcomes. Conclusions: The effect of asynchronous communication is not shown unequivocally in these studies. Patients seem to be interested in using email. Patients are willing to participate and are taking the initiative to discuss health issues with their providers. Additional testing of the effects of asynchronous communication on self-management in chronically ill patients is needed. ",
doi="10.2196/jmir.3000",
url="http://www.jmir.org/2014/1/e19/",
url="http://www.ncbi.nlm.nih.gov/pubmed/24434570"
}


@Article{info:doi/10.2196/jmir.2982,
author="Keller, Brett
and Labrique, Alain
and Jain, M. Kriti
and Pekosz, Andrew
and Levine, Orin",
title="Mind the Gap: Social Media Engagement by Public Health Researchers",
journal="J Med Internet Res",
year="2014",
month="Jan",
day="14",
volume="16",
number="1",
pages="e8",
keywords="Internet",
keywords="social media",
keywords="public health",
keywords="blogging",
abstract="Background: The traditional vertical system of sharing information from sources of scientific authority passed down to the public through local health authorities and clinicians risks being made obsolete by emerging technologies that facilitate rapid horizontal information sharing. The rise of Public Health 2.0 requires professional acknowledgment that a new and substantive forum of public discourse about public health exists on social media, such as forums, blogs, Facebook, and Twitter. Objective: Some public health professionals have used social media in innovative ways: to surveil populations, gauge public opinion, disseminate health information, and promote mutually beneficial interactions between public health professionals and the lay public. Although innovation is on the rise, most in the public health establishment remain skeptical of this rapidly evolving landscape or are unclear about how it could be used. We sought to evaluate the extent to which public health professionals are engaged in these spaces. Methods: We conducted a survey of professorial- and scientist-track faculty at the Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland, USA. We asked all available faculty via email to complete a 30-question survey about respondent characteristics, beliefs about social media, and usage of specific technologies, including blogs, Facebook, Twitter, and YouTube. Results: A total of 181 (19.8\%) of 912 professor- and scientist-track faculty provided usable responses. The majority of respondents rarely used major social media platforms. Of these 181 respondents, 97 (53.6\%) had used YouTube, 84 (46.4\%) had used Facebook, 55 (30.4\%) had read blogs, and 12 (6.6\%) had used Twitter in the prior month. More recent degree completion was the best predictor of higher usage of social media. In all, 122 (67.4\%) agreed that social media is important for disseminating information, whereas only 55 (30.4\%) agreed that social media is useful for their research. In all, 43 (23.8\%) said social media was helpful for professional career advancement, whereas 72 (39.8\%) said it was not. Only 43 (23.8\%) faculty said they would employ a full- or part-time social media consultant, and 30 (16.6\%) currently employed one. Conclusions: Despite near-universal appreciation of the potential for social media to serve as a component of public health strategy, a small minority are actually engaged in this space professionally, whereas most are either disinterested or actively opposed to professional engagement. Social media is seen by most as more useful for spreading information than obtaining it. As public discourse on a number of critical health topics continues to be influenced and sometimes shaped by discussions online from Twitter to Facebook, it would seem that greater discourse is needed about when and how public health professionals should engage in these media, and also how personal, institutional, and professional barriers to greater use of social media may be overcome. ",
doi="10.2196/jmir.2982",
url="http://www.jmir.org/2014/1/e8/",
url="http://www.ncbi.nlm.nih.gov/pubmed/24425670"
}


@Article{info:doi/10.2196/jmir.2630,
author="Magnezi, Racheli
and Bergman, S. Yoav
and Grosberg, Dafna",
title="Online Activity and Participation in Treatment Affects the Perceived Efficacy of Social Health Networks Among Patients With Chronic Illness",
journal="J Med Internet Res",
year="2014",
month="Jan",
day="10",
volume="16",
number="1",
pages="e12",
keywords="Internet",
keywords="social health network",
keywords="Patient Activation Measure (PAM)",
keywords="online health network",
abstract="Background: The use of online health-related social networks for support, peer-to-peer connections, and obtaining health information has increased dramatically. Participation in an online health-related social network can enhance patients' self-efficacy and empowerment, as they are given knowledge and tools to manage their chronic health condition more effectively. Thus, we can deduce that patient activation, the extent to which individuals are able to manage their own health care, also increases. However, little is known about the effects of participation in online health-related social networks and patient activation on the perceived usefulness of a website across disease groups. Objective: The intent of the study was to evaluate the effects and benefits of participation in an online health-related social network and to determine which variables predict perceived site usefulness, while examining patient activation. Methods: Data were collected from ``Camoni'', the first health-related social network in the Hebrew language. It offers medical advice, including blogs, forums, support groups, internal mail, chats, and an opportunity to consult with experts. This study focused on the site's five largest and most active communities: diabetes, heart disease, kidney disease, spinal injury, and depression/anxiety. Recruitment was conducted during a three-month period in which a link to the study questionnaire was displayed on the Camoni home page. Three questionnaires were used: a 13-item measure of perceived usefulness (Cronbach alpha=.93) to estimate the extent to which an individual found the website helpful and informative, a 9-item measure of active involvement in the website (Cronbach alpha=.84), and The Patient Activation Measure (PAM-13, Cronbach alpha=.86), which assesses a patient's level of active participation in his or her health care. Results: There were 296 participants. Men 30-39 years of age scored higher in active involvement than those 40-49 years (P=.03), 50-64 years (P=.004), or 65+ years (P=.01). Respondents 20-29 years of age scored higher in perceived usefulness than those 50-64 years (P=.04) and those 65+ years (P=.049). Those aged 20-29 years scored significantly lower on the PAM-13 scale than those aged 30-39 years (P=.01) and 50-64 years (P=.049). Men and women had similar PAM-13 scores (F9,283=0.17, P=.76). Several variables were significant predictors of perceived usefulness. Age was a negative predictor; younger age was indicative of higher perceived usefulness. Active involvement was a positive predictor. There was a negative relationship found between PAM-13 scores and perceived usefulness, as taking a less active role in one's own medical care predicted higher perceived website usefulness. A trend toward higher frequency of website activity was associated with increased perception of usefulness. Conclusions: Online health-related social networks can be particularly helpful to individuals with lower patient activation. Our findings add information regarding the social and medical importance of such websites, which are gradually becoming an inseparable part of day-to-day chronic disease management in the community. ",
doi="10.2196/jmir.2630",
url="http://www.jmir.org/2014/1/e12/",
url="http://www.ncbi.nlm.nih.gov/pubmed/24413148"
}


@Article{info:doi/10.2196/resprot.2886,
author="Cutrona, L. Sarah
and Roblin, W. Douglas
and Wagner, L. Joann
and Gaglio, Bridget
and Williams, E. Andrew
and Torres Stone, Rosalie
and Field, S. Terry
and Mazor, M. Kathleen",
title="Adult Willingness to Use Email and Social Media for Peer-to-Peer Cancer Screening Communication: Quantitative Interview Study",
journal="JMIR Res Protoc",
year="2013",
month="Nov",
day="28",
volume="2",
number="2",
pages="e52",
keywords="colorectal neoplasms",
keywords="electronic mail",
keywords="social media",
keywords="breast neoplasms",
keywords="early detection of cancer",
keywords="communication",
keywords="health promotion",
keywords="Internet",
keywords="peer group",
keywords="social support",
abstract="Background: Adults over age 40 are increasing their use of email and social media, raising interest in use of peer-to-peer Internet-based messaging to promote cancer screening. Objective: The objective of our study was to assess current practices and attitudes toward use of email and other e-communication for peer-to-peer dialogues on cancer screening. Methods: We conducted in-person interviews with 438 insured adults ages 42-73 in Georgia, Hawaii, and Massachusetts.  Participants reported on use of email and other e-communication including social media to discuss with peers routine health topics including breast and colorectal cancer (CRC).   We ascertained willingness to share personal CRC screening experiences via conversation, postcard, email, or other e-communication.  Health literacy scores were measured. Results: Email had been used by one-third (33.8\%, 148/438) to discuss routine health topics, by 14.6\% (64/438) to discuss breast cancer screening, and by 12.6\% (55/438) to discuss CRC screening.  Other e-communication was used to discuss routine health topics (11.6\%, 51/438), screening for breast cancer (3.9\%, 17/438), and CRC (2.3\%, 10/438).  In the preceding week, 84.5\% (370/438) of participants had used email, 55.9\% (245/438) had used e-communication of some type; 44.3\% (194/438) text, 32.9\% (144/438) Facebook, 12.3\% (54/438) instant message, 7.1\% (31/438) video chat, and 4.8\% (21/438) Twitter.  Many participants were willing to share their CRC screening experiences via email (32.4\%, 142/438 might be willing; 36.3\%, 159/438 very willing) and via other e-communication (15.8\%, 69/438 might be willing; 14.4\%, 63/438 very willing).  Individuals willing to send CRC screening emails scored significantly higher on tests of health literacy compared to those willing to send only postcards (P<.001). Conclusions: Many adults are willing to use email and e-communication to promote cancer screening to peers.  Optimal approaches for encouraging peer-to-peer transmission of accurate and appropriate cancer screening messages must be studied. ",
doi="10.2196/resprot.2886",
url="http://www.researchprotocols.org/2013/2/e52/",
url="http://www.ncbi.nlm.nih.gov/pubmed/24287495"
}


@Article{info:doi/10.2196/jmir.2852,
author="Chang, Tammy
and Chopra, Vineet
and Zhang, Catherine
and Woolford, J. Susan",
title="The Role of Social Media in Online Weight Management: Systematic Review",
journal="J Med Internet Res",
year="2013",
month="Nov",
day="28",
volume="15",
number="11",
pages="e262",
keywords="Internet",
keywords="systematic review",
keywords="overweight",
keywords="obesity",
keywords="social media",
keywords="weight loss",
abstract="Background: Social media applications are promising adjuncts to online weight management interventions through facilitating education, engagement, and peer support. However, the precise impact of social media on weight management is unclear. Objective: The objective of this study was to systematically describe the use and impact of social media in online weight management interventions. Methods: PubMed, PsycINFO, EMBASE, Web of Science, and Scopus were searched for English-language studies published through March 25, 2013. Additional studies were identified by searching bibliographies of electronically retrieved articles. Randomized controlled trials of online weight management interventions that included a social media component for individuals of all ages were selected. Studies were evaluated using 2 systematic scales to assess risk of bias and study quality. Results: Of 517 citations identified, 20 studies met eligibility criteria. All study participants were adults. Because the included studies varied greatly in study design and reported outcomes, meta-analysis of interventions was not attempted. Although message boards and chat rooms were the most common social media component included, their effect on weight outcomes was not reported in most studies. Only one study measured the isolated effect of social media. It found greater engagement of participants, but no difference in weight-related outcomes. In all, 65\% of studies were of high quality; 15\% of studies were at low risk of bias. Conclusions: Despite the widespread use of social media, few studies have quantified the effect of social media in online weight management interventions; thus, its impact is still unknown. Although social media may play a role in retaining and engaging participants, studies that are designed to measure its effect are needed to understand whether and how social media may meaningfully improve weight management. ",
doi="10.2196/jmir.2852",
url="http://www.jmir.org/2013/11/e262/",
url="http://www.ncbi.nlm.nih.gov/pubmed/24287455"
}


@Article{info:doi/10.2196/jmir.2870,
author="Zhang, Ni
and Campo, Shelly
and Janz, F. Kathleen
and Eckler, Petya
and Yang, Jingzhen
and Snetselaar, G. Linda
and Signorini, Alessio",
title="Electronic Word of Mouth on Twitter About Physical Activity in the United States: Exploratory Infodemiology Study",
journal="J Med Internet Res",
year="2013",
month="Nov",
day="20",
volume="15",
number="11",
pages="e261",
keywords="Twitter messaging",
keywords="social marketing",
keywords="motor activity",
abstract="Background: Twitter is a widely used social medium. However, its application in promoting health behaviors is understudied. Objective: In order to provide insights into designing health marketing interventions to promote physical activity on Twitter, this exploratory infodemiology study applied both social cognitive theory and the path model of online word of mouth to examine the distribution of different electronic word of mouth (eWOM) characteristics among personal tweets about physical activity in the United States. Methods: This study used 113 keywords to retrieve 1 million public tweets about physical activity in the United States posted between January 1 and March 31, 2011. A total of 30,000 tweets were randomly selected and sorted based on numbers generated by a random number generator. Two coders scanned the first 16,100 tweets and yielded 4672 (29.02\%) tweets that they both agreed to be about physical activity and were from personal accounts. Finally, 1500 tweets were randomly selected from the 4672 tweets (32.11\%) for further coding. After intercoder reliability scores reached satisfactory levels in the pilot coding (100 tweets separate from the final 1500 tweets), 2 coders coded 750 tweets each. Descriptive analyses, Mann-Whitney U tests, and Fisher exact tests were performed. Results: Tweets about physical activity were dominated by neutral sentiments (1270/1500, 84.67\%). Providing opinions or information regarding physical activity (1464/1500, 97.60\%) and chatting about physical activity (1354/1500, 90.27\%) were found to be popular on Twitter. Approximately 60\% (905/1500, 60.33\%) of the tweets demonstrated users' past or current participation in physical activity or intentions to participate in physical activity. However, social support about physical activity was provided in less than 10\% of the tweets (135/1500, 9.00\%). Users with fewer people following their tweets (followers) (P=.02) and with fewer accounts that they followed (followings) (P=.04) were more likely to talk positively about physical activity on Twitter. People with more followers were more likely to post neutral tweets about physical activity (P=.04). People with more followings were more likely to forward tweets (P=.04). People with larger differences between number of followers and followings were more likely to mention companionship support for physical activity on Twitter (P=.04). Conclusions: Future health marketing interventions promoting physical activity should segment Twitter users based on their number of followers, followings, and gaps between the number of followers and followings. The innovative application of both marketing and public health theory to examine tweets about physical activity could be extended to other infodemiology or infoveillance studies on other health behaviors (eg, vaccinations). ",
doi="10.2196/jmir.2870",
url="http://www.jmir.org/2013/11/e261/",
url="http://www.ncbi.nlm.nih.gov/pubmed/24257325"
}


@Article{info:doi/10.2196/jmir.3002,
author="Thackeray, Rosemary
and Neiger, L. Brad
and Burton, H. Scott
and Thackeray, R. Callie",
title="Analysis of the Purpose of State Health Departments' Tweets: Information Sharing, Engagement, and Action",
journal="J Med Internet Res",
year="2013",
month="Nov",
day="11",
volume="15",
number="11",
pages="e255",
keywords="social media",
keywords="public health",
keywords="engagement",
abstract="Background: Public health agencies are actively using social media, including Twitter. In the public health and nonprofit sectors, Twitter has been limited to one-way communication. Two-way, interactive communication on Twitter has the potential to enhance organizational relationships with followers and help organizations achieve their goals by increasing communication and dialog between the organization and its followers. Research shows that nonprofit organizations use Twitter for three main functions: information sharing, community building, and action. Objective: It is not known whether state health departments are using Twitter primarily for one-way information sharing or if they are trying to engage followers to build relationships and promote action. The purpose of this research was to discover what the primary function of Twitter use is among state health departments in the United States and whether this is similar to or different from nonprofit organizations. Methods: A complete list of ``tweets'' made by each state health department account was obtained using the Twitter application programming interface. We randomly sampled 10\% of each state health department's tweets. Four research assistants hand-coded the tweets' primary focus (organization centric or personal health information centric) and then the subcategories of information dissemination, engagement, or action. Research assistants coded each tweet for interactivity, sophistication, and redirects to another website. Data were analyzed using SPSS version 20. Results: There were 4221 tweets from 39 state health departments. There was no statistically significant difference in the number of tweets made by a state health department and the state population density (P=.25). The majority of tweets focused on personal health topics (69.37\%, 2928/4221) while one-third were tweets about the organization (29.14\% , 1230/4221). The main function of organization-based tweets was engagement through conversations to build community (65.77\%, 809/1236). These engagement-related tweets were primarily recognition of other organizations' events (43.6\%, 353/809) and giving thanks and recognition (21.4\%, 173/809). Nearly all of the personal health information-centric tweets involved general public health information (92.10\%, 1399/1519) and 79.03\% (3336/4221) of tweets directed followers to another link for more information. Conclusions: This is the first study to assess the purpose of public health tweets among state health departments. State health departments are using Twitter as a one-way communication tool, with tweets focused primarily on personal health. A state health department Twitter account may not be the primary health information source for individuals. Therefore, state health departments should reconsider their focus on personal health tweets and envision how they can use Twitter to develop relationships with community agencies and partners. In order to realize the potential of Twitter to establish relationships and develop connections, more two-way communication and interaction are essential. ",
doi="10.2196/jmir.3002",
url="http://www.jmir.org/2013/11/e255/",
url="http://www.ncbi.nlm.nih.gov/pubmed/24217361"
}


@Article{info:doi/10.2196/jmir.2721,
author="Greaves, Felix
and Ramirez-Cano, Daniel
and Millett, Christopher
and Darzi, Ara
and Donaldson, Liam",
title="Use of Sentiment Analysis for Capturing Patient Experience From Free-Text Comments Posted Online",
journal="J Med Internet Res",
year="2013",
month="Nov",
day="01",
volume="15",
number="11",
pages="e239",
keywords="Internet",
keywords="patient experience",
keywords="quality",
keywords="machine learning",
abstract="Background: There are large amounts of unstructured, free-text information about quality of health care available on the Internet in blogs, social networks, and on physician rating websites that are not captured in a systematic way. New analytical techniques, such as sentiment analysis, may allow us to understand and use this information more effectively to improve the quality of health care. Objective: We attempted to use machine learning to understand patients' unstructured comments about their care. We used sentiment analysis techniques to categorize online free-text comments by patients as either positive or negative descriptions of their health care. We tried to automatically predict whether a patient would recommend a hospital, whether the hospital was clean, and whether they were treated with dignity from their free-text description, compared to the patient's own quantitative rating of their care. Methods: We applied machine learning techniques to all 6412 online comments about hospitals on the English National Health Service website in 2010 using Weka data-mining software. We also compared the results obtained from sentiment analysis with the paper-based national inpatient survey results at the hospital level using Spearman rank correlation for all 161 acute adult hospital trusts in England. Results: There was 81\%, 84\%, and 89\% agreement between quantitative ratings of care and those derived from free-text comments using sentiment analysis for cleanliness, being treated with dignity, and overall recommendation of hospital respectively (kappa scores: .40--.74, P<.001 for all). We observed mild to moderate associations between our machine learning predictions and responses to the large patient survey for the three categories examined (Spearman rho 0.37-0.51, P<.001 for all). Conclusions: The prediction accuracy that we have achieved using this machine learning process suggests that we are able to predict, from free-text, a reasonably accurate assessment of patients' opinion about different performance aspects of a hospital and that these machine learning predictions are associated with results of more conventional surveys. ",
doi="10.2196/jmir.2721",
url="http://www.jmir.org/2013/11/e239/",
url="http://www.ncbi.nlm.nih.gov/pubmed/24184993"
}


@Article{info:doi/10.2196/jmir.2796,
author="Gruzd, Anatoliy
and Haythornthwaite, Caroline",
title="Enabling Community Through Social Media",
journal="J Med Internet Res",
year="2013",
month="Oct",
day="31",
volume="15",
number="10",
pages="e248",
keywords="online community",
keywords="online social networks",
keywords="information and communication technology",
keywords="social media",
keywords="Twitter",
abstract="Background: Social network analysis provides a perspective and method for inquiring into the structures that comprise online groups and communities. Traces from interaction via social media provide the opportunity for understanding how a community is formed and maintained online. Objective: The paper aims to demonstrate how social network analysis provides a vocabulary and set of techniques for examining interaction patterns via social media. Using the case of the \#hcsmca online discussion forum, this paper highlights what has been and can be gained by approaching online community from a social network perspective, as well as providing an inside look at the structure of the \#hcsmca community. Methods: Social network analysis was used to examine structures in a 1-month sample of Twitter messages with the hashtag \#hcsmca (3871 tweets, 486 unique posters), which is the tag associated with the social media--supported group Health Care Social Media Canada. Network connections were considered present if the individual was mentioned, replied to, or had a post retweeted. Results: Network analyses revealed patterns of interaction that characterized the community as comprising one component, with a set of core participants prominent in the network due to their connections with others. Analysis showed the social media health content providers were the most influential group based on in-degree centrality. However, there was no preferential attachment among people in the same professional group, indicating that the formation of connections among community members was not constrained by professional status. Conclusions: Network analysis and visualizations provide techniques and a vocabulary for understanding online interaction, as well as insights that can help in understanding what, and who, comprises and sustains a network, and whether community emerges from a network of online interactions. ",
doi="10.2196/jmir.2796",
url="http://www.jmir.org/2013/10/e248/",
url="http://www.ncbi.nlm.nih.gov/pubmed/24176835"
}


@Article{info:doi/10.2196/jmir.2719,
author="Dal Moro, Fabrizio",
title="Online Survey on Twitter: A Urological Experience",
journal="J Med Internet Res",
year="2013",
month="Oct",
day="25",
volume="15",
number="10",
pages="e238",
keywords="Twitter",
keywords="social media",
keywords="survey",
doi="10.2196/jmir.2719",
url="http://www.jmir.org/2013/10/e238/",
url="http://www.ncbi.nlm.nih.gov/pubmed/24164710"
}


@Article{info:doi/10.2196/jmir.2705,
author="Nagel, C. Anna
and Tsou, Ming-Hsiang
and Spitzberg, H. Brian
and An, Li
and Gawron, Mark J.
and Gupta, K. Dipak
and Yang, Jiue-An
and Han, Su
and Peddecord, Michael K.
and Lindsay, Suzanne
and Sawyer, H. Mark",
title="The Complex Relationship of Realspace Events and Messages in Cyberspace: Case Study of Influenza and Pertussis Using Tweets",
journal="J Med Internet Res",
year="2013",
month="Oct",
day="26",
volume="15",
number="10",
pages="e237",
keywords="Twitter",
keywords="infoveillance",
keywords="infodemiology",
keywords="cyberspace",
keywords="syndromic surveillance",
keywords="influenza",
keywords="pertussis",
keywords="whooping cough",
abstract="Background: Surveillance plays a vital role in disease detection, but traditional methods of collecting patient data, reporting to health officials, and compiling reports are costly and time consuming. In recent years, syndromic surveillance tools have expanded and researchers are able to exploit the vast amount of data available in real time on the Internet at minimal cost. Many data sources for infoveillance exist, but this study focuses on status updates (tweets) from the Twitter microblogging website. Objective: The aim of this study was to explore the interaction between cyberspace message activity, measured by keyword-specific tweets, and real world occurrences of influenza and pertussis. Tweets were aggregated by week and compared to weekly influenza-like illness (ILI) and weekly pertussis incidence. The potential effect of tweet type was analyzed by categorizing tweets into 4 categories: nonretweets, retweets, tweets with a URL Web address, and tweets without a URL Web address. Methods: Tweets were collected within a 17-mile radius of 11 US cities chosen on the basis of population size and the availability of disease data. Influenza analysis involved all 11 cities. Pertussis analysis was based on the 2 cities nearest to the Washington State pertussis outbreak (Seattle, WA and Portland, OR). Tweet collection resulted in 161,821 flu, 6174 influenza, 160 pertussis, and 1167 whooping cough tweets. The correlation coefficients between tweets or subgroups of tweets and disease occurrence were calculated and trends were presented graphically. Results: Correlations between weekly aggregated tweets and disease occurrence varied greatly, but were relatively strong in some areas. In general, correlation coefficients were stronger in the flu analysis compared to the pertussis analysis. Within each analysis, flu tweets were more strongly correlated with ILI rates than influenza tweets, and whooping cough tweets correlated more strongly with pertussis incidence than pertussis tweets. Nonretweets correlated more with disease occurrence than retweets, and tweets without a URL Web address correlated better with actual incidence than those with a URL Web address primarily for the flu tweets. Conclusions: This study demonstrates that not only does keyword choice play an important role in how well tweets correlate with disease occurrence, but that the subgroup of tweets used for analysis is also important. This exploratory work shows potential in the use of tweets for infoveillance, but continued efforts are needed to further refine research methods in this field. ",
doi="10.2196/jmir.2705",
url="http://www.jmir.org/2013/10/e237/",
url="http://www.ncbi.nlm.nih.gov/pubmed/24158773"
}


@Article{info:doi/10.2196/jmir.2792,
author="Munson, A. Sean
and Cavusoglu, Hasan
and Frisch, Larry
and Fels, Sidney",
title="Sociotechnical Challenges and Progress in Using Social Media for Health",
journal="J Med Internet Res",
year="2013",
month="Oct",
day="22",
volume="15",
number="10",
pages="e226",
keywords="social media",
keywords="social computing",
keywords="privacy",
keywords="health",
keywords="sociotechnical systems",
doi="10.2196/jmir.2792",
url="http://www.jmir.org/2013/10/e226/",
url="http://www.ncbi.nlm.nih.gov/pubmed/24148206"
}


@Article{info:doi/10.2196/jmir.2607,
author="Van de Belt, H. Tom
and Engelen, JLPG Lucien
and Berben, AA Sivera
and Teerenstra, Steven
and Samsom, Melvin
and Schoonhoven, Lisette",
title="Internet and Social Media For Health-Related Information and Communication in Health Care: Preferences of the Dutch General Population",
journal="J Med Internet Res",
year="2013",
month="Oct",
day="02",
volume="15",
number="10",
pages="e220",
keywords="social media",
keywords="patient participation",
keywords="consumer health information",
keywords="empowerment",
keywords="Health 2.0",
abstract="Background: Health care is increasingly featured by the use of Web 2.0 communication and collaborative technologies that are reshaping the way patients and professionals interact. These technologies or tools can be used for a variety of purposes: to instantly debate issues, discover news, analyze research, network with peers, crowd-source information, seek support, and provide advice. Not all tools are implemented successfully; in many cases, the nonusage attrition rates are high. Little is known about the preferences of the Dutch general population regarding the use of the Internet and social media in health care. Objective: To determine the preferences of the general population in the Netherlands regarding the use of the Internet and social media in health care. Methods: A cross-sectional survey was disseminated via a popular Dutch online social network. Respondents were asked where they searched for health-related information, how they qualified the value of different sources, and their preferences regarding online communication with health care providers. Results were weighed for the Dutch population based on gender, age, and level of education using official statistics. Numbers and percentages or means and standard deviations were presented for different subgroups. One-way ANOVA was used to test for statistical differences. Results: The survey was completed by 635 respondents. The Internet was found to be the number one source for health-related information (82.7\%), closely followed by information provided by health care professionals (71.1\%). Approximately one-third (32.3\%) of the Dutch population search for ratings of health care providers. The most popular information topics were side effects of medication (62.5\%) and symptoms (59.7\%). Approximately one-quarter of the Dutch population prefer to communicate with a health care provider via social media (25.4\%), and 21.2\% would like to communicate via a webcam. Conclusions: The Internet is the main source of health-related information for the Dutch population. One in 4 persons wants to communicate with their physician via social media channels and it is expected that this number will further increase. Health care providers should explore new ways of communicating online and should facilitate ways for patients to connect with them. Future research should aim at comparing different patient groups and diseases, describing best practices, and determining cost-effectiveness. ",
doi="10.2196/jmir.2607",
url="http://www.jmir.org/2013/10/e220/",
url="http://www.ncbi.nlm.nih.gov/pubmed/24088272"
}


@Article{info:doi/10.2196/jmir.2452,
author="Putora, Martin Paul
and Oldenburg, Jan",
title="Swarm-Based Medicine",
journal="J Med Internet Res",
year="2013",
month="Sep",
day="19",
volume="15",
number="9",
pages="e207",
keywords="swarm",
keywords="evidence",
keywords="eminence",
keywords="guidelines",
keywords="recommendations",
doi="10.2196/jmir.2452",
url="http://www.jmir.org/2013/9/e207/",
url="http://www.ncbi.nlm.nih.gov/pubmed/24052454"
}


@Article{info:doi/10.2196/jmir.2653,
author="de Viron, Sylviane
and Suggs, Suzanne L.
and Brand, Angela
and Van Oyen, Herman",
title="Communicating Genetics and Smoking Through Social Media: Are We There Yet?",
journal="J Med Internet Res",
year="2013",
month="Sep",
day="09",
volume="15",
number="9",
pages="e198",
keywords="genetics",
keywords="Internet",
keywords="public health genomics",
keywords="smoking",
keywords="social media",
keywords="Web 2.0",
abstract="Background: Social media is a recent source of health information that could disseminate new scientific research, such as the genetics of smoking. Objective: The objectives were (1) to evaluate the availability of genetic information about smoking on different social media platforms (ie, YouTube, Facebook, and Twitter) and (2) to assess the type and the content of the information displayed on the social media as well as the profile of people publishing this information. Methods: We screened posts on YouTube, Facebook, and Twitter with the terms ``smoking'' and ``genetic'' at two time points (September 18, 2012, and May 7, 2013). The first 100 posts were reviewed for each media for the time points. Google was searched during Time 2 as an indicator of available information on the Web and the other social media that discussed genetics and smoking. The source of information, the country of the publisher, characteristics of the posts, and content of the posts were extracted. Results: On YouTube, Facebook, and Twitter, 31, 0, and 84 posts, respectively, were included. Posts were mostly based on smoking-related diseases, referred to scientific publications, and were largely from the United States. From the Google search, most results were scientific databases. Six scientific publications referred to within the Google search were also retrieved on either YouTube or Twitter. Conclusions: Despite the importance of public understanding of smoking and genetics, and the high use of social media, little information on this topic is actually present on social media. Therefore, there is a need to monitor the information that is there and to evaluate the population's understanding of the information related to genetics and smoking that is displayed on social media. ",
doi="10.2196/jmir.2653",
url="http://www.jmir.org/2013/9/e198/",
url="http://www.ncbi.nlm.nih.gov/pubmed/24018012"
}


@Article{info:doi/10.2196/jmir.2741,
author="Hanson, Lee Carl
and Cannon, Ben
and Burton, Scott
and Giraud-Carrier, Christophe",
title="An Exploration of Social Circles and Prescription Drug Abuse Through Twitter",
journal="J Med Internet Res",
year="2013",
month="Sep",
day="06",
volume="15",
number="9",
pages="e189",
keywords="prescription drug abuse",
keywords="social media",
keywords="social circles",
keywords="Twitter",
abstract="Background: Prescription drug abuse has become a major public health problem. Relationships and social context are important contributing factors. Social media provides online channels for people to build relationships that may influence attitudes and behaviors. Objective: To determine whether people who show signs of prescription drug abuse connect online with others who reinforce this behavior, and to observe the conversation and engagement of these networks with regard to prescription drug abuse. Methods: Twitter statuses mentioning prescription drugs were collected from November 2011 to November 2012. From this set, 25 Twitter users were selected who discussed topics indicative of prescription drug abuse. Social circles of 100 people were discovered around each of these Twitter users; the tweets of the Twitter users in these networks were collected and analyzed according to prescription drug abuse discussion and interaction with other users about the topic. Results: From November 2011 to November 2012, 3,389,771 mentions of prescription drug terms were observed. For the 25 social circles (n=100 for each circle), on average 53.96\% (SD 24.3) of the Twitter users used prescription drug terms at least once in their posts, and 37.76\% (SD 20.8) mentioned another Twitter user by name in a post with a prescription drug term. Strong correlation was found between the kinds of drugs mentioned by the index user and his or her network (mean r=0.73), and between the amount of interaction about prescription drugs and a level of abusiveness shown by the network (r=0.85, P<.001). Conclusions: Twitter users who discuss prescription drug abuse online are surrounded by others who also discuss it---potentially reinforcing a negative behavior and social norm. ",
doi="10.2196/jmir.2741",
url="http://www.jmir.org/2013/9/e189/",
url="http://www.ncbi.nlm.nih.gov/pubmed/24014109"
}


@Article{info:doi/10.2196/jmir.2702,
author="Emmert, Martin
and Meier, Florian
and Pisch, Frank
and Sander, Uwe",
title="Physician Choice Making and Characteristics Associated With Using Physician-Rating Websites: Cross-Sectional Study",
journal="J Med Internet Res",
year="2013",
month="Aug",
day="28",
volume="15",
number="8",
pages="e187",
keywords="physician-rating website",
keywords="public reporting",
keywords="patient satisfaction",
keywords="physician choice making",
abstract="Background: Over the past decade, physician-rating websites have been gaining attention in scientific literature and in the media. However, little knowledge is available about the awareness and the impact of using such sites on health care professionals. It also remains unclear what key predictors are associated with the knowledge and the use of physician-rating websites. Objective: To estimate the current level of awareness and use of physician-rating websites in Germany and to determine their impact on physician choice making and the key predictors which are associated with the knowledge and the use of physician-rating websites. Methods: This study was designed as a cross-sectional survey. An online panel was consulted in January 2013. A questionnaire was developed containing 28 questions; a pretest was carried out to assess the comprehension of the questionnaire. Several sociodemographic (eg, age, gender, health insurance status, Internet use) and 2 health-related independent variables (ie, health status and health care utilization) were included. Data were analyzed using descriptive statistics, chi-square tests, and t tests. Binary multivariate logistic regression models were performed for elaborating the characteristics of physician-rating website users. Results from the logistic regression are presented for both the observed and weighted sample. Results: In total, 1505 respondents (mean age 43.73 years, SD 14.39; 857/1505, 57.25\% female) completed our survey. Of all respondents, 32.09\% (483/1505) heard of physician-rating websites and 25.32\% (381/1505) already had used a website when searching for a physician. Furthermore, 11.03\% (166/1505) had already posted a rating on a physician-rating website. Approximately 65.35\% (249/381) consulted a particular physician based on the ratings shown on the websites; in contrast, 52.23\% (199/381) had not consulted a particular physician because of the publicly reported ratings. Significantly higher likelihoods for being aware of the websites could be demonstrated for female participants (P<.001), those who were widowed (P=.01), covered by statutory health insurance (P=.02), and with higher health care utilization (P<.001). Health care utilization was significantly associated with all dependent variables in our multivariate logistic regression models (P<.001). Furthermore, significantly higher scores could be shown for health insurance status in the unweighted and Internet use in the weighted models. Conclusions: Neither health policy makers nor physicians should underestimate the influence of physician-rating websites. They already play an important role in providing information to help patients decide on an appropriate physician. Assuming there will be a rising level of public awareness, the influence of their use will increase well into the future. Future studies should assess the impact of physician-rating websites under experimental conditions and investigate whether physician-rating websites have the potential to reflect the quality of care offered by health care providers. ",
doi="10.2196/jmir.2702",
url="http://www.jmir.org/2013/8/e187/",
url="http://www.ncbi.nlm.nih.gov/pubmed/23985220"
}


@Article{info:doi/10.2196/jmir.2708,
author="Gholami-Kordkheili, Fatemeh
and Wild, Verina
and Strech, Daniel",
title="The Impact of Social Media on Medical Professionalism: A Systematic Qualitative Review of Challenges and Opportunities",
journal="J Med Internet Res",
year="2013",
month="Aug",
day="28",
volume="15",
number="8",
pages="e184",
keywords="social media",
keywords="professionalism",
keywords="facebook",
keywords="blogs",
keywords="Twitter",
keywords="health policy",
abstract="Background: The rising impact of social media on the private and working lives of health care professionals has made researchers and health care institutions study and rethink the concept and content of medical professionalism in the digital age. In the last decade, several specific policies, original research studies, and comments have been published on the responsible use of social media by health care professionals. However, there is no systematic literature review that analyzes the full spectrum of (1) social media--related challenges imposed on medical professionalism and (2) social media--related opportunities to both undermine and improve medical professionalism. Objective: The aim of this systematic qualitative review is to present this full spectrum of social media--related challenges and opportunities. Methods: We performed a systematic literature search in PubMed (restricted to English and German literature published between 2002 and 2011) for papers that address social media--related challenges and opportunities for medical professionalism. To operationalize ``medical professionalism'', we refer to the 10 commitments presented in the physicians' charter ``Medical professionalism in the new millennium'' published by the ABIM Foundation. We applied qualitative text analysis to categorize the spectrum of social media--related challenges and opportunities for medical professionalism. Results: The literature review retrieved 108 references, consisting of 46 original research studies and 62 commentaries, editorials, or opinion papers. All references together mentioned a spectrum of 23 broad and 12 further-specified, narrow categories for social media--related opportunities (n=10) and challenges (n=13) for medical professionalism, grouped under the 10 commitments of the physicians' charter. Conclusions: The accommodation of the traditional core values of medicine to the characteristics of social media presents opportunities as well as challenges for medical professionalism. As a profession that is entitled to self-regulation, health care professionals should proactively approach these challenges and seize the opportunities. There should be room to foster interprofessional and intergenerational dialogue (and eventually guidelines and policies) on both challenges and opportunities of social media in modern health care. This review builds a unique source of information that can inform further research and policy development in this regard. ",
doi="10.2196/jmir.2708",
url="http://www.jmir.org/2013/8/e184/",
url="http://www.ncbi.nlm.nih.gov/pubmed/23985172"
}


@Article{info:doi/10.2196/jmir.2775,
author="Neiger, L. Brad
and Thackeray, Rosemary
and Burton, H. Scott
and Thackeray, R. Callie
and Reese, H. Jennifer",
title="Use of Twitter Among Local Health Departments: An Analysis of Information Sharing, Engagement, and Action",
journal="J Med Internet Res",
year="2013",
month="Aug",
day="19",
volume="15",
number="8",
pages="e177",
keywords="Twitter",
keywords="social media",
keywords="engagement",
keywords="Internet",
keywords="audience",
abstract="Background: Social media offers unprecedented opportunities for public health to engage audiences in conversations and collaboration that could potentially lead to improved health conditions. While there is some evidence that local health departments (LHDs) are using social media and Twitter in particular, little is known about how Twitter is used by LHDs and how they use it to engage followers versus disseminating one-way information. Objective: To examine how LHDs use Twitter to share information, engage with followers, and promote action, as well as to discover differences in Twitter use among LHDs by size of population served. Methods: The Twitter accounts for 210 LHDs were stratified into three groups based on size of population served (n=69 for less than 100,000; n=89 for 100,000-499,999; n=52 for 500,000 or greater). A sample of 1000 tweets was obtained for each stratum and coded as being either about the organization or about personal-health topics. Subcategories for organization included information, engagement, and action. Subcategories for personal health included information and action. Results: Of all LHD tweets (n=3000), 56.1\% (1682/3000) related to personal health compared with 39.5\% (1186/3000) that were about the organization. Of the personal-health tweets, 58.5\% (984/1682) involved factual information and 41.4\% (697/1682) encouraged action. Of the organization-related tweets, 51.9\% (615/1186) represented one-way communication about the organization and its events and services, 35.0\% (416/1186) tried to engage followers in conversation, and 13.3\% (158/1186) encouraged action to benefit the organization (eg, attend events). Compared with large LHDs, small LHDs were more likely to post tweets about their organization (Cramer's V=0.06) but were less likely to acknowledge events and accomplishments of other organizations ($\chi$2=12.83, P=.02, Cramer's V=0.18). Small LHDs were also less likely to post personal health-related tweets (Cramer's V=0.08) and were less likely to post tweets containing suggestions to take action to modify their lifestyle. While large LHDs were more likely to post engagement-related tweets about the organization (Cramer's V=0.12), they were less likely to ask followers to take action that would benefit the organization ($\chi$2=7.59, P=.02. Cramer's V=0.08). While certain associations were statistically significant, the Cramer's V statistic revealed weak associations. Conclusions: Twitter is being adopted by LHDs, but its primary use involves one-way communication on personal-health topics as well as organization-related information. There is also evidence that LHDs are starting to use Twitter to engage their audiences in conversations. As public health transitions to more dialogic conversation and engagement, Twitter's potential to help form partnerships with audiences and involve them as program participants may lead to action for improved health. ",
doi="10.2196/jmir.2775",
url="http://www.jmir.org/2013/8/e177/",
url="http://www.ncbi.nlm.nih.gov/pubmed/23958635"
}


@Article{info:doi/10.2196/jmir.2810,
author="Dasgupta, Nabarun
and Freifeld, Clark
and Brownstein, S. John
and Menone, Mark Christopher
and Surratt, L. Hilary
and Poppish, Luke
and Green, L. Jody
and Lavonas, J. Eric
and Dart, C. Richard",
title="Crowdsourcing Black Market Prices For Prescription Opioids",
journal="J Med Internet Res",
year="2013",
month="Aug",
day="16",
volume="15",
number="8",
pages="e178",
keywords="opioids",
keywords="black market",
keywords="economics",
keywords="drug abuse",
keywords="surveillance",
keywords="crowdsourcing",
keywords="Internet",
keywords="Silk Road",
keywords="StreetRx",
keywords="RADARS System",
keywords="police",
keywords="law enforcement",
abstract="Background: Prescription opioid diversion and abuse are major public health issues in the United States and internationally. Street prices of diverted prescription opioids can provide an indicator of drug availability, demand, and abuse potential, but these data can be difficult to collect. Crowdsourcing is a rapid and cost-effective way to gather information about sales transactions. We sought to determine whether crowdsourcing can provide accurate measurements of the street price of diverted prescription opioid medications. Objective: To assess the possibility of crowdsourcing black market drug price data by cross-validation with law enforcement officer reports. Methods: Using a crowdsourcing research website (StreetRx), we solicited data about the price that site visitors paid for diverted prescription opioid analgesics during the first half of 2012. These results were compared with a survey of law enforcement officers in the Researched Abuse, Diversion, and Addiction-Related Surveillance (RADARS) System, and actual transaction prices on a ``dark Internet'' marketplace (Silk Road). Geometric means and 95\% confidence intervals were calculated for comparing prices per milligram of drug in US dollars. In a secondary analysis, we compared prices per milligram of morphine equivalent using standard equianalgesic dosing conversions. Results: A total of 954 price reports were obtained from crowdsourcing, 737 from law enforcement, and 147 from the online marketplace. Correlations between the 3 data sources were highly linear, with Spearman rho of 0.93 (P<.001) between crowdsourced and law enforcement, and 0.98 (P<.001) between crowdsourced and online marketplace. On StreetRx, the mean prices per milligram were US\$3.29 hydromorphone, US\$2.13 buprenorphine, US\$1.57 oxymorphone, US\$0.97 oxycodone, US\$0.96 methadone, US\$0.81 hydrocodone, US\$0.52 morphine, and US\$0.05 tramadol. The only significant difference between data sources was morphine, with a Drug Diversion price of US\$0.67/mg (95\% CI 0.59-0.75) and a Silk Road price of US\$0.42/mg (95\% CI 0.37-0.48). Street prices generally followed clinical equianalgesic potency. Conclusions: Crowdsourced data provide a valid estimate of the street price of diverted prescription opioids. The (ostensibly free) black market was able to accurately predict the relative pharmacologic potency of opioid molecules. ",
doi="10.2196/jmir.2810",
url="http://www.jmir.org/2013/8/e178/",
url="http://www.ncbi.nlm.nih.gov/pubmed/23956042"
}


@Article{info:doi/10.2196/med20.2667,
author="Meyer, Jochen
and Hein, Andreas",
title="Live Long and Prosper: Potentials of Low-Cost Consumer Devices for the Prevention of Cardiovascular Diseases",
journal="Med 2.0",
year="2013",
month="Aug",
day="12",
volume="2",
number="2",
pages="e7",
keywords="primary prevention",
keywords="cardiovascular diseases",
keywords="user-computer interface",
abstract="Background: Cardiovascular diseases (CVD) are one of the major causes of death worldwide. Personal behavior such as physical activity considerably influences the risk of incurring a CVD. In the last years numerous products such as pedometers have become available on the mass market that allow monitoring relevant behaviors and vital parameters. These devices are sufficiently precise, affordable, and easy to use. While today they are mostly lifestyle oriented they also have considerable potential for health and prevention. Objective: Our goal is to investigate how recent low-cost devices can be used in real-life settings for the prevention of CVD, and whether using these devices has an advantage over subjective self-assessment. We also examine whether it is feasible to use multiple of such devices in parallel. Methods: We observe whether and how persons are willing and able to use multiple devices in their daily lives. We compare the devices' measurements with subjective self-assessment. We make use of existing low-cost consumer devices to monitor a user's behavior. By mapping the devices' features with pre-defined prevention goals we ensure that the system collects meaningful data that can be used to monitor the individual's behavior. We conducted a user study with 10 healthy adults to measure usability and to identify problems with sensor use in real life. The participants used the devices' original portals to monitor their behavior. The subjects (age range 35-75) used an off-the-shelf pedometer and a sports watch for 4 weeks. Results: The participants responded in principle positively to the use of the devices. Analyzing the sensor data, we found that the users had some difficulties in operating the devices. We also found that the participants' self-assessment of their health behavior was too optimistic compared to the monitored data. They rated the usability of the overall system with 71 of up to 100 points in the ``System Usability Scale''. Conclusions: Our study indicates that today's devices are suitable for a long term monitoring of health for the prevention of CVD. Using the devices provides more precise data than a subjective self-assessment. However usability and acceptance of the systems are still major topics. ",
doi="10.2196/med20.2667",
url="http://www.medicine20.com/2013/2/e7/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25075242"
}


@Article{info:doi/10.2196/med20.2720,
author="Amrita
and Biswas, Dhrubes",
title="Health Care Social Media: Expectations of Users in a Developing Country",
journal="Med 2.0",
year="2013",
month="Aug",
day="09",
volume="2",
number="2",
pages="e4",
keywords="health care",
keywords="social media",
keywords="developing economy",
keywords="user expectations",
keywords="networking",
keywords="eHealth",
keywords="online patient care",
keywords="online medical advice",
abstract="Background: Affordability, acceptability, accommodation, availability, and accessibility are the five most important dimensions of access to health services. Seventy two percent of the Indian population lives in semi-urban and rural areas. The strong mismatched ratio of hospitals to patients, rising costs of health care, rapidly changing demographics, increasing population, and heightened demands in pricing for technological health care usage in emerging economies necessitate a unique health delivery solution model using social media. A greater disease burden lies in the health care delivery in developing country like India. This is due to the lack of health care infrastructure in the majority of semi-urban and rural regions. New techniques need to be introduced in these regions to overcome these issues. In the present scenario, people use social media from business, automobiles, arts, book marking, cooking, entertainment, and general networking. Developed and advanced countries like the United States have developed their communication system for many years now. They have already established social media in a number of domains including health care. Similar practice incidences can be used to provide a new dimension to health care in the semi-urban regions of India. Objective: This paper describes an extended study of a previous empirical study on the expectations of social media users for health care. The paper discusses what the users of social media expect from a health care social media site. Methods: Multiple regression analysis was used to determine the significance of the affect of four factors (privacy, immediacy, usability, and communication) on the usage of health care social media. Privacy, immediacy, usability, and communication were the independent variables and health care social media was the dependant variable. Results: There were 103 respondents who used the online questionnaire tool to generate their responses. The results from the multiple regression analysis using SPSS 20 showed that the model is acceptable, with P=.011, which is statistically significant on a P<.05 level.  The observed F value (2.082) in ANOVA was less than the given value in the F table (2.61), which allowed us to accept the hypothesis that the independent variables influence the dependant variable. The users of social media in India expect that they can best utilize social media through emergency service information. They want to be able to learn the operations of the social media site quickly and expect to know about health camps and insurance collaborations. However, people like to become friends with people with similar interests based on their interests identified. Conclusions: Health care social media requires intelligent implementation in developing economies. It needs to cater to the expectations of the users. The people in India, especially those in urban and semi-urban regions, are very interested in accepting the system. ",
doi="10.2196/med20.2720",
url="http://www.medicine20.com/2013/2/e4/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25075239"
}


@Article{info:doi/10.2196/med20.2717,
author="Merolli, Mark
and Gray, Kathleen
and Martin-Sanchez, Fernando",
title="Developing a Framework to Generate Evidence of Health Outcomes From Social Media Use in Chronic Disease Management",
journal="Med 2.0",
year="2013",
month="Aug",
day="08",
volume="2",
number="2",
pages="e3",
keywords="chronic disease",
keywords="social media",
keywords="Internet",
keywords="evidence-based practice, affordances",
keywords="patient-reported outcomes",
abstract="Background: While there is an abundance of evidence-based practice (EBP) recommendations guiding management of various chronic diseases, evidence suggesting best practice for using social media to improve health outcomes is inadequate. The variety of social media platforms, multiple potential uses, inconsistent definitions, and paucity of rigorous studies, make it difficult to measure health outcomes reliably in chronic disease management. Most published investigations report on an earlier generation of online tools, which are not as user-centered, participatory, engaging, or collaborative, and thus may work differently for health self-management. Objective: The challenge to establish a sound evidence base for social media use in chronic disease starts with the need to define criteria and methods to generate and evaluate evidence. The authors' key objective is to develop a framework for research and practice that addresses this challenge. Methods: This paper forms part of a larger research project that presents a conceptual framework of how evidence of health outcomes can be generated from social media use, allowing social media to be utilized in chronic disease management more effectively. Using mixed methods incorporating a qualitative literature review, a survey and a pilot intervention, the research closely examines the therapeutic affordances of social media, people with chronic pain (PWCP) as a subset of chronic disease management, valid outcome measurement of patient-reported (health) outcomes (PRO), the individual needs of people living with chronic disease, and finally translation of the combined results to improve evidence-based decision making about social media use in this context. Results: Extensive review highlights various affordances of social media that may prove valuable to understanding social media's effect on individual health outcomes. However, without standardized PRO instruments, we are unable to definitively investigate these effects. The proposed framework that we offer outlines how therapeutic affordances of social media coupled with valid and reliable PRO measurement may be used to generate evidence of improvements in health outcomes, as well as guide evidence-based decision making in the future about social media use as part of chronic disease self-management. Conclusions: The results will (1) inform a framework for conducting research into health outcomes from social media use in chronic disease, as well as support translating the findings into evidence of improved health outcomes, and (2) inform a set of recommendations for evidence-based decision making about social media use as part of chronic disease self-management. These outcomes will fill a gap in the knowledge and resources available to individuals managing a chronic disease, their clinicians and other researchers in chronic disease and the field of medicine 2.0. ",
doi="10.2196/med20.2717",
url="http://www.medicine20.com/2013/2/e3/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25075238"
}


@Article{info:doi/10.2196/med20.2269,
author="Williams, Ann Shirley
and Terras, Melissa
and Warwick, Claire",
title="How Twitter Is Studied in the Medical Professions: A Classification of Twitter Papers Indexed in PubMed",
journal="Med 2.0",
year="2013",
month="Jul",
day="18",
volume="2",
number="2",
pages="e2",
keywords="Twitter messaging",
keywords="Twitter messenging",
keywords="information science",
keywords="Twitter",
keywords="microblogging",
keywords="papers",
keywords="classification, social network systems",
abstract="Background: Since their inception, Twitter and related microblogging systems have provided a rich source of information for researchers and have attracted interest in their affordances and use. Since 2009 PubMed has included 123 journal articles on medicine and Twitter, but no overview exists as to how the field uses Twitter in research. Objective: This paper aims to identify published work relating to Twitter within the fields indexed by PubMed, and then to classify it. This classification will provide a framework in which future researchers will be able to position their work, and to provide an understanding of the current reach of research using Twitter in medical disciplines. Methods: Papers on Twitter and related topics were identified and reviewed. The papers were then qualitatively classified based on the paper's title and abstract to determine their focus. The work that was Twitter focused was studied in detail to determine what data, if any, it was based on, and from this a categorization of the data set size used in the studies was developed. Using open coded content analysis additional important categories were also identified, relating to the primary methodology, domain, and aspect. Results: As of 2012, PubMed comprises more than 21 million citations from biomedical literature, and from these a corpus of 134 potentially Twitter related papers were identified, eleven of which were subsequently found not to be relevant. There were no papers prior to 2009 relating to microblogging, a term first used in 2006. Of the remaining 123 papers which mentioned Twitter, thirty were focused on Twitter (the others referring to it tangentially). The early Twitter focused papers introduced the topic and highlighted the potential, not carrying out any form of data analysis. The majority of published papers used analytic techniques to sort through thousands, if not millions, of individual tweets, often depending on automated tools to do so. Our analysis demonstrates that researchers are starting to use knowledge discovery methods and data mining techniques to understand vast quantities of tweets: the study of Twitter is becoming quantitative research. Conclusions: This work is to the best of our knowledge the first overview study of medical related research based on Twitter and related microblogging. We have used 5 dimensions to categorize published medical related research on Twitter. This classification provides a framework within which researchers studying development and use of Twitter within medical related research, and those undertaking comparative studies of research, relating to Twitter in the area of medicine and beyond, can position and ground their work. ",
doi="10.2196/med20.2269",
url="http://www.medicine20.com/2013/2/e2/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25075237"
}


@Article{info:doi/10.2196/jmir.2552,
author="Detz, Alissa
and L{\'o}pez, Andrea
and Sarkar, Urmimala",
title="Long-Term Doctor-Patient Relationships: Patient Perspective From Online Reviews",
journal="J Med Internet Res",
year="2013",
month="Jul",
day="02",
volume="15",
number="7",
pages="e131",
keywords="social media",
keywords="qualitative",
keywords="primary care",
abstract="Background: Continuity of patient care is one of the cornerstones of primary care. Objective: To examine publicly available, Internet-based reviews of adult primary care physicians, specifically written by patients who report long-term relationships with their physicians. Methods: This substudy was nested within a larger qualitative content analysis of online physician ratings. We focused on reviews reflecting an established patient-physician relationship, that is, those seeing their physicians for at least 1 year. Results: Of the 712 Internet reviews of primary care physicians, 93 reviews (13.1\%) were from patients that self-identified as having a long-term relationship with their physician, 11 reviews (1.5\%) commented on a first-time visit to a physician, and the remainder of reviews (85.4\%) did not specify the amount of time with their physician. Analysis revealed six overarching domains: (1) personality traits or descriptors of the physician, (2) technical competence, (3) communication, (4) access to physician, (5) office staff/environment, and (6) coordination of care. Conclusions: Our analysis shows that patients who have been with their physician for at least 1 year write positive reviews on public websites and focus on physician attributes. ",
doi="10.2196/jmir.2552",
url="http://www.jmir.org/2013/7/e131/",
url="http://www.ncbi.nlm.nih.gov/pubmed/23819959"
}


@Article{info:doi/10.2196/jmir.2435,
author="Bond, S. Carol
and Ahmed, Hassan Osman
and Hind, Martin
and Thomas, Bronwen
and Hewitt-Taylor, Jaqui",
title="The Conceptual and Practical Ethical Dilemmas of Using Health Discussion Board Posts as Research Data",
journal="J Med Internet Res",
year="2013",
month="Jun",
day="07",
volume="15",
number="6",
pages="e112",
keywords="social media",
keywords="research ethics",
keywords="health",
keywords="research design",
abstract="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. ",
doi="10.2196/jmir.2435",
url="http://www.jmir.org/2013/6/e112/",
url="http://www.ncbi.nlm.nih.gov/pubmed/23748147"
}


@Article{info:doi/10.2196/jmir.2513,
author="Yu, Bei
and Willis, Matt
and Sun, Peiyuan
and Wang, Jun",
title="Crowdsourcing Participatory Evaluation of Medical Pictograms Using Amazon Mechanical Turk",
journal="J Med Internet Res",
year="2013",
month="Jun",
day="03",
volume="15",
number="6",
pages="e108",
keywords="crowdsourcing",
keywords="Amazon Mechanical Turk",
keywords="participatory design",
keywords="medical instruction",
keywords="pictogram",
keywords="patient communication",
keywords="readability",
keywords="health literacy",
abstract="Background: Consumer and patient participation proved to be an effective approach for medical pictogram design, but it can be costly and time-consuming. We proposed and evaluated an inexpensive approach that crowdsourced the pictogram evaluation task to Amazon Mechanical Turk (MTurk) workers, who are usually referred to as the ``turkers''. Objective: To answer two research questions: (1) Is the turkers' collective effort effective for identifying design problems in medical pictograms? and (2) Do the turkers' demographic characteristics affect their performance in medical pictogram comprehension? Methods: We designed a Web-based survey (open-ended tests) to ask 100 US turkers to type in their guesses of the meaning of 20 US pharmacopeial pictograms. Two judges independently coded the turkers' guesses into four categories: correct, partially correct, wrong, and completely wrong. The comprehensibility of a pictogram was measured by the percentage of correct guesses, with each partially correct guess counted as 0.5 correct. We then conducted a content analysis on the turkers' interpretations to identify misunderstandings and assess whether the misunderstandings were common. We also conducted a statistical analysis to examine the relationship between turkers' demographic characteristics and their pictogram comprehension performance. Results: The survey was completed within 3 days of our posting the task to the MTurk, and the collected data are publicly available in the multimedia appendix for download. The comprehensibility for the 20 tested pictograms ranged from 45\% to 98\%, with an average of 72.5\%. The comprehensibility scores of 10 pictograms were strongly correlated to the scores of the same pictograms reported in another study that used oral response--based open-ended testing with local people. The turkers' misinterpretations shared common errors that exposed design problems in the pictograms. Participant performance was positively correlated with their educational level. Conclusions: The results confirmed that crowdsourcing can be used as an effective and inexpensive approach for participatory evaluation of medical pictograms. Through Web-based open-ended testing, the crowd can effectively identify problems in pictogram designs. The results also confirmed that education has a significant effect on the comprehension of medical pictograms. Since low-literate people are underrepresented in the turker population, further investigation is needed to examine to what extent turkers' misunderstandings overlap with those elicited from low-literate people. ",
doi="10.2196/jmir.2513",
url="http://www.jmir.org/2013/6/e108/",
url="http://www.ncbi.nlm.nih.gov/pubmed/23732572"
}


@Article{info:doi/10.2196/ijmr.2454,
author="Klann, G. Jeffrey
and McCoy, B. Allison
and Wright, Adam
and Wattanasin, Nich
and Sittig, F. Dean
and Murphy, N. Shawn",
title="Health Care Transformation Through Collaboration on Open-Source Informatics Projects: Integrating a Medical Applications Platform, Research Data Repository, and Patient Summarization",
journal="Interact J Med Res",
year="2013",
month="May",
day="30",
volume="2",
number="1",
pages="e11",
keywords="clinical information systems",
keywords="medical informatics",
keywords="knowledge bases",
keywords="user-computer interface",
keywords="data display",
keywords="diffusion of innovation",
abstract="Background: The Strategic Health IT Advanced Research Projects (SHARP) program seeks to conquer well-understood challenges in medical informatics through breakthrough research. Two SHARP centers have found alignment in their methodological needs: (1) members of the National Center for Cognitive Informatics and Decision-making (NCCD) have developed knowledge bases to support problem-oriented summarizations of patient data, and (2) Substitutable Medical Apps, Reusable Technologies (SMART), which is a platform for reusable medical apps that can run on participating platforms connected to various electronic health records (EHR). Combining the work of these two centers will ensure wide dissemination of new methods for synthesized views of patient data. Informatics for Integrating Biology and the Bedside (i2b2) is an NIH-funded clinical research data repository platform in use at over 100 sites worldwide. By also working with a co-occurring initiative to SMART-enabling i2b2, we can confidently write one app that can be used extremely broadly. Objective: Our goal was to facilitate development of intuitive, problem-oriented views of the patient record using NCCD knowledge bases that would run in any EHR. To do this, we developed a collaboration between the two SHARPs and an NIH center, i2b2. Methods: First, we implemented collaborative tools to connect researchers at three institutions. Next, we developed a patient summarization app using the SMART platform and a previously validated NCCD problem-medication linkage knowledge base derived from the National Drug File-Reference Terminology (NDF-RT). Finally, to SMART-enable i2b2, we implemented two new Web service ``cells'' that expose the SMART application programming interface  (API), and we made changes to the Web interface of i2b2 to host a ``carousel'' of SMART apps. Results: We deployed our SMART-based, NDF-RT-derived patient summarization app in this SMART-i2b2 container.  It displays a problem-oriented view of medications and presents a line-graph display of laboratory results. Conclusions: This summarization app can be run in any EHR environment that either supports SMART or runs SMART-enabled i2b2.  This i2b2 ``clinical bridge'' demonstrates a pathway for reusable app development that does not require EHR vendors to immediately adopt the SMART API. Apps can be developed in SMART and run by clinicians in the i2b2 repository, reusing clinical data extracted from EHRs. This may encourage the adoption of SMART by supporting SMART app development until EHRs adopt the platform.  It also allows a new variety of clinical SMART apps, fueled by the broad aggregation of data types available in research repositories. The app (including its knowledge base) and SMART-i2b2 are open-source and freely available for download. ",
doi="10.2196/ijmr.2454",
url="http://www.i-jmr.org/2013/1/e11/",
url="http://www.ncbi.nlm.nih.gov/pubmed/23722634"
}


@Article{info:doi/10.2196/jmir.2610,
author="Mackey, Ken Tim
and Liang, A. Bryan",
title="Global Reach of Direct-to-Consumer Advertising Using Social Media for Illicit Online Drug Sales",
journal="J Med Internet Res",
year="2013",
month="May",
day="29",
volume="15",
number="5",
pages="e105",
keywords="health policy",
keywords="pharmacies",
keywords="social media",
keywords="Internet",
keywords="social marketing",
keywords="marketing of health services",
keywords="online pharmaceutical services",
abstract="Background: Illicit or rogue Internet pharmacies are a recognized global public health threat that have been identified as utilizing various forms of online marketing and promotion, including social media. Objective: To assess the accessibility of creating illicit no prescription direct-to-consumer advertising (DTCA) online pharmacy social media marketing (eDTCA2.0) and evaluate its potential global reach. Methods: We identified the top 4 social media platforms allowing eDTCA2.0. After determining applicable platforms (ie, Facebook, Twitter, Google+, and MySpace), we created a fictitious advertisement advertising no prescription drugs online and posted it to the identified social media platforms. Each advertisement linked to a unique website URL that consisted of a site error page. Employing Web search analytics, we tracked the number of users visiting these sites and their location. We used commercially available Internet tools and services, including website hosting, domain registration, and website analytic services. Results: Illicit online pharmacy social media content for Facebook, Twitter, and MySpace remained accessible despite highly questionable and potentially illegal content. Fictitious advertisements promoting illicit sale of drugs generated aggregate unique user traffic of 2795 visits over a 10-month period. Further, traffic to our websites originated from a number of countries, including high-income and middle-income countries, and emerging markets. Conclusions: Our results indicate there are few barriers to entry for social media--based illicit online drug marketing. Further, illicit eDTCA2.0 has globalized outside US borders to other countries through unregulated Internet marketing. ",
doi="10.2196/jmir.2610",
url="http://www.jmir.org/2013/5/e105/",
url="http://www.ncbi.nlm.nih.gov/pubmed/23718965"
}


@Article{info:doi/10.2196/jmir.2409,
author="Wilson, Kumanan
and Keelan, Jennifer",
title="Social Media and the Empowering of Opponents of Medical Technologies: The Case of Anti-Vaccinationism",
journal="J Med Internet Res",
year="2013",
month="May",
day="28",
volume="15",
number="5",
pages="e103",
keywords="social media",
keywords="immunization",
doi="10.2196/jmir.2409",
url="http://www.jmir.org/2013/5/e103/",
url="http://www.ncbi.nlm.nih.gov/pubmed/23715762"
}


@Article{info:doi/10.2196/med20.2014,
author="Elias, Pierre
and Rajan, O. Nithin
and McArthur, Kara
and Dacso, C. Clifford",
title="InSpire to Promote Lung Assessment in Youth: Evolving the Self-Management Paradigms of Young People With Asthma",
journal="Med 2.0",
year="2013",
month="May",
day="21",
volume="2",
number="1",
pages="e1",
keywords="pediatric asthma",
keywords="chronic disease management",
keywords="mobile phones",
keywords="spirometry",
keywords="gamification",
abstract="Background: Asthma is the most common chronic disease in childhood, disproportionately affecting urban, minority, and disadvantaged children. Individualized care plans supported by daily lung-function monitoring can reduce morbidity and mortality. However, despite 20 years of interventions to increase adherence, only 50\% of US youth accurately follow their care plans, which leads to millions of preventable hospitalizations, emergency room visits, and sick days every year. We present a feasibility study of a novel, user-centered approach to increasing young people's lung-function monitoring and asthma self-care. Promoting Lung Assessment in Youth (PLAY) helps young people become active managers of their asthma through the Web 2.0 principles of participation, cocreation, and information sharing. Specifically, PLAY combines an inexpensive, portable spirometer with the motivational power and convenience of mobile phones and virtual-community gaming. Objective: The objective of this study was to develop and pilot test InSpire, a fully functional interface between a handheld spirometer and an interactive game and individualized asthma-care instant-messaging system housed on a mobile phone. Methods: InSpire is an application for mobile smartphones that creates a compelling world in which youth collaborate with their physicians on managing their asthma. Drawing from design-theory on global timer mechanics and role playing, we incentivized completing spirometry maneuvers by making them an engaging part of a game young people would want to play. The data can be sent wirelessly to health specialists and return care recommendations to patients in real-time. By making it portable and similar to applications normally desired by the target demographic, InSpire is able to seamlessly incorporate asthma management into their lifestyle. Results: We describe the development process of building and testing the InSpire prototype. To our knowledge, the prototype is a first-of-its kind mobile one-stop shop for asthma management. Feasibility testing in children aged 7 to 14 with asthma assessed likability of the graphical user interface as well as young people's interest in our incentivizing system. Nearly 100\% of children surveyed said they would play games like those in PLAY if they involved breathing into a spirometer. Two-thirds said they would prefer PLAY over the spirometer alone, whereas 1/3 would prefer having both. No children said they would prefer the spirometer over PLAY. Conclusions: Previous efforts at home-monitoring of asthma in children have experienced rapid decline in adherence. An inexpensive monitoring technology combined with the computation, interactive communication, and display ability of a mobile phone is a promising approach to sustainable adherence to lung-function monitoring and care plans. An exciting game that redefines the way youth conduct health management by inviting them to collaborate in their health better can be an incentive and a catalyst for more far-reaching goals. ",
doi="10.2196/med20.2014",
url="http://www.medicine20.com/2013/1/e1/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25075232"
}


@Article{info:doi/10.2196/jmir.2620,
author="Saunders, R. Daniel
and Bex, J. Peter
and Woods, L. Russell",
title="Crowdsourcing a Normative Natural Language Dataset: A Comparison of Amazon Mechanical Turk and In-Lab Data Collection",
journal="J Med Internet Res",
year="2013",
month="May",
day="20",
volume="15",
number="5",
pages="e100",
keywords="Internet",
keywords="web",
keywords="crowdsourcing",
keywords="free recall",
abstract="Background: Crowdsourcing has become a valuable method for collecting medical research data. This approach, recruiting through open calls on the Web, is particularly useful for assembling large normative datasets. However, it is not known how natural language datasets collected over the Web differ from those collected under controlled laboratory conditions. Objective: To compare the natural language responses obtained from a crowdsourced sample of participants with responses collected in a conventional laboratory setting from participants recruited according to specific age and gender criteria. Methods: We collected natural language descriptions of 200 half-minute movie clips, from Amazon Mechanical Turk workers (crowdsourced) and 60 participants recruited from the community (lab-sourced). Crowdsourced participants responded to as many clips as they wanted and typed their responses, whereas lab-sourced participants gave spoken responses to 40 clips, and their responses were transcribed. The content of the responses was evaluated using a take-one-out procedure, which compared responses to other responses to the same clip and to other clips, with a comparison of the average number of shared words. Results: In contrast to the 13 months of recruiting that was required to collect normative data from 60 lab-sourced participants (with specific demographic characteristics), only 34 days were needed to collect normative data from 99 crowdsourced participants (contributing a median of 22 responses). The majority of crowdsourced workers were female, and the median age was 35 years, lower than the lab-sourced median of 62 years but similar to the median age of the US population. The responses contributed by the crowdsourced participants were longer on average, that is, 33 words compared to 28 words (P<.001), and they used a less varied vocabulary. However, there was strong similarity in the words used to describe a particular clip between the two datasets, as a cross-dataset count of shared words showed (P<.001). Within both datasets, responses contained substantial relevant content, with more words in common with responses to the same clip than to other clips (P<.001). There was evidence that responses from female and older crowdsourced participants had more shared words (P=.004 and .01 respectively), whereas younger participants had higher numbers of shared words in the lab-sourced population (P=.01). Conclusions: Crowdsourcing is an effective approach to quickly and economically collect a large reliable dataset of normative natural language responses. ",
doi="10.2196/jmir.2620",
url="http://www.jmir.org/2013/5/e100/",
url="http://www.ncbi.nlm.nih.gov/pubmed/23689038"
}


@Article{info:doi/10.2196/jmir.2421,
author="Black, Erik
and Light, Jennifer
and Paradise Black, Nicole
and Thompson, Lindsay",
title="Online Social Network Use by Health Care Providers in a High Traffic Patient Care Environment",
journal="J Med Internet Res",
year="2013",
month="May",
day="17",
volume="15",
number="5",
pages="e94",
keywords="social networking",
keywords="emergency medicine",
keywords="Internet",
abstract="Background: The majority of workers, regardless of age or occupational status, report engaging in personal Internet use in the workplace. There is little understanding of the impact that personal Internet use may have on patient care in acute clinical settings. Objective: The objective of this study was to investigate the volume of one form of personal Internet use---online social networking (Facebook)---generated by workstations in the emergency department (ED) in contrast to measures of clinical volume and severity. Methods: The research team analyzed anonymous network utilization records for 68 workstations located in the emergency medicine department within one academic medical center for 15 consecutive days (12/29/2009 to 1/12/2010). This data was compared to ED work index (EDWIN) data derived by the hospital information systems. Results: Health care workers spent an accumulated 4349 minutes (72.5 hours) browsing Facebook, staff cumulatively visited Facebook 9369 times and spent, on average, 12.0 minutes per hour browsing Facebook. There was a statistically significant difference in the time spent on Facebook according to time of day (19.8 minutes per hour versus 4.3 minutes per hour, P<.001). There was a significant, positive correlation between EDWIN scores and time spent on Facebook (r=.266, P<.001). Conclusions: Facebook use constituted a substantive percentage of staff time during the 15-day observation period. Facebook use increased with increased patient volume and severity within the ED. ",
doi="10.2196/jmir.2421",
url="http://www.jmir.org/2013/5/e94/",
url="http://www.ncbi.nlm.nih.gov/pubmed/23685530"
}


@Article{info:doi/10.2196/jmir.1933,
author="Moorhead, Anne S.
and Hazlett, E. Diane
and Harrison, Laura
and Carroll, K. Jennifer
and Irwin, Anthea
and Hoving, Ciska",
title="A New Dimension of Health Care: Systematic Review of the Uses, Benefits, and Limitations of Social Media for Health Communication",
journal="J Med Internet Res",
year="2013",
month="Apr",
day="23",
volume="15",
number="4",
pages="e85",
keywords="health communication",
keywords="social media",
keywords="review",
abstract="Background: There is currently a lack of information about the uses, benefits, and limitations of social media for health communication among the general public, patients, and health professionals from primary research. Objective: To review the current published literature to identify the uses, benefits, and limitations of social media for health communication among the general public, patients, and health professionals, and identify current gaps in the literature to provide recommendations for future health communication research. Methods: This paper is a review using a systematic approach. A systematic search of the literature was conducted using nine electronic databases and manual searches to locate peer-reviewed studies published between January 2002 and February 2012. Results: The search identified 98 original research studies that included the uses, benefits, and/or limitations of social media for health communication among the general public, patients, and health professionals. The methodological quality of the studies assessed using the Downs and Black instrument was low; this was mainly due to the fact that the vast majority of the studies in this review included limited methodologies and was mainly exploratory and descriptive in nature. Seven main uses of social media for health communication were identified, including focusing on increasing interactions with others, and facilitating, sharing, and obtaining health messages. The six key overarching benefits were identified as (1) increased interactions with others, (2) more available, shared, and tailored information, (3) increased accessibility and widening access to health information, (4) peer/social/emotional support, (5) public health surveillance, and (6) potential to influence health policy. Twelve limitations were identified, primarily consisting of quality concerns and lack of reliability, confidentiality, and privacy. Conclusions: Social media brings a new dimension to health care as it offers a medium to be used by the public, patients, and health professionals to communicate about health issues with the possibility of potentially improving health outcomes. Social media is a powerful tool, which offers collaboration between users and is a social interaction mechanism for a range of individuals. Although there are several benefits to the use of social media for health communication, the information exchanged needs to be monitored for quality and reliability, and the users' confidentiality and privacy need to be maintained. Eight gaps in the literature and key recommendations for future health communication research were provided. Examples of these recommendations include the need to determine the relative effectiveness of different types of social media for health communication using randomized control trials and to explore potential mechanisms for monitoring and enhancing the quality and reliability of health communication using social media. Further robust and comprehensive evaluation and review, using a range of methodologies, are required to establish whether social media improves health communication practice both in the short and long terms. ",
doi="10.2196/jmir.1933",
url="http://www.jmir.org/2013/4/e85/",
url="http://www.ncbi.nlm.nih.gov/pubmed/23615206"
}


@Article{info:doi/10.2196/jmir.2426,
author="Zhai, Haijun
and Lingren, Todd
and Deleger, Louise
and Li, Qi
and Kaiser, Megan
and Stoutenborough, Laura
and Solti, Imre",
title="Web 2.0-Based Crowdsourcing for High-Quality Gold Standard Development in Clinical Natural Language Processing",
journal="J Med Internet Res",
year="2013",
month="Apr",
day="02",
volume="15",
number="4",
pages="e73",
keywords="clinical informatics",
keywords="natural language processing",
keywords="named entity",
keywords="reference standards",
keywords="crowdsourcing",
keywords="user computer interface",
keywords="quality control",
abstract="Background: A high-quality gold standard is vital for supervised, machine learning-based, clinical natural language processing (NLP) systems. In clinical NLP projects, expert annotators traditionally create the gold standard. However, traditional annotation is expensive and time-consuming.  To reduce the cost of annotation, general NLP projects have turned to crowdsourcing based on Web 2.0 technology, which involves submitting smaller subtasks to a coordinated marketplace of workers on the Internet. Many studies have been conducted in the area of crowdsourcing, but only a few have focused on tasks in the general NLP field and only a handful in the biomedical domain, usually based upon very small pilot sample sizes. In addition, the quality of the crowdsourced biomedical NLP corpora were never exceptional when compared to traditionally-developed gold standards. The previously reported results on medical named entity annotation task showed a 0.68 F-measure based agreement between crowdsourced and traditionally-developed corpora. Objective: Building upon previous work from the general crowdsourcing research, this study investigated the usability of crowdsourcing in the clinical NLP domain with special emphasis on achieving high agreement between crowdsourced and traditionally-developed corpora. Methods: To build the gold standard for evaluating the crowdsourcing workers' performance, 1042 clinical trial announcements (CTAs) from the ClinicalTrials.gov website were randomly selected and double annotated for medication names, medication types, and linked attributes. For the experiments, we used CrowdFlower, an Amazon Mechanical Turk-based crowdsourcing platform. We calculated sensitivity, precision, and F-measure to evaluate the quality of the crowd's work and tested the statistical significance (P<.001, chi-square test) to detect differences between the crowdsourced and traditionally-developed annotations. Results: The agreement between the crowd's annotations and the traditionally-generated corpora was high for: (1) annotations (0.87, F-measure for medication names; 0.73, medication types), (2) correction of previous annotations (0.90, medication names; 0.76, medication types), and excellent for (3) linking medications with their attributes (0.96). Simple voting provided the best judgment aggregation approach. There was no statistically significant difference between the crowd and traditionally-generated corpora. Our results showed a 27.9\% improvement over previously reported results on medication named entity annotation task. Conclusions: This study offers three contributions. First, we proved that crowdsourcing is a feasible, inexpensive, fast, and practical approach to collect high-quality annotations for clinical text (when protected health information was excluded). We believe that well-designed user interfaces and rigorous quality control strategy for entity annotation and linking were critical to the success of this work. Second, as a further contribution to the Internet-based crowdsourcing field, we will publicly release the JavaScript and CrowdFlower Markup Language infrastructure code that is necessary to utilize CrowdFlower's quality control and crowdsourcing interfaces for named entity annotations. Finally, to spur future research, we will release the CTA annotations that were generated by traditional and crowdsourced approaches. ",
doi="10.2196/jmir.2426",
url="http://www.jmir.org/2013/4/e73/",
url="http://www.ncbi.nlm.nih.gov/pubmed/23548263"
}


@Article{info:doi/10.2196/jmir.2264,
author="Ko, Nai-Ying
and Hsieh, Chao-Hsien
and Wang, Ming-Chi
and Lee, Chiang
and Chen, Chun-Lin
and Chung, An-Chun
and Hsu, Su-Ting",
title="Effects of Internet Popular Opinion Leaders (iPOL) Among Internet-Using Men Who Have Sex With Men",
journal="J Med Internet Res",
year="2013",
month="Feb",
day="25",
volume="15",
number="2",
pages="e40",
keywords="Internet, intervention studies, HIV prevention, Homosexuality, Male",
abstract="Background: The Internet has become a popular venue for facilitating sex networking for men who have sex with men (MSM). Objective: The study aimed to evaluate the effectiveness of Internet popular opinion leaders (iPOL) in disseminating information about the human immunodeficiency virus (HIV), increasing the frequency of HIV testing, and reducing risky behaviors among MSM in Taiwan. Methods: A quasi-experimental study with a nonequivalent control website for comparison was used to estimate the effectiveness of iPOL. A community-level intervention, iPOL, was conducted at the Facebook social networking website and at top1069 as a control. The iPOLs actively disseminated HIV-related information via the platform of Internet opinion leaders and AIDS information center, and discussed and responded to questions or replied to Internet-using MSM. Results: A total of 369 iPOLs posted 432 articles and 503 replies to others, influencing 959,088 persons on Facebook. A total of 1037 MSM, 552 (53.23\%) from an intervention website and 485 (46.76\%) from a control website, participated in the follow-up study survey (response rate 96\%). At the 6-month follow-up after the intervention was conducted, MSM who visited the intervention website were more likely to receive HIV-related information (25.49\% versus 10.47\%, P<.001), discuss HIV issues with others (41.88\% versus 23.79\%, P<.001), review articles about HIV (90.58\% versus 79.73\%, P<.001), and be asked about or discuss HIV-related questions (51.11\% versus 31.78\%, P<.001) than those on the control website. In addition, MSM were more likely to have HIV tests within 6 months (43.89\% versus 22.31\%, P<.001) and consistently use condoms during anal sex with online sex partners than those using the control website (34.15\% versus 26.19\%, P=.004). Conclusions: The study showed the feasibility and effectiveness of the iPOL intervention as an online HIV prevention program. These findings underscore the importance of disseminating HIV information online, as well as the challenges inherent in the efforts of iPOL to reduce HIV-related risky behaviors among Internet-using MSM. ",
doi="10.2196/jmir.2264",
url="http://www.jmir.org/2013/2/e40/",
url="http://www.ncbi.nlm.nih.gov/pubmed/23439583"
}


@Article{info:doi/10.2196/jmir.2237,
author="Syed-Abdul, Shabbir
and Fernandez-Luque, Luis
and Jian, Wen-Shan
and Li, Yu-Chuan
and Crain, Steven
and Hsu, Min-Huei
and Wang, Yao-Chin
and Khandregzen, Dorjsuren
and Chuluunbaatar, Enkhzaya
and Nguyen, Anh Phung
and Liou, Der-Ming",
title="Misleading Health-Related Information Promoted Through Video-Based Social Media: Anorexia on YouTube",
journal="J Med Internet Res",
year="2013",
month="Feb",
day="13",
volume="15",
number="2",
pages="e30",
keywords="Medical Informatics",
keywords="Internet",
keywords="Online videos",
keywords="YouTube",
keywords="Eating Disorder",
keywords="Anorexia Nervosa",
keywords="Social Network",
abstract="Introduction: The amount of information being uploaded onto social video platforms, such as YouTube, Vimeo, and Veoh, continues to spiral, making it increasingly difficult to discern reliable health information from misleading content. There are thousands of YouTube videos promoting misleading information about anorexia (eg, anorexia as a healthy lifestyle). Objective: The aim of this study was to investigate anorexia-related misinformation disseminated through YouTube videos. Methods: We retrieved YouTube videos related to anorexia using the keywords anorexia, anorexia nervosa, proana, and thinspo on October 10, 2011.Three doctors reviewed 140 videos with approximately 11 hours of video content, classifying them as informative, pro-anorexia, or others. By informative we mean content describing the health consequences of anorexia and advice on how to recover from it; by pro-anorexia we mean videos promoting anorexia as a fashion, a source of beauty, and that share tips and methods for becoming and remaining anorexic. The 40 most-viewed videos (20 informative and 20 pro-anorexia videos) were assessed to gauge viewer behavior. Results: The interrater agreement of classification was moderate (Fleiss' kappa=0.5), with 29.3\% (n=41) being rated as pro-anorexia, 55.7\% (n=78) as informative, and 15.0\% (n=21) as others. Pro-anorexia videos were favored 3 times more than informative videos (odds ratio [OR] 3.3, 95\% CI 3.3-3.4, P<.001). Conclusions: Pro-anorexia information was identified in 29.3\% of anorexia-related videos. Pro-anorexia videos are less common than informative videos; however, in proportional terms, pro-anorexia content is more highly favored and rated by its viewers. Efforts should focus on raising awareness, particularly among teenagers, about the trustworthiness of online information about beauty and healthy lifestyles. Health authorities producing videos to combat anorexia should consider involving celebrities and models to reach a wider audience. More research is needed to study the characteristics of pro-anorexia videos in order to develop algorithms that will automatically detect and filter those videos before they become popular. ",
doi="10.2196/jmir.2237",
url="http://www.jmir.org/2013/2/e30/",
url="http://www.ncbi.nlm.nih.gov/pubmed/23406655"
}


@Article{info:doi/10.2196/jmir.2334,
author="Pedrana, Alisa
and Hellard, Margaret
and Gold, Judy
and Ata, Nadine
and Chang, Shanton
and Howard, Steve
and Asselin, Jason
and Ilic, Olivia
and Batrouney, Colin
and Stoove, Mark",
title="Queer as F**k: Reaching and Engaging Gay Men in Sexual Health Promotion through Social Networking Sites",
journal="J Med Internet Res",
year="2013",
month="Feb",
day="07",
volume="15",
number="2",
pages="e25",
keywords="health promotion",
keywords="Internet",
keywords="social networking sites",
keywords="sexual health",
keywords="gay men",
abstract="Background: A growing number of health promotion interventions are taking advantage of the popularity and interactivity of new social media platforms to foster and engage communities for health promotion. However, few health promotion interventions using social networking sites (SNS) have been rigorously evaluated. ``Queer as F**k''(QAF) began as pilot project in 2010 to deliver sexual health promotion via short ``webisodes'' on SNS to gay men. Now in its fifth season, QAF is among the few published examples internationally to demonstrate the sexual health promotion potential of SNS. Objective: The objective of this evaluation is to assess reach, interactivity, and engagement generated by QAF to inform future health interventions and evaluations using SNS. Methods: We undertook a mixed method process evaluation using an uncontrolled longitudinal study design that compared multiple measurements over time to assess changes in reach and engagement. We adapted evaluation methods from the health promotion, information systems, and creative spheres. We incorporated online usage statistics, interviews informed by user diary-scrapbooks, and user focus groups to assess intervention reach and engagement. Results: During Series 1-3 (April 2010 to April 2011), 32 webisodes were posted on the QAF Facebook and YouTube pages. These webisodes attracted over 30,000 views; ranging from 124-3092 views per individual episode. By April 2011, the QAF Facebook page had 2929 predominantly male fans. Interview and focus group participants supported the balance of education and entertainment. They endorsed the narrative ``soap opera'' format as an effective way to deliver sexual health messages in an engaging, informative, and accessible manner that encouraged online peer discussion of sexual health and promoted community engagement. Conclusions: QAF offers a successful example of exploiting the reach, interactivity, and engagement potential of SNS; findings from this process evaluation provide a model to inform the delivery and evaluation of future health promotion interventions on SNS. ",
doi="10.2196/jmir.2334",
url="http://www.jmir.org/2013/2/e25/",
url="http://www.ncbi.nlm.nih.gov/pubmed/23391459"
}


@Article{info:doi/10.2196/jmir.2360,
author="Emmert, Martin
and Sander, Uwe
and Pisch, Frank",
title="Eight Questions About Physician-Rating Websites: A Systematic Review",
journal="J Med Internet Res",
year="2013",
month="Feb",
day="01",
volume="15",
number="2",
pages="e24",
keywords="Physician rating websites",
keywords="patient narratives",
keywords="public reporting",
keywords="transparency",
keywords="systematic review",
abstract="Background: Physician-rating websites are currently gaining in popularity because they increase transparency in the health care system. However, research on the characteristics and content of these portals remains limited. Objective: To identify and synthesize published evidence in peer-reviewed journals regarding frequently discussed issues about physician-rating websites. Methods: Peer-reviewed English and German language literature was searched in seven databases (Medline (via PubMed), the Cochrane Library, Business Source Complete, ABI/Inform Complete, PsycInfo, Scopus, and ISI web of knowledge) without any time constraints. Additionally, reference lists of included studies were screened to assure completeness. The following eight previously defined questions were addressed: 1) What percentage of physicians has been rated? 2) What is the average number of ratings on physician-rating websites? 3) Are there any differences among rated physicians related to socioeconomic status? 4) Are ratings more likely to be positive or negative?  5) What significance do patient narratives have? 6) How should physicians deal with physician-rating websites? 7) What major shortcomings do physician-rating websites have? 8) What recommendations can be made for further improvement of physician-rating websites? Results: Twenty-four articles published in peer-reviewed journals met our inclusion criteria. Most studies were published by US (n=13) and German (n=8) researchers; however, the focus differed considerably. The current usage of physician-rating websites is still low but is increasing. International data show that 1 out of 6 physicians has been rated, and approximately 90\% of all ratings on physician-rating websites were positive. Although often a concern, we could not find any evidence of ``doctor-bashing''. Physicians should not ignore these websites, but rather, monitor the information available and use it for internal and ex-ternal purpose. Several shortcomings limit the significance of the results published on physician-rating websites; some recommendations to address these limitations are presented. Conclusions: Although the number of publications is still low, physician-rating websites are gaining more attention in research. But the current condition of physician-rating websites is lacking. This is the case both in the United States and in Germany. Further research is necessary to increase the quality of the websites, especially from the patients' perspective. ",
doi="10.2196/jmir.2360",
url="http://www.jmir.org/2013/2/e24/",
url="http://www.ncbi.nlm.nih.gov/pubmed/23372115"
}


@Article{info:doi/10.2196/jmir.2297,
author="Thackeray, Rosemary
and Crookston, T. Benjamin
and West, H. Joshua",
title="Correlates of Health-Related Social Media Use Among Adults",
journal="J Med Internet Res",
year="2013",
month="Jan",
day="30",
volume="15",
number="1",
pages="e21",
keywords="social media",
keywords="Internet",
keywords="health information",
keywords="consumer",
abstract="Background: Sixty percent of Internet users report using the Internet to look for health information. Social media sites are emerging as a potential source for online health information. However, little is known about how people use social media for such purposes. Objectives: The purpose of this study was two-fold: (1) to establish the frequency of various types of online health-seeking behaviors, and (2) to identify correlates of 2 health-related online activities, social networking sites (SNS) for health-related activities and consulting online user-generated content for answers about health care providers, health facilities, or medical treatment. Methods: The study consisted of a telephone survey of 1745 adults who reported going online to look for health-related information. Four subscales were created to measure use of online resources for (1) using SNS for health-related activities; (2) consulting online rankings and reviews of doctors, hospitals or medical facilities, and drugs or medical treatments; (3) posting a review online of doctors, hospitals or medical facilities, and drugs or medical treatments, and (4) posting a comment or question about health or medical issues on various social media. Univariate and multivariate logistic regression analyses were performed. Results: Respondents consulted online rankings or reviews (41.15\%), used SNS for health (31.58\%), posted reviews (9.91\%), and posted a comment, question, or information (15.19\%). Respondents with a chronic disease were nearly twice as likely to consult online rankings (odds ratio [OR] 2.09, 95\% CI 1.66-2.63, P<.001). Lower odds of consulting online reviews were associated with less formal education (OR 0.49, 95\% CI 0.37-0.65, P<.001) and being male (OR 0.71, 95\% CI 0.57-0.87, P<.001). Respondents with higher incomes were 1.5 times as likely to consult online rankings or reviews (OR 1.49, 95\% CI 0.10-2.24, P=.05), than respondents with a regular provider (OR 2.05, 95\% CI 1.52-2.78, P<.001), or living in an urban/suburban location (OR 1.61, 95\% CI 1.17-2.22, P<.001). Older respondents were less likely to use SNS for health-related activities (OR 0.96, 95\% CI 0.95-0.97, P<.001), as were males (OR 0.70, 95\% CI 0.56-0.87, P<.001), whereas respondents with a regular provider had nearly twice the likelihood of using SNS for health-related activities (OR 1.89, 95\% CI 1.43-2.52, P<.001). Conclusions: People are using social media for seeking health information. However, individuals are more likely to consume information than they are to contribute to the dialog. The inherent value of ``social'' in social media is not being captured with online health information seeking. People with a regular health care provider, chronic disease, and those in younger age groups are more likely to consult online rankings and reviews and use SNS for health-related activities. ",
doi="10.2196/jmir.2297",
url="http://www.jmir.org/2013/1/e21/",
url="http://www.ncbi.nlm.nih.gov/pubmed/23367505"
}


@Article{info:doi/10.2196/jmir.2112,
author="Little, Max
and Wicks, Paul
and Vaughan, Timothy
and Pentland, Alex",
title="Quantifying Short-Term Dynamics of Parkinson's Disease Using Self-Reported Symptom Data From an Internet Social Network",
journal="J Med Internet Res",
year="2013",
month="Jan",
day="24",
volume="15",
number="1",
pages="e20",
keywords="Parkinson's disease",
keywords="social networks",
keywords="medical informatics",
keywords="symptoms",
keywords="pharmacodynamics",
abstract="Background: Parkinson's disease (PD) is an incurable neurological disease with approximately 0.3\% prevalence. The hallmark symptom is gradual movement deterioration. Current scientific consensus about disease progression holds that symptoms will worsen smoothly over time unless treated. Accurate information about symptom dynamics is of critical importance to patients, caregivers, and the scientific community for the design of new treatments, clinical decision making, and individual disease management. Long-term studies characterize the typical time course of the disease as an early linear progression gradually reaching a plateau in later stages. However, symptom dynamics over durations of days to weeks remains unquantified. Currently, there is a scarcity of objective clinical information about symptom dynamics at intervals shorter than 3 months stretching over several years, but Internet-based patient self-report platforms may change this. Objective: To assess the clinical value of online self-reported PD symptom data recorded by users of the health-focused Internet social research platform PatientsLikeMe (PLM), in which patients quantify their symptoms on a regular basis on a subset of the Unified Parkinson's Disease Ratings Scale (UPDRS). By analyzing this data, we aim for a scientific window on the nature of symptom dynamics for assessment intervals shorter than 3 months over durations of several years. Methods: Online self-reported data was validated against the gold standard Parkinson's Disease Data and Organizing Center (PD-DOC) database, containing clinical symptom data at intervals greater than 3 months. The data were compared visually using quantile-quantile plots, and numerically using the Kolmogorov-Smirnov test. By using a simple piecewise linear trend estimation algorithm, the PLM data was smoothed to separate random fluctuations from continuous symptom dynamics. Subtracting the trends from the original data revealed random fluctuations in symptom severity. The average magnitude of fluctuations versus time since diagnosis was modeled by using a gamma generalized linear model. Results: Distributions of ages at diagnosis and UPDRS in the PLM and PD-DOC databases were broadly consistent. The PLM patients were systematically younger than the PD-DOC patients and showed increased symptom severity in the PD off state. The average fluctuation in symptoms (UPDRS Parts I and II) was 2.6 points at the time of diagnosis, rising to 5.9 points 16 years after diagnosis. This fluctuation exceeds the estimated minimal and moderate clinically important differences, respectively. Not all patients conformed to the current clinical picture of gradual, smooth changes: many patients had regimes where symptom severity varied in an unpredictable manner, or underwent large rapid changes in an otherwise more stable progression. Conclusions: This information about short-term PD symptom dynamics contributes new scientific understanding about the disease progression, currently very costly to obtain without self-administered Internet-based reporting. This understanding should have implications for the optimization of clinical trials into new treatments and for the choice of treatment decision timescales. ",
doi="10.2196/jmir.2112",
url="http://www.jmir.org/2013/1/e20/",
url="http://www.ncbi.nlm.nih.gov/pubmed/23343503"
}


@Article{info:doi/10.2196/jmir.2123,
author="van Velsen, Lex
and van Gemert-Pijnen, E.W.C Julia
and Beaujean, J.M.A Desir{\'e}e
and Wentzel, Jobke
and van Steenbergen, E. Jim",
title="Should Health Organizations Use Web 2.0 Media in Times of an Infectious Disease Crisis? An In-depth Qualitative Study of Citizens' Information Behavior During an EHEC Outbreak",
journal="J Med Internet Res",
year="2012",
month="Dec",
day="20",
volume="14",
number="6",
pages="e181",
keywords="Disease Outbreaks",
keywords="Foodborne Diseases",
keywords="Health Communication",
keywords="Information Dissemination",
keywords="Information Seeking Behavior",
keywords="Social networking",
abstract="Background: Web 2.0 media (eg, Facebook, Wikipedia) are considered very valuable for communicating with citizens in times of crisis. However, in the case of infectious disease outbreaks, their value has not been determined empirically. In order to be able to take full advantage of Web 2.0 media in such a situation, the link between these media, citizens' information behavior, and citizens' information needs has to be investigated. Objective: The goal of our study was to assess citizens' Web 2.0 media use during an infectious disease outbreak and to determine which Web 2.0 medium is used for which goal. With this information, we wanted to formulate recommendations for health organizations that consider using Web 2.0 media as part of their communication strategy during an infectious disease outbreak. Methods: A total of 18 student participants kept an information diary for 4 weeks during the 2011 enterohemorrhagic E. coli (EHEC) outbreak in Germany. Of them, 9 lived at the epicenter of the outbreak and 9 of them at some distance. The diaries were supplemented by a qualitative pre-survey (demographics) and postsurvey (questioning their satisfaction with information provision during the outbreak). Results: The Internet appeared to be the most popular medium for passively receiving EHEC-related information, with news websites and websites of newspapers as the most consulted sources. Twitter was used for receiving information to a small degree, while Facebook played virtually no role. Participants indicated that they thought information posted on Twitter or Facebook was not reliable or was out of place. When actively seeking information, online newspapers and wikis were important sources. Several causes for (dis)satisfaction with information provision were uncovered: source credibility, contradicting messages, and a need for closure. Conclusions: During an infectious disease outbreak, our small sample of students did not see social media (like Facebook and Twitter) as suitable or reliable sources for communicating information, but primarily viewed them as a tool for communicating with friends. Wikis, however, did fill several information needs, especially when citizens are actively searching for information. For many, source credibility is an important asset of information usefulness. Finally, we provide several general recommendations for communicating with citizens during an infectious disease outbreak. ",
doi="10.2196/jmir.2123",
url="http://www.jmir.org/2012/6/e181/",
url="http://www.ncbi.nlm.nih.gov/pubmed/23257066"
}


@Article{info:doi/10.2196/jmir.2144,
author="McKendrick, RA Douglas
and Cumming, P. Grant
and Lee, J. Amanda",
title="Increased Use of Twitter at a Medical Conference: A Report and a Review of the Educational Opportunities",
journal="J Med Internet Res",
year="2012",
month="Dec",
day="11",
volume="14",
number="6",
pages="e176",
keywords="Twitter messaging",
keywords="Social Media",
keywords="Conferences",
keywords="Congresses",
keywords="Anesthesiology",
abstract="Background: Most consider Twitter as a tool purely for social networking. However, it has been used extensively as a tool for online discussion at nonmedical and medical conferences, and the academic benefits of this tool have been reported. Most anesthetists still have yet to adopt this new educational tool. There is only one previously published report of the use of Twitter by anesthetists at an anesthetic conference. This paper extends that work. Objective: We report the uptake and growth in the use of Twitter, a microblogging tool, at an anesthetic conference and review the potential use of Twitter as an educational tool for anesthetists. Methods: A unique Twitter hashtag (\#WSM12) was created and promoted by the organizers of the Winter Scientific Meeting held by The Association of Anaesthetists of Great Britain and Ireland (AAGBI) in London in January 2012. Twitter activity was compared with Twitter activity previously reported for the AAGBI Annual Conference (September 2011 in Edinburgh). All tweets posted were categorized according to the person making the tweet and the purpose for which they were being used. The categories were determined from a literature review. Results: A total of 227 tweets were posted under the \#WSM12 hashtag representing a 530\% increase over the previously reported anesthetic conference. Sixteen people joined the Twitter stream by using this hashtag (300\% increase). Excellent agreement ($\kappa$ = 0.924) was seen in the classification of tweets across the 11 categories. Delegates primarily tweeted to create and disseminate notes and learning points (55\%), describe which session was attended, undertake discussions, encourage speakers, and for social reasons. In addition, the conference organizers, trade exhibitors, speakers, and anesthetists who did not attend the conference all contributed to the Twitter stream. The combined total number of followers of those who actively tweeted represented a potential audience of 3603 people. Conclusions: This report demonstrates an increase in uptake and growth in the use of Twitter at an anesthetic conference and the review illustrates the opportunities and benefits for medical education in the future. ",
doi="10.2196/jmir.2144",
url="http://www.jmir.org/2012/6/e176/",
url="http://www.ncbi.nlm.nih.gov/pubmed/23232765"
}


@Article{info:doi/10.2196/jmir.1982,
author="Stewart, Alan Samuel
and Abidi, Raza Syed Sibte",
title="Applying Social Network Analysis to Understand the Knowledge Sharing Behaviour of Practitioners in a Clinical Online Discussion Forum",
journal="J Med Internet Res",
year="2012",
month="Dec",
day="04",
volume="14",
number="6",
pages="e170",
keywords="Web 2.0",
keywords="health knowledge",
keywords="attitudes",
keywords="practice",
keywords="knowledge management",
keywords="information dissemination",
keywords="pain",
keywords="pediatrics",
keywords="pediatric hospitals",
keywords="education",
keywords="professional",
keywords="electronic mail",
abstract="Background: Knowledge Translation (KT) plays a vital role in the modern health care community, facilitating the incorporation of new evidence into practice. Web 2.0 tools provide a useful mechanism for establishing an online KT environment in which health practitioners share their practice-related knowledge and experiences with an online community of practice. We have implemented a Web 2.0 based KT environment---an online discussion forum---for pediatric pain practitioners across seven different hospitals in Thailand. The online discussion forum enabled the pediatric pain practitioners to share and translate their experiential knowledge to help improve the management of pediatric pain in hospitals. Objective: The goal of this research is to investigate the knowledge sharing dynamics of a community of practice through an online discussion forum. We evaluated the communication patterns of the community members using statistical and social network analysis methods in order to better understand how the online community engages to share experiential knowledge. Methods: Statistical analyses and visualizations provide a broad overview of the communication patterns within the discussion forum. Social network analysis provides the tools to delve deeper into the social network, identifying the most active members of the community, reporting the overall health of the social network, isolating the potential core members of the social network, and exploring the inter-group relationships that exist across institutions and professions. Results: The statistical analyses revealed a network dominated by a single institution and a single profession, and found a varied relationship between reading and posting content to the discussion forum. The social network analysis discovered a healthy network with strong communication patterns, while identifying which users are at the center of the community in terms of facilitating communication.  The group-level analysis suggests that there is strong interprofessional and interregional communication, but a dearth of non-nurse participants has been identified as a shortcoming. Conclusions: The results of the analysis suggest that the discussion forum is active and healthy, and that, though few, the interprofessional and interinstitutional ties are strong. ",
doi="10.2196/jmir.1982",
url="http://www.jmir.org/2012/6/e170/",
url="http://www.ncbi.nlm.nih.gov/pubmed/23211783"
}


@Article{info:doi/10.2196/jmir.2338,
author="Luengo-Oroz, Angel Miguel
and Arranz, Asier
and Frean, John",
title="Crowdsourcing Malaria Parasite Quantification: An Online Game for Analyzing Images of Infected Thick Blood Smears",
journal="J Med Internet Res",
year="2012",
month="Nov",
day="29",
volume="14",
number="6",
pages="e167",
keywords="Crowdsourcing",
keywords="Malaria",
keywords="Image Analysis",
keywords="Games for Health",
keywords="Telepathology",
abstract="Background: There are 600,000 new malaria cases daily worldwide. The gold standard for estimating the parasite burden and the corresponding severity of the disease consists in manually counting the number of parasites in blood smears through a microscope, a process that can take more than 20 minutes of an expert microscopist's time. Objective: This research tests the feasibility of a crowdsourced approach to malaria image analysis. In particular, we investigated whether anonymous volunteers with no prior experience would be able to count malaria parasites in digitized images of thick blood smears by playing a Web-based game. Methods: The experimental system consisted of a Web-based game where online volunteers were tasked with detecting parasites in digitized blood sample images coupled with a decision algorithm that combined the analyses from several players to produce an improved collective detection outcome. Data were collected through the MalariaSpot website. Random images of thick blood films containing Plasmodium falciparum at medium to low parasitemias, acquired by conventional optical microscopy, were presented to players. In the game, players had to find and tag as many parasites as possible in 1 minute. In the event that players found all the parasites present in the image, they were presented with a new image. In order to combine the choices of different players into a single crowd decision, we implemented an image processing pipeline and a quorum algorithm that judged a parasite tagged when a group of players agreed on its position. Results: Over 1 month, anonymous players from 95 countries played more than 12,000 games and generated a database of more than 270,000 clicks on the test images. Results revealed that combining 22 games from nonexpert players achieved a parasite counting accuracy higher than 99\%. This performance could be obtained also by combining 13 games from players trained for 1 minute. Exhaustive computations measured the parasite counting accuracy for all players as a function of the number of games considered and the experience of the players. In addition, we propose a mathematical equation that accurately models the collective parasite counting performance. Conclusions: This research validates the online gaming approach for crowdsourced counting of malaria parasites in images of thick blood films. The findings support the conclusion that nonexperts are able to rapidly learn how to identify the typical features of malaria parasites in digitized thick blood samples and that combining the analyses of several users provides similar parasite counting accuracy rates as those of expert microscopists. This experiment illustrates the potential of the crowdsourced gaming approach for performing routine malaria parasite quantification, and more generally for solving biomedical image analysis problems, with future potential for telediagnosis related to global health challenges. ",
doi="10.2196/jmir.2338",
url="http://www.jmir.org/2012/6/e167/",
url="http://www.ncbi.nlm.nih.gov/pubmed/23196001"
}


@Article{info:doi/10.2196/jmir.2239,
author="Yom-Tov, Elad
and Fernandez-Luque, Luis
and Weber, Ingmar
and Crain, P. Steven",
title="Pro-Anorexia and Pro-Recovery Photo Sharing: A Tale of Two Warring Tribes",
journal="J Med Internet Res",
year="2012",
month="Nov",
day="07",
volume="14",
number="6",
pages="e151",
keywords="Medical Informatics",
keywords="Internet",
keywords="Photo",
keywords="Eating Disorder",
keywords="Anorexia Nervosa",
keywords="Social Network",
abstract="Background: There is widespread use of the Internet to promote anorexia as a lifestyle choice. Pro-anorexia content can be harmful for people affected or at risk of having anorexia. That movement is actively engaged in sharing photos on social networks such as Flickr. Objective: To study the characteristics of the online communities engaged in disseminating content that encourages eating disorders (known as ``pro-anorexia'') and to investigate if the posting of such content is discouraged by the posting of recovery-oriented content. Methods: The extraction of pro-anorexia and pro-recovery photographs from the photo sharing site Flickr pertaining to 242,710 photos from 491 users and analyzing four separate social networks therein. Results: Pro-anorexia and pro-recovery communities interact to a much higher degree among themselves than what is expected from the distribution of contacts (only 59-72\% of contacts but 74-83\% of comments are made to members inside the community). Pro-recovery users employ similar words to those used by pro-anorexia users to describe their photographs, possibly in order to ensure that their content appears when pro-anorexia users search for images. Pro-anorexia users who are exposed to comments from the opposite camp are less likely to cease posting pro-anorexia photographs than those who do not receive such comments (46\% versus 61\%), and if they cease, they do so approximately three months later. Our observations show two highly active communities, where most interaction is within each community. However, the pro-recovery community takes steps to ensure that their content is visible to the pro-anorexia community, both by using textual descriptions of their photographs that are similar to those used by the pro-anorexia group and by commenting to pro-anorexia content. The latter activity is, however, counterproductive, as it entrenches pro-anorexia users in their stance. Conclusions: Our results highlight the nature of pro-anorexia and pro-recovery photo sharing and accentuate the need for clinicians to be aware of such content and its effect on their patients. Our findings suggest that some currently used interventions are not useful in helping pro-anorexia users recover. Thus, future work should focus on new intervention methods, possibly tailored to individual characteristics. ",
doi="10.2196/jmir.2239",
url="http://www.jmir.org/2012/6/e151/",
url="http://www.ncbi.nlm.nih.gov/pubmed/23134671"
}


@Article{info:doi/10.2196/jmir.1819,
author="Th{\'e}riault, Nathanaelle
and Bi, Peng
and Hiller, E. Janet
and Nor, Mahdi",
title="Use of Web 2.0 to Recruit Australian Gay Men to an Online HIV/AIDS Survey",
journal="J Med Internet Res",
year="2012",
month="Nov",
day="06",
volume="14",
number="6",
pages="e149",
keywords="Internet",
keywords="advertising",
keywords="HIV",
keywords="Australia",
keywords="homosexuality",
keywords="male",
abstract="Background: Continuous prevention efforts for human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) are recommended among those men who have sex with men (MSM). Creative use of e-technologies coupled with a better understanding of social networks could lead to improved health interventions among this risk population. Objective: The aims of the study were to (1) compare the impact of various advertising strategies on recruiting MSM participants to an online HIV/AIDS survey, and (2) explore the feasibility of using a social network service (SNS) for study advertising. Methods: A cross-sectional online survey was conducted in 2009. South Australian men over 18 years were invited to participate if they had had sexual intercourse with men in the previous year. A short questionnaire was used to collect demographics and information on sexual behavior, HIV history, use of the Internet for dating purposes, and sources of health information. The survey was promoted in community settings and online, including advertisements through social networks. Results: A total of 243 men completed the online survey during the 8-week data collection period. Online advertisements recruited 91.7\% (220/240) of the sample. Conversely, traditional advertisements in the community recruited only 5.8\% (14/240) of the sample. Ten volunteers were asked to advertise on their personal SNS application, but only 2 effectively did so. Only 18/240 (7.5\%) of the respondents reported having learned of our study through the SNS application. In this sample, 19.3\% (47/243) of participants had never been tested for HIV. Among the participants who had been tested, 12.8\% (25/196) reported being HIV-positive. Regarding Internet use, 82.3\% (200/243) of participants had dated online in the previous 6 months. Among the participants who had dated online, most (175/200, 87.5\%) had found an Internet sexual partner and two-thirds (132/200, 66.0\%) had had anal sex with these partner(s). Among men who had anal sex with an Internet partner, 68.2\% (90/132) used a condom during sex. Conclusions: The MSM participants in this study had high-risk profiles for HIV and other sexually transmitted diseases (STDs), which highlights the need for ongoing health interventions among this group. In this study, the SNS marketing strategy did not appear to create a viral effect and it had a relatively poor yield. ",
doi="10.2196/jmir.1819",
url="http://www.jmir.org/2012/6/e149/",
url="http://www.ncbi.nlm.nih.gov/pubmed/23128646"
}


@Article{info:doi/10.2196/jmir.2280,
author="Greaves, Felix
and Pape, J. Utz
and Lee, Henry
and Smith, M. Dianna
and Darzi, Ara
and Majeed, Azeem
and Millett, Christopher",
title="Patients' Ratings of Family Physician Practices on the Internet: Usage and Associations With Conventional Measures of Quality in the English National Health Service",
journal="J Med Internet Res",
year="2012",
month="Oct",
day="17",
volume="14",
number="5",
pages="e146",
keywords="Patient Experience",
keywords="Primary Care",
keywords="Internet",
keywords="Quality",
abstract="Background: Patients are increasingly rating their family physicians on the Internet in the same way as they might rate a hotel on TripAdvisor or a seller on eBay, despite physicians' concerns about this process. Objective: This study aims to examine the usage of NHS Choices, a government website that encourages patients to rate the quality of family practices in England, and associations between web-based patient ratings and conventional measures of patient experience and clinical quality in primary care. Methods: We obtained all (16,952) ratings of family practices posted on NHS Choices between October 2009 and December 2010. We examined associations between patient ratings and family practice and population characteristics. Associations between ratings and survey measures of patient experience and clinical outcomes were examined. Results: 61\% of the 8089 family practices in England were rated, and 69\% of ratings would recommend their family practice. Practices serving younger, less deprived, and more densely populated areas were more likely to be rated. There were moderate associations with survey measures of patient experience (Spearman $\rho$ 0.37?0.48, P<.001 for all 5 variables), but only weak associations with measures of clinical process and outcome (Spearman $\rho$ less than {\textpm}0.18, P<.001 for 6 of 7 variables). Conclusion: The frequency of patients rating their family physicians on the Internet is variable in England, but the ratings are generally positive and are moderately associated with other measures of patient experience and weakly associated with clinical quality. Although potentially flawed, patient ratings on the Internet may provide an opportunity for organizational learning and, as it becomes more common, another lens to look at the quality of primary care. ",
doi="10.2196/jmir.2280",
url="http://www.jmir.org/2012/5/e146/",
url="http://www.ncbi.nlm.nih.gov/pubmed/23076301"
}


@Article{info:doi/10.2196/jmir.2138,
author="McGowan, S. Brian
and Wasko, Molly
and Vartabedian, Steven Bryan
and Miller, S. Robert
and Freiherr, D. Desirae
and Abdolrasulnia, Maziar",
title="Understanding the Factors That Influence the Adoption and Meaningful Use of Social Media by Physicians to Share Medical Information",
journal="J Med Internet Res",
year="2012",
month="Sep",
day="24",
volume="14",
number="5",
pages="e117",
keywords="Social media",
keywords="continuing medical education",
keywords="physicians and social media",
keywords="physician-physician relationship",
keywords="oncologists",
keywords="primary care physicians",
keywords="education technology",
keywords="physicians' practice patterns",
abstract="Background: Within the medical community there is persistent debate as to whether the information available through social media is trustworthy and valid, and whether physicians are ready to adopt these technologies and ultimately embrace them as a format for professional development and lifelong learning. Objective: To identify how physicians are using social media to share and exchange medical information with other physicians, and to identify the factors that influence physicians' use of social media as a component of their lifelong learning and continuing professional development. Methods: We developed a survey instrument based on the Technology Acceptance Model, hypothesizing that technology usage is best predicted by a physician's attitudes toward the technology, perceptions about the technology's usefulness and ease of use, and individual factors such as personal innovativeness. The survey was distributed via email to a random sample of 1695 practicing oncologists and primary care physicians in the United States in March 2011. Responses from 485 physicians were analyzed (response rate 28.61\%). Results: Overall, 117 of 485 (24.1\%) of respondents used social media daily or many times daily to scan or explore medical information, whereas 69 of 485 (14.2\%) contributed new information via social media on a daily basis. On a weekly basis or more, 296 of 485 (61.0\%) scanned and 223 of 485 (46.0\%) contributed. In terms of attitudes toward the use of social media, 279 of 485 respondents (57.5\%) perceived social media to be beneficial, engaging, and a good way to get current, high-quality information. In terms of usefulness, 281 of 485 (57.9\%) of respondents stated that social media enabled them to care for patients more effectively, and 291 of 485 (60.0\%) stated it improved the quality of patient care they delivered. The main factors influencing a physician's usage of social media to share medical knowledge with other physicians were perceived ease of use and usefulness. Respondents who had positive attitudes toward the use of social media were more likely to use social media and to share medical information with other physicians through social media. Neither age nor gender had a significant impact on adoption or usage of social media. Conclusions: Based on the results of this study, the use of social media applications may be seen as an efficient and effective method for physicians to keep up-to-date and to share newly acquired medical knowledge with other physicians within the medical community and to improve the quality of patient care. Future studies are needed to examine the impact of the meaningful use of social media on physicians' knowledge, attitudes, skills, and behaviors in practice. ",
doi="10.2196/jmir.2138",
url="http://www.jmir.org/2012/5/e117/",
url="http://www.ncbi.nlm.nih.gov/pubmed/23006336"
}


@Article{info:doi/10.2196/jmir.2016,
author="David, Isabelle
and Poissant, Lise
and Rochette, Annie",
title="Clinicians' Expectations of Web 2.0 as a Mechanism for Knowledge Transfer of Stroke Best Practices",
journal="J Med Internet Res",
year="2012",
month="Sep",
day="13",
volume="14",
number="5",
pages="e121",
keywords="Qualitative research",
keywords="health personnel",
keywords="Internet",
keywords="evidence-based practice",
keywords="information dissemination",
abstract="Background: Health professionals are increasingly encouraged to adopt an evidence-based practice to ensure greater efficiency of their services. To promote this practice, several strategies exist: distribution of educational materials, local consensus processes, educational outreach visits, local opinion leaders, and reminders. Despite these strategies, gaps continue to be observed between practice and scientific evidence. Therefore, it is important to implement innovative knowledge transfer strategies that will change health professionals' practices. Through its interactive capacities, Web 2.0 applications are worth exploring. As an example, virtual communities of practice have already begun to influence professional practice. Objective: This study was initially developed to help design a Web 2.0 platform for health professionals working with stroke patients. The aim was to gain a better understanding of professionals' perceptions of Web 2.0 before the development of the platform. Methods: A qualitative study following a phenomenological approach was chosen. We conducted individual semi-structured interviews with clinicians and managers. Interview transcripts were subjected to a content analysis. Results: Twenty-four female clinicians and managers in Quebec, Canada, aged 28-66 participated. Most participants identified knowledge transfer as the most useful outcome of a Web 2.0 platform. Respondents also expressed their need for a user-friendly platform. Accessibility to a computer and the Internet, features of the Web 2.0 platform, user support, technology skills, and previous technological experience were found to influence perceived ease of use and usefulness. Our results show that the perceived lack of time of health professionals has an influence on perceived behavioral intention to use it despite favorable perception of the usefulness of the Web 2.0 platform. Conclusions: In conclusion, female health professionals in Quebec believe that Web 2.0 may be a useful mechanism for knowledge transfer. However, lack of time and lack of technological skills may limit their use of a future Web 2.0 platform. Further studies are required with other populations and in other regions to confirm these findings. ",
doi="10.2196/jmir.2016",
url="http://www.jmir.org/2012/5/e121/",
url="http://www.ncbi.nlm.nih.gov/pubmed/23195753"
}


@Article{info:doi/10.2196/jmir.2178,
author="Vyas, N. Amita
and Landry, Megan
and Schnider, Marisa
and Rojas, M. Angela
and Wood, F. Susan",
title="Public Health Interventions: Reaching Latino Adolescents via Short Message Service and Social Media",
journal="J Med Internet Res",
year="2012",
month="Jul",
day="12",
volume="14",
number="4",
pages="e99",
keywords="Public health interventions",
keywords="SMS",
keywords="short message service",
keywords="social media",
keywords="health behavior",
keywords="Latinos",
keywords="adolescents",
abstract="Background: Adolescents are substantial users of short message service (SMS) and social media. The public health community now has more opportunities to reach this population with positive youth development and health messages through these media. Latinos are a growing and youthful population with significant health risks and needs. This population may benefit from SMS and social media health interventions. Objective: To examine (1) SMS and social media utilization and behavior among Latino youth, and (2) how SMS and social media can be effectively used as a component of public health interventions focused on decreasing sexual risk taking among Latino youth. Methods: A mixed-methods approach, using both quantitative survey data and qualitative interview data, was used to provide a robust understanding of SMS and social media use and behavior for public health interventions. We recruited 428 ninth and tenth grade, self-identifying Latino adolescents to participate in a quantitative survey. Additionally, we conducted five key informant interviews with staff and 15 youth. Results: We found that 90.8\% (355/391) of respondents had access to a mobile phone either through having their own or through borrowing or sharing one. Of those who had access to a mobile phone, 94.1\% (334/355) used SMS, with 41.1\% (113/275) sending and receiving more than 100 text messages per day. Of 395 respondents, 384 (97.2\%) had at least one social media account, and the mean number of accounts was 3.0 (range 0--8). A total of 75.8\% (291/384) of adolescents logged in to their account daily. Of those with a social media account, 89.1\% (342/384) had a Facebook account. Youth who took the survey in English were significantly more likely than those who took it in Spanish to have access to a mobile phone ($\chi$21 = 5.3; 93.3\% vs 86.3\%; P = .02); to be high-volume texters ($\chi$22 = 16.8; 49.4\% vs 25.3\%; P < .001); to use the Internet daily ($\chi$21 = 5.0; 76.6\% vs 66.0\%; P = .03); to have a Facebook account ($\chi$21 = 9.9; 90.9\% vs 79.7\%; P = .002); and to have a greater mean number of social media accounts (t387 = 7.9; 3.41 vs 2.07; P < .001). Conclusions: SMS and social media are pervasive among Latino youth. Program staff and youth perceive these as credible and essential methods of communication in the context of public health programs. Public health interventions must continue to innovate and maximize new ways to reach young people to reinforce public health messages and education. ",
doi="10.2196/jmir.2178",
url="http://www.jmir.org/2012/4/e99/",
url="http://www.ncbi.nlm.nih.gov/pubmed/22789678"
}


@Article{info:doi/10.2196/jmir.2127,
author="Nakamura, Carlos
and Bromberg, Mark
and Bhargava, Shivani
and Wicks, Paul
and Zeng-Treitler, Qing",
title="Mining Online Social Network Data for Biomedical Research: A Comparison of Clinicians' and Patients' Perceptions About Amyotrophic Lateral Sclerosis Treatments",
journal="J Med Internet Res",
year="2012",
month="Jun",
day="21",
volume="14",
number="3",
pages="e90",
keywords="Amyotrophic lateral sclerosis",
keywords="ALS",
keywords="Lou Gehrig's disease",
keywords="treatment response",
keywords="treatment efficacy",
keywords="online social network",
keywords="online patient community",
abstract="Background: While only one drug is known to slow the progress of amyotrophic lateral sclerosis (ALS), numerous drugs can be used to treat its symptoms. However, very few randomized controlled trials have assessed the efficacy, safety, and side effects of these drugs. Due to this lack of randomized controlled trials, consensus among clinicians on how to treat the wide range of ALS symptoms and the efficacy of these treatments is low. Given the lack of clinical trials data, the wide range of reported symptoms, and the low consensus among clinicians on how to treat those symptoms, data on the prevalence and efficacy of treatments from a patient's perspective could help advance the understanding of the symptomatic treatment of ALS. Objective: To compare clinicians' and patients' perspectives on the symptomatic treatment of ALS by comparing data from a traditional survey study of clinicians with data from a patient social network. Methods: We used a survey of clinicians' perceptions by Forshew and Bromberg as our primary data source and adjusted the data from PatientsLikeMe to allow for comparisons. We first extracted the 14 symptoms and associated top four treatments listed by Forshew and Bromberg. We then searched the PatientsLikeMe database for the same symptom--treatment pairs. The PatientsLikeMe data are structured and thus no preprocessing of the data was required. Results: After we eliminated pairs with a small sample, 15 symptom--treatment pairs remained. All treatments identified as useful were prescription drugs. We found similarities and discrepancies between clinicians' and patients' perceptions of treatment prevalence and efficacy. In 7 of the 15 pairs, the differences between the two groups were above 10\%. In 3 pairs the differences were above 20\%. Lorazepam to treat anxiety and quinine to treat muscle cramps were among the symptom--treatment pairs with high concordance between clinicians' and patients' perceptions. Conversely, amitriptyline to treat labile emotional effect and oxybutynin to treat urinary urgency displayed low agreement between clinicians and patients. Conclusions: Assessing and comparing the efficacy of the symptomatic treatment of a complex and rare disease such as ALS is not easy and needs to take both clinicians' and patients' perspectives into consideration. Drawing a reliable profile of treatment efficacy requires taking into consideration many interacting aspects (eg, disease stage and severity of symptoms) that were not covered in the present study. Nevertheless, pilot studies such as this one can pave the way for more robust studies by helping researchers anticipate and compensate for limitations in their data sources and study design. ",
doi="10.2196/jmir.2127",
url="http://www.jmir.org/2012/3/e90/",
url="http://www.ncbi.nlm.nih.gov/pubmed/22721865"
}


@Article{info:doi/10.2196/jmir.1905,
author="Bhavnani, K. Suresh
and Warden, Michael
and Zheng, Kai
and Hill, Mary
and Athey, D. Brian",
title="Researchers' Needs for Resource Discovery and Collaboration Tools: A Qualitative Investigation of Translational Scientists",
journal="J Med Internet Res",
year="2012",
month="Jun",
day="05",
volume="14",
number="3",
pages="e75",
keywords="Translational research",
keywords="collaborative computing",
keywords="Clinical and Translational Science Awards",
keywords="CTSA",
keywords="Resource Discovery",
abstract="Background: A critical aspect of clinical and translational science (CTS) is interdisciplinary and collaborative research, which increasingly requires a wide range of computational and human resources. However, few studies have systematically analyzed such resource needs of CTS researchers. Objective: To improve our understanding of CTS researchers' needs for computational and human resources in order to build useful and useable supporting informatics tools. Methods: We conducted semistructured interviews of 30 CTS researchers from the University of Michigan, followed by qualitative analysis of the interview transcripts. Results: The analysis identified three recurring themes: the need for the federation of information, the need to address information overload, and the need to humanize computing, including strong and well-informed views about the use of social networking tools for research collaboration. These findings helped us to narrow down the available design choices for assisting CTS researchers, and helped to identify potential deficiencies of well-known theoretical frameworks used to guide our study, with suggestions for future remedies. Conclusions: The user needs identified through the study, along with concrete design suggestions, provided key design, methodological, and theoretical insights, which are being used to guide the design and development of a CTS resource portal. The results and interview instrument should be useful to other institutions with Clinical and Translational Science Awards that face similar challenges related to helping CTS researchers make more effective use of computational and human resources. ",
doi="10.2196/jmir.1905",
url="http://www.jmir.org/2012/3/e75/",
url="http://www.ncbi.nlm.nih.gov/pubmed/22668750"
}


@Article{info:doi/10.2196/jmir.2063,
author="Turner, M. Anne
and Kirchhoff, Katrin
and Capurro, Daniel",
title="Using Crowdsourcing Technology for Testing Multilingual Public Health Promotion Materials",
journal="J Med Internet Res",
year="2012",
month="Jun",
day="04",
volume="14",
number="3",
pages="e79",
keywords="Crowdsourcing",
keywords="health promotion",
keywords="public health informatics",
keywords="limited English proficiency populations",
abstract="Background: Effective communication of public health messages is a key strategy for health promotion by public health agencies. Creating effective health promotion materials requires careful message design and feedback from representatives of target populations. This is particularly true when the target audiences are hard to reach as limited English proficiency groups. Traditional methods of soliciting feedback---such as focus groups and convenience sample interviews---are expensive and time consuming. As a result, adequate feedback from target populations is often insufficient due to the time and resource constraints characteristic to public health. Objective: To describe a pilot study investigating the use of crowdsourcing technology as a method to gather rapid and relevant feedback on the design of health promotion messages for oral health. Our goal was to better describe the demographics of participants responding to a crowdsourcing survey and to test whether crowdsourcing could be used to gather feedback from English-speaking and Spanish-speaking participants in a short period of time and at relatively low costs. Methods: We developed health promotion materials on pediatric dental health issues in four different formats and in two languages (English and Spanish). We then designed an online survey to elicit feedback on format preferences and made it available in both languages via the Amazon Mechanical Turk crowdsourcing platform. Results: We surveyed 236 native English-speaking and 163 native Spanish-speaking participants in less than 12 days, at a cost of US \$374. Overall, Spanish-speaking participants originated from a wider distribution of countries than the overall Latino population in the United States. Most participants were in the 18- to 29-year age range and had some college or graduate education. Participants provided valuable input for the health promotion material design. Conclusions: Our results indicate that crowdsourcing can be an effective method for recruiting and gaining feedback from English-speaking and Spanish-speaking people. Compared with traditional methods, crowdsourcing has the potential to reach more diverse populations than convenience sampling, while substantially reducing the time and cost of gathering participant feedback. More widespread adoption of this method could streamline the development of effective health promotion materials in multiple languages. ",
doi="10.2196/jmir.2063",
url="http://www.jmir.org/2012/3/e79/",
url="http://www.ncbi.nlm.nih.gov/pubmed/22664384"
}


@Article{info:doi/10.2196/jmir.1992,
author="Van de Belt, H. Tom
and Berben, AA Sivera
and Samsom, Melvin
and Engelen, JLPG Lucien
and Schoonhoven, Lisette",
title="Use of Social Media by Western European Hospitals: Longitudinal Study",
journal="J Med Internet Res",
year="2012",
month="May",
day="01",
volume="14",
number="3",
pages="e61",
keywords="Social media",
keywords="health 2.0",
keywords="medicine 2.0",
keywords="eHealth",
keywords="participatory health care",
keywords="patient empowerment",
keywords="Web 2.0",
keywords="patient-centered care",
abstract="Background: Patients increasingly use social media to communicate. Their stories could support quality improvements in participatory health care and could support patient-centered care. Active use of social media by health care institutions could also speed up communication and information provision to patients and their families, thus increasing quality even more. Hospitals seem to be becoming aware of the benefits social media could offer. Data from the United States show that hospitals increasingly use social media, but it is unknown whether and how Western European hospitals use social media. Objective: To identify to what extent Western European hospitals use social media. Methods: In this longitudinal study, we explored the use of social media by hospitals in 12 Western European countries through an Internet search. We collected data for each country during the following three time periods: April to August 2009, August to December 2010, and April to July 2011. Results: We included 873 hospitals from 12 Western European countries, of which 732 were general hospitals and 141 were university hospitals. The number of included hospitals per country ranged from 6 in Luxembourg to 347 in Germany. We found hospitals using social media in all countries. The use of social media increased significantly over time, especially for YouTube (n = 19, 2\% to n = 172, 19.7\%), LinkedIn (n =179, 20.5\% to n = 278, 31.8\%), and Facebook (n = 85, 10\% to n = 585, 67.0\%). Differences in social media usage between the included countries were significant. Conclusions: Social media awareness in Western European hospitals is growing, as well as its use. Social media usage differs significantly between countries. Except for the Netherlands and the United Kingdom, the group of hospitals that is using social media remains small. Usage of LinkedIn for recruitment shows the awareness of the potential of social media. Future research is needed to investigate how social media lead to improved health care. ",
doi="10.2196/jmir.1992",
url="http://www.jmir.org/2012/3/e61/",
url="http://www.ncbi.nlm.nih.gov/pubmed/22549016"
}


@Article{info:doi/10.2196/med20.2039,
author="G{\'o}mez-Z{\'u}{\~n}iga, Beni
and Fernandez-Luque, Luis
and Pousada, Modesta
and Hern{\'a}ndez-Encuentra, Eul{\`a}lia
and Armayones, Manuel",
title="ePatients on YouTube: Analysis of Four Experiences From the Patients' Perspective",
journal="Med 2.0",
year="2012",
month="Apr",
day="25",
volume="1",
number="1",
pages="e1",
keywords="Medical informatics",
keywords="Internet",
keywords="patient-physician relationship",
keywords="health communication",
keywords="social networks",
keywords="chronic conditions",
keywords="YouTube",
abstract="Background: Many patients share their personal experiences and opinions using online video platforms. These videos are watched by millions of health consumers and health care professionals. Although it has become a popular phenomenon, little is known about patients who share videos online and why they do so. Objective: We aimed to explore the motivations and challenges faced by patients who share videos about their health and experiences on YouTube. As part of a conference discussion, we asked several patients actively engaged on YouTube to make a video explaining their motivations. This paper discusses these videos. Methods: In this qualitative study, we performed an analysis of the videos created by 4 patients about their self-reported motivations and challenges they face as YouTube users. First, two judges compared the transcriptions and decided the exact wording when confusing content was found. Second, two judges categorized the content of the videos to identify the major themes. Results: Four main categories emerged: (1) the origin or cause for making the first video, (2) the objectives that they achieve by continuing to make videos, (3) the perception of community, and (4) the negative consequences of the experience. Conclusions: The main reason for making videos was to bridge the gap between traditional health information about their diseases and everyday life. The first consequence of sharing their life on YouTube was a loss of privacy. However, they also experienced the positive effects of expressing their feelings, being part of a large community of peers, and helping others to deal with a chronic condition. ",
doi="10.2196/med20.2039",
url="http://www.medicine20.com/2012/1/e1/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25075229"
}


@Article{info:doi/10.2196/jmir.1983,
author="Archambault, Michel Patrick
and Bilodeau, Andrea
and Gagnon, Marie-Pierre
and Aubin, Karine
and Lavoie, Andr{\'e}
and Lapointe, Jean
and Poitras, Julien
and Croteau, Sylvain
and Pham-Dinh, Martin
and L{\'e}gar{\'e}, France",
title="Health Care Professionals' Beliefs About Using Wiki-Based Reminders to Promote Best Practices in Trauma Care",
journal="J Med Internet Res",
year="2012",
month="Apr",
day="19",
volume="14",
number="2",
pages="e49",
keywords="Wiki",
keywords="Collaborative writing applications",
keywords="Web 2.0",
keywords="traumatic brain injury",
keywords="interprofessional collaboration",
keywords="reminders",
keywords="computerized clinical decision-support system",
keywords="knowledge translation",
keywords="evidence-based medicine",
keywords="theory of planned behavior",
abstract="Background : Wikis are knowledge translation tools that could help health professionals implement best practices in acute care. Little is known about the factors influencing professionals' use of wikis. Objectives : To identify and compare the beliefs of emergency physicians (EPs) and allied health professionals (AHPs) about using a wiki-based reminder that promotes evidence-based care for traumatic brain injuries. Methods : Drawing on the theory of planned behavior, we conducted semistructured interviews to elicit EPs' and AHPs' beliefs about using a wiki-based reminder. Previous studies suggested a sample of 25 EPs and 25 AHPs. We purposefully selected participants from three trauma centers in Quebec, Canada, to obtain a representative sample. Using univariate analyses, we assessed whether our participants' gender, age, and level of experience were similar to those of all eligible individuals. Participants viewed a video showing a clinician using a wiki-based reminder, and we interviewed participants about their behavioral, control, and normative beliefs---that is, what they saw as advantages, disadvantages, barriers, and facilitators to their use of a reminder, and how they felt important referents would perceive their use of a reminder. Two reviewers independently analyzed the content of the interview transcripts. We considered the 75\% most frequently mentioned beliefs as salient. We retained some less frequently mentioned beliefs as well. Results : Of 66 eligible EPs and 444 eligible AHPs, we invited 55 EPs and 39 AHPs to participate, and 25 EPs and 25 AHPs (15 nurses, 7 respiratory therapists, and 3 pharmacists) accepted. Participating AHPs had more experience than eligible AHPs (mean 14 vs 11 years; P = .04). We noted no other significant differences. Among EPs, the most frequently reported advantage of using a wiki-based reminder was that it refreshes the memory (n = 14); among AHPs, it was that it provides rapid access to protocols (n = 16). Only 2 EPs mentioned a disadvantage (the wiki added stress). The most frequently reported favorable referent was nurses for EPs (n = 16) and EPs for AHPs (n = 19). The most frequently reported unfavorable referents were people resistant to standardized care for EPs (n = 8) and people less comfortable with computers for AHPs (n = 11). The most frequent facilitator for EPs was ease of use (n = 19); for AHPs, it was having a bedside computer (n = 20). EPs' most frequently reported barrier was irregularly updated wiki-based reminders (n = 18); AHPs' was undetermined legal responsibility (n = 10). Conclusions : We identified EPs' and AHPs' salient beliefs about using a wiki-based reminder. We will draw on these beliefs to construct a questionnaire to measure the importance of these determinants to EPs' and AHPs' intention to use a wiki-based reminder promoting evidence-based care for traumatic brain injuries. ",
doi="10.2196/jmir.1983",
url="http://www.jmir.org/2012/2/e49/",
url="http://www.ncbi.nlm.nih.gov/pubmed/22515985"
}


@Article{info:doi/10.2196/jmir.2005,
author="Segal, Jeffrey
and Sacopulos, Michael
and Sheets, Virgil
and Thurston, Irish
and Brooks, Kendra
and Puccia, Ryan",
title="Online Doctor Reviews: Do They Track Surgeon Volume, a Proxy for Quality of Care?",
journal="J Med Internet Res",
year="2012",
month="Apr",
day="10",
volume="14",
number="2",
pages="e50",
keywords="Doctor review",
keywords="rating websites",
keywords="physician reviews",
keywords="online reputation",
keywords="clinical outcomes",
keywords="selection of physicians",
keywords="surgical volume",
keywords="surgeon volume",
abstract="Background: Increasingly, consumers are accessing the Internet seeking health information. Consumers are also using online doctor review websites to help select their physician. Such websites tally numerical ratings and comments from past patients. To our knowledge, no study has previously analyzed whether doctors with positive online reputations on doctor review websites actually deliver higher quality of care typically associated with better clinical outcomes and better safety records. Objective: For a number of procedures, surgeons who perform more procedures have better clinical outcomes and safety records than those who perform fewer procedures. Our objective was to determine if surgeon volume, as a proxy for clinical outcomes and patient safety, correlates with online reputation. Methods: We investigated the numerical ratings and comments on 9 online reviewwebsites for high- and low-volume surgeons for three procedures: lumbarsurgery, total knee replacement, and bariatric surgery. High-volume surgeonswere randomly selected from the group within the highest quartile of claimssubmitted for reimbursement using the procedures' relevant currentprocedural terminology (CPT) codes. Low-volume surgeons were randomlyselected from the lowest quartile of submitted claims for the procedures'relevant CPT codes. Claims were collated within the Normative HealthInformation Database, covering multiple payers for more than 25 millioninsured patients. Results: Numerical ratings were found for the majority of physicians in our sample (547/600, 91.2\%) and comments were found for 385/600 (64.2\%) of the physicians. We found that high-volume (HV) surgeons could be differentiated from low-volume (LV) surgeons independently by analyzing: (1) the total number of numerical ratings per website (HV: mean = 5.85; LV: mean = 4.87, P<.001); (2) the total number of text comments per website (HV: mean = 2.74; LV: mean = 2.30, P=.05); (3) the proportion of glowing praise/total comments about quality of care (HV: mean = 0.64; LV: mean = 0.51, P=.002); and (4) the proportion of scathing criticism/total comments about quality of care (HV: mean = 0.14; LV: mean = 0.23, P= .005). Even when these features were combined, the effect size, although significant, was still weak. The results revealed that one could accurately identify a physician's patient volume via discriminant and classification analysis 61.6\% of the time. We also found that high-volume surgeons could not be differentiated from low-volume surgeons by analyzing (1) standardized z score numerical ratings (HV: mean = 0.07; LV: mean = 0, P=.27); (2) proportion of glowing praise/total comments about customer service (HV: mean = 0.24; LV: mean = 0.22, P=.52); and (3) proportion of scathing criticism/total comments about customer service (HV: mean = 0.19; LV: mean = 0.21, P=.48). Conclusions: Online review websites provide a rich source of data that may be able to track quality of care, although the effect size is weak and not consistent for all review website metrics. ",
doi="10.2196/jmir.2005",
url="http://www.jmir.org/2012/2/e50/",
url="http://www.ncbi.nlm.nih.gov/pubmed/22491423"
}


@Article{info:doi/10.2196/jmir.1988,
author="Swan, Melanie",
title="Crowdsourced Health Research Studies: An Important Emerging Complement to Clinical Trials in the Public Health Research Ecosystem",
journal="J Med Internet Res",
year="2012",
month="Mar",
day="07",
volume="14",
number="2",
pages="e46",
keywords="Community-Based Participatory Research",
keywords="Preventive Medicine",
keywords="Personalized Medicine",
keywords="Individualized Medicine",
keywords="Consumer Participation",
keywords="Health Services Research",
keywords="Health Care Research",
keywords="Public Health",
keywords="Genomics",
keywords="Medicine",
abstract="Background: Crowdsourced health research studies are the nexus of three contemporary trends: 1) citizen science (non-professionally trained individuals conducting science-related activities); 2) crowdsourcing (use of web-based technologies to recruit project participants); and 3) medicine 2.0 / health 2.0 (active participation of individuals in their health care particularly using web 2.0 technologies). Crowdsourced health research studies have arisen as a natural extension of the activities of health social networks (online health interest communities), and can be researcher-organized or participant-organized. In the last few years, professional researchers have been crowdsourcing cohorts from health social networks for the conduct of traditional studies. Participants have also begun to organize their own research studies through health social networks and health collaboration communities created especially for the purpose of self-experimentation and the investigation of health-related concerns. Objective: The objective of this analysis is to undertake a comprehensive narrative review of crowdsourced health research studies. This review will assess the status, impact, and prospects of crowdsourced health research studies. Methods: Crowdsourced health research studies were identified through a search of literature published from 2000 to 2011 and informal interviews conducted 2008-2011. Keyword terms related to crowdsourcing were sought in Medline/PubMed. Papers that presented results from human health studies that included crowdsourced populations were selected for inclusion. Crowdsourced health research studies not published in the scientific literature were identified by attending industry conferences and events, interviewing attendees, and reviewing related websites. Results: Participatory health is a growing area with individuals using health social networks, crowdsourced studies, smartphone health applications, and personal health records to achieve positive outcomes for a variety of health conditions. PatientsLikeMe and 23andMe are the leading operators of researcher-organized, crowdsourced health research studies. These operators have published findings in the areas of disease research, drug response, user experience in crowdsourced studies, and genetic association. Quantified Self, Genomera, and DIYgenomics are communities of participant-organized health research studies where individuals conduct self-experimentation and group studies. Crowdsourced health research studies have a diversity of intended outcomes and levels of scientific rigor. Conclusions: Participatory health initiatives are becoming part of the public health ecosystem and their rapid growth is facilitated by Internet and social networking influences. Large-scale parameter-stratified cohorts have potential to facilitate a next-generation understanding of disease and drug response. Not only is the large size of crowdsourced cohorts an asset to medical discovery, too is the near-immediate speed at which medical findings might be tested and applied. Participatory health initiatives are expanding the scope of medicine from a traditional focus on disease cure to a personalized preventive approach. Crowdsourced health research studies are a promising complement and extension to traditional clinical trials as a model for the conduct of health research. ",
doi="10.2196/jmir.1988",
url="http://www.jmir.org/2012/2/e46/",
url="http://www.ncbi.nlm.nih.gov/pubmed/22397809"
}


@Article{info:doi/10.2196/jmir.1875,
author="Gold, Judy
and Pedrana, E. Alisa
and Stoove, A. Mark
and Chang, Shanton
and Howard, Steve
and Asselin, Jason
and Ilic, Olivia
and Batrouney, Colin
and Hellard, E. Margaret",
title="Developing Health Promotion Interventions on Social Networking Sites: Recommendations from The FaceSpace Project",
journal="J Med Internet Res",
year="2012",
month="Feb",
day="28",
volume="14",
number="1",
pages="e30",
keywords="Health promotion",
keywords="Internet",
keywords="social networking sites",
doi="10.2196/jmir.1875",
url="http://www.jmir.org/2012/1/e30/",
url="http://www.ncbi.nlm.nih.gov/pubmed/22374589"
}


@Article{info:doi/10.2196/jmir.1911,
author="Cobb, K. Nathan
and Graham, L. Amanda
and Byron, Justin M.
and Niaura, S. Raymond
and Abrams, B. David
and ",
title="Online Social Networks and Smoking Cessation: A Scientific Research Agenda",
journal="J Med Internet Res",
year="2011",
month="Dec",
day="19",
volume="13",
number="4",
pages="e119",
keywords="Smoking cessation",
keywords="social support",
keywords="social networks",
keywords="addiction",
keywords="treatment",
keywords="tobacco",
abstract="Background: Smoking remains one of the most pressing public health problems in the United States and internationally. The concurrent evolution of the Internet, social network science, and online communities offers a potential target for high-yield interventions capable of shifting population-level smoking rates and substantially improving public health. Objective: Our objective was to convene leading practitioners in relevant disciplines to develop the core of a strategic research agenda on online social networks and their use for smoking cessation, with implications for other health behaviors. Methods: We conducted a 100-person, 2-day, multidisciplinary workshop in Washington, DC, USA. Participants worked in small groups to formulate research questions that could move the field forward. Discussions and resulting questions were synthesized by the workshop planning committee. Results: We considered 34 questions in four categories (advancing theory, understanding fundamental mechanisms, intervention approaches, and evaluation) to be the most pressing. Conclusions: Online social networks might facilitate smoking cessation in several ways. Identifying new theories, translating these into functional interventions, and evaluating the results will require a concerted transdisciplinary effort. This report presents a series of research questions to assist researchers, developers, and funders in the process of efficiently moving this field forward. ",
doi="10.2196/jmir.1911",
url="http://www.jmir.org/2011/4/e119/",
url="http://www.ncbi.nlm.nih.gov/pubmed/22182518"
}


@Article{info:doi/10.2196/jmir.2012,
author="Eysenbach, Gunther",
title="Can Tweets Predict Citations? Metrics of Social Impact Based on Twitter and Correlation with Traditional Metrics of Scientific Impact",
journal="J Med Internet Res",
year="2011",
month="Dec",
day="16",
volume="13",
number="4",
pages="e123",
keywords="bibliometrics",
keywords="blogging",
keywords="periodicals as topic",
keywords="peer-review",
keywords="publishing",
keywords="social media analytics",
keywords="scientometrics",
keywords="infodemiology",
keywords="infometrics",
keywords="reproducibility of results",
keywords="medicine 2.0",
keywords="power law",
keywords="Twitter",
abstract="Background: Citations in peer-reviewed articles and the impact factor are generally accepted measures of scientific impact. Web 2.0 tools such as Twitter, blogs or social bookmarking tools provide the possibility to construct innovative article-level or journal-level metrics to gauge impact and influence. However, the relationship of the these new metrics to traditional metrics such as citations is not known. Objective: (1) To explore the feasibility of measuring social impact of and public attention to scholarly articles by analyzing buzz in social media, (2) to explore the dynamics, content, and timing of tweets relative to the publication of a scholarly article, and (3) to explore whether these metrics are sensitive and specific enough to predict highly cited articles. Methods: Between July 2008 and November 2011, all tweets containing links to articles in the Journal of Medical Internet Research (JMIR) were mined. For a subset of 1573 tweets about 55 articles published between issues 3/2009 and 2/2010, different metrics of social media impact were calculated and compared against subsequent citation data from Scopus and Google Scholar 17 to 29 months later. A heuristic to predict the top-cited articles in each issue through tweet metrics was validated. Results: A total of 4208 tweets cited 286 distinct JMIR articles. The distribution of tweets over the first 30 days after article publication followed a power law (Zipf, Bradford, or Pareto distribution), with most tweets sent on the day when an article was published (1458/3318, 43.94\% of all tweets in a 60-day period) or on the following day (528/3318, 15.9\%), followed by a rapid decay. The Pearson correlations between tweetations and citations were moderate and statistically significant, with correlation coefficients ranging from .42 to .72 for the log-transformed Google Scholar citations, but were less clear for Scopus citations and rank correlations. A linear multivariate model with time and tweets as significant predictors (P < .001) could explain 27\% of the variation of citations. Highly tweeted articles were 11 times more likely to be highly cited than less-tweeted articles (9/12 or 75\% of highly tweeted article were highly cited, while only 3/43 or 7\% of less-tweeted articles were highly cited; rate ratio 0.75/0.07 = 10.75, 95\% confidence interval, 3.4--33.6). Top-cited articles can be predicted from top-tweeted articles with 93\% specificity and 75\% sensitivity.  Conclusions: Tweets can predict highly cited articles within the first 3 days of article publication. Social media activity either increases citations or reflects the underlying qualities of the article that also predict citations, but the true use of these metrics is to measure the distinct concept of social impact. Social impact measures based on tweets are proposed to complement traditional citation metrics. The proposed twimpact factor may be a useful and timely metric to measure uptake of research findings and to filter research findings resonating with the public in real time. ",
doi="10.2196/jmir.2012",
url="http://www.jmir.org/2011/4/e123/",
url="http://www.ncbi.nlm.nih.gov/pubmed/22173204"
}


@Article{info:doi/10.2196/jmir.1398,
author="Lau, S.M Adela",
title="Hospital-Based Nurses' Perceptions of the Adoption of Web 2.0 Tools for Knowledge Sharing, Learning, Social Interaction and the Production of Collective Intelligence",
journal="J Med Internet Res",
year="2011",
month="Nov",
day="11",
volume="13",
number="4",
pages="e92",
keywords="E-learning \& Collective Intelligence",
keywords="Web 2.0 tools",
keywords="human behavioral adoption",
abstract="Background: Web 2.0 provides a platform or a set of tools such as blogs, wikis, really simple syndication (RSS), podcasts, tags, social bookmarks, and social networking software for knowledge sharing, learning, social interaction, and the production of collective intelligence in a virtual environment. Web 2.0 is also becoming increasingly popular in e-learning and e-social communities. Objectives: The objectives were to investigate how Web 2.0 tools can be applied for knowledge sharing, learning, social interaction, and the production of collective intelligence in the nursing domain and to investigate what behavioral perceptions are involved in the adoption of Web 2.0 tools by nurses. Methods: The decomposed technology acceptance model was applied to construct the research model on which the hypotheses were based. A questionnaire was developed based on the model and data from nurses (n = 388) were collected from late January 2009 until April 30, 2009. Pearson's correlation analysis and t tests were used for data analysis. Results: Intention toward using Web 2.0 tools was positively correlated with usage behavior (r = .60, P < .05). Behavioral intention was positively correlated with attitude (r = .72, P < .05), perceived behavioral control (r = .58, P < .05), and subjective norm (r = .45, P < .05). In their decomposed constructs, perceived usefulness (r = .7, P < .05), relative advantage (r = .64, P < .05), and compatibility (r = .60,P < .05) were positively correlated with attitude, but perceived ease of use was not significantly correlated (r = .004, P < .05) with it. Peer (r = .47, P < .05), senior management (r = .24,P < .05), and hospital (r = .45, P < .05) influences had positive correlations with subjective norm. Resource (r = .41,P < .05) and technological (r = .69,P < .05) conditions were positively correlated with perceived behavioral control. Conclusions: The identified behavioral perceptions may further health policy makers' understanding of nurses' concerns regarding and barriers to the adoption of Web 2.0 tools and enable them to better plan the strategy of implementation of Web 2.0 tools for knowledge sharing, learning, social interaction, and the production of collective intelligence. ",
doi="10.2196/jmir.1398",
url="http://www.jmir.org/2011/4/e92/",
url="http://www.ncbi.nlm.nih.gov/pubmed/22079851"
}


@Article{info:doi/10.2196/jmir.1775,
author="Liang, A. Bryan
and Mackey, K. Timothy",
title="Prevalence and Global Health Implications of Social Media in Direct-to-Consumer Drug Advertising",
journal="J Med Internet Res",
year="2011",
month="Aug",
day="31",
volume="13",
number="3",
pages="e64",
keywords="Illegal pharmacies",
keywords="social media",
keywords="pharmaceutical marketing",
keywords="direct-to-consumer-advertising",
keywords="internet pharmacies",
keywords="global health",
keywords="law",
keywords="health policy",
abstract="Background: Direct-to-consumer advertising (DTCA), linked to inappropriate medication use and higher health care expenditures, is the fastest growing form of pharmaceutical marketing. DTCA is legal only in the United States and New Zealand. However, the advent of online interactive social media ``Web 2.0'' technologies---that is, eDTCA 2.0---may circumvent DTCA legal proscriptions. Objective: The purpose of this study was to assess the prevalence of DTCA of leading pharmaceutical company presence and drug product marketing in online interactive social media technologies (eDTCA 2.0). Methods: We conducted a descriptive study of the prevalence of eDTCA 2.0 marketing in the top 10 global pharmaceutical corporations and 10 highest grossing drugs of 2009. Results: All pharmaceutical companies reviewed (10/10, 100\%) have a presence in eDTCA 2.0 on Facebook, Twitter/Friendster, sponsored blogs, and really simple syndication (RSS) feeds. In addition, 80\% (8/10) have dedicated YouTube channels, and 80\% (8/10) developed health care communication-related mobile applications. For reviewed drugs, 90\% (9/10) have dedicated websites, 70\% (7/10) have dedicated Facebook pages, 90\% (9/10) have health communications-related Twitter and Friendster traffic, and 80\% (8/10) have DTCA television advertisements on YouTube. We also found 90\% (9/10) of these drugs had a non-corporate eDTCA 2.0 marketing presence by illegal online drug sellers. Conclusion: Pharmaceutical companies use eDTCA 2.0 to market themselves and their top-selling drugs. eDTCA 2.0 is also used by illicit online drug sellers. Regulators worldwide must take into account the current eDTCA 2.0 presence when attempting to reach policy and safety goals. ",
doi="10.2196/jmir.1775",
url="http://www.jmir.org/2011/3/e64/",
url="http://www.ncbi.nlm.nih.gov/pubmed/21880574"
}


@Article{info:doi/10.2196/jmir.1716,
author="Hughes, Shannon
and Cohen, David",
title="Can Online Consumers Contribute to Drug Knowledge? A Mixed-Methods Comparison of Consumer-Generated and Professionally Controlled Psychotropic Medication Information on the Internet",
journal="J Med Internet Res",
year="2011",
month="Jul",
day="29",
volume="13",
number="3",
pages="e53",
keywords="Psychotropic drugs",
keywords="mental health",
keywords="consumer health information",
keywords="Internet",
keywords="pharmacoepidemiology",
keywords="drug monitoring",
keywords="product surveillance, postmarketing",
abstract="Background: Ongoing initiatives to filter online health searches exclude consumer-generated content from search returns, though its inferiority compared with professionally controlled content is not demonstrated. The antidepressant escitalopram and the antipsychotic quetiapine have ranked over the last 5 years as top-selling agents in their respective drug classes. Both drugs have various off-label mental health and non--mental health uses, ranging from the relief of insomnia and migraines to the treatment of severe developmental disorders. Objective: Our objective was to describe the most frequently reported effects of escitalopram and quetiapine in online consumer reviews, to compare them with effects described in professionally controlled commercial health websites, and to gauge the usability of online consumer medication reviews. Methods: A stratified simple random sample of 960 consumer reviews was selected from all 6998 consumer reviews of the two drugs in 2 consumer-generated (www.askapatient.com and www.crazymeds.us) and 2 professionally controlled (www.webmd.com and www.revolutionhealth.com) health websites. Professional medication descriptions included all standard information on the medications from the latter 2 websites. All textual data were inductively coded for medication effects, and intercoder agreement was assessed. Chi-square was used to test for associations between consumer-reported effects and website origination. Results: Consumers taking either escitalopram (n = 480) or quetiapine (n = 480) most frequently reported symptom improvement (30.4\% or 146/480, 24.8\% or 119/480) or symptom worsening (15.8\% or 76/480, 10.2\% or 49/480), changes in sleep (36\% or 173/480, 60.6\% or 291/480) and changes in weight and appetite (22.5\% or 108/480, 30.8\% or 148/480). More consumers posting reviews on consumer-generated rather than professionally controlled websites reported symptom worsening on quetiapine (17.3\% or 38/220 versus 5\% or 11/220, P < .001), while more consumers posting on professionally controlled websites reported symptom improvement (32.7\% or 72/220 versus 21.4\% or 47/220, P = .008). Professional descriptions more frequently listed physical adverse effects and warnings about suicidal ideation while consumer reviews emphasized effects disrupting daily routines and provided richer descriptions of effects in context. The most recent 20 consumer reviews on each drug from each website (n = 80) were comparable to the full sample of reviews in the frequency of commonly reported effects. Conclusion: Consumer reviews and professional medication descriptions generally reported similar effects of two psychotropic medications but differed in their descriptions and in frequency of reporting. Professional medication descriptions offer the advantage of a concise yet comprehensive listing of drug effects, while consumer reviews offer greater context and situational examples of how effects may manifest in various combinations and to varying degrees. The dispersion of consumer reviews across websites limits their integration, but a brief browsing strategy on the two target medications nonetheless retrieved representative consumer content. Current strategies for filtering online health searches to return only trusted or approved websites may inappropriately address the challenge to identify quality health sources on the Internet because such strategies unduly limit access to an entire complementary source for health information. ",
doi="10.2196/jmir.1716",
url="http://www.jmir.org/2011/3/e53/",
url="http://www.ncbi.nlm.nih.gov/pubmed/21807607"
}


@Article{info:doi/10.2196/jmir.1636,
author="Doing-Harris, M. Kristina
and Zeng-Treitler, Qing",
title="Computer-Assisted Update of a Consumer Health Vocabulary Through Mining of Social Network Data",
journal="J Med Internet Res",
year="2011",
month="May",
day="17",
volume="13",
number="2",
pages="e37",
keywords="Consumer health information",
keywords="vocabulary",
keywords="natural language processing",
keywords="automatic term recognition",
keywords="data mining",
keywords="social networking",
abstract="Background: Consumer health vocabularies (CHVs) have been developed to aid consumer health informatics applications. This purpose is best served if the vocabulary evolves with consumers' language. Objective: Our objective was to create a computer assisted update (CAU) system that works with live corpora to identify new candidate terms for inclusion in the open access and collaborative (OAC) CHV. Methods: The CAU system consisted of three main parts: a Web crawler and an HTML parser, a candidate term filter that utilizes natural language processing tools including term recognition methods, and a human review interface. In evaluation, the CAU system was applied to the health-related social network website PatientsLikeMe.com. The system's utility was assessed by comparing the candidate term list it generated to a list of valid terms hand extracted from the text of the crawled webpages. Results: The CAU system identified 88,994 unique terms 1- to 7-grams (``n-grams'' are n consecutive words within a sentence) in 300 crawled PatientsLikeMe.com webpages. The manual review of the crawled webpages identified 651 valid terms not yet included in the OAC CHV or the Unified Medical Language System (UMLS) Metathesaurus, a collection of vocabularies amalgamated to form an ontology of medical terms, (ie, 1 valid term per 136.7 candidate n-grams). The term filter selected 774 candidate terms, of which 237 were valid terms, that is, 1 valid term among every 3 or 4 candidates reviewed. Conclusion: The CAU system is effective for generating a list of candidate terms for human review during CHV development. ",
doi="10.2196/jmir.1636",
url="http://www.jmir.org/2011/2/e37/",
url="http://www.ncbi.nlm.nih.gov/pubmed/21586386"
}


@Article{info:doi/10.2196/jmir.1521,
author="Reynolds, J. Carl
and Wyatt, C. Jeremy",
title="Open Source, Open Standards, and Health Care Information Systems",
journal="J Med Internet Res",
year="2011",
month="Feb",
day="17",
volume="13",
number="1",
pages="e24",
keywords="Health Care Information Systems",
doi="10.2196/jmir.1521",
url="http://www.jmir.org/2011/1/e24/",
url="http://www.ncbi.nlm.nih.gov/pubmed/21447469"
}


@Article{info:doi/10.2196/jmir.1560,
author="Bender, L. Jacqueline
and Jimenez-Marroquin, Maria-Carolina
and Jadad, R. Alejandro",
title="Seeking Support on Facebook: A Content Analysis of Breast Cancer Groups",
journal="J Med Internet Res",
year="2011",
month="Feb",
day="04",
volume="13",
number="1",
pages="e16",
keywords="Internet",
keywords="Facebook",
keywords="breast cancer",
keywords="supportive care",
keywords="peer support",
keywords="health promotion",
keywords="fundraising",
abstract="Background: Social network sites have been growing in popularity across broad segments of Internet users, and are a convenient means to exchange information and support. Research on their use for health-related purposes is limited. Objective: This study aimed to characterize the purpose, use, and creators of Facebook groups related to breast cancer. Methods: We searched Facebook (www.Facebook.com) using the term breast cancer. We restricted our analysis to groups that were related to breast cancer, operated in English, and were publicly available. Two of us independently extracted information on the administrator and purpose of the group, as well as the number of user-generated contributions. We developed a coding scheme to guide content analysis. Results: We found 620 breast cancer groups on Facebook containing a total of 1,090,397 members. The groups were created for fundraising (277/620, 44.7\%), awareness (236, 38.1\%), product or service promotion related to fundraising or awareness (61, 9\%), or patient/caregiver support (46, 7\%). The awareness groups as a whole contained by far the most members (n = 957,289). The majority of groups (532, 85.8\%) had 25 wall posts or fewer. The support oriented groups, 47\% (27/57) of which were established by high school or college students, were associated with the greatest number of user-generated contributions. Conclusions: Facebook groups have become a popular tool for awareness-raising, fundraising, and support-seeking related to breast cancer attracting over one million users. Given their popularity and reach, further research is warranted to explore the implications of social network sites as a health resource across various health conditions, cultures, ages, and socioeconomic groups. ",
doi="10.2196/jmir.1560",
url="http://www.jmir.org/2011/1/e16/",
url="http://www.ncbi.nlm.nih.gov/pubmed/21371990"
}


@Article{info:doi/10.2196/jmir.1589,
author="Heilman, M. James
and Kemmann, Eckhard
and Bonert, Michael
and Chatterjee, Anwesh
and Ragar, Brent
and Beards, M. Graham
and Iberri, J. David
and Harvey, Matthew
and Thomas, Brendan
and Stomp, Wouter
and Martone, F. Michael
and Lodge, J. Daniel
and Vondracek, Andrea
and de Wolff, F. Jacob
and Liber, Casimir
and Grover, C. Samir
and Vickers, J. Tim
and Mesk{\'o}, Bertalan
and Laurent, R. Micha{\"e}l",
title="Wikipedia: A Key Tool for Global Public Health Promotion",
journal="J Med Internet Res",
year="2011",
month="Jan",
day="31",
volume="13",
number="1",
pages="e14",
keywords="Internet",
keywords="Wikipedia",
keywords="public health",
keywords="health information",
keywords="knowledge dissemination",
keywords="patient education",
keywords="medical education",
doi="10.2196/jmir.1589",
url="http://www.jmir.org/2011/1/e14/",
url="http://www.ncbi.nlm.nih.gov/pubmed/21282098"
}


@Article{info:doi/10.2196/jmir.1432,
author="Fernandez-Luque, Luis
and Karlsen, Randi
and Bonander, Jason",
title="Review of Extracting Information From the Social Web for Health Personalization",
journal="J Med Internet Res",
year="2011",
month="Jan",
day="28",
volume="13",
number="1",
pages="e15",
keywords="Medical informatics",
keywords="Internet, information storage and retrieval",
keywords="online systems",
keywords="health communication",
keywords="data mining",
keywords="natural language processing",
doi="10.2196/jmir.1432",
url="http://www.jmir.org/2011/1/e15/",
url="http://www.ncbi.nlm.nih.gov/pubmed/21278049"
}


@Article{info:doi/10.2196/jmir.1687,
author="Wicks, Paul
and Massagli, Michael
and Kulkarni, Amit
and Dastani, Homa",
title="Use of an Online Community to Develop Patient-Reported Outcome Instruments: The Multiple Sclerosis Treatment Adherence Questionnaire (MS-TAQ)",
journal="J Med Internet Res",
year="2011",
month="Jan",
day="24",
volume="13",
number="1",
pages="e12",
keywords="Medication adherence",
keywords="multiple sclerosis",
keywords="online communities",
abstract="Background:  Patients with multiple sclerosis (MS) may face barriers, such as treatment fatigue, memory problems, or side effects, that may influence their adherence to medication. Objective:  The objective of our study was to use an online community to develop a self-report questionnaire to quantify adherence and barriers to achieving adherence, that is specific to MS disease-modifying treatments (DMTs) and predictive of missed doses. Methods:  A review of the scientific literature and analysis of discussions between MS patients on PatientsLikeMe.com were used to generate survey items salient to patients. Cognitive debriefing was used to refine the items. The Multiple Sclerosis Treatment Adherence Questionnaire (MS-TAQ) contains 30 questions in three subscales: Barriers, Side Effects, and Coping Strategies. Results:  MS patients completed an online survey (response rate: 431 of 1209 invited, 35.7\%). Between 16\% (14/86) and 51\% (51/100) of MS patients missed at least 1 dose of their DMT in the previous 28 days, with significant between-treatment differences. The MS-TAQ Barriers scale was positively correlated with the proportion of doses missed (r = .5), demonstrating a stronger relationship between adherence and perceived barriers than was found with clinical or demographic variables (r ? .3). The Coping Strategies subscale was negatively correlated with missed doses (r = -.3), suggesting that use of more coping strategies is associated with higher adherence. Conclusions:  Online communities can provide domains of interest and psychometric data to more rapidly develop and prototype patient-reported outcome instruments. The MS-TAQ offers patients and clinicians a simple method for identifying barriers to adherence, which may then be targeted through interventions. ",
doi="10.2196/jmir.1687",
url="http://www.jmir.org/2011/1/e12/",
url="http://www.ncbi.nlm.nih.gov/pubmed/21266318"
}


@Article{info:doi/10.2196/jmir.1643,
author="Frost, Jeana
and Okun, Sally
and Vaughan, Timothy
and Heywood, James
and Wicks, Paul",
title="Patient-reported Outcomes as a Source of Evidence in Off-Label Prescribing: Analysis of Data From PatientsLikeMe",
journal="J Med Internet Res",
year="2011",
month="Jan",
day="21",
volume="13",
number="1",
pages="e6",
keywords="Off-label",
keywords="Internet",
keywords="research",
keywords="patient platform",
keywords="methods",
keywords="online community",
abstract="Background:  Evaluating a new use for an existing drug can be expensive and time consuming. Providers and patients must all too often rely upon their own individual-level experience to inform clinical practice, which generates only anecdotal and unstructured data. While academic-led clinical trials are occasionally conducted to test off-label uses of drugs with expired patents, this is relatively rare. In this work, we explored how a patient-centered online research platform could supplement traditional trials to create a richer understanding of medical products postmarket by efficiently aggregating structured patient-reported data. PatientsLikeMe is a tool for patients, researchers, and caregivers (currently 82,000 members across 11 condition-based communities) that helps users make treatment decisions, manage symptoms, and improve outcomes. Members enter demographic information, longitudinal treatment, symptoms, outcome data, and treatment evaluations. These are reflected back as longitudinal health profiles and aggregated reports. Over the last 3 years, patients have entered treatment histories and evaluations on thousands of medical products. These data may aid in evaluating the effectiveness and safety of some treatments more efficiently and over a longer period of time course than is feasible through traditional trials. Objective:  The objective of our study was to examine the illustrative cases of amitriptyline and modafinil -- drugs commonly used off-label. Methods:  We analyzed patient-reported treatment histories and drug evaluations for each drug, examining prevalence, treatment purpose, and evaluations of effectiveness, side effects, and burden. Results:  There were 1948 treatment histories for modafinil and 1394 treatment reports for amitriptyline reported across five PatientsLikeMe communities (multiple sclerosis, Parkinson's disease, mood conditions, fibromyalgia/chronic fatigue syndrome, and amyotrophic lateral sclerosis). In these reports, the majority of members reported taking the drug for off-label uses. Only 34 of the 1755 (1\%) reporting purpose used modafinil for an approved purpose (narcolepsy or sleep apnea). Only 104 out of 1197 members (9\%) reported taking amitriptyline for its approved indication, depression. Members taking amitriptyline for off-label purposes rated the drug as more effective than those who were taking it for its approved indication. While dry mouth is a commonly reported side effect of amitriptyline for most patients, 88 of 220 (40\%) of people with amyotrophic lateral sclerosis on the drug reported taking advantage of this side effect to treat their symptom of excess saliva. Conclusions:  Patient-reported outcomes, like those entered within PatientsLikeMe, offer a unique real-time approach to understand utilization and performance of treatments across many conditions. These patient-reported data can provide a new source of evidence about secondary uses and potentially identify targets for treatments to be studied systematically in traditional efficacy trials. ",
doi="10.2196/jmir.1643",
url="http://www.jmir.org/2011/1/e6/",
url="http://www.ncbi.nlm.nih.gov/pubmed/21252034"
}


@Article{info:doi/10.2196/jmir.1569,
author="Chou, Sylvia Wen-Ying
and Hunt, Yvonne
and Folkers, Anna
and Augustson, Erik",
title="Cancer Survivorship in the Age of YouTube and Social Media: A Narrative Analysis",
journal="J Med Internet Res",
year="2011",
month="Jan",
day="17",
volume="13",
number="1",
pages="e7",
keywords="narrative communication, cancer survivors, social media, qualitative research, linguistics, health communication.",
abstract="Background: As evidenced by the increasing popularity of YouTube (www.youtube.com), personal narratives shared through social media are an area of rapid development in communication among cancer survivors. Identifying the thematic and linguistic characteristics of YouTube cancer stories can provide a better understanding of this naturally occurring communication channel and inform social media communication efforts aiming to use personal stories to reach individuals with serious illnesses.  Objective: The objective of our study was to provide an in-depth description of authentic personal cancer stories. Through a linguistically based narrative analysis of YouTube stories, the analysis explicates the common attributes of these narratives. Methods: Informed by narrative theories, we conducted an iterative, bottom-up analysis of 35 YouTube videos identified by the search terms ``cancer survivor'' and ``cancer stories''. A list of shared thematic and linguistic characteristics was identified and analyzed. Results: A subnarrative on the cancer diagnosis was present in 86\% (30/35) of the stories under analysis. These diagnostic narratives were characterized by dramatic tension, emotional engagement, markers of the loss of agency or control, depersonalized reference to the medical personnel, and the unexpectedness of a cancer diagnosis. The analysis highlights the themes of story authenticity and emotional engagement in this online communication medium. Conclusions: Internet advances have enabled new and efficient exchange of personal stories, including the sharing of personal cancer experience among cancer survivors and their caregivers. The analytic results of this descriptive study point to the common characteristics of authentic cancer survivorship stories online. Furthermore, the results of this descriptive study may inform development of narrative-based communication, particularly in maintaining authenticity and emotional engagement. ",
doi="10.2196/jmir.1569",
url="http://www.jmir.org/2011/1/e7/",
url="http://www.ncbi.nlm.nih.gov/pubmed/21247864"
}